At this point it is worth noting the effects of passive smoking on young people. It is estimated that second-hand smoking causes thousands of deaths each year and children are more affected because of their undeveloped bodies.
Second -hand smoking contains 4000 toxic chemicals and non-smokers have the same risk of developing diseases such as heart and lung cancer, as a people who smoke.
The government have put in place many strategies, programmes and plans to help young people to stop smoking. Firstly there is a programme called; The Children and young people's plan.
The aim of the service is for every local authority to identify and address local needs, for example in Westminster this would be: Childhood obesity, Immunisation, Sexual Health and Smoking. The local authorities are accountable to the government and a meeting is held every year to make sure that the needs of young people are being met and addressed. MyAction, is a programme that was set up to help individuals and families to stop smoking, lose weight and eat more healthily.
The programme was put in place to support local people in Westminster to live and change their lifestyle. MyAction was chosen by the borough of Westminster because it was a programme that had been tried and tested in the London borough of Bromley with success. Michael Scott the Chief Executive quotes “ The scheme costs £5 million pounds to put in place, however in the long run it will help save lives and be more cost effective”.
The Government White Paper smoking Kills (DOH 1998) was set up and supported with £100 million pounds to reduce the uptake of smoking. However, young people are still taking up the habit and smoking is on the increase nevertheless The three greatest risks to good health are smoking, obesity and alcohol misuse. It is expected that many lessons will be learned as we research - for example, it will help us make changes to existing and new health services. It will also help us understand our residents better, and can be used for other projects and to address important health issues.
Earlier this year Westminster carried out their own major works asking residents why they smoked, why there were overweight or obese and took part in harmful activities such as drinking. These are the three most preventable causes of death and ill health in the borough and in the UK as a whole. The information will help future works to help improve the people of Westminster.
The nurse may encounter obstacles or difficulties that will impede the progress of these strategies.
- language barrier
- Adolescents are reluctant to talk, wont visit clinics, peer pressure
- Say about health inequalities – some areas are wealthier to provide funding to prevent smokers
" Peer Pressure in older children the smoking habits of friends is important. Going against the group norm is difficult and refusal skills have to be learnt.
" Deprivation children living in poor areas seem to be affected by their environment - how can they afford to by cigarettes?
" Boredom-children who take up smoking are usually bored
" Media - most influential of all apart from parental role - recognise and accept responsibility - role models of actors -
Young smokers are a particularly difficult group to target since they are actively trying to smoke making the role of the nurse a challenging one. (Bullet point)
They hide their smoking from their parents and are least likely to feel the need for support as they do not recognise it as a problem since they are actively trying to smoke - they see it as a 'cool' thing to do. Teenagers see themselves as invincible and they will never become ill. This makes them a hard group to target leading to difficulties relating to nurses involvement.
Hard hitting and relevant information on all aspects of smoking should be available for informed choices to be made. (Outside school)
Parent/child will need to be given full information regarding smoking so they can make an informed choice when the time arises.
School nurses and staff provide support and advice whilst acting as role models. (Within school)
School nurses are able to give advice and educate pupils - staff will act as role models - If they have a good relationship these may well be the first to become aware of the young person smoking or to be told. How they act upon this is fundamental - the need to not loose trust - confidentiality.
Use innovative teaching methods to help young people to develop the skills to resist peer and social pressures to smoke both in primary and secondary schools.
Involve the family and parents in non-smoking education to reinforce classroom teaching (open evenings and discussions).
Provide relevant information on short and long term effects of smoking
Ethical issues that may affect nursing practice need to be considered. Firstly, the age and competency of the child is important. If they are over the age of sixteen years they may not want their parents present or to be involved in discussions. If the child is "Frasier Competent" The nurse need not necessarily inform parents as the child can consent to treatment. But where possible the nurse should try and find out why the child may not want their parents involved. As it has been proven that when parents are involved in their childs welbeing it greatly improves the health of the child. Additionally, confidentiality should be maintained. Young people will consult professionals without wanting their parents to be informed and this should be respected even if the nurse disagrees with the decision. Ellis, Hartley (2004) implies that nurses must understand that, the individual will need to make their own informed choices as a part of the patients' autonomy. Where this right may be compromised is when the child is not Frasier competent ie mentally incompetent.
In conclusion, it is part of your responsibility to be mindful at all times regarding patient confidentiality and privacy in all matters. (Ellis and Hartley, 2004)
Reference List
Asthma – Symptoms,[Online] [Accessed 06.01.2011].
My Action [Online].Available from: http://www.myaction.org.uk/ Accessed23rd
Raikou M, McGuire A. (2007) Preventing the uptake of smoking by children: Review of cost effectiveness. [online] Available from:
http://www.nice.org.uk/nicemedia/pdf/ph14reviewofcosteffectiveness.pdf [Accessed 12 November 2010].
World Health Organisation (2010) Young people: health risks and solutions [online] [Accessed 06.01.2011].
Beauchamp & Childress. (2001) Principles Biomedical Ethics. Oxford: Department of public health and primary care trust.
Department of Health,(1998) Smoking Kills: A White Paper on Tobacco. London: The Stationary Office
Sidey,A & Widdas, D. (2005) Community Children's Nursing. Edinburgh:Elsevier.