Epidemiology & Population Health in Australia - Essay Example

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Epidemiology and Population Health Briefing on Smoking in Adolescents in Australia Main Messages Smoking prevalence is on the rise in the entire world as well as Australia; One of the hardest hit groups of population is young people who under the influence of peer pressure and the media tend to take up smoking; The inclusion of nicotine in tobacco makes it a very addictive substance; The adoption of smoking at an early age produces tobacco users who find it very difficult to quit smoking in their later years; Smoking produces more casualties than alcohol and illicit drug use combined; Controlling smoking is the number one method of increasing public health levels; The use of mass media campaigns coupled with school intervention, community intervention and restrictive policies is the best method to go forward to prevent adolescents from smoking; The government will have to put in long term commitment to ensure that mass media campaigns can be effective enough – stopping mass media campaigns can reverse the effects of previous mass media campaigns; Greater focus has to go to remote communities such as Aborigines as they display greater rates of smoking prevalence. 2. Executive Summary The use of tobacco in adolescents remains a key focus area for improving public health. People who have begun to smoke at an early age generally find it far more difficult to quit smoking. There is an increased urge for students to begin smoking during their adolescent years with 19.1% of school students indicating that they could begin smoking next year. Moreover around 9.5% of the students in developed countries are already smoking. (MMWR, 2008) An estimate has placed tobacco smoking as the single most preventable cause of death and ill health in Australia. Smoking causes more hospitalisation than the consumption of alcohol and the use of illicit drugs combined. Major problems resulting from smoking include coronary heart disease, stroke, peripheral vascular disease as well as cancer and the use of smoking every day only exacerbates the problem. (Homer, 2010) In terms of the Australian population, the Aborigines display smoking prevalence of 50% compared to 23% for the non-Aboriginal population. (Trewin, 2006) In Australia around 35% of the population suffers from common mental disorders while 60% of the people with schizophrenia smoke. (Jablensky et al., 1999) Smoking is generally utilised as a way of dealing with feelings like anxiety, stress and boredom but nicotine in cigarettes is physically addictive. The largest groups put at risk in Australia due to smoking are the homeless, young people, schizophrenics, Aboriginal people as well as low income single parents. Furthermore, people from lower socio-economic backgrounds have greater smoking rates than the general public. (Siapush et al., 2005) People from groups with multiple disadvantages have the greatest risk of smoking. (Baker et al., 2005) This evidence indicates that smoking is a major public health problem and that most people begin smoking at an early age and then find smoking hard to quit. The consequences of smoking on public health entail a large cost and active strategies need to be implemented in order to discourage smoking especially amongst young people particularly adolescents. 2.1. Techniques for Discouraging Smoking A review of the available literature reveals that multiple techniques have been employed to discourage the use of smoking in adolescents. These techniques have included increasing the price of tobacco through federal duties, keeping the price of tobacco equal between different states and territories, community intervention, promotion of healthier activities through schools and the use of the mass media. (Brinn et al., 2011) The use of the mass media has been seen as an effective and highly encouraging method to dissuade smoking in young people. It has been suggested that the mass media be used as a tool for building up the image of non-smokers and this should be reinforced by restrictive smoking policies. (Kremer et al., 2004) The use of the mass media is a cheap yet effective method to reach large audiences especially more remote audiences. Moreover the use of the mass media has the potential to change the attitudes of large portions of the population simultaneously. (Redman et al., 1990) The role of the mass media has been found to be particularly useful to deliver messages to the youth as they are more exposed to the media and more interested in it than other portions of the population. (US Department of Health and Human Services, 1994) The younger population is estimated to spend roughly twice the time exposed to mass media (22,000) hours than exposed to schooling (12,000 hours) (Worden et al., 1988) which indicates the pervasiveness of media in their lives. The media’s power can also be realised from the fact that by age 18 a person would have spent more time exposed to mass media than any other activity except for sleeping. (Davies, 1993) The mass media in general and television in particular is extremely effective at defining the views of young people as per socially acceptable behaviour (Strasburger, 1995) and can thus be used to intervene to control smoking in adolescents. 2.2. Effectiveness of Suggested Techniques Controlled field experiments and population studies indicate that mass media campaigns were able to lower the numbers of young people adopting smoking (National Cancer Institute, 2008) and were also able to increase the numbers of adults smoking (Bala et al., 2008) (National Cancer Institute, 2008). It must also be noted that mass media interventions were most effective when backed up by school programs, community intervention or both (National Cancer Institute, 2008). Adult smoking prevalence was also seen to decrease with the use of augmenting policies such as smoke free policies and higher rates of tobacco through duties (National Cancer Institute, 2008). It has been argued that the effects of mass media campaigns alone on discouraging smoking cannot be isolated but certain studies have managed to prove otherwise. The beneficial independent effects of media campaigns on lowering tobacco consumption have been demonstrated (Farrelly et al., 2009) through analysis over a period of time (Wakefield et al., 2008) as well as through special experimental designs (Durkin et al., 2009). The use of tobacco has been found to increase in populations where the mass media campaigns were withdrawn (Durkin et al., 2009) (Farrelly et al., 2009) (Wakefield et al., 2008). Tobacco is generally advertised with the help of the mass media and therefore such results are not surprising. It can therefore be inferred that the use of mass media coupled with other programs serves as the best method for discouraging smoking in both young people as well as adults. 2.3. Mass Media Campaign Details In this regard, mass media may be considered as any channel of communication that is directed at a large audience and does not rely on person to person contact. These channels include television, radio, internet, newspapers, billboards, posters, leaflets and booklets. The mass media campaign required to deal with smoking in adolescents should place more emphasis on discouraging the uptake of smoking. The campaign should also try to discourage young people who are smoking to quit smoking. The mass media campaign should also be backed up by governmental regulations and policies. Currently Australia has one of the highest prices for tobacco in the world and these prices should be kept as such or increased in order to discourage further uptake of smoking by young people. In order to provide positive reinforcement at schools, schools should be provided with counsellors to deal with issues such as smoking through training. Positive reinforcement from schools will ensure that more and more students keep away from smoking while those who smoke are able to reject smoking as a lifestyle option. Another important consideration within the Australian context is the fact that smoking prevalence is greatest in communities that are remote such as the Aborigines and Torrent Strait Islanders. In order to reach young populations in these areas, it will be necessary to garner anti-smoking campaigns that deal with these cultures specifically. Moreover the lower socio-economic status of these subgroups of population will require further strengthening through community intervention as well as policies such as smoke free environments and stricter control of tobacco sale to adolescents. 2.4. Government’s Role The government would have to allocate greater resources especially funding in order to create and run such campaigns. Moreover it is pertinent to note that these campaigns would have to be in place all the time in order to counter the pro-smoking campaigns of tobacco sellers. As cited before, the removal of these campaigns tends to reverse the effects of the campaign so a long term commitment would be required from the government’s end. A risk associated with such campaigns would be the intensification of the pro-smoking campaigns that might negate the effects of the anti-smoking campaigns. Bibliography Baker, A. et al., 2005. Where there's smoke, there's fire: high prevalence of smoking among some sub-populations and recommendations for intervention. Drug and Alcohol Review, 25, pp.85-90. Bala, M., Strzeszynski, L. & Cahill, K., 2008. Mass media interventions for smoking cessation in adults. Cochane Database System. Brinn, M.P. et al., 2011. 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Unplanned smoking initiation: new insights and implications for interventions. Patient Education and Counselling, 55, pp.345-52. MMWR, 2008. Global Youth Tobacco Surveillance. Morbidity Mortality Weekly Review, 57(SS01), pp.1-21. National Cancer Institute, 2008. The role of the media in promoting and reducing tobacco use. Bethesda: National Cancer Institute US Department of Health and Human Services. Redman, S., Spencer, E.A. & Sanson-Fisher, R.W., 1990. The role of mass media in changing health-related behaviour: a critical appraisal of two models. Health Promotion International, 5, pp.85-101. Siapush, M., Heller, G. & Singh, G., 2005. Lower levels of occupation, income and education are strongly associated with a longer smoking duration: multi-variate results from the 2001 Australian National Drug Strategy Survey. Public Health, 119, pp.1105-10. Strasburger, V.C., 1995. Adolescents and the Media: Medical and Social Impact. London: Sage. Trewin, D., 2006. 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