Affordable healthcare:tobacco smoking - Research Paper Example

? Affordable Healthcare Act: Tobacco Smoking Upon his arrival in 1610, CDC (2007) affirms that John Rolfe tried to farm smokable tobacco but from small-leafed Nicotiana Rustica which was grown by the Virginia Indians and by the time 1612 came, farms of Nicotiana Tabacum were widespread as Rolfe had obtained and planted the large-leafed Spanish Tobacco seed. This large-leafed Spanish Tobacco was a plant that grew in the subtropical region and had a very distinct taste and aroma. This species arrived in England in the year 1613 and received much success. This was the savior of Jamestown colony as the golden-leaf tobacco became their first commodity for export (Zeller, 2007). The settlers used tobacco for quite some time as a medium of exchange and means of payment of wages and salaries and by 1791, one-fifth of American exports was tobacco and its products (Zeller, 2007). Currently, it sits at position seven among other leading American export commodities thus contributing largely to the country’s economy. However, tobacco consumption, mainly through cigarette smoking, has been proved to be a major cause of lung cancer among active and passive smokers, which has resulted in deaths of many American citizens and other people worldwide. Over the years, leading health organizations have tried to address the issue of cigarette smoking but with minimal success. This paper examines the history of tobacco and cigarette smoking, the health issue of cigarette smoking among smokers and non-smokers, and the measures being taken to control the issue of cigarette smoking. In addition, the paper evaluates the nature of the opposing parties and the lobbyists regarding the issue of tobacco consumption. Affordable Healthcare Act: Tobacco Smoking Introduction to Tobacco Researchers have established that pipe smoking tobacco comes in three types; Aromatic, English, and Burley (CDC, 2007). Aromatic tobacco has some flavor that has been added to the leaf, for instance cherry or vanilla. This type of pipe has won over the tobacco faithfulls worldwide despite the fact that it is prohibited in England. Numerous misnomers exist regarding Aromatic tobacco, with some mistaking it for Cavendish. In essence, Cavendish is a cut of tobacco in which the leaf is compressed in layers and small diamond patterns are cut from it. This type of tobacco is found in most English styles of tobacco and many other tobacco blends, hence Cavendish has nothing to do with any tobacco flavoring (CDC, 2007). Secondly, English tobacco is characterized by lack of any flavored additions during the process of curing (Warren, Lee, & Lea, 2009). This type receives its flavor from the type of soil it is grown from and thus named after the place of growth. The curing process is believed to have some changes on the end product, for instance, when a Virginia is dark-stoved, it becomes sweeter and more flavored than the initial product (Warren, Lee, & Lea, 2009). Lastly, Burleys are grown in Kentucky and Tennessee and can be served straight, English or Aromatic. It has very low amounts of sugar providing the smokers with an aroma that is dryer and more flavored than Virginia. Burley is widely used in pipe tobaccos and due to its large consumption; it represents a huge portion of the total world’s tobacco production. The origin of Burley is traced back to Kentucky, USA with other notable growers in Malawi, Mexico and the south of Brazil (CDC, 2007). Burley has very long leaves, ranging from 20-50cm and a color variation of light to dark brown. Harvesting is done once the middle leaves of the plant have dried, which is then dried in the air hence its dry and chocolate like aroma. The strong, full and relatively dry taste of Burley tobacco changes and becomes stronger, to taste almost like a nut when it is roasted in very severe temperatures. This is the same process that is used by coffee makers to bring out the fine taste degrees in coffee (CDC, 2007). A Brief History of Tobacco Timeline (Mackay, Eriksen & Shafey, 2006)  1492 - The Arawak people from Bahamas gifted Christopher Columbus with tobacco during his renowned American voyages. 1556 - Explorers from Europe introduced France to tobacco and spread out quickly to the rest of Europe. 1571 – Tobacco was used by Spanish physicians as medicine. 1584 - While in England, Sir Walter Raleigh is introduced to tobacco by Sir Francis Drake. The two were famous explorers. 1612 – America grows its first commercial tobacco crop. 1619 – First African slaves arrived in Jamestown to till the tobacco farms. 1640 – New Amsterdam, now New York City banned tobacco smoking. The Greenwich Village was famously referred to as the land where tobacco grows. 1661 – Legalization of slavery in Virginia. 1730 – Snuff Mills, the first tobacco factory was opened in Virginia. 1775 – On set of the American Revolution dubbed the tobacco war. Along the Tobacco Coast (Chesapeake Bay), the factors that led to the resistance/revolt were associated with British tobacco taxes. However, tobacco was used to fund the Revolution as it served as security for French loans. 1861 – Tobacco was used with food and drink rations during the Civil War, introducing many northerners to tobacco smoking. In addition, popularity of cigarettes began to grow as tobacco was initially smoked in cigars and pipes. 1864 – The opening of the first cigarette factory in the US. 1917 – Cigarettes were sent to US soldiers in World War I by the Department of War. 1940 – Hitler terms tobacco as a wrath of the red man against the white man for having been given hard liquor and commences the first national anti-tobacco movement in the world which sees him raise taxes on retail prices of tobacco by 90% of the then price. 1987 – Flight passengers of below 2 hours are restricted from smoking by the US Congress 1998 – California becomes the first state to ban cigarette smoking in bars. 1998 – Forty six states agreed to sign and agree with the tobacco industry to settle the lawsuits of the state. Many researchers have not identified the exact date when the use of tobacco came in but evidence dates it to more than 2,000 years ago when the Aztec and Mayan used it for medical and religious purposes (Warren, Jones & Eriksen, 2006). The existence of archaeological evidence in an ancient Mayan vase which shows a dancing scene and smoking skeletons, which was a representation of god of death, which a fine indicator than the ancient people associated tobacco with death. When Christopher Columbus stepped into West Indies in 1492, he documented in his journal about certain leaves (dried) that had a special smell. Subsequently, Rodrigo de Jerez, a Spanish explorer shipped tobacco to Spain. While there, Jerez was imprisoned with the thought that he was possessed by demons due to the smoke that came out of his mouth but was later released only to find the consumption of cigarette vaster than he left it. When John Rolfe and other investors from England began to grow tobacco in Jamestown colony in 1612, the economy of the colonial America was boosted (Warren, Jones & Eriksen, 2006). The tobacco trade had been dominated by the Spanish before his arrival, but this changed as he married a Native American, Pocahontas making her the tobacco’s first poster girl. The two went to England to secure more funds for investment with the marriage bringing a union between the natives and people of Jamestown hence the crop thrived bringing in new settlers and more slaves to work on the farms. More land was allocated to tobacco farmers and as population of the farmers grew, more land for cultivation became a requirement thus the Native American Indians were displaced from their villages (WHO, 2012). The British levied heavy taxes on tobacco and instructed that all tobacco harvested should be shipped back to England. As a result of the heavy taxes, the Revolutionary War began since colonies did not confer with it. The French provided loans to the revolutionists who promised to give back tobacco. Half-way through the year 1800, close to 40% of the colonists had been employed as slaves working on tobacco farms. This led to growth of large billion-dollar tobacco territories by large-scale tobacco farmers like the Duke families and the Reynolds. These collaborated with the Confederacy due to the fear of losing free labor (slaves). Stakeholders in the Opposition of Smoking Bans Over the past few years, anti-tobacco campaigns have taken centre stage where public health policy and legislation have implemented very tight measures to control the consumption of tobacco and make it less attractive to the youth (Warren, Jones & Eriksen, 2006). The US has the Food Drug Administration Tobacco regulation Bill which mandates the US government to control ingredients of products, rule against new commodities, and control the labeling process. In Australia, the toxic contents of all cigarettes must be disclosed, include the health implications of smoking; provide guidance on whom to visit for advice when one wants to quit smoking and a graphic warning. This measures have are subject to adherence and failure to do so has some form of consequence. In addition, inclusion of all the above will mean the company in question will have to incur extra costs, which is a disadvantage to the company as they all want to minimize costs and maximize revenue. According to WHO (2012), the bill also incorporates other measures like restrictions on TV, radio, newspaper and magazine adverts; bans restricting smoking in public areas such as playgrounds, beaches, bars and restaurants; monitoring the sale of cigarettes in the hunt to capture those who sell cigarette and related tobacco products to persons under the age of 18; and restriction of tobacco industries from sponsoring games and arts. Media companies are heavily affected by this bans for they cannot advertize this product which reduces its prospected customers. In addition, WHO (2012) argues that tobacco sponsorships to certain major events like sports and other games has been prohibited which negatively affects the youth’s participation and funding of the events. Smoking bans, like the California ban that prohibited smoking in public areas including bars and restaurants had a massive effect on shareholders in major restaurants, bars and other entertainment/leisure places as they received low incomes from the sale of cigarettes (WHO, 2012). In addition, some of the regular customers had to change their ways as their place of comfort had been tempered with hence reduced sales in other products being sold in the bar and/or restaurant. Another group affected by smoking policies is farmers and workers, who actually make a living from the growing of the crop (farmers) and those workers who work on the farms and cigarette producing industries are likely to lose their jobs as a result of reduced smoking (Zeller, 2007). Hitler, upon realizing that smoking was growing; he implemented a scheme that saw cigarette smokers taxed up to 90% of the then retail price (WHO, 2012). This meant that the government collected huge sums from taxes levied on tobacco and its products, thus, when these policies are implemented, the government authorities collecting taxes record low taxes as a result. Other groups affected by low cigarette smoking include merchants who trade in tobacco and its products, and the people who want to smoke. Cigarette Anti-smoking Campaigners According to Mendez and Warner (2008), cigarette smoking was heavy during World War I and as a result, when the soldiers returned home, they introduced the habit to their friends and families, which grew very fast as most young people saw it as a form of illicit that would attract forgiveness from their parents. This resulted in formation of small groups resisting cigarette smoking but broke down due to minimal support. In 1970, The World Health (2012) asserts that many began to get frustrated by the smoking habit and probable health risks involved with passive smoking of tobacco. The smoke gave some individuals headaches, some coughed while those with respiratory disorders could not enter a smoke-filled environment. This group of non-smokers came together and formed a local organization referred to as Group Against Smoking Pollution (GASP) with a view of limiting public smoking and this resulted in the formation of California Group Against Pollution in 1976 (Mendez & Warner, 2008). Later, the organization was advocating for the statewide implementation of the law but failed twice and decided to pass local ordinances instead which later became Californians for Nonsmokers’ Rights in 1981. Other states grew fond of the success of the law and as a result the organization magnified in 1988 to form Americans for Nonsmokers’ Rights (ANR) (Warner & Mendez, 2010). Through continued efforts of its staffs and members, ANR has largely contributed towards having a smoke free environment. Currently, the World Health (2012) estimates that there are over 3,500 municipalities that have laws prohibiting public smoking. The major players in the fight against smoking are Non-Governmental Organizations who want to see a smoke-free environment for nonsmokers, charities with the same intentions, medical or health organizations that are fighting against cancer and respiratory diseases related to smoking of tobacco. In addition, the government provides funds to these groups who are in the fight to control tobacco consumption in order to protect nonsmokers from unwanted and fatal contact with passive smoke. To achieve this, ANR (Pample, 2008); i. Supports the adoption of policies that prohibit exposure to secondhand smoke. ii. Promotes indoor environments that are smoke free as a norm. iii. Monitors, depicts and counters efforts made by tobacco manufacturers to halt the anti-smoking campaigns. iv. Votes in favor of public health policy measures which influence the tobacco manufacturers. v. Supports possible litigation measures regarding smoking. Present Status of the Anti-Smoking Campaign Many countries worldwide have made sure that all their public areas have laws prohibiting smoking of tobacco, same to American States (Henningfield, London, Pogun & Hammond, 2009). California was the first state in the US to ban smoking in public places, including bars and restaurants. Recently, a US court of appeal rejected a bill that asked tobacco industries to include graphics of health hazards associated with smoking on the top half the packets saying that the images will push consumers into refraining from smoking which would be against the freedom of speech right of the tobacco companies. In addition, the feds have come up with advertisements that are to run on television and radio and in newspapers and magazines for around 12 weeks (Warner & Mendez, 2010). It has been affirmed that watching of the adverts is not mandatory as some graphics are disturbing. All this is to reduce cigarette smokers and discourage those who are planning to start smoking. According to Pample (2008), tobacco smoking is practiced by nearly half of the men’s population while women begin smoking at a younger age as compared to the previous ages. This means that low and middle income earners are the highest consumers of tobacco thus; there is a burning need for policy changes in these nations. These findings are in line with a statement made by the WHO establishing that developed nations can reduce smoking hugely as compared to developing nations, which is usually the opposite of the trend in developing nations. WHO also argues that a continuation of the current smoking trends will result in close to a billion deaths in the 21st century (Henningfield, London, Pogun & Hammond, 2009).  According to Zeller (2007), WHO introduced a policy called MPOWER that is aimed at controlling tobacco consumption around the world. After a successful survey by WHO’s Global Adult, The World Health (2012) established that tobacco dominance in 2010 was about 23.7% and that if the situation remained the same with no additions and subtractions of policies, then the global dominance will reduce to 22.7% and 22.0% in 2020 and 2030 respectively. However, Zeller (2007) argues that implementation of the MPOWER policy in 2010 would mean 100% increment in cigarette prices thus the global tobacco dominance will be 15.4% and 13.2% in 2020 and 2030. This is an indicator that implementation of MPOWER would hugely reduce the number of premature deaths globally (The World Health, 2012). The use of tobacco, especially cigarette smoking is one of the fiercest killer around the world that can be prevented. It is believed that it causes more deaths than a combination of HIV/AIDS, malaria and tuberculosis. The good thing is that the global community is aware of the tobacco situation and is working towards making policies that will see the situation fully contained. In addition, governments and many other NGOs are forming alliances in the fight against tobacco smoking so as to create an environment that is smoke free and culture norm. References CDC (Center for Disease Control). (2007). Best practices for comprehensive tobacco control programs. Atlanta. Henningfield, J. E., London, E. D, Pogun, S., & Hammond, K. S. (2009). Global patterns of nicotine and tobacco consumption. In: Henningfield, J. E, London, E. D, Pogun S., eds. Nicotine Psychopharmacol. Berlin Heidelberg: Springler-Verlag, 3–28. Mackay, J., Eriksen M., & Shafey O. (2006). The tobacco atlas. 2nd edn. Geneva: World Health Organization. Mendez, D., & Warner K. E. (2008). Setting a challenging yet realistic smoking prevalence target for healthy people 2020: learning from the California experience. AJPH, 98:556–9. Pample, F. (2008). Tobacco use in Sub-Saharan Africa: Estimates from the demographic health surveys. Soc Sci Med, 66:1772–83.  The World Health Organization. (2012). MPOWER: A policy package to reverse the tobacco epidemic. Retrieved Sep 24, 2012 at http://www.who.int/tobacco/mpower/mpower_english.pdf Warner, K. E, & Mendez, D. (2010). Tobacco control policy in developed countries: Yesterday, today, and tomorrow. Nicotine Tob Res, 9:876–87. Warren, C., Jones N., & Eriksen M., (2006). Patterns of global tobacco use in young people and implications for future chronic disease burden in adults. Lancet, 367:749–53.  Warren, C., Lee J., & Lea V. (2009). Evolution of global tobacco surveillance system (GTSS) 1998-2008. Glob Health Promot, 2:4–37. WHO. (2012). GATS (Global Adult Tobacco Survey). Retrieved Sep 24, 2012 at http://www.who.int/tobacco/surveillance/gats/en/index.html Zeller, M. (2007). Expansion of non-cigarette tobacco products: Current research and policy implications. Texas. Read More