Services Available for Smoking Consideration

Smoking is as psychological addiction that has adverse health effects (Shiffman, et al., 2014). According to Office of National Health Statistics UK (2017), the year 2015-16 saw approximately 474 reported cases of hospital admission arising out of smoking. UK National Health Service further reported that in the year 2015, there are 79000 smoking related deaths in UK. Thus increase in smoking among the population in UK must be taken into consideration. The following essay aims to highlight how the tendency of smoking is influenced by the social and psychological perceptive and are the services available for smoking considerations.

Services available for smoking consideration

Public Health England, has initiated a campaign named smoke free generation. In order to implement campaign government of UK has drafted several national ambitions which will assist to focus on the tobacco control across the entire UK population. The first ambition is initiating the concept of smoke-free generation where the people should never be encouraged in smoking (Department of Health UK 2017). According to Public Health England, this will help to reduce the smoking among the children and young adults while reducing the inequality gap in smoking prevalence between the manual and routine occupations. The second ambition taken by the Public Health England is to reduce smoking tendency among the pregnant women. The third aim is to give more importance towards smoking related complications among the mentally ill patients than people who are physically ill. The last and the final ambition of smoke-free campaign is to back the evidence based innovations to support quit smoking while maximizing safer alternatives to smoking (Department of Health UK 2017).

UK’s Department of health has also taken 5 years tobacco control plan which has six strands are:

1. Ban in commercial adds that promote cigarette
2. Increasing the cost of price of cigarettes, making it less affordable
3. Regulatory control over the supply and demand of tobacco products
4. Guiding chain smokers and tobacco users to quit using tobacco
5. Reduction harmful effects of passive smoking via banning smoking cigarettes in public places
6. Effective communication towards tobacco control

Government of UK, Department of Health has also introduced E-cigarette (EC) in order to reduce the smoking prevalence. E-cigarettes or electronic cigarettes are battery operated devices which are designed with an aim to mimic the action of the standard cigarette while minimising the toxic effect of nicotine (Etter et al. 2011). According the UK Office of National Statistics (2017), 2.3 million people in UK currently use EC in order to quit smoking. The use of EC was impactful in reducing adult smoking prevalence in UK. According to Government of UK, Department of Health (2017), the prevalence of smoking has fallen considerably in 2016, in comparison to last few decades. Public Health England, evidence review stated that vaping of EC poses minimal risks of smoking and switching from smoking to vaping has substantial health benefits. However, smoking still remains one of the leading causes of premature death and preventable illness and one of the largest causes of health inequalities (UK Department of Health 2017).

UK’s Department of Health 5 Years Tobacco Control Plan

Moreover, ECs has its share of side-effects and comprehensive application of governmental policies faces several barriers specially coming from the manufacturers of cigarettes.

According to symbolic interaction theory, human-begins are motivated via macro-level social institutions, social structures, organizations and meso-level social settings (Reitzes et al. 2010). There lies a difference in the smoking prevalence rate on the basis of age, economic background, marital status, gender and education (details statistics provided in appendix 1). According to Goffman (1959), individuals negotiate with others while staying within the border context of shared sociological meanings, roles expectations and behaviour under specific social settings. Significant other person when smokes influence the tendency of smoking among other person who perceived smoking as an inappropriate behaviour. Here the significant other is the person to whom the individuals give importance and thus may modulates their behaviour. Individuals are also carried away by the breadth or scope of social networks. In context of smoking, more the number of chain smokers in the closed peers, more likely is the tendency to smoke (Reitzes et al. 2010). Goffman also highlighted importance of interactional strategy of selectively engaging in self-presentation in order to protect one’s self-image and positive regard to significant others. In the relation to smoking, self-presentation includes concealing the act of smoking from significant others who condemns the act of smoking. According to Reitzes et al. (2010), having significant other who smokes and hiding smoking from significant other are an amalgamation of  interactional strategies which in turn increases the tendency of smoking while discouraging plans to quit.

Self-efficacy and self-esteem are main pillars that modulate smoking behaviour. Individuals having positive or high self-esteem may consider smoking and its associated adverse outcomes as in-consistent with their urge to enhance and maintain their feeling of self-worth. Thus high level of self-esteem may decrease the frequency of smoking via reducing the short-term desires to smoke. This has long-term motives to view self in a positive way (Reitzes et al. 2010). Moreover, high level of self-esteem may also motivate smokers to take active initiatives in quitting cigarette smoking. High level of self-efficacy also discourages people from smoking. Under high self-efficacy, smoking is considered as a form of dependency, an urge towards self-control and mastery may influence smokers to get rid of the habit of smoking (Reitzes et al. 2010). According to Lawn et al. (2002), cigarettes provide a sense of safety among the smokers and thus the urge to increase the self-efficacy may promote smoking while de-motivating the inner strength to quit smoking.  

Use of E-cigarettes for Reducing Smoking Prevalence

Nature-nature debate states is based on the framework that are the human begins are born as “blank slates”, over which anything can be inked or the destiny of a particular person is sealed even before they are born.

The national smoking prevalence continues to decline in UK but the scenario is not so positive for all the communities and groups across England. According to Public Health England (2017), smoking still remain highest among the groups of population who are the prime victims of poor health backup and other associated disadvantages. According to reports published by the Office of National Statistics UK (2017), there are thrice as many smokers among the lowest earners in society in comparison to highest earners. Office of National Statistics UK (2017), further reported that in 2016, the act of smoking prevalence among the people working as routine or manual labour is double that of people working in managerial posts. Smoking generates an inter-generational cycle of inequality. Under this banner of inequality, children of smokers frequently becomes dependent over tobacco as a result of passive, much before they reach adulthood. According to UK, Department of Health (2017), parent who smokes at least 2 to 3 times a day and likely to have children who will become smokers in the later stages of life. The rate of smoking also differs significantly among the ethnic minority group of UK. However, the people who belong to the LGBT (lesbian, gay, bisexual, transgender) are less likely to smoke in comparison to general population.

The main reason behind the high-prevalence of smoking among the minority group and people who are under poor socio-economic bracket is high level of stress. Stress has a significant negative impact on the mental health (Cooper and Marshall 2013). Stress generates racing thoughts creating imbalance in mental stature and this creates difficulty in concentrating. In to cope up with stress, people take help of smoking (Azagba and Sharaf 2012). Cigarettes contain nicotine, mood altering drug that triggering release of dopamine, generating a feeling of relaxation. However, this feeling of relaxation is apparent and in turn causes high blood pressure (Conrad et al. 2013). Thus, smoking is not a remedy for stress and it in turn increases stress (Folkman 2013).

In European countries, socio-economic inequalities in the statistics of morbidity and mortality rate are attributable to smoking (Tchicaya, Lorentz and Demarest 2016). Substantial evidences highlight that poor people in resource rich country like England carry the load of tobacco related disability and premature death. Moreover, socio-economic inequality is apparent in initiation of smoking for example the risk associated with young person getting addicted with smoking is less prevalent among the privileged groups and same logic goes with smoking cessation or quitting approach. Smoking in under-privileged population can additional health impacts that go beyond the direct adverse affect over health which further exacerbates the health-inequality. According to Hosseinpoor et al (2012), in low socio-economic group, lack of proper financial backup leads to diversion from basic amenities of life like health care, education, quality food, sanitation and proper housing. This lack of proper hygiene further makes them more susceptible to smoking related mortality. The lack of education on the other hand, creates a dearth of knowledge regarding adverse affect of smoking or other cessation program associated with smoking and they continue to smoke to salvage the pain of their unsuccessful life. Moreover, the tendency of smoking further imposes threat of financial crisis as it resist the family from buying fruits and vegetables for the malnourished children and this increases childhood mortality. Thus wealth apart from education is also a significant determinant of smoking risk and health inequality.

Thus from the above discussion it can be concluded that act of smoking is not hardwired before birth. It is the social and health inequality prevalent in UK that increases the tendency of smoking among the population. However, the government of UK is significant steps to reduce the rate of smoking related mortality in UK.

References

Azagba, S. and Sharaf, M.F., 2012.The association between workplace smoking bans and self-perceived, work-related stress among smoking workers. BMC public health, 12(1), p.123.

Conrad, M., Wardle, M., King, A. and de Wit, H., 2013.Relationship of Self?Reported and Acute Stress to Smoking in Emerging Adult Smokers. Journal of clinical psychology, 69(7), pp.710-717.

Cooper, C.L. and Marshall, J., 2013. Occupational sources of stress: A review of the literature relating to coronary heart disease and mental ill health. In From Stress to Wellbeing Volume 1 (pp. 3-23). Palgrave Macmillan UK.

Department of Health UK., 2017. Towards a Smoke-free Generation: A Tobacco Control Plan for England. Public Health England. United Kingdom.

Etter, J.F., Bullen, C., Flouris, A.D., Laugesen, M. and Eissenberg, T., 2011. Electronic nicotine delivery systems: a research agenda. Tobacco control, 20(3), pp.243-248.

Folkman, S., 2013.Stress: appraisal and coping.In Encyclopedia of behavioral medicine (pp. 1913-1915).Springer New York.

Goffman, E., 1959. The presentation of self in everyday life. New York.

Hosseinpoor, A.R., Parker, L.A., d’Espaignet, E.T. and Chatterji, S., 2012. Socioeconomic inequality in smoking in low-income and middle-income countries: results from the World Health Survey. PloS one, 7(8), p.e42843.

Lawn, S.J., Pols, R.G. and Barber, J.G., 2002. Smoking and quitting: a qualitative study with community-living psychiatric clients. Social Science & Medicine, 54(1), pp.93-104.

Public health England., 2017. PHE publishes independent expert e-cigarettes evidence review. viewed 6 February 2018. from https://www.gov.uk/government/news/phe-publishes-independent-expert-e-cigarettes-evidence-review.

Reitzes, D.C., DePadilla, L., Sterk, C.E. and Elifson, K.W., 2010. A Symbolic Interaction Approach to Cigarette Smoking: Smoking Frequency and the Desire to Quit Smoking. Sociological focus, 43(3), pp.193-213.

Tchicaya, A., Lorentz, N. and Demarest, S., 2016. Socioeconomic inequalities in smoking and smoking cessation due to a smoking ban: general population-based cross-sectional study in Luxembourg. PloS one, 11(4), p.e0153966.

UK Office of National Statistics., 2017. Statistics on Smoking, England 2017. England. National Health Service.