Explanation of Smoking among Adolescents and the Influence of Psychosocial Factors - Essay Example

?Running head: PSYCHOSOCIAL FACTORS AS TO WHY ADOLESCENTS SMOKE Psychosocial Factors as to why Adolescents Smoke Insert Insert Grade Insert Tutor’s Name 26 March 2012 Psychosocial Factors as to why Adolescents Smoke Introduction Smoking cigarette has been identified as a problem facing many countries and as one of the main preventable causes of cancer, heart disease, and premature death (Rezaei, Nedjat, Golestan and Majdzadeh, 2011; Lapointe, 2008).Tobacco consumption is responsible to many cases of premature mortality and morbidity in different countries of the world. For example, it has been estimated that about 5.4 million people die from tobacco related diseases every year (Rezaei, Nedjat, Golestan, and Majdzadeh, 2011). At the same time, it has been established that, if the current trends in tobacco consumption does not change, high possibilities point to a situation whereby, 8 million lives will be lost annually by the year 2030 due to tobacco consumption (Rezaei, Nedjat, Golestan and Majdzadeh, 2011). Demographic factors such as age, gender, social class, race, and ethnicity, and many more may explain as to why many people smoke (Mercken, Snijders, Steglich, Vertiainen and Hein, 2010). Many factors explain why adolescents smoke and the primary objective of this study will be to identify and discuss psychosocial factors that lead adolescents into smoking tobacco. Adolescents and Smoking in United Kingdom By the year 2011, it was estimated that adolescents in England who start smoking every year numbered 340,000 aged below 16 years, and these adolescents have never smoked before (Action on Smoking and Health, 2011). At the same time, it has been found that every year, about 200,000 adolescents and children become regular smokers, and 67 per cent of these adolescents start smoking before they reach 18 years. Furthermore, 84 per cent start to smoke before they reach age 19 years. However, studies have shown that, on overall, the number of young people who smoke has been declining, and this may be attributed to many campaign initiatives aimed at increasing awareness and changing adolescents’ behaviour with regard to smoking. With regard to how frequent adolescents are likely to smoke in the country, especially in high schools, it has been established that many adolescents are regular smokers, since they are likely to smoke at least one cigarette per week. As a result, statistics of 2010 indicate that regular smokers among the adolescents smoked a mean (average) of 38.3 cigarettes in one week, while occasional smokers were found to have smoked an average of about 5.2 cigarettes a week (Action on Smoking and Health, 2011). With regard to gender and relation to adolescents smoking, it has been established that, for a long time now, girls as compared to boys are likely to be regular smokers and to have smoked more cigarettes than boys. On overall, the prevalence of regular smoking increases with age, from less than 0.5 per cent of 11 year olds to 15 per cent of 15-year olds (Action on Smoking and Health, 2011). At the same time, other studies have been carried out to establish factors and prevalence of adolescents smoking in United Kingdom and Scotland. For example, one such study has been carried out by Edinburgh Study of Youth Transitions and Crime in 2004. The report titled, ‘Adolescent Smoking, Drinking, and Drug Use’ found out that numerous factors are likely to lead adolescents to start smoking and persist with the behaviour (McVie and Bradshaw, 2005). Key findings of the report indicated that tobacco consumption was much prevalent among the adolescents aged between 12 and 15 years; and among the adolescents aged 13 to 14 years, the increase in consumption of tobacco was drastic and sharp (McVie and Bradshaw, 2005). At the same time, the study found out that, girls as compared to boys were likely to be consumers of tobacco and were likely to start such behaviours at age of 13 years. Moreover, among the adolescents who were found to be smokers, it was established that some had started such behaviours much earlier when they were children, and all indications showed that they were likely to continue with such behaviours in their future lives. In addition, the report found out that, adolescents who smoked tobacco were likely to abuse other drugs as well, such as alcohol and illicit drugs (McVie and Bradshaw, 2005). The three aspects were found to relate to each other. It has to be noted that majority of these adolescents start smoking habits as one-off affair, but many end up progressing with the habit, and with time, majority of them become addicted to the use of tobacco (McVie and Bradshaw, 2005). Lastly, majority of adolescents interviewed during the study indicated that those who smoke, especially the regular smokers, were likely to suffer from delinquency and victimization, higher impulsivity, and low self-esteem, greater involvement in unconditional activities, weaker parental supervision, and stronger peer influence (McVie and Bradshaw, 2005). On the other hand, Action on Smoking and Health (2011) establishes that, smoking, especially among adolescents, is motivated by numerous factors that can be termed as risky. These factors include parental and sibling smoking, the little problems incurred while obtaining cigarettes, smoking by friends and peer group members, socio-economic status, exposure to tobacco marketing, and depictions of smoking in films, television, and other media (Action on Smoking and Health, 2011). The home environment has been established to be the major contributor in adolescents smoking whereby, more adolescents who live with parents or siblings who smoke are up to 3 times likely to become smokers themselves than children from non-smoking households (Action on Smoking and Health, 2011). As a result, every year, about 23,000 adolescents start smoking behaviour at the age 15 years largely as exposure to smoking in the home (Action on Smoking and Health, 2011). Apart from other drugs playing role in the likelihood of adolescents becoming tobacco smokers, it has been established that adolescents who are largely truant with regard to schooling have greater chance of becoming regular tobacco smokers. For instance, those in school but largely seen to be truant have been found to be two times more likely to be become regular smokers, while those totally out of school have been found to be three times more likely to become regular smokers (Action on Smoking and Health, 2011). Moreover, there have been attempts to carry out studies aimed at establishing the impact of smoking, especially at young age. Majority of evidences indicate that, when adolescents start smoking at an early age, they are likely to be heavy smokers, likely to highly depend on others, exhibit low chances of quitting, and have higher mortality rates (Action on Smoking and Health, 2011). Therefore, smoking among adolescents is likely to result into long-term effects. With regard to health impact, smoking among the adolescents has been associated with respiratory health problems, manifesting in short and long term. For instance, adolescents who smoke regularly are likely to be two to six times more susceptible to coughs and increased phlegm, wheeziness, and shortness of breath as compared to those who do not smoke. At the same time, according to studies carried on adolescents and children who smoke especially regular smokers, it has been established that majority are likely to suffer from lung impairment, which limits growth, and at same time, initiate premature lung function. Decline or dysfunctional lung results into increased risks of chronic obstructive lung cancer later on in the life of the victim. Theories Explaining Smoking Behaviours among Adolescents Smoking behaviours among the adolescents has been associated with numerous factors, which can be captured well in a number of theories or models (Luce, Smelser and USA-National Research Council, 1989). Simonich (1991) observes that, theories that explain why people smoke can be categorized into two broad groups: cognitive and con-cognitive theories (Gochman, 1997). Cognitive theories postulate that, individuals are likely to smoke based on the knowledge, perception and beliefs of the individual concerning particular behaviour or issue. On the other hand, non-cognitive theories state that an individual decides to smoke based on factors that are outside or external to his or her control (Gochman, 1997). As a result, cognitive theories can be seen to be based on individual’s consideration of what is right or wrong as a result of individual’s cost-benefit analysis. Therefore, an individual is likely to smoke based on personal conviction that smoking is right for him or her, not as explained or expressed by others but as personal intuition convinces the individual. Cognitive theories go further to indicate that smoking among individuals such as adolescents can be discouraged or minimised by adopting and implementing interventions that increase victim’s awareness of the negative consequences of smoking. Such negative consequences of smoking that may be highlighted include the dangers of smoking, higher cigarette prices, restrictions on the time and place of smoking, and emphasis on the positive aspects of smoking (Gochman, 1997). On the other hand, con-cognitive theories posit that smoking among adolescents or any other group is not voluntary, but emerges from factors that are beyond control by the individual. In such cases, an individual is seen to be in dire need of help from external sources. For instance, some theories in this group have linked smoking to nicotine addiction, which of course did not originate within the individual but originated outside. Outside sources for such nicotine addiction may be from peer influence, cigarette advertisement, and other powerful sources (Gochman, 1997). As a result, it has been observed that, apart from carrying educational and awareness campaigns to reduce level of addiction, there is need to do much in preventing people from smoking at the initial stage when they start (Gochman, 1997). From the above analysis, two prominent theories have emerged, which explain smoking behaviours among the adolescents. The two theories are social cognitive theory and the problem behaviour theory. Social cognitive theory postulates that, manifestation of any kind of behaviour is likely to be associated or linked to personal factors such as self-efficacy, family environment and also the school environment (Ando, Asakura, Ando and Simons-Morton, 2007). As a result, adolescents who interact or associate with smoking peers or friends have high chances of being influenced by the friends and later become smokers (USA-Institute of Medicine, Stratton, and Wallace, 2007). In other words, the peers act as role models, make availability of cigarettes easy, coerce their friends into the habit, and many more. On the other hand, behaviour theory postulates that, adolescents who largely experiment with smoking are likely to meet other adolescents in similar activities or behaviours, and the continued pattern of contact and interaction is likely to influence them into smoking or consuming tobacco and other hard drugs (Ando, Asakura, Ando, and Simons-Morton, 2007). Psychosocial Factors Related to Adolescent Smoking Behaviours Smoking behaviours among the adolescents in United Kingdom, just like in any other region of the world, can be explained using psychosocial factors that have been identified and studied over time. It should be noted that, the studies on the psychosocial factors have produced diverse results across societies, gender, and even age. Therefore, there is likelihood that differences may be witnessed or observed as far as factors of psychosocial in relation to smoking among adolescents is concerned (Neinstein, 2007). DiClemente, Hansen, and Ponton (1996) observe that tobacco consumption among adolescents is likely to be caused by factors such as socio-demographic, environmental, behavioral, and personal factors, which combine to form psychosocial factors. These are factors seen to increase or explain how adolescents are likely to start smoking behaviours and continue with such behaviours, hence experiencing the adverse health effects of continued use. Furthermore, the author has observed that psychosocial factors can be conceptualised on a continuum of proximal and distal factors (DiClemente, Hansen and Ponton, 1996). What the author means by these terms is that, personal and behavioral factors have a direct and immediate role of affecting adolescent’s choice to use tobacco and as a result, the factors are considered proximal (DiClemente, Hansen and Ponton, 1996). On the other hand, distal factors constitute environmental and socio-demographic conditions and influences perceived to affect consumption of tobacco among individuals in an indirect manner (DiClemente, Hansen and Ponton, 1996). It has been found out that distal factors such as the impacts originating from advertisement may in one way or the other influence proximal factors such as the perceived benefits of smoking and as a result, be able to influence use of tobacco among the adolescents (DiClemente, Hansen and Ponton, 1996). Elders (1997) investigates psychosocial factors that contribute to adolescents smoking behaviours and notes the following observations. According to the author, socio-economic status (SES) constitutes an important risk factor with regard to smoking behaviours among the adolescents. For example, adolescents from lower-SES have been found to be at greater risk of starting smoking behaviours as compared from adolescents in the higher-SES (Elders, 1997). Some of the notable reasons for this have to do with inability of adolescents from lower-SES to access opportunities of health development, while lack of parental supervision may be high in this socio-economic category (Elders, 1997). Another risk factor identified has to do with gender, and just like socio-economic factors, gender explains varied smoking behaviours among the adolescents, with some studies indicating existence of no difference, while other showing clearly that boys and girls differ with regard to smoking. Recent studies have pointed to the fact that, smoking among girls is more established and prevalent than among boys. As a result, girls are likely to persist with their smoking behaviours as compared to boys. At the same time, race and ethnicity have been investigated and found to be risk factors contributing to differences among adolescents consuming tobacco (DiClemente, Hansen and Ponton, 1996). In a related study, Conrad et al. (1992) carried out an intensive and detailed research work that involved review of 27 prospective studies detailing the onset of smoking (DiClemente, Hansen and Ponton, 1996). According to the author, adolescents were likely to embrace smoking behaviours due to aspects such as peers, friends, and siblings. Moreover, these aspects are considered proximal environmental factors. Influence of peers and friends in smoking behaviour among the adolescents is seen to be exceptionally strong during the preparatory, trying, and experimentation stages, as well as during the regular use and addiction stages; personal pharmacological may also be important contributing factor (Wagner, 2000). To add on the proximal environmental factors, parental smoking has been identified as another strong factor explaining the smoking behaviours among the adolescents (Thirlaway and Upton, 2009). This has especially been noted among the white and female adolescents, especially during the early stages of smoking. Related studies carried out indicate that parental smoking behaviour may lead to related factors such as approval or disapproval of smoking behaviours by the parents, parents taking time to get involved in the lives and supervision of adolescents, parents taking time to communicate health related issues to their children regarding smoking, and also parents taking time to promote academic achievement for their children (DiClemente, Hansen and Ponton, 1996). Furthermore, proximal factors may also constitute and explain variety of behavioral factors that may contribute smoking behaviours among the adolescents. For instance, detailed investigations have been done and findings show that, smoking is positively associated with alcohol and other related drug use (Columbus, 2008). In addition, studies by Newcomb and Bentler (1986) indicated that, risk-taking and rebellious behaviours are likely to indirectly influence smoking behaviours among the adolescents (DiClemente, Hansen and Ponton, 1996). Other activities in this category may include involvement in peer groups at relatively early age. On the other hand, those behaviours likely to reduce levels of smoking among adolescents, which authors have identified, include academic achievement, involvement in sports, healthy eating and physical activity patterns, and acquisition of skills to resist offers of cigarettes (DiClemente, Hansen and Ponton, 1996). At the same time, attempts have been made to investigate personal factors related to smoking and evidence shows that, such personal factors and attributes have proximal and direct influence on the decision individual makes regarding smoking behaviours (DiClemente, Hansen and Ponton, 1996). For instance, Conrad et al. (1992) found out that, adolescents who present themselves to lack positive self-image and exhibit to have lower self-esteem are likely to start smoking as compared to adolescents with aspects opposite to these (DiClemente, Hansen and Ponton, 1996). Although greater studies have been carried out on other factors such as: depression, helplessness, aggression, pessimism and inability to consider future consequences, there has been no succinct evidence to show how and to what extend the factors are related to smoking behaviours among the adolescents (DiClemente, Hansen and Ponton, 1996). In another study which seem to give reinforcement to already studies that have been conducted and discussed, Tyas and Pederson (1998) conducted a review of literature concerning adolescent smoking and came up with numerous psychosocial factors that contribute or enhance smoking behaviours among the adolescents. According to the author, psychosocial factors can be categorized into four groups of elements that are likely to give rise or motivate adolescents to smoke. The first category has socio-demographic factors, where prominent identified factors likely to influence smoking among adolescents include age, gender, ethnicity, acculturation, and family structure, socio-economic status of parents, individual income, and urban and rural residence (Tyas and Pederson, 1998). The second category has environmental factors and here, prominent factors include smoking habits of parents, attitudes exhibited by parents, the smoking behaviours among siblings, friends and peers who are smoking, attitudes, and norms of the friends, availability of tobacco, the general environment of the family, and one’s attachment to family and friends (Tyas and Pederson, 1998). The third category involves behavioral factors that include factors to do with schooling, risk behaviour and factors that characterise lifestyle of the individual (Tyas and Pederson, 1998). Lastly, there are personal factors such as stress, coping strategies and behaviours, depression, self-esteem, attitudes expressed by smokers, knowledge about effects of smoking and personal health concerns (Tyas and Pederson, 1998). Conclusion One phenomenal which has become notable in modern world is that, many young people, especially adolescents experiment with smoking and this in turn results into regular smoking behaviours which leads to addiction if early treatment is not initiated. As compared to adults, adolescents around the world have been found to consume tobacco in large quantity and prevalence of tobacco consumption in this age group is high. Evidences as established in the paper show that, adolescents who smoke are likely to experience problems of physical growth and the age at which majority of adolescents starts smoking generally affect their health in older ages. At the same time, addiction has been associated with those who start smoking at an early age, and this shows that, once adolescents’ starts smoking habits, they are likely to continue with the behavior into their adulthood. Despite effort being increased of finding best strategies to deal with smoking among adolescents, evidence shows that prevalence of smoking is still high and this calls fort more studies to be conducted in order to come up with effective programmes to implement. References Action on Smoking and Health. (2011). Young People and Smoking. Retrieved from http://ash.org.uk/files/documents/ASH_108.pdf. Ando, M., Asakura, T., Ando, S., & Simons- Morton, B. G. (2007). Psychological Factors Associated with Smoking and Drinking Among Japanese Early Adolescents Bys and Girls: Cross-sectional Study. BioPsychoSocial Medicine, Vol. 1, No. 13. Retrieved March from http://www.bpsmedicine.com/content/1/1/13. Columbus, A. M. (2008). Advances in Psychology Research. NY: Nova Publishers. DiClemente, R. J., Hansen, W. B., & Ponton, L. E. (1996). Handbook of Adolescent Health Risk Behaviour. NY: Springer. Elders, M. J. (1997). Preventing Tobacco Use among Young People: A Report of the Surgeon General. NY: DIANE Publishing. Gochman, D. S. (1997). Handbook of Health Behavior Research. NY: Springer. Lapointe, M. M. (2008). Adolescent Smoking and Health Research. NY: Nova Publishers. Luce, R. D., Smelser, N. J., & USA-National Research Council. (1989). Leading Edges in Social and Behavioral Science. NY: Russell Sage Foundation. McVie, S., & Bradshaw, P. (2005). Adolescent Smoking, Drinking and Drug Use. The Edinburgh Study of Youth Transitions and Crime. Centre for Law and Society, The University of Edinburgh. Retrieved from http://www.law.ed.ac.uk/cls/esytc/findings/digest7.pdf. Mercken, L., Snijders, T. A., Steglich, C., Vertiainen, E., & Hein, D. V. (2010). Smoking-based Selection and Influence in Gender-segregated friendship networks: A social Network Analysis of Adolescent Smoking. Addiction, Vol. 105, No. 7, pp. 1280-1289. Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=6&hid=107&sid=c57350ee-b23d-428b-a746-a74d600930d0%40sessionmgr113. Neinstein, L. S. (2007). Adolescent Health Care: A practical Guide. PA: Lippincott Williams & Wilkins. Rezaei, F., Nedjat, S., Golestan, B., & Majdzadeh, R. (2011). Comparison of Onset Age and Pattern of Male Adolescent Smoking in Two Different Socioeconomic Districts of Tehran, Iran. International Journal of Preventive Medicine, Vol. 2, No. 2, pp. 224-228. Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=6&hid=107&sid=c57350ee-b23d-428b-a746-a74d600930d0%40sessionmgr113. Thirlaway, K., & Upton, D. (2009). The Psychology of Lifestyle: Promoting Healthy Behaviour. MA: Taylor & Francis. Tyas, S. L., & Pederson, L. L. (1998). Psychosocial Factors Related to Adolescents Smoking: A Critical Review of the Literature. Tobacco Control, Vol. 7, pp. 409-420. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1751465/pdf/v007p00409.pdf. USA-Institute of Medicine, Stratton, K. R., & Wallace, R. B. (2007). Ending the Tobacco Problem: A Blueprint for the Nation. NY: National Academies Press. Wagner, E. F. (2000). Nicotine Addiction among Adolescents. NY: Routledge. Read More