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Why Do Americans still smoke?
Why Do Americans still smoke?
Joseph Bustamante
Walden University
HLTH 4900-2
November 18,2014
Statistics/ Epidemiological Data
An estimated 42.1 million people or about 18 percent of adults smoke cigarettes.
Smoking is the leading cause of preventable death.
About 16 million people suffer from tobacco related diseases.
Facts
Smoking is directly linked to
Cardiovascular disease
Lung Cancer
High blood pressure
Lung inflammation
Tuberculosis
Smoking one cigarette reduces your life by 11 minutes.
The more you use tobacco the more likely you are to increase your risk for disease and shorten your life.
Facts (Continued)
Every year around 480,000 people die from tobacco related diseases in the United States.
At it highest 40 percent of Americans smoked. (1950s)
In 2005 20 percent of Americans smoked in 2012 that number dropped down to 18 percent.
Facts (Continued)
Who is more likely to use tobacco products?
Those with a GED
LGBT individuals
Mixed Races
By Gender: By Age: By Race By Education: By Poverty Level:
20.5% of Men 17.3% 18-24 21.8% American Indian/Alaska Native 24.7% 12 years or less 27.9% Below
15.8% of Women 21.6% 25-44 10.7% Asian 41.9% GED 17.0% At or above
19.5% 45-65 18.1% Blacks 23.1% Diploma
8.9% 65 + 12.5% Latinos 9.1% Undergrad
19.7% Caucasians 5.9% Postgrad
26.1% Multiple Races
CDC.gov
5
Quality of Healthcare Delivery
Every year 400,000 under 18 smoke their first cigarette and yet less than 1/3 of teens report their doctors have talked to them about tobacco use.
Second hand smoke can increase a nonsmokers risk for heart disease by as much as 30%
Doctors are always asking older Americans or those who are at high risk or have heart disease if they are exposed to second hand smoke.
Quality of Healthcare Delivery (Continued)
Tobacco use has a long history of false information and exaggerated benefits.
Tobacco use is proven to exaggerate health conditions and create further complications for users.
Better and repetitive information from healthcare professional to patients about risks at every assessment.
How Does This Health Issue Transcend Borders?
Almost all of the worlds 1 billion smokers live in low and middle income countries
Tobacco use kills almost 6 million people each year
Just over 5 million of those death are directly related to its use
Worse is that more than 600,000 are from exposure to second hand smoke
(WHO) estimates the annual death toll could reach 8 million by the year 2030
Health Behavior
Education on the risks of tobacco use is key
Over 40% have lost at least one smoking parent
In 2004 children made up 28% of the deaths attributed to second hand smoke
There are 400 chemicals in tobacco smoke, 250 are harmful, and 50 that cause cancer
Smoke free laws protect the health of nonsmokers
There is no safe level of exposure to second hand smoke
9
Health Behavior(Continued)
When smokers are well informed the majority want to quit
Counseling and medications can increase a smoker to quit by half
Image warnings of smoking help reduce the number of children who start
Mass media is helpful in reducing use
Ad bans (influencing promotion and sponsorship)
Taxes on tobacco products
Tobacco tax 10% increase = 4% decrease(high income countries) 5% (low/middle income countries)
WHO recommends
Monitor tobacco use and prevention policies
Protect people from tobacco use
Offer help to quit tobacco use
Warn about the dangers of tobacco
Enforce bans on tobacco advertising, promotion and sponsorship
Raise taxes on tobacco.
10
Culture
Exposure (from family and friends)
Income level
Education level
Access to healthcare (including information regarding risks)
Perception (smoking as cool)
What role does culture play?
11
Culture (Continued)
Prevention policies/ legislation
Such as:
Protection for the youth from second hand exposure
Programs developed to assist people to quit and educate
Taxes associated on tobacco products cost the family unit as a whole
Technology
Electronic cigarettes
Vaporizers
Nicotine patches
Chewing tobacco
Bluetooth, recharging stations, USB ports, monitoring technologies imbedded into the E-cig to record use
13
Legal and Ethical Issues
Taxing
Advertisement restrictions
Smoking bans
Marketing campaigns
Purchasing restrictions (age, hours, quantities)
How Can Interdisciplinary Team Approaches Help?
Increasing the length Doctors/ healthcare workers are able to discuss risk factors with their patients
Education workers, public officials, police officers, actors, can all reach their audiences and increase the flow of information
Involving multiple academic approaches
15
Possible Roles As A Scholar Practitioner
Broad changes could include:
Help get healthcare workers become more embedded into lifestyle decisions on individuals
Involving more than one treatment practice into care, and prevention
Increasing the information and involvement of parents in early youth prevention and education
Blending scholarly and medical information and real world knowledge in order to promote an advancement
16
Possible Roles As A Scholar Practitioner (Continued)
More direct changes:
Handing out more visually striking images to promote education on health risks
Healthy lifestyle changes like exercise and nutrition
Promoting the various costs of tobacco use, health, medical, social, life expectancy, and insurance coverage
References:
McLaughlin, I., Pearson, A., Laird-Metke, E., & Ribisl, K. (2014). Reducing Tobacco Use and Access Through Strengthened Minimum Price Laws. American Journal Of Public Health, 104(10), 1844-1850. doi:10.2105/AJPH.2014.302069
Hawkins, S. S., & Baum, C. F. (2014). Impact of State Cigarette Taxes on Disparities in Maternal Smoking During Pregnancy. American Journal Of Public Health, 104(8), 1464-1470. doi:10.2105/AJPH.2014.301955
Agaku, I. T., King, B. A., & Dube, S. R. (2014). Current Cigarette Smoking Among Adults - United States, 2005-2012. MMWR Recommendations & Reports, 63(2), 19-34.
Henry, B. J. (2013). Impact of Tobacco-Control Legislation. Clinical Journal Of Oncology Nursing, 17(2), 195-200. doi:10.1188/13.CJON.195-200
Mazurek, J. M., Syamlal, G., King, B. A., & Castellan, R. M. (2014). Smokeless tobacco use among working adults - United States, 2005 and 2010. MMWR: Morbidity & Mortality Weekly Report, 63(22), 477-482.
Kann, L., Kinchen, S., Shanklin, S. L., Flint, K. H., Hawkins, J., Harris, W. A., & ... Zaza, S. (2014). Youth Risk Behavior Surveillance United States, 2013. MMWR Surveillance Summaries, 63(4), 1-170.
Offen, N., Smith, E. A., & Malone, R. E. (2013). "They're Going to Die Anyway": Smoking Shelters at Veterans' Facilities. American Journal Of Public Health, 103(4), 604-612. doi:10.2105/10AJPH.2012.301022
Asma, S., Song, Y., Cohen, J., Eriksen, M., Pechacek, T., Cohen, N., & Iskander, J. (2014). CDC Grand Rounds: Global Tobacco Control. MMWR: Morbidity & Mortality Weekly Report, 63(13), 277-280.
Noguchi, Y. (July 31, 2014). Amid Smoking Decline, Look Who's Still Lighting Up . In NPR. Retrieved November 1, 2014, from http://www.npr.org/blogs/health/2014/07/31/336386346/amid-smoking-decline-look-whos-still-lighting-up.
Internal Revenue Service. (Last reviewed or updated September 23, 2014). Excise Tax. In IRS. Retrieved November 9, 2014, from http://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Excise-Tax
Pope III, C. A., Burnett, R. T., Turner, M. C., Cohen, A., Krewski, D., Jerrett, M., & ... Thun, M. J. (2011). Lung Cancer and Cardiovascular Disease Mortality Associated with Ambient Air Pollution and Cigarette Smoke: Shape of the Exposure-Response Relationships. Environmental Health Perspectives, 119(11), 1616-1621.
Shang, S., Ordway, D., Henao-Tamayo, M., Bai, X., Oberley-Deegan, R., Shanley, C., & ... Chan, E. (2011). Cigarette smoke increases susceptibility to tuberculosis--evidence from in vivo and in vitro models. Journal Of Infectious Diseases, 203(9), 1240-1248. doi:10.1093/infdis/jir009
A&E Television Networks, LLC.. (2014). Apr 1, 1970:Nixon signs legislation banning cigarette ads on TV and radio. In This Day in History. Retrieved November 3, 2014, from http://www.history.com/this-day-in-history/nixon-signs-legislation-banning-cigarette-ads-on-tv-and-radio.
National Park Services U.S. Department of the Interior. (November 17, 2014). Tobacco: The Early History of a New World Crop. In Historic Jamestowne. Retrieved November 17, 2014, from http://www.nps.gov/jame/historyculture/tobacco-the-early-history-of-a-new-world-crop.htm.
National Association of Attorneys General . (2006-2013). Tobacco and Hollywood: Smoking Lights Up the Box Office. In NAAGazette. Retrieved November 17, 2014, from http://www.naag.org/tobacco-and-hollywood-smoking-lights-up-the-box-office.php.
References (Continued)
World Health Organization . (2014). Tobacco . In World Health Organization . Retrieved November 16, 2014, from http://www.who.int/mediacentre/factsheets/fs339/en/.
Fox News. (November 11, 2014). Doctors should ask heart patients about secondhand smoke, study says. In Fox News. Retrieved November 16, 2014, from http://www.foxnews.com/health/2014/11/11/doctors-should-ask-heart-patients-about-secondhand-smoke-study-says/.
Doyle , K. (August 19, 2014). Doctors may be missing chances to talk to teens about smoking. In Reuters. Retrieved November 16, 2014, from http://www.reuters.com/article/2014/08/19/us-teen-smoking-healthcare-idUSKBN0GJ1UH20140819.
Shaw, M., Mitchell, R., Dorling, D. (January 1, 2000). Time for a smoke? One cigarette reduces your life by 11 minutes. In US National Library of Medicine . Retrieved November 16, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117323/.