Defining the Policy Issue: Smoking as an Enormous Health Hazards - Essay Example

Smoking Cessation in Public Areas Defining the Policy Issue Smoking creates enormous health hazards and one of the leading causes of cancer,lung disease, vision impairment, autoimmune disorders, bone weakness and many more. Secondhand smoke causes nearly 3,000 lung cancer deaths each year in the US. (National Cancer Institute, 2011). A low level of involuntary smoke is also harmful. The safest way to protect nonsmokers is to completely shut indoor smoking from all public places. Ventilation is not sufficient to eliminate secondhand smoking completely. Smoking at public places such as hospitals, restaurants, schools and colleges, airports, bus stops, theaters, stadiums is a malaise as it affects children, women, old-age people, and everyone alike. Studies reveal that children get affected most with asthma symptoms due to environmental tobacco smoke. Even an adult who does not smoke but live with a smoker have a 30% higher risk of lung cancer than the one who is not a passive smoker (U.S. Department of Health and Human Services, 2010). It is estimated that secondhand smoke kills over 50,000 non-smokers in the US each year (Graff, 2008). Over the years, nonsmokers have been convincing authorities to put a ban on smoking at all public places as they do not want to become passive smokers and endanger their health. Smokers, on the other hand, oppose any policy that imposes ban on smoking at public places. According to them, such policy is a clear violation to their liberty and basic rights as made out in the US constitution (Kjono, 2007). Currently, the state laws differ significantly in banning smoking at public places. A Policy Analysis Framework While formulating a policy framework to create smoke-free public places, it becomes imperative to examine such policy in the context of social, ethical, legal and economic perspectives affecting varied stakeholders. Stakeholders Involved Smokers, nonsmokers, and cigarette or cigar manufacturers and marketers are the major stakeholders who are going to be affected from this policy issue. The policy proposition is to safeguard the health of nonsmokers from the second-hand smoke; smokers will lose their freedom of smoking at the place causing inconvenience to them. Any reduction in smoking due to this policy implementation will lower the business potential of the cigarette manufacturers and marketers. The State as a stakeholder will be benefitted in the long-term due to reduced spending on public healthcare. Social Perspective There is a clear divide between smokers and non-smokers as nonsmokers believe that all employees have the right to inhale smoke-free clean air at work places and must be protected from becoming passive smokers; however, the policy formulators have to accommodate smokers too so that they do not feel discriminated and isolated. Legal Perspective Legally, many state laws come in the way of enacting a smoke-free policy proposition. State laws are "ineffective at protecting the public from exposure to secondhand smoke" (Graff, 2008 p. 5) because state preemptive legislation works against local smoke-free policy matter. Several states have implemented smoker protection laws that impede local employers to create smoke-free policies. State smoker protection laws assure smokers that their employment opportunities will not be affected due to their off-duty smoking behaviors. Smokers want their right of smoking not to be diluted. Many of them are opposed to any ban on smoking at public places as their freedom to smoking is imperiled; however, the fact remains that smokers have not been provided with a constitutional "right to smoke". Therefore, smoke-free environment at all public places should be a legitimate goal of the establishment across the US for the purpose of safeguarding non-smokers at large (Graff, 2008). Ethical Implications Most smokers state that it is unethical to ban smoking at bars and restaurants. After all, bars and restaurants are the places of recreation and stimulations. Moreover, putting a ban on smoking at bars and restaurants infringes on business owners’ rights to conduct their businesses. In a way, it restricts the business owners targeted clientele and at the same time, it also prevents the customers from enjoying their desired drinking/dining experience (Owing, 2008). The other ethical dilemmas are compassion, fairness, freedom, and respect. Fairness means both the sides need to be unbiased, and objective. Smokers need to respect aspirations of non-smokers and vice versa. Freedom always comes with the responsibility of rightful behavior that nonsmokers demand from smokers. Compassion is needed for those who are addicted to smoking and struggling hard to give up. Thus, a policy framework must take into account the ethical dimensions while formulating a healthcare policy. Economic Perspective A unique characteristic of the smoking epidemic is that it affects nonsmokers significantly. Raising cost of cigarettes has not been an effective solution to eliminate smoking anywhere in the world. The US healthcare expenditure has already crossed over 15% of the gross domestic product. Moreover, health spending is outpacing economic growth. It is estimated that medical costs pertaining to smoking (active or passive) is anywhere between 6% and 14% of total medical spending in the country. Smoking costs the US economy over $150 billion per year (Owing, 2008). Policy Options/Solutions While developing policy options for the policy matter under discussion, it is important to classify the public places according to the importance and harms that may be inflicted to the stakeholders involved. High Prioritization (Radical Change) Medium Prioritization (Partial Change) Low Prioritization (No Change) Public Places Hospital, Public transport system, Airports, Schools, Theaters/Stadiums Bars and Restaurants Garden, Zoo, Public roads and other open places The theoretical underpinning of the above solutions is to approach the issue not as a ‘knee-jerk’ reaction but to provide the smokers breathing time to adjust to the new situation. After all, smokers are also one of the stakeholders to this new healthcare policy proposition. Health Advocacy Aspects and Leadership Requirements Banning smoking completely at high priority places as mentioned above is needed because of critical health issues. Hospitals are meant for health restorations and treatments where utmost care needs to be taken to ensure that environment is free off toxicity and harmful gases. Similarly, kids and children below age 14 needs to be protected completely due to their weak immunity. Public transport system, airports, and theaters/stadiums are all crowded venues and close proximity to smokers may lead to passive smoking. All those who work at these places must refrain from smoking not only to show their solidarity with the policy implementation but also to encourage others to give up smoking for their own health. Bars and Restaurants being the places of recreation, there is no need to impose complete ban on smoking; however, it must be kept in mind that smoking room does not prevent secondhand smoking completely as is evident from the Oklahoma report. Restaurants and bars must upgrade the smoking rooms to further reduce the very fine inhalable suspended particles in restaurants to the acceptable levels (Tobacco Smoke Pollution in Oklahoma Workplaces, 2010). Local authorities must impose tax on those bars and restaurants that provide the facility of smoking room in their establishment. This will work as a deterrent to the restaurant owners and customers both for providing and availing such facility. Currently, no policy formulation is needed for areas such as public gardens, and other open places where chance of passive smoking is minimal; however, smokers must be instructed clearly at such places to keep themselves at distance while smoking so as not to affect nonsmokers. Inter-professional Collaboration The solutions need some sort of inter-professional collaboration too. For example, the patients who are smokers may need to admit in hospital for the treatment and even if their nature of illness permits smoking (for instance, orthopedic treatment), they would not be due to ban imposed. Hospital doctors and nurses must support such patients through counseling and by providing cessation strategies. Nurses need to be trained to provide nicotine patches as non-pharmacological aids to the patient or some sort of pharmacological aids under doctor’s prescription. Hospital administration through collaborative approach with physicians and nurses needs to be vigilant enough to help such patients so that they do not give negative feedback. It is quite likely that the patient may see his or her hospital admission as an opportunity to give up smoking permanently. Similarly, in bars and restaurants a collaborative approach is needed between administrative and service staff to serve both kinds of customers (smokers and nonsmokers) so that they do not feel offended due to differential treatment. Pros and Cons of Suggested Change Each option as detailed above is feasible in the current circumstances to implement the smoking cessation in public areas. This public health policy of banning smoking is in line with the state and federal laws. A Plan for Building Consensus on Policy Issues Usually, large workplaces do have written smoking ban policies and most of them have disciplinary procedures for policy violations. This is also true in the firms where the management is done through executive mandates; however, at times, the consensus building process is necessary to implement policy measures successfully and to accommodate the needs of smokers. A detailed plan to bring consensus among all stakeholders will begin with notifying them as to why such a policy plan is needed. This will inform them the health hazard of smoking not only for them but also for non-smokers. It is necessary to emphasize that need of the proposed policy plan has emerged out of a necessity to safe guard the health of a large section of the stakeholders that include owners, employees, visitors, and customers alike. All stakeholder needs to be taken into confidence that in no way, it is to subjugate smoking rights of the smokers. They must be convinced that those who want to quit smoking will be provided with all support including cessation assistance such as pharmacotherapy during transition period free of cost. They would also be provided with adequate break times to compensate for smoke breaks. It is important to inform the smokers that cessation of smoking policy bringing radical change is voluntary in nature and all support to smokers will remain in force for 8 weeks once the ban is imposed on smoking. References escience news, (2009). Study raises concerns about outdoor second-hand smoke. esciencenews .com. Retrieved January 26, 2014 from http://esciencenews.com/articles/2009/11/18/study.raises.concerns.about.outdoor.second.hand.smoke Graff, S.K. (2008). There is no constitutional right to smoke. Tobacco Control Legal Consortium. Retrieved January 25, 2014 from http://publichealthlawcenter.org/sites/default/files/resources/tclc-syn-constitution-2008_0.pdf Kjono, N. E. (2007). Opposition to Smoking Bans Heats Up. Retrieved January 26, 2014 from http://www.forces.org/writers/kjono/files/economic_impact.htm National Cancer Institute (2011). Secondhand Smoke and Cancer. Retrieved January 25, 2014 from http://www.cancer.gov/cancertopics/factsheet/Tobacco/ETS. Owing, J.H. (2008). Smoking and health research. Retrieved January 25, 2014. Nova science Publishers. New York. President Obama Signs Anti-Smoking Law (2011). abcnews.go.com. Retrieved December 31, 2013 from http://abcnews.go.com/Politics/Health/story?id=7897525 Sanders, C. (2013). The Legal & Ethical Issues of Smoking as Related to Health Care Organization. Retrieved January 26, 2014 from. http://www.academia.edu/4454719/Legal_and_Ethical_issues_of_Smoking_A_health_care_management_Perspective U.S. Department of Health and Human Services (2010). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA. Tobacco Smoke Pollution in Oklahoma Workplaces (2010). Oklahoma Tobacco Research Center. Retrieved January 26, 2014 from http://www.ouhsc.edu/otrc/research/documents/PreliminaryIAQreport.pdf Read More