The Saudi Arabia Model - Health Promotion Intervention - Essay Example

Educating school age children on ways tobacco companies behave to attract them to smoking behavior, the Saudi Arabia model: A proposal for health promotion intervention Background As a global epidemic, smoking is considered by many countries as a major health dilemma and concern (Saeed, 1996). Many evidence of the unfavorable health effects that tobacco and cigarette use give are overwhelming. However, global effort to combat tobacco companies’ aggressive marketing practices that persuades people from adopting this unhealthy vice, continues to be a herculean challenge and a struggle for many countries. One country that is considered among the largest importer of cigarettes, Saudi Arabia is now currently considered by some analysts with an increasing number of cigarettes and tobacco users (Jarallaha, et al., 1999). At least three out of every ten Saudis smokes (Jarallaha, et al., 1999), where adolescents comprised the large slice of the pie of smokers against those in most industrialized nations (Abolfatouh, et. al, 1997). Concerning school health education, it was noted in studies that Saudi adolescents receive uneven knowledge about the negative effects of smoking cigarettes, but impresses that they have positive attitudes towards public action against this vice. In Saudi Arabia, smoking in education facilities are banned (World Health Organization, 2002). In 2005, the Ministry of Health ratified the World Health Organization’s Framework Convention on Tobacco Control that aims to protect future generations from the perils of exposure and impact of smoking tobacco (Novick, 2005). Saudi Arabia's joining of the treaty comes as part of the government's efforts to protect public health, Al-Bedah said, adding that the treaty would contribute in dissuading children from smoking and helping adults quite the habit. For becoming the 65th participating nation, Saudi Arabia joins in the global effort to impose ban on tobacco advertising, place graphic health warnings on cigarette packaging, step up measures to protect non-smokers from secondhand smoke, raise the cost of tobacco products, and make a firm stand to stop smuggling of tobacco (NCSA, 2007). Efforts aimed at cutting adolescent smoking rates is relevant because this is the age range when smoking often begins. Although many school health and smoking prevention groups have contributed to a substantial decrease in smoking among adolescents, however, school health programmes and intervention arguments are contradictory about their effectivity and stance. To help deciper some of the puzzling problems and implement a health promotion intervention plan, it will be of value to look into the different discourses about health promotion intervenion of experts in this field. Project Goal/Long Term Goal To raise awareness and establish long-term health promotion initiative that will educate Saudi elementary grade students’ about the harmful effects of smoking and protecting the future generation. To train Saudi elementary grade students’s civic involvement in community development initiatives that will seek to maintain smokefree zones in educational facilities, homes and public places. Project Aim To strengthen health intervention programme for the promotion of a smokefree environment among Saudi elementary grade students through programs that will train students’ civic participation and initiative. To incrementally organize mobile smokefree educational missions to the different elementary schools in Saudi Arabia, for a span of six months. Target Group This proposal aims to implement the health intervention initiative using Saudi elementary grade students in the three regions in Saudi Arabia, mostly pre-teens age of 6 to 13 years old. Setting The projected project setting will be the all male Saudi elementary schools in three regions in Saudi Arabia Project Partners Saudi Elementary School Teachers – They will be tapped to provide lessons about the harmful effects of smoking and how children will be made conscious about protecting the future generation. Schools and campuses – The awareness raising campaigns are better held within the confines of the learning instutions and they can help in influencing change among the students, who can also be tapped to assist with the project. Review of Related Literature Saudi Arabia, like most countries, considers smoking among its most pressing health problems including the dilemma facing most school health intervention programmes to pre-teen students (Shiva, 2008). However, several discourses have yielded contradicting results about the sufficiency of evidence on the effectiveness of health programme intervention that will greatly impact people’s behaviour and attitude toward smoking in the long run (Kerr, 2000; Abolfotou, 1997; Wilson, 2008). In their study, Smoking intervention programme for male secondary-school students in south-western Saudi Arabia, Abolfotou and her team (1997) stressed that health beliefs about smoking are regarded to be a major predictor of smoking cessation. Although certain knowledge are learned by Saudi adolescent students about the impact of smoking to health, the findings show that such knowledge is uneven, whereas smokers are less knowledgeable and possess poorer attitude than nonsmokers. This finding was the result of a one-day antismoking programme initiated by the group led by Mostafa Abolfotouh for up to 290 students in a male secondary school in Abha, Saudi Arabia that aimed to change behaviours, knowledge, and attitude. Similarly in New Zealand, smoking prevention education deals with the harmful effects of tobacco use is prescribed in the health and physical education curriculum. Programme activities include interactive teaching of refusal skills, critical analysis of social and media messages, and teaching of life skills. If health education programme may be considered as a way to influence and change attitudes, the same may also be said of information campaigns. However, as is the case most of the time, information campaigns often fail to change attitudes. In their research, Herbert Hymann and Paul Sheatsley (1947) explained that the reason most information campaigns fail is due to the fact that people tend to acquire information mostly about things that they find of interest and tend to avoid information that they have been unavoidably exposed to uninteresting and disagreeable information. The use of major smoking control interventions in New Zealand, as reviewed byWilson, Thomson and Edwards in their study published by the New Zealand Medical Journal (2008), revealed that most of these efforts are still wanting for enhancements to catch up with the OECD guidelines in certain tobacco-control areas. Among the obacco control interventions identified by the social researchers include: 1. Increasing the unit price of tobacco, 2. Controls on marketing, 3. Mass media campaigns, and 4. Smokefree environment regulations. Despite persistent effort effort to meet the tenets of the OECD leaders in preventing smoking, however it is identified that there must be some measures that need to be taken to catch up to OECD leaders in this regard. For example, while effort to increase the tax levels for factory-made cigarettes was meant to increase the rate of smoking cessations, however, the result was that people only transferred to loose tobacco because it is much cheaper. However, smoking prevention education alone will not suffice in ensuring the long-term impact of this effort in educating the pre-teen from smoking, the most crucial stage before most young peeople are initiated to this vice (Walker and Darling, 2007). Realizing that implementing smoke-free education for primary school students alone will not be enough to prevent most young people from trying smoking, the researches identified the need for rigorous programme evaluation and challenges programmes that became acceptable to the population which may not necessarily be effective. In a study titled, Evidence and arguments on tobacco retail displays: marketing an addictive drug to children?, the researchers led by Thomson investigated how a smoke free measure such as banning the use of tobacco displays in New Zealand shops can result positively or negatively the efforts to control smoking among adolescents (Thomson, et. al., 2008). While main arguments used to contradict display bans (e.g., fears of financial losses, claims that tobacco is a normal product, lack of effectiveness of display bans) are meant to be an excuse only to dissed out the programme, however, it does not necessarily follow that arguments in favor of the ban are already consistent or supported by local and international research evidence. However, the study remains an interesting subject worthy of further investigation for being one of the tools use by tobacco companies in promoting a lifestyle of smoking even among the most youngest members of the population. Strategies Based on most smoking intervention initiatives studied in this paper, most of the programme dealt not so much about how the pre-teens must be trained and educated on the basic information about how harmful cigarette or tobacco smoking is to one’s health or how should the young will be groomed to become conscious about protecting the future generation from being initiated in smoking. This paper thus proposes that training should also include developing the civic-mindedness and involvement of the young about how the pervasive marketing and advertising practices of these tobacco and cigarette companies can impact their growth. However serious, training the young about being involved in their society can be achieved through efforts shaped based on the basic faculties of children gradually as they grow toward adolescence. Bayat (2000) noted the rise of such activism as a grassroot non-movement which he termed as the “quiet encroachment of the ordinary”. This concept illustrates a condition that espouses a non-collective direct actions of individuals and families to acquire basic necessities in life, such as land, shelter, urban collective consumptions, informal jobs, business opportunities in a quiet, unassuming manner. The difference with traditional activism with this new emerging activism is that it seeks direct, individual and informal actions. As a result, there is a “pressure from below” that will inevitably create realities that authorities will sooner or later adjust their policies. Had grassroots actions been totally absent, there would have been no change happening in countries where this new activism emerged. Under the proposed strategy, the mobile educational missions will be setup to assist in facilitating fun, educational classes about the importance of inspiring other people, such as members of the family to quit or at least stop smoking when there are children around. The facilitators, such as teachers, will have to use modules targeted to be appreciated and comprehended by school children based on their years in school or age bracket. Strategies are proposed to be comprised of the following actions: Policy mapping with the different educational facilities and locating partners who can assist the project (from non-profit, media, to government areas) Establish partnership with learning institutions or media networks that espouses kid-friendly programming to provide the media exposure needed by such program to gain popularity and finally understanding among the people in order to boost reinforcements from volunteers and help from outside sources (community, learning sectors, etc.) Mobile Learning Mission Carts or Tents will be constructed and will be situated in schools and used as a common fixtures in schools, to draw attention, curiosity and excitement and fun. Develop a website that will house and document activities, progress and the mission statements of the project. This way, it can also be one of the means for interested people to reach the organizing committee of the project. Create key partnerships with teaching professionals in the community and involving them to support the project even by giving at least a day’s worth of their service to the community. The volunteerism is expected to generate civic involvement of these people as well, hence a domino-effect of civic impact will be established. As a token of appreciation, the names of individual participants and organizations will be included in a report that will be published online. Evaluation The success of the project can be evaluted based on the following evaluation measures: Mileage or the exposure the project will generate from the media to the online space (blogs, social media networks, etc.) Publications citing the project in journals and other forms of credible media. Interview of testimonial videos of the participants, especially the children who will take part during the course of their involvement with the programme. References Abolfotouh, M.A., Mostafa, A.A., Badawi, I.A., & Alakija, W. (1997). Smoking intervention programme for male secondary-school students in south-western Saudi Arabia, vol. 3, issue 1, 1997, 90-100. Retrieved: http://www.emro.who.int/publications/emhj/0301/11.htm Bayat, A. 2000,‘Social Movements, Activism and Social Development in the Middle East’, Programme Paper, number 3, retrieved 17 August 2009, United Nations Research Institute for Social Development online. BBC News. (2006 November 25). Saudi Warning Over Tobacco Firms Cigarette. BBC Online. Retrieved on 4th, Oct, 2009 from: http://news.bbc.co.uk/2/hi/business/6194972.stm. Jarallaha, J.S., Al-Rubeaanb, K.A., Rahman, A., Al-Nuaimb, A., Atallah, A.A., & Kalantana, A. (1999) Prevalence and determinants of smoking in three regions of Saudi Arabia, Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia, b Endocrinology Division, Department of Medicine. Retrieved: http://tobaccocontrol.bmj.com/cgi/content/abstract/8/1/53 Jarallah, J.S., Al-Rubeaan, K.A., Al-Nuaim, A.R.A., Al-Ruhaily, A.A. and Kalantan, K.A. (1999). Prevalence and determinants of smoking in three regions of Saudi Arabia. Tobacco Control, 8, 53-56. Kerr, J. (2000). Community Health Promotion: Challenges for Practice. 26th ed, New York, USA: Elsevier Health Sciences. National Center for Addiction and Substance Abuse (NCASA).(2007). Saudi Arabia Sues Tobacco Industry for Billions in Health Costs. Retrieved on 5th, Oct, 2009 from: http://www.jointogether.org/news/headlines/inthenews/2007/saudi-arabia-sues-tobacco.html NHMRC. (2002). Summary Statement on Consumer and Community Participation in Health and Medical Research. Commonwealth of Australia. 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