Health Care in the UK: Smoking and Pregnancy - Report Example

1. Introduction 1 Global Prevalence of Smoking: Tobacco is responsible for the death of approximately half of the people who use tobacco in various forms worldwide. (WHO, 2013). Approximately six million deaths are reported worldwide due to the use of tobacco, with five million as a direct use of tobacco and more than six hundred thousand due to passive smoking. (WHO, 2013). WHO predicts eight million deaths due to tobacco by the year 2030? (WHO, 2013) “Nearly 80% of the worlds one billion smokers live in low- and middle-income countries. Consumption of tobacco products is increasing globally, though it is decreasing in some high-income and upper middle-income countries.” (WHO, 2013). Although global prevalence of daily use of smoking in people more that fifteen years has decreased from about 41% in 1980 to 31% in 2012 (for men) and 10.5% to 6.2% (for women), the total number of smokers has increased from 721 mn to 965 mn in the same period.(Freeman et al, 2014). The number of smokers and their daily consumption of cigarettes varies among different countries.(Freeman et al, 2014) 1.2 Prevalence of Smoking in UK:   1974 1978 1982 1986 1990 1994 1998 1998 2002 2006 2010 2012 Men 51 45 38 35 31 28 28 30 27 23 21 22 Women 41 37 33 31 29 26 26 26 25 21 20 19 All 45 40 35 33 30 27 27 28 26 22 20 20 Source: Smoking Statistics; Ash Fact Sheet Oct. 2013.(ASH, 2013) [Chart based on above-mentioned data sourced from Ash Fact Sheet (Oct. 2013)](ASH, 2013) General predominance around mature people (aged 16 and over) has been declining since inquiries regarding smoking were first included in the annual lifestyle survey. (ASH, 2013). The greatest fall was seen during 1974 to 1994. From that point forward the extent of grown-ups smoking kept on declining however at a slower rate. Be that as it may, since 2007 the rate of smoking has remained to a great extent unaltered. (ASH, 2013) 1.4 Smoking as a dangerous habit and powerful addiction: Over the years, Addiction has generally been defined as “A kind of possession, in which a powerful drug is able to produce behavior that would not otherwise occur” (Bell & Keane, 2012 p. 244)(Bell & Keane, 2012). Berridge (1998) proposes that “in the British context, tobacco was historically seen to be associated with dependence rather than addiction per se.” Initially, Tobacco was looked upon as a physical problem (leading to physical ailments) rather than a psychological problem. (Bell & Keane, 2012 p. 244) Judith Anderson (2005) says that Mental addiction of nicotine happens as nicotine can be both stimulating and relaxing.(Anderson, 2005). Moreover, we associate it with being stressed or bored, which leads to a psychological dependence. (Anderson, 2005 p. 17) 1.5 Smoking and Pregnancy: Smoking during pregnancy has directly been linked to low birth weight, spontaneous abortion, still birth and neo natal death. (Oaks, 2001 p. 58) (Oaks, 2001) 2. Health Risks of Smoking: Radon transforms a radioactive dust in the air we breathe. The dust is trapped in our aviation routes and radiates radiation that harms our lungs. This harm, as the harm initiated by smoking, increments our danger of lung disease(HPA, 2009). Radon Level (pCi/L) Extra Cancer Deaths (per 1000 people) Equivalent Smoking Risk (cigarettes per day) 100 0.5 200 40 0.2 20 0.1 40 10 0.05 4 0.02 8 2 0.01 1 0.005 2 0.5 0.0025 0.1 0.0005 (Lipkus, 2007) Based on Data Above (Lipkus, 2007) Smoking has been indicated to be interlinked with different neurological, cardiovascular, and pulmonary ailments. Smoke influences the smokers as well as the well being of the non-smokers. Presentation to tobacco smoke affects well being in youngsters and is a noteworthy danger element for asthma. Cigarette smoke holds a few carcinogens that adjust biochemical protection frameworks prompting lung cancer.(Das, 2003). Since lung is a directly influenced organ by smoke smoking, different respiratory maladies including lung malignancy, unending obstructive pulmonary illness, interstitial lung ailments, bronchial asthma, are brought on and get worse by cigarette smoking if there should be an occurrence of dynamic smoking as well as in the event of detached smoking. A considerable measure of carcinogen in smoke causes lung disease through the DNA harm. Oxidants in smoke prompt aviation route aggravation and tissue damage. Various kinds of protease including neutrophil elastase and matrix metalloproteinase cause emphysema. Moreover, aggravation simultaneously instigates lung fibrosis. Smoke smoking is a danger variable for the advancement of asthmas and is connected with diminished asthma control and expanded danger of mortality and intensifications.(Ishii, 2013) There is strong reason that links parental smoking to wheeze, asthma, bronchitis and nocturnal cough in children; with effects of before or after birth exposures for most children. (Pattenden et al, n.d p. 300) 3. Factors influencing smoking during pregnancy: In 2010, 26% of UK women smoked immediately before or during their pregnancy and 12% smoked continuously. (Fahy et al, 2014). The way that smoke unfavorably influences fetal well being, development, and improvement has been entrenched. The nicotine breathed in by the mother crosses the placenta and is found in sums 15 times higher than in maternal blood levels. Presentation to savage levels of carbon monoxide meddles with tissue 4 improvement and radically builds the danger of fetal passing. Buka, Shenassa, & Niaura (2003) reported that kids whose moms reported smoking a pack of cigarettes (20 smokes) throughout the course of their whole pregnancy were fundamentally more inclined to have a lifted danger of tobacco reliance.(Katirai, 2011) (Katirai, 2011 p.3) 3.1 Environmental Factors: Women are a large target audience for Tobacco Companies, particularly in the UK. Tobacco companies create innovative promotional campaigns and advertising strategies to target women to start smoking; this trend is seen to have been continued even before, during and after pregnancy in women. They promote images specifically designed to induce women to start smoking. (Amos, 1990) (Amos, 1990 p.417). Tobacco Companies at times create specific brands for women only. (Amos, 1990 p. 417) [Illustration in Appendix]. Moreover, they use Women’s Magazines to focus on this potentially large market. Magazines such as Vogue, Elle & Cosmopolitan, which are quite popular amongst women in UK carry promotional information of cigarettes target for women. (Amos, 1990 p. 419). Moreover, they link smoking to glamour by introducing images of models in the glamour world smoking a specific brand. Women with less than a high school education and those with current-year nicotine reliance had the most astounding danger of smoking (90.5%), contrasted and ladies with a higher education and without nicotine reliance (3.9%).(Gilman et al, 2008;). 3.2 Economic Factors: Since lower income group women are at an increased danger of having low weight newborn children, elements connected with birth weight around such aggregations have exceptional significance. Cigarette smoking has developed as an imperative indicator of low conception weight because of intrauterine development impediment and preterm deliveries.(McCormick et al, 1990). Moreover, other economic factors that are seen to encourage smoking may depend on the woman’s employment status, the number of children she already has, to what extent is family support available to her, her budgets and whether or not she is surviving on Government benefits. (Richardson, 2001) (Richardson, 2001 p.15) 3.3 Social Factors: In a research conducted by Nafstad et al (1996) in Norway, it was found that women without higher education and living with a smoking partner were seven times more likely to smoke even during pregnancy than women with higher education and living with a non-smoking partner. (Lu et al, 2001) (Lu et al, 2001 p. 357). NICE clinical guideline 110 (Sept. 2010) finds that the probability of smoking in pregnant women is highest amongst: 1. women who misuse substances (alcohol and/or drugs)(NICE, 2010) 2. women who are recent migrants, asylum seekers or refugees, or who have difficulty reading or speaking English(NICE, 2010) 3. young women aged under 20(NICE, 2010) 4. Women who experience domestic abuse.(NICE, 2010)“Smoking prevalence (29%) was lower and quit rates (36%) were higher than national rates for women aged 25–34 in 2000 (32% and 29% respectively). These rate differences were in line with regional variations in smoking status in England; with prevalence in the south east lower than both northern regions and the country as a whole.” (Graham et al, 2006 p.230) More information on table below: Socioeconomic and smoking profile of the sample Number of cases % Of sample Working Women Professional and Managerial 3254 38.6 Intermediate 2850 33.8 Semi-routine/routine 2333 27.7 Age of leaving full time education 22 and over 1218 14.4 19–21 1123 13.3 17–18 2330 27.6 16 and under 3766 44.6 Age of entry into motherhood No births at time of interview 3696 43.8 25 and over 2178 25.8 22–24 1085 12.9 20 and 21 690 8.2 Read More