Etter and Perneger (2000) conducted questionnaires and found that smokers believed it was a fun activity and encouraged sociability and subsequently gave them confidence within the situation and that it has pleasurable and calming affects. Wiltshire, Amos and Haws (2005) however claim that smoking initiation is strongly associated with peer pressure and acceptability. Whereas Powell and Chaloupka (2005) have shown that parental influence on teenager’s decisions to smoke is of high significance. The prevalence was higher if they smoke themselves and was followed by a strict upbringing. This may be a result of the rebelliousness in teenage behaviour (Raby 2002).
Smoking has detrimental affects on health, Benhamou et al (2002) reported that cigarette smoking is related to lung cancer, Hirayama (2000) reported that passive smokers also develop lung cancer. However, research has shown that cigarette smoking is also related to various other forms of cancer including; Mizoue (2000) stomach, bowel and liver cancer, Morabia (2002) breast cancer in women and Cummings et al (2002) increased risk of throat cancer, asthma and bronchitis. Tashkin (2001) reported other chronic diseases such as, heart disease, restriction of arteries, increased blood pressure, heart rate, faster respiration; can all be affected by nicotine inhalation.
Smoking also affects immediate family, friends or the general public, this is known as passive smoking. Passive smoking can produce, as may detrimental effects as it does for the smoker, and in some cases can have worse effects as the smoke in inhaled and not exhaled to the degree that a smoker exhales. Cigarette smoking has also been related to; sudden infant death syndrome (Pollack 2001), Mishra (2000) reported a higher risk of miscarriage. Wisborg et al (2000) reported the increase in cot death with families who smoke indoors, Ponsonpy et al (2002) reported on the effects of smoking around young children causing childhood asthma attacks and Johnson et al (2001) reported on the increased risk of developing lung cancer as an adult if exposed to passive smoke as a child. Olsson et al (2003) added that children’s sense of smell could be affected by passive smoking, as when a study was carried out children from non-smoking families could differentiate between more smells than smoking families. Eisner et al (2001) reported on passive smoking and its effects on asthma to adults. They suggest that the more passive smoke a person is exposed to, through work, their family or social life, the more opportunity they have of developing asthma. Nowak et al (1997) report on the irritation smoke causes to peoples eye’s, both to the smoker and the passive smoker. Peres and Roxen (2001) reported on how non-smokers had fewer headaches than smokers and that passive smokers complained of the most severe headaches. Dicpinigaitis (2003) added that passive smokers could be affected through sore throats and coughs that tend to occur from the chest, resulting from the passive smoke. Dallery et al (2003) added that passive smoking could cause dizziness and nausea. Cook and Strachan (1999) report that passive smoking can cause respiratory disease in children. Janson (2001) added in more severe cases of passive smoking lung function is hindered and a decrease in coronary blood flow has been reported. Whincup et al (2004) have reported how long term exposure to cigarette smoke in a passive condition can lead to a high risk of developing chronic heart disease, Taylor et al (2000) added that passive smokers are also at risk of developing lung cancer.
Interventions
When interventions are considered to enable a smoker to quit, the severity to their addiction needs to be considered. The more addicted or longer the individual has smoked for the harder and longer the withdrawal process may be. The longer abuse of nicotine results in withdrawal symptoms that can be detrimental to the individual psychologically and physiologically. Shiffman et al (2000) reported on the effects of nicotine withdrawal and depression. They concluded that the withdrawal effects of nicotine on the body can be detrimental to mental health and that the best way to stop smoking was to slowly cut down the amount of nicotine intake over time. Pomerleau, Marks and Pomerleau (2000) report on how withdrawal within nicotine addicts can result in increased levels of anxiety and if this cannot be dealt with then they are more likely to relapse. Mayer et al (2001) reported on nicotine withdrawal and its subsequent affects on the addict, they reported an increase in chronic headaches within the first three days of quitting.
Traditional pharmacological methods can be used to aid withdrawal such as nicotine replacement therapy (NRT), which is used to cut down the amount of nicotine intake gradually over time reducing withdrawal effects. Nicotine replacement therapies are available in a number of different varieties; Patches are stuck on an individual’s arm, which contains a semi permanent membrane where nicotine passes into the blood stream. Nasal Spray can offer faster relief from withdrawal as the spray reaches the blood stream faster. Nicotine chewing gum can be used to reduce levels of withdrawal, however the addict needs to keep chewing the gum for a certain length of time and then place the chewing gum under the tongue for a period of time, causing frustration to many addicts and subsequent relapse. Tablets can be used, as prescribed by a doctor in which withdrawal can be reduced. Oral Inhalers and Lozenges can be used to distribute nicotine slowly through the body. The oral inhaler is thought to also cure the addiction of placing the cigarette to the mouth, however if the inhaler is successful in withdrawing from the nicotine the addiction of placing the inhaler or the cigarette to the lips may still occur.
On April 2nd 2007 the Government brought the “no smoking ban” into Wales where individuals are forbidden to smoke in any public space that is over 50% enclosure. Restaurants, bars, clubs and the workplace have now obtained the authority to stop individuals smoking within their facility. Violations of the law can result in a £50 fine to the individual and a fine to the facility. This Law can reduce the risks to passive smokers and may also give smokers a strong incentive to quit.
Social support plays a vital role in quitting behaviours, without the support and encouragement of others withdrawal can be a difficult and in some cases an impossible task. Riggotti (2002) suggests individual counselling can be conducted to change the way individuals think about smoking and focus on the positives and negative aspects of smoking, these should then be prioritised and encouragement made to quit. Zuh et al (2000) believes group therapy is the most effective and can be used to encourage individuals to sit down with other sufferers and talk through feelings and experiences. This can encourage the individual as they wont feel they are going through sensations alone. Talking through problems with other sufferers can provide moral support. Niaura et al (2000) believes that a combination of therapies and pharmacological treatments will have the best outcome. Cognitive behavioural therapy can be used as this centres on the basic idea that emotions are experienced as a result of the behaviours experienced or perceived experience. It focuses on the meaning of the event that triggers the emotion and motive. This can be an extremely beneficial way of treating smoking habits as it focuses on underlying principles also. (Perkins 2001)
As discussed previously lifetime smoker’s start as teenagers and interventions should therefore be aimed towards educating teens before they believe it is cool to smoke. Simons-Morton et al (2001) report on peer pressure, and how it is one of the most common denominators in the initiation of smoking. Campaigns through medias such as magazines and television have been designed and aimed at teenagers as they emphasise short term effects of smoking such as skin effects (spots) and the smell that surrounds a smoker, as these images are important to teenagers. Long term effects don’t seem to effect teenagers as they deny it would happen to them. Educational approaches should address predisposing factors which are motivations to quit, enabling factors which are the skills needed to carry out the action and reinforcing factors including the rewards of the actions as reported by Gatchel et al (1989). De-Vries et. al., (2003) report on the European smoking prevention framework approach (ESFA), which has been targeted at school aged children in order to discourage them from smoking by making them aware of the health risks associated with smoking at a young age. They also aim at training them in peer pressure refusal skills, which may be far more beneficial and effective.
This essay provides an understanding of the effects smoking can have on a person and their surrounding family and friends, the risks associated with smoking were outlined and the stress for interventions. All interventions discussed in the essay have proved successful and should be considered by all smokers in order to enhance their health in both the short term and the long term.
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