Public Health in Relation to Smoking Prevention
Content
- 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
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
- HEALTH PROMOTION
- INTEGRATED CARE
- COMMUNICATION
- EVIDENCE-BASED PRACTICE
Contact…
- 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).
Conclusion
- 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.
Reference
- Action on Smoking and Health (2017) the Economics of Tobacco. Available at: http://ash.org.uk/category/information-and-resources/fact-sheets/ (Accessed: 8 March 2019).
- Action on Smoking and Health (2018) Smoking Statistics. Available at: http://ash.org.uk/category/information-and-resources/fact-sheets/ (Accessed: 8 March 2019).
- Department of Health (2017). Towards a Smoke-free Generation- A Tobacco Control Plan for England. Available at:https://www.gov.uk/government/publications/towards-a-smoke-free- 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:
- https://www.nice.org.uk/search?q+smoking+harm+reduction (Accessed: 04 March 2019).
- National Institute for Health and Care Excellence (2018) Stop Smoking Interventions and Services. Available at: https://www.nice.org.uk/guidance/ng92/chapter/context (Accessed: 10 March 2019).
- NHS Digital (2018) Statistics on Smoking – England 2018. Available at: https://digital.nhs.uk/data-and- 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: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf (Accessed: 27 March 2019) .
- Office for National Statistic (2018) Adult Smoking Habits in the UK: 2017. Available at: https://www.gov.uk/government/statistics/adult-smoking-habits-in-the-uk-2017 (Accessed: 29 March 2019).
- Public Health England (2018) Turning the tide on tobacco: Smoking in England hits a new low. Available at: https://publichealthmatters.blog.gov.uk/2018/07/03/turning- 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: https://doi.org/10.1016/j.puhe.2008.05.021
World Health Organisation (2016) Health Statistics and Information System.
Available at:
https://www.who.int/healthinfo/global_burden_disease/projections/en/ (Accessed:29 March 2018).
World Health Organisation (2018) Tobacco. Available at: https://www.who.int/news-room/fact-sheets/detail/tobacco (Accessed: 04 March 2019).