Health Promotion Methods for Smoking Prevention and Cessation | Questions and Answers

Public Health in Relation to Smoking Prevention


  • Introduction to this health subject
  • Epidemiology: Why smoking is a public health issue
  • Public health policy relevant to smoking
  • The implication of public health policy on community nursing practice: Local and National Initiative
  • Professional responsibilities according to the Code (NMC 2018)
  • Conclusion
  • Reference List

What is Smoking

  • Smoking is the inhale and exhale of smoke from burning cigarettes, cigars and pipe tobacco (Institute of Medicine (US) committee (2010).
  • Smoking as a health issue is one of the biggest threat with its impact going beyond direct effect on the individual smoker and their personal health and wellbeing. NHS Digital (2018)

Smoke Epidemiology

  • The leading cause of preventable death
  • Almost 7 million deaths every year worldwide caused by tobacco smoking including second-hand smoke (WHO, 2018)
  • Around 7.6million of the population in UK smokes (ASH, 2018)
  • Over 7 thousand death in the UK (NHS Digital, 2018)
  • Leading cause of lung cancer, cardiovascular disease, and chronic obstructive pulmonary disease (NICE, 2013)
  • 474,000 hospital admissions were related to smoking. (NICE, 2018)
  • Smoking costs England £12.9billion annually and NHS estimate of £2.5 billion (ASH, 2017)


Smoking Mortality

  • Globally: Currently death toll of 7million a year expected to rise to 10million a year by 2030
  • (WHO, 2016; ASH, 2018)
  • Nationally: In 2016 there were 77,900 deaths due to smoking in the UK, a decrease from 79,100 in 2015 and 83,400 in 2006, a reduction of 2% and 7% respectively (Office of National Statistic, 2018; NHS Digital, 2018)
  • This figure represents 16% of all deaths, thus a decrease from 18% in 2006 and 33% of deaths for conditions caused by smoking (NHS Digital, 2018)
  • Locally: Between 2014 -2016 Manchester had the highest death rate of 499 per 100,000 population followed by Kingston upon Hull with 470 (NHS Digital, 2018)
  • Lowest death rates were in Harrow and Wokingham and Rutland with a rate of 262, 181 and 184 respectively (NHS Digital, 2018)

Smoking Prevalence

Smoking prevalence in England has reduced from 19.8% in 2011 to14.9% in 2017

Public Health England, (2018)

National Health Policy

  • Smoke-free generation: tobacco control plan for England (Department of Health, 2017)
  • Aimed at:
  • Reduce smoking among adult, young people and pregnant women.
  • Reduce health inequalities in areas where smoking rates remain high.
  • Parity to esteem for those with mental health conditions.
  • The use of evidence-based innovations to support quitting.
  • Smoke-free England by 2022.

Action to be taken

  • Prevention first
  • Supporting smokers to quit
  • Eliminating variation in smoking rate
  • Effective enforcement
  • Department of Health, (2017)

Source: Public Health England, 2018

Implication of Public Health Policy on Community Nursing Practice

Medical>> Empowerment >> Educational >> Social >> Behavior Change

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Local and National

  • Medical or Prevention Approach: Smoking cessation services which include nicotine replacement therapy (NRT), e-cigarette and drugs, referral to NHS stop smoking service, support individual work through any smoking cessation pattern chosen, monitoring cessation and preventing relapse.
  • Behaviour Change: Motivate and persuade an individual to make changes in their lifestyle for their health. This includes face-to-face/ group counselling, Stoptober campaign.
  • Educational: Raise awareness of health implication of smoking through advice, counselling, leaflets, booklets and visual display on the benefit of cessation.
  • Empowerment: Encouraging and working with individual and communities to gain skills and confidence that will change their health.
  • Social change: Aimed to bring physical, social and economic environment for the positive effect to individuals

Professional Responsibilities to Public Health



  • Early intervention- prevention ill-health recognising those most at risk, health promotion and meeting the changing health and care needs of individuals and their communities.
  • Working in partnership with the patient – their families and communities using verbal and non-verbal communication means.
  • Provide integrated care based on best evidence and focused on prevention, health promotion and support self-care.
  • Support individuals to access relevant health and social care, information and support needed for their health and wellbeing.
  • To keep up to date of continuing professional development to ensure competence, safety and evidence-based practice
  • To be culturally sensitive in understanding and responding to the individual’s personal and health needs
  • To integrate care through effective communication with colleagues and healthcare professionals

(NMC, 2018)

Tannahill’s Model of Health Promotion

  • Health Education
  • Prevention
  • Health Protection

Tannahill’s, (2009).


  • The role of a community nurse is necessary for reducing the prevalence of smoking.
  • Focuses on early intervention, prevention and health promotion using skills and knowledge to improve the health and wellbeing of individuals and communities
  • Although smoking rates continued to decline, the harm remains high causing health damage.
  • Lifestyle choices, behavior change and self-control which promote positive health are essential for smokers to overcome smoking.
  • Nurses have the responsibility to educate individuals/communities, be an agent of change and make every contact count.
  • Smoke-free generation is a change that should be embraced by all and sundry.


  • Action on Smoking and Health (2017) the Economics of Tobacco. Available at: (Accessed: 8 March 2019).
  • Action on Smoking and Health (2018) Smoking Statistics. Available at: (Accessed: 8 March 2019).
  • Department of Health (2017). Towards a Smoke-free Generation- A Tobacco Control Plan for England. Available at: generation-tobacco-control-plan-for-England (Accessed: 31 March 2019).
  • Institute of Medicine (US) Committee (2010) Second-hand Smoke Exposure and Cardiovascular Effects: making sense of the evidence. National Academies Press (US): Washington (DC)
  • Naidoo, J.and Wills, J. (2009) Foundations for Health Promotion. Edinburgh: Bailliere Tindall Elsevier
  • National Institute for Health and Care Excellence (2013) Smoking: Harm reduction. Available at:
  • (Accessed: 04 March 2019).
  • National Institute for Health and Care Excellence (2018) Stop Smoking Interventions and Services. Available at: (Accessed: 10 March 2019).
  • NHS Digital (2018) Statistics on Smoking – England 2018. Available at: information/publications/statistical/statistics-on-smoking/statistics-on-smoking-england-2018/part-1-smoking- related-ill-health-and-mortality (Accessed: 9 March 2019).
  • Nursing and Midwifery Council (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. Available at: (Accessed: 27 March 2019) .
  • Office for National Statistic (2018) Adult Smoking Habits in the UK: 2017. Available at: (Accessed: 29 March 2019).
  • Public Health England (2018) Turning the tide on tobacco: Smoking in England hits a new low. Available at: the-tide-on-tobacco-smoking-in-England-hits-a-new-low/ (Accessed: 25 March 2019).
  • Tannahill, A. (2009) ‘Health Promotion: the Tannahill model revisited’ Public Health, 123(5), pp. 396-399. doi:

World Health Organisation (2016) Health Statistics and Information System.

Available at: (Accessed:29 March 2018).

World Health Organisation (2018) Tobacco. Available at: (Accessed: 04 March 2019).