Smoking has been and continues to be a very critical issue in our societies today. This is primarily due to the harmful effects it has on people’s health. Leone and Landini (2010) observed that in the United States, tobacco smoking is one of the chief causes of preventable illness and premature mortality, as well as the main risk factor for oral cancer. Almost half of all tobacco smokers will succumb to a smoking-related disease (Chinn & Kramer, 2010). This paper provides a concept analysis of tobacco smoking. In addition, the side effects of tobacco smoking, measures that can be undertaken to prevent it, as well as smoking cessation measures are discussed and analyzed comprehensively.
- Significance of this concept to my practice and to nursing in general
Nurses can serve as agents for promoting smoking cessation. The concept allows nurses to intervene and assist smokers to quit smoking by informing them about the harmful health effects of smoking, and provide advice and counseling to them to help them quit smoking. Moreover, it allows me to better understand the medical needs of patients with smoking problems and smoking-related illness, and how I can properly attend to them as a nurse. It is also significant since it allows nurses to have a positive perception regarding people with smoking-related illnesses, and thus, provide effective, high quality care and treatment to them.
- Uses and Definitions of the concept
There are several definitions of smoking. In the discipline of medicine, smoking is the act of inhaling the smoke of burning tobacco that is encased in pipes, cigars and cigarettes. In the discipline of social sciences, smoking is the act of breathing in the gases as well as hydrocarbon vapors produced by slowly burning tobacco contained in cigarettes (Hanson, Ventrulli, & Fleckenstein, 2008). In the discipline of sociology, tobacco smoking refers to the practice or behavior of burning tobacco and then inhaling the ensuing smoke, which contains chemical substances. From the Sociocultural perspective, smoking is the act of inhaling the smoke of burned tobacco, which may occur habitually or occasionally as a result of physical addiction to some chemicals, chiefly nicotine (Leone & Landini, 2010). From the medical perspective, smoking is also defined as the act of directly inhaling tobacco smoke and is the basis of major health hazards (Reardon & Miller, 2008).
Uses and historical developments of the concept
Saunders (2005) pointed out that in Americans, tobacco has a very long history. The American Indian communities grew tobacco before the Europeans arrived in North America. The Natives smoked tobacco using a pipe, and they smoked only for special medical and religious purposes, and not every day (Saunders, 2005). In the 19th Century, many people started using small quantities of tobacco by chewing it or smoking it occasionally in a pipe and the first commercial cigarettes were made in 1865. The harmful effects of tobacco smoking were first discovered in mid 1960s by the Surgeon General of the United States who presented a crucial report regarding the harmful health effects of smoking, and said the tar and nicotine in cigarettes lead to cancer. Consequently, in 1965, the United States Congress passed a legislation that required every cigarette pack to have a warning label (Slovic, 2001).
- Formulate defining criteria. The concept’s antecedents and consequences.
There are many antecedents or reasons that might make a person smoke tobacco. The first is peer and family influence as Elders (2007) stated. Most people begin smoking when they are teenagers, and those with parents/friends who smoke have a higher chance of smoking tobacco than those who do not. The second reason is the price breaks and promotions such as cigarette ads in the tobacco industry. These have an immense influence on people. Tobacco companies spend substantial amounts of money annually in creating and marketing advertisements showing tobacco smoking as thrilling, exciting, safe and alluring. Other reasons for smoking are stress relief, ignorance about the dangers of smoking and curiosity with regard to the effects of tobacco (American Lung Association, 2013).
Illnesses as a result of tobacco smoking – According to the American Cancer Society (2013), tobacco smoking causes several illnesses such as heart disease, emphysema and stroke. Most importantly, tobacco smoking causes a range of cancers such as cancer of the lung, mouth, throat, voice box, nose, pancreas, oesophagus, kidney, stomach, ovary, bladder, cervix, bowel, ureter, liver and bone marrow. Lung damage starts early in people who smoke, and their lung function worsens as they continue smoking. With regard to heart disease, a tobacco user with a heart attack is more probable to pass away within just an hour of the heart attack compared to an individual who does not smoke (Inness et al., 2008).
Effect on length and quality of life – Tobacco smokers often die younger compared to non-smokers. Tobacco smoking reduces the life span of men users by 13.2 years, and that of women by 14.5 years. The many illnesses and health problems caused by smoking tobacco steals away an individual’s quality of life long before death. This is primarily because illnesses related to smoking limits an individual’s everyday life since they make it difficult for them to breathe, work, or just getting around (Hanson, Ventrulli, & Fleckenstein, 2008).
Effect on pregnant women and their babies – Mateo and Kirchhoff (2009) stated that expectant women who smoke tobacco endanger not only the health, but also the lives of their unborn infants. This is chiefly because tobacco smoking when pregnant is connected to a higher likelihood of premature delivery, miscarriage, stillbirth, infant death and low birth-weight. Moreover, it is also linked to sudden infant death syndrome (SIDS). Roughly, 5 percent of all infant mortality could be avoided if pregnant women stopped smoking.
According to Zaccagnini and White (2010), nearly 90% of tobacco smokers start before attaining the age of 18 years. Nevertheless, there are several prevention measures that can be undertaken to impede individuals from engaging in tobacco smoking. The first is to encourage schools to help students stay tobacco-free. Early prevention at the school level will help to prevent years of tobacco use and dependence. For schools to help in preventing youth/adolescent tobacco use among their students, they must create a conducive environment that encourages and supports anti-tobacco behaviors and beliefs (Elders, 2007). The efforts they can put in place include forbidding tobacco use by visitors, staff and students on all school grounds and even at all school-sponsored events. In schools, tobacco-free policies that are consistently and clearly communicated, applied and enforced help to reduce and prevent among smoking among students (Reardon & Miller, 2008). Providing a comprehensive smoking prevention education – According to Reardon and Miller (2008), community-based education programs to prevent tobacco smoking can work and they have to be done in the right way. To work effectively, such programs must comprehensively address every aspect of tobacco use, including the long-term and short-term negative health effects, social influences, social acceptability, negative social consequences, peer pressure and peer norms, refusal and resistance skills, as well as media literacy as it relates to tobacco advertising and marketing (Chen et al., 2012).
Parents and families be involved in efforts to prevent tobacco use – Typically, families have a significant influence on an adolescent’s perceptions and attitudes towards tobacco smoking, and family members have to be involved in school or community tobacco-free initiatives as much as possible. Initiatives that educate and involve parents together with other family members help to increase family discussions on this critical topic, and could lead to better formulation of better home policies regarding smoking, and even encourage adult smokers to try to quit (Glantz, Landman, & Cortese, 2007). Restricting cigarette commercials and advertising – Advertising tobacco products by cigarette companies serves to encourage young people to smoke. As such, restricting and even stopping cigarette manufacturers from advertising tobacco products plays an important role as much as preventing tobacco smoking is concerned (Inness et al., 2008). Increasing the taxes on tobacco products – States and the national government at large should increase taxes on tobacco products such as cigarettes with a view of increasing their price. High price of cigarettes will play an important role in not only preventing, but also reducing consumption, particularly among the youth and adolescent (Reardon & Miller, 2008).
Several measures can be undertaken to increase the knowledge about quitting smoking. The first one is addressing the subject of smoking and tobacco use. Placing tobacco smoking on the agenda will help in sending a comprehensible message to the patient/smoker that tobacco smoking is a significant issue (Saunders, 2005). This is particularly important where people may not be aware of the essential information with regard to health and tobacco. Introducing the subject of tobacco smoking can initiate as well as legitimize a structured interceding or intervention, which is tailored to the needs of the patient/smoker.
Establishing and increasing cessation services – Tobacco smoking is very addictive and the possibility of success in quitting smoking is greater with the use of support services (Hanson, Ventrulli, & Fleckenstein, 2008). Workplace and group cessation programs play a significant role in reducing the barriers to smoking cessation and improving the likelihood of success. Increasing knowledge and awareness, and supporting policies that support smoking cessation – Anti-tobacco media campaigns about the side effects of smoking and the benefits of quitting are very essential in increasing cessation rates. In addition, policies that encourage individuals to quit smoking tobacco – for instance provision of insurance cover for cessation treatment or raising the prices of tobacco products – increases the chances of successful cessation (Reardon & Miller, 2008).
Increasing the number of health care systems and providers in order to promote cessation among young people and adults. Many tobacco smokers visit a primary care clinician, and it is indispensable that clinicians prepare themselves to intervene to smokers who show willingness to quit. Intervention steps involve asking if she/he smokes, advising the individual to stop, assessing his/her willingness to quit, assisting him/her to quit, and finally making follow-up contact in order to prevent reversion or relapse (Leone & Landini, 2010). Cessation counseling significantly contributes to success in quitting tobacco smoking.
- Present an exemplar case or model case
An exemplar case is drawn from an actual experience. When I was 14 years in my 9th Grade in high school, peer influence and pressure was common at the school. There were five particular 10th Grade students who were from wealthy, but smoking households since their parents smoked tobacco. Sometimes they would come to school with cigars and smoked them in secret, saying it was cool to smoke and that it felt good. With time, the five influenced ten other students into smoking. Seeing the possible side effects, I reported the matter to the school management. The students who smoked were then counseled, and those who could not stop were expelled from the school.
The school’s management then took various measures to prevent students from smoking. For instance, all visitors, staff and students were prohibited from using tobacco on all school grounds and even at all school-sponsored events. The school also began to provide education on the harmful health effects of tobacco use. With these measures in place, there was no other incidence of tobacco smoking in the school. Today, many years after graduating from high school, the students who took the anti-tobacco education seriously do not smoke and live healthy lives. The smoking students had been influenced by their parents, and three of those parents later died of lung cancer at the ages of 45, 47 and 53 respectively due to smoking.
- Explore what the concept is not by constructing 3 cases (Borderline, related, and contrary)
Borderline – As much as tobacco smoking results in so many illnesses including lung diseases, heart disease, and a range of cancers, there are also other causes of these diseases. In other words, tobacco smoking is not the only cause of such illnesses. Other aspects such as alcohol, drugs, genetics and the food people eat also play a role (Chen et al., 2012). Related – Smoking is an acquired behavior that an individual picks up in life, and it could be very addictive particularly due to the nicotine chemicals contained in tobacco products. It is not a disease but a behavior, although it is related to many illnesses. Contrary – The government is undertaking various measures to prevent and reduce tobacco smoking for instance restricting advertisements of tobacco products, and increasing their prices. On the contrary, people continue to smoke tobacco, especially adults, meaning that some preventive measures do not necessarily work as expected.
Tobacco smoking is bad for one’s health and harms roughly every organ of the smoker’s body. Since smoking is an acquired behavior, it is one of the causes of mortality in our society that can be easily prevented. It is estimated that tobacco smoking causes 87% of all lung cancer deaths (American Lung Association, 2013). It also leads to a range of other cancers. Furthermore, women smokers stand a greater chance of certain pregnancy complications, or even having the baby succumb to sudden infant death syndrome (SIDS). Smoking related illnesses could limit an individual’s daily life by making it difficult to breathe, play, work or just getting around (Glantz et al., 2007).
A vast majority of smokers today started smoking before reaching the age of 18 years. Thus, this can be better prevented with combined efforts of schools, families, policy makers and communities at large. At the family level, parents can set a good example for their children simply by not smoking themselves, as well as keeping their homes tobacco smoke-free. At the school level, educational institutions can provide tobacco smoking prevention programs in order to educate the students about the harmful side effects of smoking. At the state and national levels, legislation can be passed to raise the prices of tobacco products. States can also enact and execute comprehensive legislation that prevents minor’s access to cigarettes as well as other tobacco products (American Lung Association, 2013).
Cessation measures that could be undertaken to help smokers quit smoking include, increasing knowledge and awareness regarding the detrimental health effects of tobacco smoking through anti-tobacco media campaigns. Supporting policies that support smoking cessation for instance policies that raise prices of tobacco products. Establishing and increasing cessation services in order to help those who are willing to quit. These cessation services will provide counseling to smokers and advise them on how to quit. Increasing the number of health care systems and providers who will intervene and assist tobacco smokers who are willing to stop.
American Cancer Society. (2013). Questions About Smoking, Tobacco, and Health. Retrieved from http://www.cancer.org/cancer/cancercauses/tobaccocancer/questionsaboutsmokingtobaccoandhealth/questions-about-smoking-tobacco-and-health-cancer-and-health
American Lung Association. (2013). Preventing Smoking. Retrieved from http://www.lung.org/stop-smoking/about-smoking/preventing-smoking/
Chen, X., Ren, Y., Lin, F., MacDonell, K., & Jiang, Y. (2012). Exposure to School and Community Based Prevention Programs and Reductions in Cigarette Smoking among Adolescents in the United States, 2000-08. Evaluation And Program Planning, 35(3), 321-328.
Chinn. P., & Kramer, M. (2010). Integrated Theory & Knowledge Development in Nursing (8th Ed.). Boston, MA: Mosby
Elders, J.M. (2007). Preventing Tobacco Use Among Young People: A Report from the Surgeon General. Crescent City, CA: DIANE Publishing
Glantz, S., Landman, A., & Cortese, D. (2007). Tobacco Industry Sociological Programs to Influence Public Beliefs about Smoking. National Center for Biotechnology Information. 66(4): 970-981
Hanson, G., Ventrulli, P., & Fleckenstein. (2008). Drugs & Society. New York, NY: Jones & Bartlett Publishers
Inness, M., Barling, J., Rogers, K., & Turner, N. (2008). De-marketing tobacco through price changes and consumer attempts quit smoking. Journal of Business Ethics, 77(4), 405-416. doi: http://dx.doi.org/10.1007/s10551-007-9356-x
Leone, A., & Landini, L. (2010). What is tobacco smoke? Sociocultural dimensions of the association with cardiovascular risk. PubMed. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20550508
Mateo, M., & Kirchhoff, K. (2009). Research for Advanced Practice Nurses: From Evidence to Practice. New York, NY: Springer Publishing
Reardon, J., & Miller, C. (2008). Smoking prevention messages for adolescents: How intensity, valence, and recipient of consequences affect attitude toward the ad and intent to smoke. Journal of Marketing Theory and Practice, 16(1), 67-77. Retrieved from http://search.proquest.com/docview/212189884?accountid=45049
Saunders, B. (2005). Smoking. Chicago, Ill: Black Rabbit Book
Slovic, P. (2001). Smoking: Risk, Perception, Policy. Boston, MA: SAGE
Zaccagnini, M., & White, K. (2010). The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing. New York, NY: Jones & Bartlett Publishers