Cigarette Smoking: Addiction or a Choice - Research Paper Example

Kathleen Mallett English 1520 November 20, Oakland Community College Cigarette Smoking: Addiction or a Choice? This study will seek to present an argument of cigarette smoking both a matter of personal choice as well as a result of addiction. Cigarette Smoking as Choice To argue that cigarette smoking is a matter of personal choice, one should ask and then provide an answer to the question “When does smoking become a choice?” According to Kelly (2011), people’s lifestyles are as a result of the choices that they make in life and 99 % of all the choices made are completely within a person’s control. The choices a person makes can make that person become a smoker or non- smoker. Kelly argues that to make better choices about smoking requires a person to carry out an evaluation of the reasons why a person should not be a smoker. Among the reasons for giving up smoking involves saving money, having better health, feeling better, smelling nice and ultimately being free from nicotine addition. Kelly also notes that even if a person is a smoker or not, a person has utmost authority at discretion to identify a set of other alternative activities to stop the craving for smoking or to replace the smoking habit. Kelly emphasizes that smoking does not arise by accident and every cigarette that an individual smokes, whether the person is a teenager or an adult arises out of choice made. Kelly, further, adds that even if a person through peer pressure smoked, such a person had the freedom of choice to say no to cigarette and could have walked away. (Kelly, 2011) Yates and Elizabeth (1984, p 83), notes that smoking as a habit is basically a choice, which a person makes after evaluating the positive and negative rewards of tobacco products. They further assert that all people have the right to choose to smoke or not to smoke. Yates and Elizabeth note that people have various reasons to either choose to continue to smoke or discontinue the habit totally. Some of the obvious reasons behind smoking are; smoking calms the mind, provides a sense of confidence to people and it minimizes a person’s appetite helping to reduce unnecessary eating which maintains a good body health. Psychiatrists and Psychologists also, provide a number of other reasons as to why people smoke, which are discussed below. The stimulus of tobacco products provides smokers with a gratifying feeling of pleasure or relaxation. Psychiatrists and Psychologists note that when people see cigarette (Stimulus), this evokes the desire to smoke. (Response) In many cases, patients relate smoking with a nirvana-like feeling in their body. Smoking causes the chest to expand as smoke is inhaled. The patients express a pleasant sensation as warm gases flow through their lungs and provide them with an enjoyment which is partly subliminal. To many people, they associate smoking to as a way of expressing anger against a powerful force which might be disturbing a person. Smoking provides an immediate physiological gratification. Smoking releases glucose into the blood, raises energy levels in the body, lower body temperature, and generally relaxes the sympathetic nervous system. Yates and Elizabeth highlight a number of reasons as to why some individuals may choose not to smoke. Some of the obvious reasons are; smoking stains teeth, fingers and hands making a person look dirty, it is an expensive habit, smoke form cigarettes produces bad smell. Smoking also presents a dangerous threats to people’s heath. Smoking results into Chronic Obstructive pulmonary disease, chronic bronchitis and damaging of epithelial lining of the bronchial tubes (Yates and Elizabeth, 1984, p 86). Thus, Colby (2008) concludes by noting that it is important for smokers or those willing to smoking to carry out an in-depth analysis of the positive and negative effects of smoking. For smokers, this will help them make choices on how to go about quitting the habit. For non- smokers it will provide them with a guide whether to pursue smoking or to give up on smoking. Rls (2011, p25) states that human life involves making of choices which can either be bad or good. Rsl points out tobacco use as a bad choice that people make in life. People in spite of the warning messages printed on the Package, would still go ahead and smoke, thus, risking their lives to lung cancer, oral cancer and even early deaths. Rls (2011, p 50), notes that Young people make a choice to smoke, despite being warned by their friend and parents about the harmful effects of smoking. Rls also, notes that losing a loved or the high costs involved in treating cigarette-related illness neither stops a person from continuing to smoke Rls further highlights that people are never coerced to smoke, they make choices, that is, according to their free will. (Rsl, 2011, p 50) Cigarette Smoking as an Addiction To comprehensively discuss the idea of smoking as an addictive behavior, there is the need to clearly understand what is meant by the term addiction. To begin, Scanlon (1991, p 8) refers to addiction as to a style of life which includes the dependency on drugs in both physical and psychological aspects of an individual’s life as well as the compulsive, continued and overuse of a drug. Scanlon further adds that addiction refers to the risks and harms associated with the use of a drug and thus necessitating the need to stop its use whether individuals understands the risks, agrees to stop using the drug or not. To exemplify on the idea of smoking as an addictive behavior, the discussion will make frequent references to the definition. Lynch et al (1994, p 5) notes that cigarette and other forms of tobacco have the capability of causing addiction and most tobacco users consume tobacco regularly because they get addicted to nicotine with time and thus find it difficult to quit the use of tobacco since they became addicted to nicotine. This can be captured in Lynch et al remarks that “Tobacco use is an addiction that is caused by nicotine”. This is also highlighted by Worsnop’s statement that nicotine is an ingredient found in cigarettes and other products of tobacco. Nicotine is one of the most addictive substances to be known to man. (Cooper, 2004, p 2) Lynch et al (1994), observes that most cigarette smokers begin the habit as a matter of personal choice, in childhood and in adolescence. Afterwards, addiction takes effect after a few years of tobacco use. Also, they note that if individuals who choose to abstain from the use of tobacco at an early age of life then the chances of becoming smokers will be very low. In the United States, the population of teenagers who smoke cigarettes daily is between 80-90%. These individuals started smoking on a daily basis before they reached the age of 20 years. (Worsnop, 1999, p 2) Thus, it can be inferred that if an individual reaches the age of 20 without using tobacco products, then there is a high unlikelihood of becoming a tobacco user later in life during adulthood. However, for most children and youths who begin using tobacco products frequently, they become addicts and their addiction persists for many years and perhaps throughout their entire life. (Lynch et al, 1994, p 6) In her publication, Elders notes that nicotine that is derived from the smoking of cigarettes is highly addictive. According to Elders, about 20 million people in the United States make an effort every year to stop the habit of smoking but only 3% of the smokers succeed in the long term. She adds that even the addicts who have lost a lung because of cancer or those who have undergone cardiovascular surgery, only 50% succeed in abstaining from the habit of smoking for a period of more than a week. (Elders, 1997, p31) Lynch notes that the use of tobacco products is USA’s deadliest addiction and cigarette smoking are the major cause of preventable diseases in United States. It is estimated that more than 400,000 people die prematurely annually from diseases related to tobacco use. The deaths resulting from tobacco use are higher compared to deaths arising from AIDS, alcohol fires, homicides, car accidents and illegal drugs combined. Cigarette smoking accounts for 87% of all deaths resulting from lung cancer, 30% of all deaths from cancer, 82% of pulmonary diseases, and 21 percent of deaths resulting from chronic heart disease. The use of smokeless tobacco (snuffs) results into oral cancer. (Lynch, 1994, p 3) The deaths resulting from cigarette smoking have made it difficult for the United States government to calculate the value of human lives, which have been lost as a result of tobacco related diseases. The suffering that individuals and their families undergo through the result from tobacco related deaths is also difficult to quantify. The Office of Technology Assessment in the Year 1990 estimated the social cost of smoking stood at $68 billion. This cost included $20.8 billion in direct health costs and a $6.9 billion loss in productivity as a result of disabilities related to smoking and $40.3 billion loss in productivity as a result of smoking–related deaths early in life. The decision, also, by the youths to embrace smoking habits annually costs the health care system an extra $8.2 billion to cater for medical expenses during their lifetime. As a result of the negative impacts of tobacco use on its population and spending, the United States government has been compelled with the task of reducing the social burden of tobacco use throughout its population. To deal with the problem of youth addiction and dependency on drugs and thus reduce the negative effects of tobacco use on health care system, the United States government has adopted some strategies. A law has been enacted which regulates the coverage of tobacco products under safety and food products with the sole purpose of discouraging cigarette use and reducing the mortality rate associated with their use. The promotion and advertising of tobacco products have also been regulated, and manufacturers have been required to include a warning message on cigarette packages. (Lynch, 1994, p 22) The United States government has also doubled the tax on cigarette commodities, to make them expensive to the young people and this has seen a 40% decline in tobacco use among children. (Worsnop, 1999, p3) The United States government has also made it illegal for people to smoke in any work place or any food restaurant. As a result, it has introduced the Michigan Smoke Free Law. This law aims to preserve and improve the health, comfort and the environment for non-smoking people by protecting them from active smokers. This study seeks to elaborate on ideas within the confines of the definition, the introduction and the background provided. More specifically, it looks into the following; The physical and psychological aspects of cigarettes smoking to an individual’s life, The risks and harms associated with cigarette smoking, and The various control mechanisms adopted to minimize the risks and hazards related to cigarette smoking. The presence of nicotine in the body has both physical and psychological effects to smokers. The absorption of cigarettes smoke in the lungs occurs rapidly and with each inhalation, a high concentration of nicotine reaches the brain within 10-16 seconds via arteries. In an individual’s body, nicotine has a terminal life of two hours and a distributional life of 15-20 minutes in the blood. Thus, for every stick of cigarette taken by a smoker, they experience a repetitive and high concentration of nicotine in their blood, which necessitates frequent smoking so as to maintain the raised nicotine concentration. Nicotine from cigarettes has adverse effects on the brain neurochemistry of individuals. It is said to activate nicotinic acetylcholine receptors (nAchRs) which are evenly distributed in the brain and has the ability of inducing the release of dopamine in the nucleus accumbens. These effects are similar to those produced by abuse of other drugs such as cocaine. Nicotine, which is assimilated in the brain, serves as a psychomotor stimulant and among those starting to smoke; it speeds up reaction and improves performance on tasks that require great attention. However, with time individuals develop tolerance to the effects of nicotine and chronic users do not continue to get complete improvements in performance or cognitive reasoning. In most occasions, smokers report that cigarettes calm them down when they are undergoing stressful moments and help them to concentrate on their work and improve performance, but little evidence exists to support that nicotine provides effective medication to individuals to deal with adverse moods or to cope up with stress. (Benowitz, 2010) The reason as to why smokers perceive cigarettes as having a calming effect is as a result of what is referred to the withdrawal effects of nicotine. Smokers in most occasions, a few hours after smoking a cigarette, they begin to experience an impairment of mood and performance. These feelings and effects are only alleviated by lighting a cigarette. Thus, in their life time, smokers go through this process and at long last this forces them to identify with cigarettes as the effective medication to deal with the withdrawal effects. (Jarvis, 2004) The negative effects of nicotine are very numerous among smokes and particularly on their health. In US, cigarette smoking is the biggest non-genetic contributor to death. It is estimated that more than 400,000 smokers die every year from smoking related illness. The deaths from smoking related illness are estimated to be more than that of AIDS, car accidents, fire, homicides, illegal drugs and suicides all combined. Smoking also results into other diseases like heart disease, lung cancer, emphysema and chronic bronchitis. Smokeless tobacco, that is, snuff and chewing tobacco causes leukoplakia, gum recession and tooth abrasion. Smoking is also the cause of poor pregnancy outcomes in the US. It is estimated that of all pregnant women, 15-30% smoke. The pregnancy complications linked to maternal smoking includes premature detachment of the placenta, bleeding during pregnancy, premature rupturing of the membrane and premature delivery. Maternal smoking has also been associated with low birth weight and premature abortions. (Institute of Medicine (U.S.) Committee on Health and Behavior, 2001, pp 88, 90) There are a number of strategies, which have been adopted, to minimize risks associated with cigarette smoking which include: In Article 6 of the Framework Convention on Tobacco Control (FCTC), it states that all Parties supporting the convection must recognize that prices and tax measures are a crucial means of reducing tobacco consumption among the section of their population particularly the young person. Section 2 of Article 6 states that every state has the obligation to determine and establish policies on taxation in relation to its national health objectives and tobacco control and adopt or maintain measures appropriately. One of these measures is the implementation of tax policies on tobacco so as to contribute to the health goals aimed at minimizing tobacco consumption. Such policies would as well prohibit or restrict the sale or importations by international travelers of tobacco products that are tax and duty- free. Section 3 states that all the parties to the convection shall provide the rate of taxation for all tobacco products and trends in the consumption of tobacco in their reports presented periodically to the Conference of the Parties and in accordance with Article 21 (WHO, 2005). The imposition of high taxes by US government on tobacco products has helped to deal with smoking problems among the youths. Studies have revealed that smokers are sensitive to increase in prices particularly the children. Studies estimated that a 40% decline among teenage smokers was experienced after taxes on cigarettes doubled (Cooper, 2004, p 12). It was also established that smokers in American households who are below median income level are responsive to price increases four times more than smokers living above median income levels. Thus, Jha et al (2011) notes that the estimate of price elasticity for low and middle-income countries will double those of estimated from high income countries. This implies that a significant increase in tobacco taxes would be effective in reducing tobacco product usage. Under this Article 7 of FCTC, the parties to the convection recognize that non-price measures, which are comprehensive, are an important means of reducing tobacco consumption. It is also stated that every party shall adopt and implement measures which are legislative, executive, and administrative or other means which are deemed necessary to implement the pursuing of obligations. This is in relation to article 8 and 13 and each state shall cooperate with others directly or through other international bodies to help in the implementation of their obligations. (WHO, 2005) Under Article 8 of the FCTC, parties recognize that scientific findings have effectively established that exposure to tobacco smoke causes disease, disability and death. This section also states that every party should adopt and implement in areas of national jurisdiction as may be determined by national laws. It should promote in other levels of jurisdiction the adoption and implementation of administrative, legislative and executive measures. Also, it should protect individuals from exposure to tobacco smoke in public transport, indoor work places, indoor public places and other public places. Article 9 of the FCTC states that, the Conference of the parties (in consultation with international bodies which are competent), will propose guidelines for measuring and testing the emissions. The body would as well test the contents of tobacco products and the regulation of these emissions and contents. It further states that every party shall adopt and implement effective administrative, executive and legislative measures for testing, measuring or regulating the contents of tobacco products. Such measures must be approved by national authorities that are competent. (WHO, 2005) Article 10 of the FCTC provides that each Party shall in accordance of its national laws adopt and implement legislative, administrative or executive measures which will require importers and manufacturers of products of tobacco to disclose to the authorities of government information pertaining to the contents and emissions of tobacco products. This section further requires each party to implement measures for the information disclosure to the members of the public about the toxic components of tobacco products and the emissions they produce. Article 11 of the FCTC states that every party after a three year period entry into the Convection, will adopt and implement effective measures in accordance with its national laws to ensure that the packaging and labeling of tobacco products do not in any way promote tobacco products in any way that is false, misleading or any means likely to bring about a mistaken impression with regards to its characteristics, emissions, hazards or health effects. This includes any term, trademark, figurative or descriptor that may create an impression that is false that a specific tobacco product is not as harmful as other tobacco products. These may as well include terms like low tar, ultra-light or mild. This Article requires that every packet and packaging of tobacco products to carry health warnings and messages that describe the harmful effects of tobacco use. The warning messages shall be approved by a national authority that is competent and shall be large, clear, visible and legible and in the form of pictures or pictograms and should cover more than 50% of the displayed areas. Article 12 of the FCTC states that, every member to the convection has a duty to promote and strengthen public awareness campaigns against tobacco products using all available communication tools. The communication tools should provide information relating to the addictiveness of tobacco consumption, health risks of exposure to tobacco smoke and the benefits of cessation of tobacco use and tobacco-free lifestyles. The training, sensitization and awareness programs should target change agencies like community workers, social workers and educators so as to realize the objectives of members to the Convection. (WHO, 2005) According tobaccoinaustralia.org.au (2011), the adoption of smoke-free laws and policies in the recent times has been as a result of awareness of the health risks of SHS (Second Hand Smoking) and the dislike of cigarette smoking by the public. The banning of smoking in public places is meant to protect non-smokers from hazards of exposure to cigarette smoke. The website notes that, with the introduction of smoke free laws, bar workers have experienced a decrease in respiratory illness symptoms and salivary cotinine which are a sign of exposure to SHS. The ban on smoking has also been beneficial to the health of smokers. This is because it has encouraged more smokers to attempt to quit their habit and thereby increasing the chances of successful quitting attempts. In the US, the implementation of Smoke free laws in Alabama has seen the reduction in the prevalence of smoking rate by 3.8 %. Smoking bans also reduces the number of individuals associated with smoking related diseases. In the US, after the implementation of city ordinance, which banned smoking in public places, the population of patients admitted for coronary heart disease reduced by 47%. (tobaccoinaustralia.org.au, 2011) In the State of Michigan, the Michigan legislators passed Alabama smoke-free law which was signed by the Governor on December 2009. This law came into effect on May 1, 2010. Its aim was to prohibit smoking in public places. The law provides that all public business inclusive of restaurants, bars, and hotels be smoke free zones. However, there are some exceptions which include tobacco specialty shops, casinos and designated cigar bars. The aim of the law of Smoke Free Air is to aid in children protection and citizens who do not smoke from predicaments associated with second-hand smoke. The law will also ensure that employees work in a healthier environment as tobacco smoke contains toxins and carcinogens that cause diseases and death among non-smoking citizens. (dhd2.org, 2011) According to cdc.gov (2011), it states that the majority of teenagers who smoke purchase their own cigarettes, meaning they are locally available. This, therefore, suggests that the reduction in their availability may help in the minimization of the prevalence of tobacco abuse among minors. In the US, the state has taken several approaches to limit minor access to tobacco. Thus, the state has totally banned the use of vending machines and require cigarettes be obtained directly from a sales person. The state has also sent compelling warning messages to the sellers making it illegal to sell tobacco products to minors. Penalties and sanctions to sellers who violate the laws may involve revocation of licenses. (cdc.gov, 2011) According to Jha et al (2011), cigarettes are the heavily advertised and promoted products in the world. In the year 2002, cigarette companies in the US were estimated to have spent $12.5 billion on advertising and promotion which is the highest expenditure to date. Tobacco advertising uses forms of advertising on TV, radio, magazines, newspapers, billboards and sponsorship of sporting and cultural events. The increase in advertising and promotion of cigarettes both directly and indirectly promotes the demand for cigarettes and the initiation of smoking. This has made studies conclude that cigarette advertising is effective in capturing and retaining the attention of children which may later initiate smoking intentions. Thus, a ban on advertising and promotion will help reducing smoking among teenagers significantly. A study conducted in the period of 1970-1992, provided strong evidence that a ban on adverting and promotion led to a sharp decrease in cigarette smoking in high income countries by more than 6%, taking into account both price and non-price control mechanisms. These are services given to smokers with the sole intention of helping them to quit the habit of smoking. These includes behavioral and psychological interventions, quit and win competitions, use of internet based services, Physician advice, and use of self help materials (WHO and Silva, 2003, p 18) The only medication available to cigarette addicts is Nicotine therapy treatment. The purpose of stop smoking services also known as cessation services is to provide clinical treatment to smokers who are making plans to quit the habit and would like assistance in doing so. These services are provided by smoking cessation adviser specialists and mostly in group settings. These specialists provide messages such as the one stated by McEwen et al that” There is strong evidence that getting help, support and advice from someone trained in smoking cessation will roughly double your chances of success. Medications that help with stopping smoking have a similar effect and our local stop smoking service can help you choose which medication is most suitable for you.” (McEwen et al, 2006, p, 49) In conclusion, it can be noted that the young people contribute to a significant population of smokers. Thus, any government that is concerned about its youthful population should always have appropriate control measures to help keep off teens from the health risks associated with cigarettes whether teens have made a personal choice of taking up the smoking habit. As a result, the spending on health care will be reduced. Also these will help prevent the loss of the working population which is very crucial for economic development. The findings and the arguments in the study are in the process of seeking to support the argument of the study, “Cigarette smoking: addiction or a choice?” Works Cited: Benowitz, Neal L. Pharmacology of Nicotine: Addiction, Smoking-Induced Disease, and Therapeutics (2002). Retrieved on 12th November 2011 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946180/ cdc.gov. Reducing Tobacco Use: A Report of the Surgeon General (2000). Retrieved on 12th November 2011 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4916a1.htm Colby, Annette. Why People Smoke Cigarettes - Five Reasons That Might Surprise You. (2008). Retrieved on 23rd November 2011 http://ezinearticles.com/?Why-People-Smoke-Cigarettes---Five-Reasons-That-Might-Surprise-You&id=1176890 Cooper, Mary H. Tobacco Industry: Do ads and new products still target teen smokers? 2004, p 4. dhd2.org. Michigans Smoke-Free Air Law. (2011). Retrieved on 12th November 2011 http://www.dhd2.org/s_tobreg Elders, M. J. Preventing Tobacco Use among Young People: A Report of the Surgeon General. Edition illustrated. DIANE Publishing, 1997, p31. fctc.org. Framework Convection Alliance: A world free from the devastating health, social, economic and environmental consequences of tobacco and tobacco use. (2011) Retrieved on 12th November 2011 http://www.fctc.org/index.php?option=com_content&view=article&id=25&It emid=31 Institute of Medicine (U.S.) Committee on Health and Behavior: Research, Practice, and Policy. Health and behavior: the interplay of biological, behavioral, and societal influences. Edition illustrated. National Academies Press, 2001. Jarvis, Martin J. Why people smoke. (2004) BMJ Publishing Group Ltd. Retrieved on 12th November 2011 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC324461/ Jha, Prabhat et al. Tobacco Addiction (2011) Retrieved on 12th November 2011 http://files.dcp2.org/pdf/DCP/DCP46.pdf Kelley, Fred H. Smoking is a Choice. (2011) Retrieved on 12th November 2011 http://www.quitsmoking.com/info/articles/choice.htm Lynch, B. S. et al. Growing up Tobacco Free: Preventing Nicotine Addiction in Children and Youths. National Academies, 1994, pp 3, 5, 6, 22. McEwen, Andy et al. Manual Of Smoking Cessation: A Guide for Counselors and Practitioners. Edition illustrated. Wiley-Blackwell, 2006, p 49. Rls. Life, Its All about Choices. Xlibris Corporation, 2011, pp 25, 50. Scanlon, Walter F. Alcoholism and drug abuse in the workplace: managing care and costs through employee assistance programs. Edition 2. ABC-CLIO, 1991, p8. tobaccoinaustralia.org.au. Why implements smoke free environments. (2011). Retrieved on 12th November 2011 http://www.tobaccoinaustralia.org.au/chapter-15-smokefree- environment/15-1-why-implement-smokefree-environments- World Health Organization. Who Framework Convention on Tobacco Control (2005). Retrieved on 12th November 2011 http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf World Health Organization and Vera da Costa e Silva. Policy Recommendations for Smoking Cessation and Treatment of Tobacco Dependence. Edition 2, illustrated, reprint. World Health Organization, 2003, p 18. Worsnop, Richard L. Teens and Tobacco: Do Cigarette Ads Encourage Teens to Start Smoking? 1999. pp 2, 3. Yates, John M. and Elizabeth S. Wallace. The Complete Book of Self-Hypnosis. Rowman & Littlefield, 1984, pp 83-86. Read More