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Smoking as a Health Issue in the UK

Smoking is among the leading causes of illnesses and death in the UK. In 2010, tobacco smoking caused about 101,000 deaths as well as 19% of all cancers in the UK (Parkin & Walker, 2011). The dangers of smoking arise from the various substances contained in tobacco smoke.  According to Talhout et al. (2011), tobacco smoke is both toxic and carcinogenic and contains over five thousand chemicals. Notably, tobacco contains different substances including acetone, tar, nicotine, and carbon monoxide that have an adverse impact on one’s health (Talhout, et al., 2011). Hence, tobacco smoke is responsible for some chemically mediated diseases in man. According to Rubin et al. (2011), smoking-related causes of death are cardiovascular diseases, chronic obstructive pulmonary disease and lung cancer(Rubin, et al., 2011).  Both smokers and nonsmokers can suffer adverse health effects from smoking (Schick & Glantz, 2005). While smokers inhale mainstream smoke, nonsmokers inhale sidestream smoke which is emitted into the surrounding. Both mainstream and sidestream smoke have similar chemical composition meaning that both smokers and nonsmokers will be affected by tobacco smoke. According to Schick & Glantz (2005), fresh sidestream smoke was found to be four-times more potent than mainstream cigarette smoke. With this research, it is conclusive that nonsmokers are equally affected by tobacco smoke upon exposure. The essay will, therefore, discuss smoking as a health issue.

The rationale for choosing this health issue?

The popularity of smoking stems from its short-term effects, little awareness of its health risks, as well as, the effective marketing campaign (Harrald & Watkins, 2010). According to research carried out by Aryal et al. (2013), a section of smokers noted that smoking conferred multiple benefits including increased concentration, alertness and slight euphoria. Nevertheless, long-term smoking leads to nicotine addiction and withdrawal exposes users to insomnia, restlessness and anxiety (Aryal, et al., 2013). Notably, the research recommended that there was the need to institute intervention programs that communicate the social, addiction and health risks of smoking. Though Arya et al. (2013), noted that smoking had some benefits, the research recommended a further study to counteract the social benefits of smoking. The effective marketing campaigns means that many people are likely to emulate the smoking habit. This would mean that more people would be affected by the negative effects of smoking.

Smoking is associated with numerous health problems, such as emphysema, cardiovascular diseases, lung cancer and musculoskeletal disorders. Cigarette smoking has a notable deleterious effect on the musculoskeletal system as it leads to the loss of the bone mineral content as well as increased chances of fractures  (Abate, et al., 2013). This is because nicotine has a direct toxic effect on the osteoclasts. Smoking can, therefore, aggravate the progression of back pain and rheumatoid arthritis. The various smoking-related diseases are costly to the National Health Service (NHS) and the NHS annually spends about £3 to £6 billion in treating smoking-related illnesses (Full Fact, 2015). Arguably, smoking also leads to loss of tax revenue since smoking-related diseases lead to decreased productivity.  Based on the facts presented, smoking undisputedly leads to numerous adverse health effects, hence posing a public health concern.

In developed countries, tobacco was found to be accountable for 24% of all male deaths and 7% of female mortality; these figures can be as high as 40% in men in eastern Europe and 17% in females in the USA (Boyle, 1997). The average mortality of smokers is about 3 times higher than in nonsmokers. In the UK, smoking accounts for about 96000 deaths a year (ash. Fact Sheet, 2016). Globally, smoking causes about 6 million deaths (World Health Organization, 2017). If no interventions are instituted, fatalities are bound to increase in the next decades.  Jha (2012), estimates that owing to the current trends, by 2030, the annual tobacco deaths would grow to ten million. This shows that smoking poses serious health problem that needs to be addressed. The alarming death statistics show that smoking is a health problem that leads to loss of lives that can otherwise be saved. Smoking is, therefore, a health issue as it leads to various illnesses and is responsible for massive expenditures by the NHS in treating smoking-related illnesses. Furthermore, smoking leads to decreased productivity stemming from the different diseases that it causes. Smoking is also a major problem in both developing and developed nations, perhaps explaining the high global mortality rates.

Discuss the Epidemiology and Demography of Smoking

Tobacco being a leading disease risk factor, there is the need to understand the trends in its prevalence and usage. This is crucial in prioritizing action, as well as, evaluating smoking control progress. In 2015, it was reported that over 1.1 billion people smoked tobacco most of whom were males (World Health Organization, n.d.). Though the global trends in smoking appeared to decrease, the frequency of smoking was noted to be growing in the African and the WHO Mediterranean Regions (World Health Organization, n.d.). In the USA, there is a notable decrease in smoking frequency from 20.9% in 2005 to 15.1% in 2015 (Jamal, et al., 2016). Even though there is a decrease in smoking prevalence, it is still the leading cause of death and diseases. About 480, 000 Americans die from smoking-related diseases translating to 1 in every 5 deaths (Public Health Service, 2014). Furthermore, smoking costs the US government $170 billion in medical expenses (Xu, et al., 2015).

According to the data reviewed by the Health & Social Care Information Centre (hscic), the number of adults who smoked in the UK decreased from 46% in 1974 to 19% in 2014 (Health & Social Care Information centre, 2016). Moreover, 18% of high school students attested to having tried smoking. Notably, in 2015, there was a further decline in the number of smokers to 17.2 up from 20.1% in 2010 (Office for National Statistics, 2017). The Office for National Statistics (2017), notes that there was also a notable reduction in the number of current smokers in Wales and Scotland. Notably, 16.9% of adult smokers were found in England, 19.0% in Northern Ireland, 18.1% in Wales and 19.1% in Scotland (Office for National Statistics, 2017). Based on Gender, the Office for National Statistics (2017), noted that 19.3% of men in the UK were smokers as compared to 15.3% of women. Furthermore, smoking has become less common across all the ages in the UK. A substantial decrease was noted in the group aged between 18 to 24. The data collected by the Office for National Statistics (2017), recorded a drop in the average number of cigarettes smoked per day, about 11.3 cigarettes per day. This was notably the lowest since 1974. Additionally, the number of quitters increased in 2015; this was represented as 56.7%. This means that 56.7% of adults in the UK had quit smoking. Arguably, it was established that smoking was prevalent among the unemployed and individuals that earned less than £10,000 annually (Office for National Statistics, 2017). The current decade has seen the introduction of e-cigarettes and about 14.4% of current smokers used them (Office for National Statistics, 2017). Statistically, there are more male smokers than the females. The statistics presented also show a decline in the smoking trends and the decline in the smoking trend in the individuals aged 18 to 24 can be attributed to a number of factors including sensitisation on the dangers posed by smoking. The decrease in the average number of cigarettes smoked per day can be attributed to campaigns that criminalise smoking making smokers more cautious. Moreover, the decline can be as a result of the increased number of quitters.

Factors Influencing Smoking

Various studies have been established to explore the context and environment that cause young people to smoke and reinforce the habit. Socio-economic status influences a number of opportunities, exposure and behaviours that threaten health. In Britain, no social class differences have been noted in the prevalence of smoking among children and teenagers (Loddenkemper & Kreuter, 2015). Tobacco and poverty have a vicious cycle in which people with low-income smoke more and spend more on tobacco. Notably, cigarette is a tool that helps individuals of low socio-economic status fight boredom and relieves stress. A study carried out by Laaksonen, et al., (2005), it was established smoking was correlated with a low socioeconomic status. This conforms to the discovery that people from a lower socio-economic status smoke more than their counterparts with a higher socioeconomic status.

Several demographic factors influence smoking initiation, continuation or quitting. Age tends to play a crucial role in the initiation of smoking. Moreover, most of the tobacco addictions can be linked to adolescence and teenage as they are the transitional years. A significant proportion of adolescent smoking is experimental as they begin the habit with the aim of quitting and in the process, get trapped in it. Prevalence rates of smoking also vary across all ages in a population (Office for National Statistics, 2017). This means that there exists a “cohort effect” across the population. Smoking initiation is notably common among the youths and the young population and the decrease in the prevalence in certain age groups is attributed to smoking cessation.

Various psychological factors have been found to influence smoking. Depression has a high likelihood of influencing an adolescent’s uptake and consequent progression in smoking behavior. Depression is a predictor in smoking initiation and is associated with nicotine dependence (Ulrich, et al., 2004). Individuals with depressive symptoms were more likely to uptake smoking as they argue that smoking helps them alleviate the negative symptoms. Furthermore, people with emotional and behavioural challenges are more likely to be smokers (Royal College of Physicians of London, 1992). Possibly, such a group of people are encouraged to smoke by their carers who give them cigarettes as a reward for their improved characters.

Lifestyle has a great influence on smoking. Friends and family in the environment that surrounds individuals influences their behaviours. Though the family has a critical impact on a person during the early stages of growth, influence from friends becomes stronger over time. Various studies in the UK have shown that having best friends that smoked predisposed one to take up the habit (Park, 2011). The impact of friendship in the uptake of smoking behavior operates through peer bonding and peer influence. Friends are known to convince their non-smoking friend to emulate the habit. Moreover, traits such as poor self-image, rebelliousness and risk-taking have been found to be linked to the initiation and experimentation with smoking. Smoking is a notable health impairing behavior and has negative effects on health as it predisposes individuals to diseases. Stress, as a health-related behavior was found to promote smoking (Steptoe, et al., 1996). Moreover, emotional distress also leads to increased tobacco use as smoking helps smokers cope with the negative emotions and unpleasant feelings.

Identify and discuss the related UK government policy

The government has instituted a number of policies aimed at reducing smoking as such will lead to an eventual reduction of deaths caused by smoking. In the recent years, sales and promotion of tobacco have been regulated through the ban on TV and press advertising (HM Government, 2011). Even though the prohibition of tobacco advertising is provided for in the Tobacco Advertising and Promotion Act 2002, tobacco industry has continued to devise ways of promoting tobacco. Moreover, the government has forced retailers to phase out bright colours and logos in cigarette packs (Cox, 2017). With the reduced tobacco advertisements, it’s expected that the number of young people taking up the habit will significantly reduce. The government also has the plans to work with media regulators and the entertainment industry to minimize the portrayal of smoking in the entertainment media.

The institution of high tobacco taxes reduces its use since the high prices discourage people from buying it (HM Government, 2011). The cost of cigarettes in the UK is notably higher than in other countries in the EU. Moreover, the government has implemented strict measures to tackle illicit tobacco products. Further, the government has revised a joint working relationship between the local authorities, and HM Revenue and Customs to prevent the entry of illegal tobacco into the country which would lead to lower prices and increased prevalence (HM Government, 2011). Finally, the government has adopted anti-smoking campaigns have resulted in increased smoking cessation. Such campaigns help people to change their behavior by sensitizing them on the dangers of smoking (HM Government, 2011). Furthermore, anti-smoking campaigns encourage smokers to quit smoking effectively.

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