ENHANCING HEALTH AND WELLBEING ACROSS POPULATIONS:
The purpose of this essay is to identify a public health issue related in my field. To facilitate the discussion smoking as a public health issue has been chosen. The holistic impact smoking have on the wellbeing of an individual will be explored. The stage of change model and the Healthy Lives (2010) policy will be explored in relation to smoking.
The rationale for choosing this topic is because smoking is an important public health issue. The smoke is very toxic to every human tissue it touches on its way into, through and out of the smoker’s body (Ewles 2005). Smoking is considered as a health hazard because Tobacco smoke contains nicotine, a poisonous alkaloid, and other harmful substances such as carbon monoxide, acrolein, ammonia and tars.Gorvenment initiatives like the Public Health White Paper, choosing health; Making Choices Easier (DH 2004) will be addressed. The nurse’s role and other professions involved will be highlighted .Confidentiality shall be maintained throughout this essay as prescribed by the Nursing and Midwifery Council (2008). The impact of tobacco smoking on public health extends beyond the direct effects on the individual smoker and their personal health, plus taking into account the effect on their economic, environmental and social effects (Ewles 2005).). Smoking harms nearly every organ of the body thereby causing many diseases, reducing quality of life and life expectancy. Also it has been estimated that in England, 364,000 patients are admitted to NHS hospitals each year due to smoking related diseases which translates into about 7,000 hospital admission per week and 1,000 admissions per day (ASH 2006). In the UK, smoking causes about a fifth of all deaths, approximately 114,000 each year, most of which are premature with an average of 21 years early (Ewles 2005). According to Peto et. al. (2003) cited in Ewles (2005), most premature deaths caused by smoking are Lung and coronary cancer, chronic obstructive heart diseases and coronary heart diseases with 42800, 29100 and 30600 deaths respectively every year. In addition, smoking is known to also bring increased risk of many debilitating conditions like impotence, infertility, gum disease, asthma and psoriasis (Ewles 2005). Research has also shown that non-smokers are put at risk by exposure to other people’s smoke which is known as passive or involuntary smoking and is also referred to as second-hand smoke (SHS) or environmental tobacco smoke (ETS) (Cancer Research 2009).
According to the Oxford Medical Companion (1994) cited in the WHO report on the global tobacco epidemic 2008, “tobacco is the only legally available consumer product which kills people when it is used entirely as intended”. Tobacco is the leading preventable cause of death in the World which causes one in ten deaths among adults worldwide and in 2005, tobacco caused about 5.4million deaths, an average of one death every six second Certain behaviors have been labeled as risky behaviors associated with negative health outcomes among which smoking is and which has been the subject of UK national health strategies (Naidoo & Wills 2005). Smoking causes about one fifth of all deaths in the UK, most of which are premature and has hugely significant impacts on the wider environment and community through causing air pollution, fires, litter and environmental damage (Ewles 2005).
Prevalence of smoking among the low paid groups has been observed to be twice those of the affluent groups because of the great difficulty people in the less affluent groups experience in stopping smoking (Ewles 2005). Tobacco smoking is also widely recognized as a cause of health inequality in the UK because it is common among the deprived groups and also compromises the already poorer health of deprived population such as those that fall within the marginalized groups. Examples are people with mental problems and prisoners, who are more likely to smoke and less likely to have access to mainstream smoking cessation services (Ewles 2005). The Index of multiple deprivation ranks areas from the most deprived to the least deprived and the odds of smoking increases as deprivation in the area increases (The NHS Information centre 2008).
Children smoke for all sorts of reasons. Some smoke to show their independence, others because their friends do while some smoke because adults tell them not to and others do smoke to follow the example of role models. There is no single cause. Parents, brothers and sisters who smoke are a powerful influence. Also is the way it is been advertised and the tobacco companies sponsor sport which makes children want to try it (DH 1998). The problems of smoking during pregnancy are closely related to health inequalities between those in need and the most advantaged. Women with partners in manual groups are more likely to smoke during pregnancy than those with partners in non-manual groups: 26 per cent of women with partners in manual groups smoke during pregnancy, compared with 12 per cent with partners doing non-manual work (DH 1998).
Health promotion is a complex activity and is difficult to define. Davies and Macdowall (2006) describe health promotion as “any strategy or intervention that is designed to improve the health of individuals and its population”. However perhaps one of the most recognized definitions is that of the World Health Organization’s who describes health promotion as “a process of enabling people to increase control over their health and its determinants, and thereby improve their health (WHO 1986).
If we look at this in relation to the nurse’s role in smoking cessation and giving advice to a patient, this can be seen as a positive concept in that with the availability of information together with support, the patient is then able to make an informed decision, thus creating empowerment and an element of self control. Bright (1997) supports this notion suggesting that empowerment is created when accurate information and knowledgeable advice is given, thus aiding the development of personal skills and self esteem.
A vital component of health promotion is health education which aims to change behavior by providing people with the knowledge and skills they require to make healthier decisions and enable them to fulfill their potential. Healthy Lives Healthy People (2010) highlight the vital role nurses play in the delivery of health promotion with particular attention on prevention at primary and secondary levels.Nurses have a wealth of skills and knowledge and use this knowledge to empower people to make lifestyle changes and choices. This encourages people to take charge of their own health and to increase feelings of personal autonomy (Christensen 2006). Smoking is one of the biggest threats to public health, therefore nurses are in a prime position to help people to quit by offering encouragement, provide information and refer to smoking cessation services.
In 2010 the white paper Healthy Live Healthy People set out the government long term policy for improving public health and in 2011 a new tobacco control plan was published (Department of Health 2011). The Whitepaper Healthy Life Healthy People set out a range of measures aimed at preventing people from starting to smoke and helping them to stop, such as banning cigarettes advertising on billboards, in size and action on tobacco intensified (DH, 2011).
WHO defines health promotion a process of enabling people to increase control over and to improve, their health. It implies that the ideology moves beyond a focus on individual behavior towards a wide range of social and environmental interventions. Naidoo and Wills (2010), states ‘health promotion is based on theories about what influences people’s health and what are effective interventions or strategies to improve health.