Health Promotion and Policy This assignment will look at an 18 year old girl who is two months pregnant, and a smoker. It will be a reflection on a real life situation from practice,

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Health Promotion and Policy

This assignment will look at an 18 year old girl who is two months pregnant, and a smoker. It will be a reflection on a real life situation from practice, so all names and information that could identify the client, will be changed in accordance with the Nursing and Midwifery Council guidelines to protect patient confidentiality (2004). For the purpose of this assignment the client will be called Hannah. Hannah left school at age 15, she lives in a council flat with her parents in Devon, and currently works 16 hours a week in a supermarket. This paper will look at the issue of smoking and smoking during pregnancy, in terms of its epidemiology. The main focus will then be on Health Promotion, and certain models and approaches will be addressed to see what could be useful when trying to promote someone to make a lifestyle change to benefit of their own, and in this case, the health of an unborn child. I will then look at the Government Initiatives and policies surrounding this matter, and any ethical issues that arise from this situation.

        In 2006, Action on Smoking and Health (ASH), released a fact sheet stating that over ten million people in Great Britain smoke, which is almost a quarter of the population. This figure undoubtedly includes a number of pregnant women, and according to a survey carried out by The Information Centre for the NHS, 32 per cent of mothers in 2005 admitted to smoking in the twelve months prior to, or during their pregnancy, and 17 per cent of these mothers confessed to smoking through the full term (2007). This shows that Hannah’s situation is not uncommon among pregnant women throughout the UK. It was acknowledged as an issue by the government, and in 1998 the Department of Health (DOH) set a target to reduce the number of women who smoke during pregnancy, from what was then 23 per cent, to 15 per cent by the year 2010 (DOH 1998).

 Hannah lives in Devon, and according to the statistics shown on the Department of Health website for the first quarter 2006/07, the south west has the second highest number of females who smoke during pregnancy, totalling almost 12 per cent of pregnancies in the area (2007). The British Medical Association (BMA) has made links between smoking during pregnancy, and women’s educational backgrounds, economic and employment status (2004). Certain statistics show that Hannah’s individual circumstances may have put her at risk of becoming a teenage mother who smokes. Both Hannah’s parents smoke, and there is a direct correlation between children and young people starting to smoke, if they live in an environment with smokers (Fergusson et al 2007).  She left school at age 15, and since then has been working in the supermarket. The BMA say women lacking in education are 10 times more likely to smoke during pregnancy, than women who stay in education until the age of 21 (2004). Studies have shown that around 26 per cent of women in unskilled occupations smoke, compared to only 4 per cent of women with professional jobs (BMA 2004). This indicates that Hannah is likely to be in a working environment where she is surrounded by many other smokers, which could make the process of quitting more difficult.

Communication and education are essential tools in helping Hannah to decide upon taking healthy action. From the statistics linking smoking during pregnancy with a lack of education, it is logical to think that Hannah may be unaware of the dangers of smoking to the unborn foetus, and the health professional’s role would be to ensure that Hannah has all the current information. This will allow her to make an informed choice, with an understanding of the risks and consequences this decision may hold (DOH 2007). Finding out that she had become pregnant was a shock to Hannah, and she struggled to come to terms with this, making her worried, anxious, and feel that she wanted to smoke more. This in tern has made her feel guilty as she may be damaging her baby further. Erblich et al (2003) suggest that stressful situations cause smokers to increase the amount of cigarettes they have per day, and this need is further increased if they have direct relations who smoke. This helps us to understand why Hannah feels she needs to smoke more, so by informing her that it is common for smokers to feel their cravings increase during stressful periods, it may help to decrease her guilt and anxiety levels, reducing her cravings and need to smoke.

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As a Health Professional it is important to recognise how a person is feeling about their situation, therefore with a clear understanding of how Hannah is feeling, we can decide on the appropriate manor in which to facilitate a healthy choice. Giving up smoking had not been something Hannah had considered before the pregnancy, and due to her anxiety it would be inappropriate to frighten her with all the possible health risks she may be inflicting on the baby, as well as on herself. Ewles and Simnett (2003) stress the importance of talking to people in a non-judgemental way, ...

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