Excess Mortality and Morbidity amongst Infants - Research Paper Example

? Excess Mortality and Morbidity amongst Infants The following critique shows and analyses the effects of prenatal smoking on infants. It furthermore continues to prove that in the first world nations the trends have been on the decline; however, there has been no change in the trends in the third world nations, and children continue to be born pre-term and die as a result of their mothers’ smoking. The article furthermore also emphasizes on the causes, effects as wells as the preventive measures in order to curb the practice of smoking amongst pregnant females. Excess Mortality and Morbidity among Infants The smoking of tobacco or cannabis is the drill of sweltering of the tobacco and huffing of the resultant, which is the smoke. This smoke consists of many components and particles, with gases like carbon monoxide contributing for a major chunk of the composition of the smoke. The exercise of smoking dates back far in history and it is believed by many historians that it had begun in the year 5000 BC, however tobacco was imported to the regions of Europe and Asia, far later in the 1500s. After its introduction to the continents of Europe and Asia, tobacco became a common trade item and was preferred by many for the cause of trade. The trade of tobacco resulted in its increased popularity because of which came the criticism from the West. By that very time tobacco and smoking had become an integral part of people’s lives and households and the modern cigarettes had been introduced too. In the early 20th century, a group of scientists from Germany discovered and highlighted the existential link between smoking and cancer, particularly that of the lung and hence, began the international campaigning against the practice of smoking, the foremost and the most significant one being right after Second World War. By the mid of the 20th century, British scientists and researchers verified and confirmed a clear relationship between cancer and smoking, which gave way to further research on the subject. As a result of increased research and development into the cause of smoking in the decade of 1980s, there was increased intervention on the governmental fronts across the world, in order to curb the growing menace of smoking. There were embargoes and quotas imposed on the trade of tobacco and strict measures were taken to curb the underage smoking. The overall smoking trends since the year, 1965 have been fluctuating, in the first world nations across the world, nevertheless, in the developing nations, they continue to increase and take the toll. In the early 20th century, a group of scientists from Germany discovered and highlighted the existential link between smoking and cancer, particularly that of the lung and hence, began the international campaigning against the practice of smoking, the foremost and the most significant one being right after Second World War. By the mid of the 20th century, British scientists and researchers verified and confirmed a clear relationship between cancer and smoking, which gave way to further research on the subject. As a result of increased research and development into the cause of smoking in the decade of 1980s, there was increased intervention on the governmental fronts across the world, in order to curb the growing menace of smoking. There were embargoes and quotas imposed on the trade of tobacco and strict measures were taken to curb the underage smoking. The overall smoking trends since the year, 1965 have been fluctuating, in the first world nations across the world, nevertheless, in the developing nations, they continue to increase and take the toll. According to figure, by the year 2000, the practice of smoking had taken its toll and was practiced by more than 1.22 billion people across the world. Men account for a major portion of the world’s total smoking population and to as much as five times more than women, but the gender gap is not very prominent, especially in the lower age groups. It is estimated that twenty percent of all young teenagers in the third world communities smoke worldwide and are aged between thirteen to fifteen years. According to the World Health Organization, a major reason for premature mortality and disease burden can be attributed to smoking. Eighty five percent of the total world’s smokers across the world are residents of transitional economies, which clearly show that the trends in developed world and the developing world are quite contrary to each other. It is estimated that almost ten percent of all deaths are as a result of smoking by those people and out which seventy percent of the deaths were in the developing countries. Prenatal smoking can be defined as an activity or a practice by the women who are in pregnant, which involves, the smoking of a cigarette at different stages of the period of pregnancy and gestation. Even though, the numbers of pregnant female smokers have declined remarkably, as a result of an increased awareness of the its dire consequences as well as the effects to the child, during gestation and afterwards, there are still many females who are unable to practice cessation during their pregnancies, putting aside the fact that it may incredibly harm their child’s birth, growth and development, at later stages afterwards. It is estimated that the count of the prenatal female smokers, who were expecting babies, decreased by almost, an effective seven percent, falling from eighteen percent to eleven percent, but still prenatal smoking remains a core cause of the prenatal deaths and post natal abnormalities amongst the children that are born. Numerous reports across the world including that of the Surgeon General of the United States of America “concluded that the evidence was suff?cient to infer a causal relationship between prenatal smoking and premature rupture of the membranes, placenta previa, placental abruption, preterm delivery, fetal growth restriction, and sudden infant death syndrome (SIDS)” (Dietz et al., 2010, p. 45). Before conducting the analysis of any factor that concerns smoking or deliberating about the adverse effects of the practice of smoking, the question of why people smoke must be answered. The more there would be political pressure and the governments would try to create awareness amongst the people about the adverse risks that are associated with the practice of smoking, the more there would be rejection from the smokers, particularly in the developing countries, however there have been bans and sanctions on the practice of smoking in indoor public places and places in the places where there is a prominence of children and the elderly. The encouraging factor however, is that cigarettes in most countries of the world are not expensive at all for the smokers to purchase. The purchase of cigarettes, in economic terms can be considered as a normal good, making them available to all, with a very less practice and implementation of age restrictions that have been supposedly imposed by the government. The percentage of smokers, who commence the practice of smoking after the age of eighteen, till date, remains very less. The fact of the matter is that a major faction of smokers takes up this habit in early or mid teens, later resulting in the abnormalities in the children and even prenatal or postnatal death. One of the basic reasons because of which this happens is that at a tender age, the human mind is not mature enough to think up of the negative and adverse consequences of the practice of smoking. The young smokers often contemplate, about giving up but normally are not able to because of a lack of will power to do so. “However, the reality is that it doesn't take long to become addicted to nicotine and smoking. Within a short period of time, children can experience the same cravings and withdrawal symptoms as an adult, as well as smoke as many cigarettes or more” (Why People Smoke?). Pressure from friends and peers is one of the most important reasons and plays a very important part in making children start smoking. Many teenagers or children, for that matter, smoke a cigarette or get into the practice of smoking because their peers smoke or have tried it and found it to be fascinating. Some may also start smoking after getting influenced by the grown-ups who smoke. These children smoke to look like their elders, without knowing the consequences of getting addicted to this absurd and negative habit. Children can also get used to the practice of smoking as an act of defiance whenever stopped from doing so. Smoking may also help some children to regain their self-esteem. If a child has a low self-esteem, he or she may begin to smoke a cigarette to get along with people and make new friends. They feel that they will be accepted in the society if they begin to practice smoking or even in cases where they would want to appear older, particularly in the cases where those children are enclosed by the older members of the youth who are smoking. “A number of children are only experimenting with smoking and just want to try it so see what all the fuss is about. As it is prohibited to smoke until the age of sixteen or even eighteen in some countries, children who smoke and get away with it without being caught, can get a thrill or feeling of excitement out of flaunting the law and doing what grown up adults do all the time” (“Why do People Smoke?”). As discussed earlier, some teenagers may be influenced by their favorite celebrities who may smoke and in order to copy them, the teenagers, in return would start smoking too. The usual psyche is that like their celebrity stars, the particular teenagers too may seem glamorous, like them. The cigarette brands and the tobacco companies too advertise their products in a very dazzling manner that may make the drugs attractive. These adverts in some countries have been banned but are socially acceptable in most countries. The aforementioned causes are, henceforth, a major contributor to the prenatal deaths that are caused by smoking. Smoking may be an addictive practice but it most certainly has solutions and this growing problem can be solved. The first and foremost step that must be taken is that the smokers, particularly, the youth must be educated. They must be informed of the adverse effects of smoking on the human body and mental capacity of the human being. Heart diseases, bronchitis and emphysema’s pains and sufferings must be deliberated upon and motivational speakers must be invited to have talks on ending smoking and how it may affect childbirth. Media plays a very major role in empowering the youth and influencing them. Similarly, media can play its responsible role of launching an anti-smoking campaign and making the viewer aware of the consequences associated with smoking. The media too can make the celebrities take up this cause in order to remove their inspiration of being cool by smoking a cigarette. The girls in particular must be informed about the anomalies and adversities that they may have to face for smoking in pregnancy or their gestational phases. They must be educated as to how it will affect their newly born children and there should be testimonial services from those who have suffered from this practice, to make the new mothers learn, what they should not do. “According to Prof Bolliger, any form of NRT increases the success rate of a smoking cessation program. All the different types of NRT have been shown to be effective, with little or no side-effects. NRT can be regarded as a temporary solution that helps smokers get past the first hurdle on their journey to long-term smoking cessation” (5 ways to quit smoking). The future trends of smoking can be predicted if the aforementioned measures are carried out. It is a well-established fact that almost eight percent of the preterm births and almost four percent of the later-term births can be endorsed to prenatal smoking. According to a study, prenatal smoking continues to be one of the most important reasons for the cases of infant morbidity and mortality in the United States of America; however it must be noted that its prevalence is decreasing by the day and with time. This can be further brought to a halt through sustainable activities encouraging controlled and no use of tobacco at all and giving free consultation and rehabilitation services to those demanding it. Considering the trends of the previous years, it can however be predicted that the trends may fall considerably as they have done so previously. Obesity, apart from congenital abnormalities and death is one of the major factors and areas of interest, which links up prenatal smoking and childbirth. According to a study by a team of researchers and doctors, maternal prenatal smoking is one of the major factors that contribute towards obesity in a child. “Health promotion and prevention of infant obesity must come from efforts directed at community, family, and individuals. Perinatal educators can participate in the prevention of initial low birth weight and potentially later obesity through community efforts to improve prenatal care and prenatal nutrition and through community smoking cessation programs. Family and individual supportive interventions can be directed toward encouraging mothers who smoke to stop smoking during pregnancy in order to improve the birth outcomes and to help reduce the risk of later infant obesity” (Nancy A. Sowan). Other healthcare implications of prenatal smoking may include preterm labor or death. It is estimated that around five percent of the preterm labor cases in the United States of America are because of the fact that the mothers were either smokers or passive smokers. The Sudden Infant Death Syndrome is also very common in such cases. As a result of the Sudden Infant Death Syndrome, a born child may die as soon as it is born or may die in his mother’s womb, because of the nicotine inhalation by their mothers while smoking. “Exposures to tobacco products during fetal life seem to restrict visceral organ growth and alter the neural control of autonomic, behavioral and homeostatic functions. High concentrations of nicotine in fetal circulation may induce structural cell loss and damage in many parts of the central nervous system. None of these effects is life threatening but they may decrease the tolerance to exogenous stress factors such as hyperthermia, airway obstruction, carbon dioxide - rebreathing or infection” (E.A.Mitchell, 1999) A general opinion that floats regarding prenatal smoking varies with respect to the countries, the part of the world and the cultures. In the developed countries, the trends are falling because of the increased awareness amongst the people, particularly the youth, but there too the places, where the effects have not been publicized much, still suffer from this menace. However in the developing world and in places where smoking has taken its toll, there are a high number of prenatal deaths, which are as a result of smoking by the mothers during pregnancy. In the Muslim conservative countries, around the world, smoking by females can be considered as a social taboo and as socially unacceptable. In these societies, the general opinion that floats is very biased and some countries may label the women as murderers, who practice prenatal smoking and the newly born child is born dead. “Statistics suggest that preterm-related mortality rate was 2 for every 1000 live singleton births in 2002. Of women who delivered infants who died from a preterm-related death, 15.7% smoked during pregnancy. Compared to women whose infants did not die or whose infants died from non–preterm-related causes, women whose infants died from preterm-related causes were more likely to be aged 20 years, non-Hispanic black, nulliparous, and unmarried, and to have less than 13 years of education, have had low weight gain, and have had no prenatal care or entry into prenatal care in the third trimester” (Dietz et al., 2010, p. 47). Therefore, it is very simple and not at all arduous to conclude that prenatal smoking is not only harmful for the mothers but also their infants and can cause a lot of pain, suffering as well as death to them. The prenatal smoking, as a result of the increased awareness, is coming to a decline in the developed world, but still has taken its toll and is existential at high degree in the developing countries which makes it arduous for the respective governments to impose control methods because of its great influence over the niche market, especially that of the teenagers, however, if curbed this can result in a decrease in the number of prenatal deaths, early labor, late labor and as well as abnormalities in the children that are born, all of which are a resultant of smoking by the mothers during pregnancies and gestational periods. References 5 ways to quit smoking. (n.d.). Retrieved from http://www.health24.com/medical/Condition_centres/777-792-1952-1958,26646.asp Dietz, P. M., England, L.J., Shapiro-Mendoza, C.K., Tong, V.T., Farr, S.L., & Callaghan, W.M. (2010). Infant morbidity and mortality attributable to prenatal smoking in the United States of America. American Journal of Preventive Medicine, 39(1), 45-52. E.A.Mitchell. (1999). Smoking and sudden death syndrome. Auckland, Newzealand. Sowan, Nancy A., & Stember, Marylin L. (2000). Effect of maternal prenatal smoking on infant growth and development of obesity. Journal of Perinatal Education, 9(3), 22-29. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595035/ Why do people smoke? (n.d.). Retrieved from http://www.helpwithsmoking.com/why-people-smoke.php Read More