Ending the Tobacco Problem among Adolescents - Dissertation Example

Ending the Tobacco Problem among Adolescents Introduction to target health behaviour and population Smoking among adolescents as studies show is not limited to psychosocial influences such as peer pressure only. There are cases of biological reasons which lead to increase in this behaviour among the adolescents. Studies have related intermittent smoking to the development of smoking addiction in some teenagers (Lapointe, 2008). Addiction, as widely used, depicts various social and medical disorders linked to compulsive ingestion of chemicals that are psychoactive. Abuse of narcotics, including nicotine present in tobacco, may lead to addiction. Increased susceptibility to smoking addiction is reinforced by effects of nicotine present in tobacco combined with other chemicals found in cigarettes (Owing, 2005). A chemical known as acetaldehyde has nicotine addiction increment properties among teenagers. Nicotine use is the most common form of abuse, through cigarette smoking and by the continued absorption of it in the body leads to a pattern hard to give up (Verster, 2012). As such, adults who start smoking during their adolescence have a higher risk of becoming addicted in the future. The World Health Organisation (WHO) identifies smoking as a leading cause of pre-mature deaths and illnesses among adults in developed countries. Smoking in most people starts in adolescence leading to addiction which may have ripple effects in the health of the teenagers such as low respiratory function, poor physical fitness, an increase in asthmatic problems, severe respiratory illness and susceptibility to it (Sloan, 2003).These short and long term health problems are common among regular smokers. European monitoring centre for drugs and drug addiction conducted a survey that shows that at least two in every fifteen year old in the UK have smoked or tried cannabis. These statics are higher than in any other country in Europe (Jaffe, 2001). An estimated number of 3,200 teenagers have their first cigarette before the age of 18 with an estimated over 2,000 becoming addicted such that they make smoking a daily habit in America. If this trend continues, over 5 million of American teenagers could die due to pre-mature illnesses associated with smoking. This is equivalent to 1 in every 13 year old likely to die before the age of 17. Smoking among teenagers has gone down steadily since the 1990’s through to 2004 but shot up again in 2005. 13 percent of teenagers today smoke a cigarette at least once in a month (Diclemente et al, 1996). Teenagers who watch movies with smoking scenes are likely to be drawn to the act of smoking than those who do not. Teenagers who are addicted experience withdrawal symptoms in their attempt to quit smoking (Alters et al, 2006).It is therefore necessary to understand why and how teenagers become addicted to smoking in order to develop appropriate prevention and intervention methods to meet their specific needs. In this paper, I will evaluate processes of behaviour change among communities and individuals through intervention methods. I will also describe a health and conceptual intervention model to address the issue of smoking abuse among the targeted group, in this case, adolescents. I will also showcase how the intervention methods are aimed at changing behaviour, and whether they are effective or not. Prevalence of young people smoking in the UK and ethical issues Research shows that approximately 200,000 children in the UK start smoking every year. 2/3 of adult smokers say that they started smoking from their adolescence, before the age of eighteen. The annual government survey of smoking among high school students in the UK defines regular smoking as taking one cigarette every week. Most adolescents take more cigarettes than that; therefore can be identified as regular smokers (Wagner & Waldron, 2007). The prevalence of smoking among the teenagers continues to drop significantly with only 22% of adolescents aged 15 years admitting to have smoked in 2013 as compared to 58% since 1982. The percentage of smokers aged 15 has gone down since 2003 by half. 42% to 22% in 2013, the prevalence of regular smokers however increases with age from 0.5% below 11 years to 8% of 15 years. There are ethical issues that are related to smoking abuse especially for the researchers carrying out surveys among the adolescents. The teenagers are not of legal age to be interviewed without a guardian, therefore the researchers have to obtain permission from the parents before they carry out their survey. The parents might react angrily if they find out that their children are smokers, or some may want to hide this fact from the researchers. This may affect the overall outcome of the survey. The researchers and enumerators are trusted to maintain confidentiality. However, this is not always the case as some information may be leaked out to the public therefore exposing smokers among the adolescents (Jaffe, 2010). There is also the ethical dilemma researchers are faced with of whether to give remuneration to teenagers who have participated in the study or not. The smokers may take advantage of this to get money to buy cigarettes. Health models/ interventions to address smoking abuse among teenagers Human behaviour plays a major role in maintenance of good health and preventing diseases. Effective programs aimed at behaviour change require a multi-faceted approach to assist people adopt, change and maintain the newly acquired behaviour (Lewis, 2010). Forceful strategies are necessary in combating smoking among the teenagers. The biggest percentage of adult smokers report that they started smoking when they were teenagers; as such, it is necessary to come up with ways to intervene in order to stop smoking among teenagers as it could lead to addiction later in life which is a difficult pattern to abandon (Parkinson, 2007). Several health intervention methods can be used to stem smoking abuse among adolescents in schools, hospitals and the community. Media Campaigns Teenagers are more likely to be attracted to this form of intervention as they are regular movie watchers. Teenagers spend most of their free time watching Television, movies or on social media. These are therefore effective platforms that can be used to target adolescents who have either taken up the habit of smoking, those who are in the process and to prevent those who are susceptible (Wewers et al, 1997). Advertisements containing the dangers associated with smoking should be scheduled for broadcast right before or in the middle of popular programmes with teenagers. At this age, teenagers are likely to copy what is happening around them, replicating it later. Dangers related to smoking such as premature deaths and respiratory function failure should be well highlighted to pass the message in a simple and fun way to the teenagers (Pettus, 2006). Social media campaigns containing the negative effects of smoking should also be considered by health promoters in their endeavours to stem smoking abuse among teenagers. Use of graphic images and messages that are hard to forget, such as deteriorated organs as a result of smoking, should be encouraged on social media. This is an effective way of health intervention promotion (Fichtenberg & Glantz, 2002). Peer Educators Teenagers are likely to listen more to their fellow teenagers than they listen to their teachers and adults (Öberg et al, 2011). It is therefore important to train young teenagers on the dangers of smoking, with an aim of sending them out to other teenagers to educate them on the same. Counselling and educating teenagers by fellow age mates will encourage the smoking teenagers to adopt change easily. This is a proper intervention method as teens succumb to peer pressure easily as their brain is not fully developed to reason like adults. School based intervention Schools include drug abuse education in their curriculum to encourage behaviour change and prevent risky habits from developing among the teenagers. This should not only be targeted to the teenagers only but the parents and guardians as well (Sloan, 2004). They should be educated on the steps to take to discourage smoking to their children and proper behaviour such as giving up smoking, for the smoking parents as they serve as role models to their children. Teenagers especially the young ones, about 13 and 14 years are likely to imitate their parents’ behaviour (Hales, 2010). It is therefore necessary to encourage the parents to be good role models to their children. Brochure for Anti-smoking campaign (Check the attached Zip folder to find brochure). The graphic images are meant to show just how dangerous smoking is and the consequences it has in the long run. The images and text are primarily meant to change the behaviour of adolescents in to giving up smoking since no adolescent would want to have rotten teeth, wrinkled skin or deteriorated body organs. At this age, they are transforming in to adulthood and as such, are very concerned about their appearance (Baumeister & Vohs, 2013). The brochure shows just how dangerous smoking can be to their overall appearance. This will convince them to give up the vice. The bright colours used are to capture attention. There are attractive colours to the eyes, therefore will provoke the target group to pick up the material and see what is inside. There is also use of several images. Text alone can sometimes be boring and could keep away the target group from picking up the brochure. However, the images will serve as an attraction point, driving their curiosity to read the text behind the images. There is also help numbers that an adolescent can call if there is need for assistance. At times, teenagers find it easier to talk to strangers who will not judge them for their failures rather than talking to those who are close them (Rosner, 2013). They will prefer guidance from an adult who they think has knowledge about a disturbing issue rather than speaking to their parents as this is a sensitive age, where they tend to be rebellious towards their parents. The help centre will attract teenagers who want to talk and are in need of help. Conceptual model to address smoking abuse among adolescents and intervention Social influence has the largest effect on behaviour among the adolescents. It is through socialization, norms and beliefs that the behaviour of young people is modelled into either becoming responsible citizens or delinquents (Bonnie & Wallace, 2007). When considering the best health intervention method to apply to curb smoking abuse, it is first necessary to understand how social influence affects behaviour. The conceptual model I am going to present posits that social influences on adolescent smoking are acquired through social context, social networks and group membership that operate mainly on social norms. Social norms are sets of accepted beliefs, attitudes and behaviours (Donovan & Marlatt, 2008). Individuals take up these norms over time from family, school, religious institutions and the community. Social norms influence social context, membership in to groups, and social networks (Koop, 2004). Socialization can be an important factor in intervention efforts in adolescents. Intervention through social influence can be done at home, school, in religious institutions and by the members of the community such as the elders and neighbours (Schmitz & Gray, 1995). It is these basic institutions that should be entrusted with the duty of intervening to either prevent the habit of smoking from starting among young people; or efforts to stop smoking abuse if it has already started. These institutions instil norms amongst the adolescents to allow them acquire behaviour that is acceptable to that particular community (Viscusi, 2002). Smoking and substance abuse in the society is considered to go against the norms. As such, pre-requisites are taken to ensure behaviour change is acquired, or that the young people do not get in the habit of drug abuse in the first place. The family is the primary socialization agent (Wagner & Waldron, 2007).Teenagers will observe what is happening at home and they are likely to acquire the behaviour of those other family members for example the parents, elder siblings and other close members of the family. Therefore, the family should always set a good example to the adolescents as they teach them on the acceptable behaviour. This will socialize the teenager in to taking up behaviour that is considered acceptable. Intervention is done in the same manner. It is the family, especially the parents that should take up the duty of re-shaping the behaviour of the teenagers who have taken up the habit of smoking (Kozlowski Henningfield & Brigham, 2001). The parents should teach their adolescent children on the right behaviour and take up different approaches such as punishment through grounding. This is an effective way of changing behaviour and acquiring better health promotion strategies as smoking has serious consequences on the health of individuals. Other institutions in the society should also intervene through various methods such as showing the consequences smoking abuse may have on the teenagers for example the risk of being ostracized by the community or their fellow teenagers (Reznicek, 2011). Below is a model to show how social influences can have effect on the adolescence behaviour. The conceptual model of interconnectedness between social context and teenage behaviour Health Rainbow This model shows how the socio-economic, cultural and environmental conditions influence people’s decisions. How the health promotion material provided changes behaviour Health promotion involves the development of an individual, a group or a community in the process of improving behaviour, knowledge, skills and attitudes. Health promotion reduces the rate of premature deaths due to smoking related illnesses, enhances quality life for all people, it reduces finances that could have been used to treat smoking related disorders and ensuring health status is maintained for everyone in the community (Breinbauer & Maddaleno, 2005). Health promotion requires that people take initiative in maintaining proper behaviour change. Smoking cessation will have positive results on the overall health of an individual. My campaign, targets behaviour change among adolescents who are already in to smoking as well as teenagers who are susceptible to this vice. I chose to use a brochure for passing information since it is attractive therefore appeals to the younger generation. It contains images and graphics that are meant to capture attention and pass the message home. Messages that are easy to read are also easy to understand. The brochure contains messages on behaviour change and the grave consequences smoking has in the short and long term. Social marketing objective is to encourage behaviour change for the social good (Parkinson, 2007). My brochure is custom made to meet the target audience, in this case the adolescents. The brochures can be issued at school, through home visits by the peer educators and even in hospitals as well as in social media platforms with a target of changing behaviour among the adolescents. The brochure evokes emotions as it contains the grave consequences associated with smoking such as cancer, bad breath, discoloured teeth and other respiratory diseases as well as the possibility of pre-mature death. This will for sure elicit fear that will provoke behaviour change among the young people. This approach will also encourage those giving interventions be it parents, teachers, religious leaders or other members of the community to be persuasive when giving interventions (Lewis, 2010). This will lead to a successful campaign. Brochures are also cost effective and therefore are likely to reach many people as compared to other methods of intervention. They can also be kept for future reference which serves as a constant reminder of the dangers of smoking. The brochure is small and easy to carry around and contains most of the information aimed at behaviour change. The adolescents will most likely hold on to the brochures as compared to leaflets that are easily disposable due to size. During discussions amongst the youths, they can refer to the brochures to reinforce their arguments. It contains social norms that can be adopted by the adolescents in rectifying their behaviour, such as giving up smoking and the people they can contact if they are trying to modify behaviour, such as counsellors and other institutions. Family based intervention model Universal Selected Indicated Program Family matters Creating long term family connections Strategic family therapy Target population Twelve to fourteen teen year olds Ten to seventeen year olds Sixteen to nineteen Providers Implementation by parents at home with telephone follow up by health educators Two or more health facilitators Health educators with masters level training and years of experience Objectives -To address the issues that might accommodate smoking abuse at home. -Help parents to improve on monitoring, family communication and family support. -Enhance family bonding and communication skills between parents and their children -Facilitation of appropriate community resources in resolving family problems and addressing youth problem behaviour. Providing families with tools to overcome individual and family risk factors through focused intervention enhancing family interactions and skills building. Materials Instructional booklets, brochures that can be mailed to parents weekly Facilitator manual, participant notebooks and posters and brochures. Video equipment needed for training. Teaching methods Self administration by parents, adolescents and other adult members of the family. Facilitators trained to educate on health promotion methods. Family therapy. There is a high likelihood that this method will be effective in preventing smoking among the adolescents. This method of intervention will mostly work on the younger group, 12-15 as compared to teenagers who are much older, 15-19 (Royal College of physicians of London, 2005). School based smoking cessation programs Strategy/program Description Target group School drug education and awareness Classroom education, support by the teachers, drug information for the parents, community education on drugs and drug abuse, intervention principles and response strategies. All adolescent student Cigarette as poison This includes strategies and tools that can be used to by schools to curb smoking habit or prevent it. These include extra-curriculum activities and moral ethics lessons. All adolescent students Tobacco Prevention activities and accountability framework. 12-15 years. No smoking policy This applies to all, adults and students. No one is allowed to smoke within the school premises. All students and teachers. These are just but a few programs that schools can implement to curb drug use which includes smoking. For such programs to be effective, they should be based around the evidence of factors that lead to smoking abuse. For example, it is important to understand how social influences contribute to drug abuse. As such, schools should use a more interactive delivery method for their cessation programs, the social influence model, use of peer educators rather than relying on adults only, involving the community and incorporate norms and be committed to seeing the program through (Kuhar, 2012). David Beck ham encouraging smoking cessation to young people. Recommendations Few countries have taken the initiative to the successful treatment and prevention of tobacco taken steps by developing a policy meant to curb smoking and addiction to tobacco. There are other nongovernmental organizations also that have taken the initiative to stem the use of tobacco among the teenagers (Lewis, 2010). Supportive environment is of essence to the teenagers who are experiencing addiction. The parents and close family members, teachers and peers should offer their support to those who are going through interventions. Parents especially those who indulge in tobacco use should show their solidarity by quitting smoking also. This will serve as an encouragement to the young people who are struggling with the vice. Schools should include smoking cessation as part of their curriculum. This way, every teenager who goes through the system is able to gain knowledge about smoking and the likely effects. Schools and parents should also use those who have been affected one way or the other, especially those who have been taken ill due to smoking related effects. Such people should be encouraged to talk to adolescents to show them just how dangerous smoking can be. Health promoters should use methods that have an objective of changing the social climate to promote supportive environment. Adolescents should also be encouraged to seek help anonymously to allow them to feel secure about their fears of being judged harshly. This can be achieved by establishment of call centres meant to assist the young people by offering help and guidelines. Reference list Lewis, K. E. (2010). Smoking cessation. Oxford, Oxford University Press. Parkinson, A. (2007). The Layman's guide to smoking cessation. Canton, Mass, Lulu.com. Wewers, M. E., & Ahijevych, K. (1997). Smoking cessation: implementing the AHCPR guideline in clinical practice. [Boston, Mass.?], Medical Information Services. Alters, S & Schiff, W. (2006). Essential concepts for healthy living. Sudbury, Mass: Jones and Bartlett Publishers. Top of Form Pettus, M. (2006). It's all in your head: Change your mind, change your health. Sterling, Va: Capital Books. Fichtenberg, C & Glantz, S. (2002). Effect of smoke-free workplaces on smoking behaviour: systematic review. Bmj, 325(7357), 188. Öberg, M., Jaakkola, M. S., Woodward, A., Peruga, A., & Prüss-Ustün, A. (2011). Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. The Lancet, 377(9760), 139-146. Hales, D. (2010). An invitation to health. Belmont, CA: Wadsworth Cengage Learning. Schmitz, C. M., & Gray, R. A. (1995). Smoking: the health consequences of tobacco use: an annotated bibliography with analytical introduction. Ann Arbor, Mich, Pierian Press. Koop, C. Everett, M.D. (2004). Health Consequences Of Smoking Cardiovascular Disease Report Of The Surgeon General. Diane Pub Co. Owing, J. H. (2005). Trends in smoking and health research. New York, Nova Biomedical Books. Bonnie, R. J., Stratton, K. R., & Wallace, R. B. (2007). Ending the tobacco problem: a blueprint for the nation. Washington, DC, National Academies Press. Donovan, D. M., & Marlatt, G. A. (2008). Assessment of addictive behaviours. New York, Guilford. Viscusi, W. K. (2002). Smoke-filled rooms a post-mortem on the tobacco deal. Chicago, University of Chicago Press. Sloan, F. A., Smith, V. K., & Taylor, D. H. (2003). The smoking puzzle: information, risk reception, and choice. Cambridge, Mass, Harvard University Press. Sloan, F. A. (2004). The price of smoking. Cambridge, Mass, MIT Press. Top of Form Verster, J. C. (2012). Drug abuse and addiction in medical illness causes, consequences and treatment. New York, NY, Springer. Bottom of Form Baumeister, R. F., & Vohs, K. D. (2013). Handbook of self-regulation: research, theory, and applications. New York, Guilford. Royal college of physicians of London. (2005). Going smoke-free: the medical case for clean air in the home, at work and in public places. London, Royal College of Physicians of London. Monti, P. (2012). Adolescents, Alcohol, and Substance Abuse Reaching Teens through Brief Interventions. New York, Guilford Publications. Rosner, R. (2013). Clinical handbook of adolescent addiction. Chichester, West Sussex, Wiley-Blackwell. Wagner, E. F., & Waldron, H. B. (2007). Innovations in adolescent substance abuse interventions. Amsterdam [etc.], Elsevier. Kozlowski, L. T., Henningfield, J. E., & Brigham, J. (2001). Cigarettes, nicotine, & health: a biobehavioral approach. Thousand Oaks, Calif, Sage. Kuhar, M. J. (2012). The addicted brain: why we abuse drugs, alcohol, and nicotine. Upper Saddle River, N.J., FT Press. Reznicek, M. J. (2011). Blowing smoke: rethinking the war on drugs without prohibition and rehab. Lanham, Md, Rowman & Littlefield Publishers. Lapointe, M. M. (2008). Adolescent smoking and health research. New York, Nova Biomedical Books. Jaffe, S. L. (2001). Staff manual for Adolescent substance abuse intervention workbook: taking a first step. Washington, DC, American Psychiatric Press. Diclemente, R. J., Hansen, W. B., & Ponton, L. E. (1996). Handbook of adolescent health risk behaviour. New York, Plenum Press. Breinbauer, C., & Maddaleno, M. (2005). Youth: choices and change: promoting healthy behaviours in adolescents. Washington (D.C.), Pan American Health Organization. Glanz, K., Rimer, B. K., Viswanath, K., & Orleans, C. T. (2008). Health behaviour and health education theory, research, and practice. San Francisco, CA, Jossey-Bass. Top of Form Bottom of Form Bottom of Form Read More