Health Promotion Framework: reducing harm done by tobacco for Australians - Assignment Example

? The department of Human Services (DHS) has developed a new Health Promotion Framework whose main aim is to promote health and wellbeing in Victoria. They have established state-wide health promotion priorities along with Vic health for the period from 2007 to 2012 which would provide an opportunity to improve overall health and reduce health inequalities. This framework aims at addressing the major health issues facing the Australian population which includes risk factors for persistent diseases and the societal determinants causing and aggravating these diseases. One of the priorities which aim at reducing harm done by tobacco has been a matter of major focus for Australians since a long while (Victorian government department of human services 2007, p. 2). For this health issue, we need to understand the various diseases caused by tobacco smoking; the various social, environmental or economic factors which lead to smoking habits and lastly, the existing and new strategies undertaken to overcome the health issue in concern. However, an understanding of the various ways of smoking, contents of tobacco which causes harm as well as its prevalence and severity in Australia is also deemed necessary. Smoking can be active or passive – active when the person himself smokes where as passive smoking is when a person inhales other person’s smoke. Cigarettes and other tobacco products are said to contain carcinogens (cancer causing agents), nicotine (an addictive agent) and various other poisonous substances. It is said that the increase in the number of cigarettes smoked daily and the number of years of smoking, particularly when it has started at an early age leads to the increase in the risk factors and diseases related to smoking (Better Health Channel, 2011). Smoking is one of the major risk factors which cause mainly three diseases – ischaemic heart disease, cerebro-vascular disease and lung cancer. Further tobacco has led to cancers of mouth, bladder, kidney, stomach and cervix among others. It also leads to increased risk of developing chronic obstructive pulmonary disease and reduced lung function. Many other health conditions have been associated with the use of tobacco – diabetes, peptic ulcers, some vision problems, and back pain. Also smoking during pregnancy can cause miscarriage, stillbirth or premature birth (Health Insite, 2011). Tobacco smoking not only affects the health of self smokers but also of non-smokers. Passive smoking has been determined to be more harmful than active smoking. Passive smoking implies inhaling the tobacco smoke of some other person who might be using cigarettes, cigars, pipes and other sources. It is especially harmful for pregnant women, children and partners of smokers. It causes many health related problems – like, sudden infant death syndrome (SIDS or cot disease), middle ear disease, asthma, respiratory illness, lung cancer and coronary heart disease (Better Health Channel, 2011). Smoking has been found to be the main cause leading to most of the premature deaths and diseases in Australia. Almost a quarter of deaths caused by smoking occur in middle age in the country. According to reports, there are 15,000 deaths from smoking each year. This number is much more than the deaths caused by alcohol and drugs put together (Cancer Council NSW, 2010). According to Health Insite, it has caused around 80%of all lung cancer deaths and 20% of all cancer deaths in Australia (Health Insite, 2011). Further, it has been stated that smoking is responsible for about 8% of the total burden of disease and injury for all Australians – 9.5% of total for females and 6.1% of total for females. Further, second hand smoke has adversely affected the health of adults by causing heart related diseases, cancer and various other problems. Children have been exposed to high risk of asthma, SIDS, severe respiratory problems and ear problems due to second hand smoke in this country. Tobacco is responsible for 11.7% of deaths in Australia. Smoking has burdened the government with economic costs estimated to be over $31 billion far exceeding the $5.5 billion expected by the Australian government in tobacco taxes from the year 2009-2010 (Cancer Council NSW, 2010). The prevalence of smoking has affected people belonging to different age groups, income groups and people suffering from other health problems in varying degrees in Australia. For instance, low income single parent have smoking rates over 45%, youngsters in the age group account for 24%of smokers and aboriginal people have rates around 50%. Further, people suffering from mental illness account for smoking rates ranging from 20% to 90%. However, the highest rates has been seen among people consuming drugs and alcohol, which ranges from 51to 95 percent. Definitely smoking rates for the whole population have reduced to 18% over the last 40 years due to continuous efforts of the government and various anti smoking campaigns but a lot of reduction is still required among the weak and susceptible groups (Cancer Council NSW, 2010). For this purpose we need to understand the various social, environmental and biological factors responsible for the prevalence of the concerned health issue – reducing tobacco related harm. According to Wilkinson and Marmot (2003), there are ten factors that affect the health conditions of the people. They are (1) the social gradient, (2) stress, (3) early life, (4) social exclusion, (5) work, (6) unemployment, (7) social support, (8) addiction, (9) food and (10) transport. These factors play a vital role in determining what cause a particular disease and help in its prevention in the future. Tobacco smoking is also the result of mainly three factors – early life, addiction and stress due to low self esteem or socio economic deprivation. These social, environmental and economic determinants help us in understanding why people get addicted to smoking and how it can be prevented (Wilkinson & Marmot, 2003). The majority of smokers start smoking due to peer pressure or in the company of other smokers. This happens mostly at an early stage when they are children or youngsters and start smoking because their friends try or smoke themselves. They feel that smoking will help them make friends or get accepted in a group. Many youngsters start smoking in order to look older or appear ‘cool’. Many children see their parents, siblings or other family members smoke and with the desire to ape them start smoking themselves. The advertisements by tobacco companies also misguide the children as well the adults. They portray a very sophisticated and glamorous image of smokers in the media. Advertisements by tobacco brands have been held majorly responsible for increasing new smokers especially youngsters although they have been completely banned today (Scarinci et al.2007, p.146). Cigarette smoking and chewing tobaccos are habits, which are very hard to cease. These practices soon turn into addictions. This happens because of the production of nicotine, an addictive chemical, during smoking. This chemical leads to a series of biochemical reactions and sensations to which a smoker becomes eventually habituated. Regular tobacco users have admitted they get adapted to the need of going through this feeling as it makes them sense better and at ease (McDonough, 2011). According to Prochaska and his counterparts (1997), addiction of tobacco is a strong and relentless addiction which results from an everlasting change in the brain and is acquired at a very fast rate. This habit can only be ceased by a strong and conscious act of an addict himself such as calling a Quit line or taking the help of other counselling services. For quitting it is very important for a person to realise that smoking is not just a habit but a problem which needs to be solved. Only then a person will be ready to go through the psychological help and counselling which will help him quit (cited in Meyrick & Yusuf 2006, p.229). Dorsett (1999) had stated that increase in the prevalence of smoking is directly related to lower status or socio economic deprivation. Many people including children suffer from low self esteem either due to lack of confidence or because they are not economically well off. Such people take up smoking so as to look desirable and get accepted in the higher strata of society (cited in Meyrick & Yusuf 2006, p.228).Youngsters and children who belong to the low income group feel that smoking makes them look cool and attractive. People who are stressed out due to socioeconomic pressure say that they smoke because it makes them feel relaxed. However, they should realize that smoking doesn’t leads to relaxation instead hinders one’s health since nicotine acts a stimulant which makes one’s heart beat faster and raises the blood pressure. People need to be educated regarding the consequences of smoking so as to help them in quitting the habit (Help with smoking.com, n.d) Smoking has been claimed to be the most vital reason leading to preventable mortality and morbidity in Australia, USA and UK. Anti -smoking campaigns have been spreading the message that smoking causes major harm to smokers as well as to the non smokers since the last forty years. Some of these campaigns being anti-smoking advertisements; increase in the price of cigarettes and inclusion of education of tobacco related harm in the school curriculum. Further, many legislators are fighting for the cause by demanding limitation on the sale of tobacco products and halting their advertisements (Meyrick &Yusuf 2006, p.227). In most of the countries, two major interventions have been initiated to reduce tobacco related harm – television advertisements and introduction of new legislative policies. For example, in Australia from the year 1997 to 2002, there were basically two main sources of anti- smoking television advertisements – one was tobacco control advertisements sponsored by state and national governments or other public health forums and secondly, face to face consumer advertising of NRT by pharmaceutical companies. NRT or nicotine replacement therapies are alternative smoking cessation products introduced by the pharmaceutical companies and have been made increasingly accessible to the Australian population. Further, Australia’s National tobacco campaign which was a joint effort of the state and the federal government had started anti tobacco advertisements which carried the message that “every cigarette is doing you damage” and mainly targeted the age group of 18-40 year olds (Wakefield et al. 2008, p.1444) However after 2002, most advertisements were incorporated by the state level tobacco control programs which spoke about the serious health effects of smoking. They took the help of messages; graphic messages inscribed on cigarette packs; display of personal stories or replicated display of health consequences and were primarily aimed at adults. Further there were some advertisements at state level which also broadcasted the negative effect on the health of the passive smokers and some of them targeting the youth which tried to convey the message that smoking is not ‘cool’. After 1997, the pharmaceutical companies also initiated many advertisements to spread the popularity of NRT. The increase in the mass media campaigns and the pharmaceutical companies’ advertisements for NRT has brought about major reduction in the use of tobacco by the people (Wakefield et al. 2008, p.1444). Another important initiative that has been taken by many countries is change in the policies which has affected the prices of tobacco related products, limited their use in public places and encouraged people to cease smoking. The government has imposed excise taxes on cigarettes, thereby increasing their prices and this has proved to be the most effective policy in reducing the percentile of smokers. The pharmaceutical companies have reduced the prices of NRT through sources like Quit lines, thus making a major step towards cessation of smoking. The government has also banned the mass media cigarette promotions made by tobacco manufacturing companies which have stopped the visibility of television brands thereby reducing its demand (Hoek & Jones 2011, p. 40). A new policy has been introduced in Australia which makes it mandatory for all tobacco brands to make the cigarette packing simple and display the pictorial health warnings on them in a bigger size. The Australian government has also banned smoking in restaurants and on all public transports and at tram, bus and train shelters in many states. Also by the end of 2006, smoking was made illegal in all Australian pubs and clubs (Tobin, 2006). The Australian government had recommended the price at which cigarette should be sold in the market. These prices were higher than the actual prices thereby making cigarettes expensive. However, a research done during 1997 to 2001 revealed that the price of cigarettes sold in commercial stores and petrol stations were more or less same as the recommended price but were much lower than the recommended price in supermarkets and tobacco shops. Further it was found that the sale of the top two brands in Australia had jumped from 32% of total sales in 1994 to 38% in 2003(Cancer council NSW, 2010). This shows that although the government is trying its level best to reduce the level of smoking but much more needs to be done to achieve the desired results. It has been seen that reduction in tobacco usage will immensely improve the public health conditions yet the government is not working upon it appropriately and neither is considering the expenditure on tobacco control as a vital area in comparison to what they do for other primary services like intensive care and ambulances (Wakefield et al., 2006). As a health professional, the most important thing that I have learnt from this assignment is that ‘Prevention is better than cure’. This assignment has helped me in understanding the fact that every health issue is the outcome of certain social, economic and environmental factors. A clear understanding of the specific societal determinant that causes the particular disease will help us in taking the required steps so as to cease their prevalence in the future. For instance we came to know that smoking may start at an early stage due to peer pressure or low self esteem or, due to the prevailing trend of smoking in the family. This situation can be handled if education related to tobacco harm and its consequences is included in the school curriculum. Also children suffering from low esteem or socio economic deprivation should be provided with proper counselling from health professionals like us. Further, parents and other family members who smoke should be educated regarding the ill effects that smoking is causing them and their children. We as health professionals can provide help and counselling to such parents in quitting smoking. Further, if through a proper forum the message of the ill effects of certain harmful activities can be spread to the mass or population, much can be done towards the control of various diseases caused by them. For example, providing smoking cessation education through advertisements, anti smoking campaigns and health forums organised by health professionals will help in improving the scenario. Thus, we see that smoking can be stopped with an immense amount of willpower, a huge amount of support from family and friends and definitely with the help of expert advice. This study will go a long way in helping me in my job as a health professional by guiding me in every action and job undertaken by me. References Better Health Channel 2011, ‘Passive smoking’, retrieved 27 August 2011, Commonwealth of Australia 2002, Style manual for authors, editors and printers, 6th ed., John Wiley & Sons Australia Ltd, Canberra, retrieved 30 August 2011, Health Insite 2011, ‘Health effects of smoking’, retrieved 26 August 2011, Scarinci, IC, Silveira, AF, Santos, DFD & Beech, BM 2007, ‘Socio cultural factors associated with cigarette smoking among women in Brazilian worksites: a qualitative study’, Health Promotional International: Oxford Journals, vol. 22, no.2, p.146, retrieved 27 August 2011, Help with smoking.com n.d, ‘Why do people start to smoke’, retrieved 29 August 2011, Hoek, J & Jones, SC 2011, ‘Regulation, public health and social marketing: a behaviour change trinity’, Journal of Social Marketing, vol.1, no. 1, pp. 40. McDonough, B 2011, ‘Smoking: causes’, Better Medicine, retrieved 26 August 2011, http://www.bettermedicine.com/article/smoking/causes Meyrick, JD & Yusuf, F 2006, ‘The application of household expenditure data in the development of anti-smoking campaigns’, Health Education: ProQuest Education Journals, vol. 106, no. 3, pp. 227-229. The Cancer council NSW 2010, Local government reducing tobacco related harm across the community, The Cancer Council NSW, retrieved 27 August 2011, Tobin, H 2006, ‘What really happens when you ban smoking’, Institute of Public Affairs, vol. 58, no. 3, p.41 Victorian government department of human services 2007, Developing a new framework for promoting health and wellbeing in Victoria: A discussion paper, State Government of Victoria, retrieved 26 August 2011, Wakefield, MA, Durkin, S, Spittal, MJ, Siahpush, M, Scollo, M, Simpson, JA, Chapman, S, White, V & Hill, D 2008, ‘Impact of tobacco control policies and mass media campaigns on monthly adult smoking prevalence’, American Journal of Public Health, vol. 98, no. 8, pp. 1444. Wilkinson, R & Marmot, M 2003, Social determinants of health: the solid fact, 2nd ed., World Health Organization Regional Office for Europe. Read More