Category: Smoking

Smoking has various effects on a pregnant woman; it affects both the unborn child and the expectant woman. Prolonged or excessive smoking is even more detrimental to the health of a pregnant woman. Unfortunately, there is a sizeable number of women who still smoke when they are expecting a child (Andriani and Kuo 4). While some of them do so out of ignorance, others do it because they are not aware of the effects that it has on their pregnancy. Cigarettes contain harmful components that can cause breathing difficulties and respiratory issues. When these substances are inhaled, they have fatal impacts on both the mother and the unborn child.

Smoking reduces womens chances of getting pregnant. Even if they are impregnated, there is a high chance that they will experience complications during both the pregnancy and when giving birth. Smoking has been widely linked to miscarriage and stillbirth. While a miscarriage may happen in the first three months of the pregnancy, stillbirth is when the unborn child dies prematurely before being delivered (Andriani and Kuo 12). Smoking can also lead to problems with a pregnant womans placenta. When the placenta is affected, it hinders the development of the fetus, meaning the woman cannot get pregnant. Moreover, if the child survives, they may experience congenital disabilities such as respiratory problems, low birth weight and other deficiencies. These affect the childs growth and development during later stages in life.

Smoking can cause damage to the tissues of both the pregnant woman and the unborn child. One of the harmful substances in cigarettes is carbon monoxide, which reduces the amount of oxygen that the child can get; hence, it can either cause a miscarriage or stillbirth. In most cases, mothers who smoke deliver their children early (McDonnell and Regan 7). It leads to premature babies being born before the gestation period elapses. An infant who is born earlier than expected often risks developing birth defects. Besides, since the newborn comes unexpectedly when the womans body is not fully ready to receive the infant, most of the cases of premature births end up being done through the caesarean section or surgery (Oncel and Erdeve 9). A majority of the mothers would not wish to deliver through this procedure because of the complications and the risk that comes with it. Moreover, a newborn who is delivered prematurely may have low birth weight. In this case, they have to be placed under incubation. Unfortunately, some of these infants die due to birth complications and defects associated with either being born prematurely or congenital disabilities.

Smoking increases the risk of a woman developing health problems and transferring some of the health complications to the unborn child. One of the health defects that pregnant women may experience if they smoke during pregnancy is difficulty in breathing. Some of them may develop adverse effects, such as lung cancer (Oncel and Erdeve 21). Besides, a woman who smokes may experience premature labor, which can be extremely painful to the pregnant woman and also may strain the unborn child leading to birth defects (McDonnell and Regan 5). There are several complications and defects associated with such a habit. Therefore, smoking during pregnancy has profound effects on both the pregnant mother and the unborn child. It is prudent that a pregnant woman should not smoke during pregnancy.

Works Cited

Andriani, Helen, and Hsien-Wen, Kuo. Adverse Effects of Parental Smoking During Pregnancy in Urban and Rural Areas. BMC Pregnancy and Childbirth, vol. 14, no. 1, 2015, pp. 2-16.

McDonnell, Brenda and Regan, Carmen. Smoking in Pregnancy, Pathophysiology of Harm and Current Evidence for Monitoring and Cessation. The Obstetrician & Gynaecologist, vol. 21, no. 3, 2019, pp. 169-175.

Oncel, Mehmet, and Erdeve, Omer. Impact of Cigarette Smoking During Pregnancy on Conception and Fetal Health Through Serum Folate Levels. Handbook of Fertility, 2015, pp. 27-33.

Smoking is like murder; it’s risky. In the beginning, it might seem fun and exhilarating, but after a while, reality hits you like a punch from Dwyane “The Rock” Johnson. There will be numerous severe consequences waiting for you. That is why I will never smoke, or even be near a pack of cigarettes. And you shouldn’t either. If you’d like to learn about why you shouldn’t smoke, and the terrible effects of smoking, continue reading.

Smoking is extremely harmful for your health, physically and mentally. You will think you’re suffering in the beginning, but that’s nothing compared to what’s to come. When you first start smoking, you will begin to have terrible breath, always be fatigue, and have tainted yellow nails and teeth. You will also have a reduction in taste and smell, and will be constantly coughing. At this stage, you might lose some people who are close to you, because who would want to be around someone who’s breath reeks of cigarettes, and is basically killing themselves? If you continue to smoke for an extended period of time like 5 years, your condition will worsen drastically. As stated by nhs.uk, long term smoking enhances your risk of developing deadly illnesses like heart attack, stroke, heart disease, osteoporosis, pneumonia, cancer, and more. When people think of the effects of smoking, they usually think of the physical effects, but there are several mental effects to smoking too. Smoking can alter your behavior to make you feel more irritable, anxious, and stressed. Long term smoking can even lead to developing mental illnesses like anxiety or depression.Your health will only deteriorate more with time, so you should quit smoking as soon as possible.

Not only is smoking damaging for our health, but it is also awfully expensive and costly. Smoking is a huge waste of money. According to quora.com, the average price of one pack of cigarettes in Canada is $15. If you purchased one pack of cigarettes per day, you would be wasting $5,475 per year on cigarettes. As claimed by mymoneycoach.ca, the average amount of money a Canadian citizen spends on food per month is $214. With the money you waste on cigarettes per year, you could pay for the food for a person for over 2 years! The money you’re wasting could be used for a better cause like charity. You could be giving starving homeless children a warm meal, instead of wasting money on cigarettes. What kind of monster wouldn’t want to help a homeless child in need? However, if you aren’t interested in donating to a charity, you could be spoiling yourself with the money you saved from quitting smoking. Think of how much money you would be saving if you didn’t smoke.

To understand why you should avoid cigarette use, you first have to understand what a cigarette is and it’s contents. A cigarette is essentially tobacco that is wrapped in paper. According to lung.org, there are approximately 600 ingredients in a single cigarette. One of the ingredients in a cigarette is called tar. The tar in cigarettes is the same kind of disgusting dark and thick tar that is used to pave roads. Just imagine your precious lungs, with black gooey tar all over them. The website also suggests that when just one cigarette is lit, it releases over 7,000 chemicals into the air. At least 69 of the chemicals released have been proven to cause cancer. There are also several toxic chemicals in cigarettes. One of the toxic chemicals found in cigarettes is called arsenic. According to healthline.com, arsenic is an extremely poisonous chemical, that can cause serious illnesses like lung cancer and heart disease, or prolonged death if small doses are consumed or inhaled over a long period of time. Arsenic is also found in rat poison. Your practically inhaling rat poison- the toxic liquid used to kill rats in households! If you are still craving cigarettes, just remember that you are basically putting the same ingredients found in tar, rat poison, household cleaners, and more absurd things into your body.

Have you ever wondered what makes cigarettes so dangerously addictive? We already know that cigarettes mainly consist of tobacco, which is a plant that contains a chemical called nicotine. Nicotine is incredibly addictive, it is so addictive that quebec.ca and the book, “Tobacco And Nicotine (Dangerous Drugs),” by Micheal Burgan even suggests that nicotine dependency is comparable to heroin or cocaine addiction. It doesn’t take long for someone to become dependent on nicotine. Just one pack of cigarettes can make your brain crave cigarettes non- stop for the rest of your life. Nicotine will not only make you hooked on cigarettes, but will also increase your blood pressure and heart rate. You could argue that nicotine might have positive effects, but those effects only last for a short period of time, and are ineffective. Nicotine is a stimulant like caffeine, so it may help with focusing or concentrating, just like how a cup of coffee might make you feel energized. But are the prices you have to pay, and consequences of inhaling nicotine worth being able to focus for a limited amount of time?

If someone was educated and fully aware of the terrible effects of smoking, why would they even start smoking? It is very common that someone begins smoking because they are pressured by somebody they trust, like a family member, close friend, or significant other. This type of pressure is called peer pressure. Peer pressure is when somebody makes you do something that you initially wanted to abstain from doing. Peer pressure usually occurs with adolescents, when someone is influenced to smoke to boost their social status, impress someone, or fit in with others. According to the book, “Teen Smoking,” by Lydia Bjornlund, over 80 percent of current smokers began smoking before the age of 18. You can resist peer pressure by making an excuse like, “No thank you, I have to go home now,” or you can just straightforwardly refuse to smoke. Others usually begin to smoke because they’re struggling with their mental health. People who suffer from a mental illness like PTSD or depression might use smoking as a way of forgetting their suffering for a limited amount of time. In this case, you can resist from resorting to drugs like cigarettes to help make you feel better. Instead, you can seek help from someone you trust like a family member or friend, or you can consult with a professional doctor, therapist, or psychologist . You have to know that you’re not alone when you are trying to resist cigarettes, or drug use in general.

If you are a smoker, not only are you deteriorating your own health, but also the health of the people who are constantly near you when you smoke, like your beloved family. When you smoke, you are releasing over 7,000 different harmful chemicals into the air around you. When you light a cigarette, you aren’t inhaling all of the smoke being released, so the smoke escapes to fill the air in the surrounding area. That means that everyone near you is put in danger too. If someone near you inhales the smoke being released from your cigarette, they are secondhand smoking. As claimed by canada.ca, secondhand smoke causes 800 devastating deaths in Canada, each year. Secondhand smoke is especially detrimental for children and infants. Would you choose cigarettes over the health of your own precious family and children?

This may sound surprising, but smoking can greatly affect fertility in men and women. Smoking decreases sperm count, sperm motility, and sperm quality in men. All of those factors lower your chances of becoming a father, drastically. Smoking also damages genetic material in sperm, which might be passed down to the baby. The website, yourfertility.org.au suggests that you quit smoking at least three months before trying to conceive, if you want to have any probability to conceive. According to quitgenius.com, Prince Harry, Duke of Sussex, decided to quit smoking for good, because he wanted to start a family with Meghan Markle. For women, smoking can lower the total quantity of eggs in your ovaries, and cause your ovaries to age prematurely. Smoking can still affect your baby, if you decide to begin smoking again, right after giving birth. Smoking transmits dangerous chemicals to your baby, through the breast milk you feed them. Women who smoke also produce a reduced supply of breast milk, and produce breast milk that might have changed compositions. The website, reproductivefacts.org suggests that both male and female smokers are twice as unlikely to conceive than nonsmokers. The more cigarettes you smoke, the more fertility problems you will face.

Every year, about 6.7 million tons of tobacco are produced throughout the world. According to Jegede(2019), in the list of top producers of tobacco in the entire world, the top five are China, Brazil, India, U.S.A, and Indonesia in that order. U.S.A is the fourth largest producer of tobacco in the world. Its production in the year 2019 is about 467 956 000 pounds according to statista.com. With all this production and the amount of income it earns the country, do we really stop to think of the effects this brings and the side effects that we suffer, as a country and the whole world in extension, from the production of tobacco? Have we considered other options and other income generating activities that do not involve production of a substance dangerous to our health and the environment? Do we really consider the persons who suffer from tobacco, not because they chose to but because other people around them chose to use tobacco subsistence? Do we consider the possibility of having counterfeits that look genuine but contain more harmful and unregulated substances that may harm us? Have we really thought how in producing the tobacco, we actually affect all the creatures of sea and dry land? Do we care how it affects the productivity of the people, the country and the whole world? With the hazards that tobacco causes, both to our health and the environment, I strongly believe tobacco should be banned not only in the United State but all around the world.

What are the effects of tobacco to a country and the entire world population? Tobacco smoking leads to diseases that affect almost every part of the body. It is time to take a close look at this general statement. The inhaled substances damage the lungs and leaves one vulnerable to such infections as emphysema which is the destruction of air sacs and chronic bronchitis which is a permanent inflammation on the bronchus. These are health hazards from basic smoking of tobacco products – cigarettes. Tobacco consumption also results to effects on the integumentary system – the skin, hair and nails. It literally changes the skin structure therefore increasing the risk of squamous cell carcinoma popularly known as skin cancer. This clearly shows how tobacco affects the body respiratory system and the skin structure which is a serious health hazard. These effects run deep as they are not easy to treat and are mostly long term – one will not notice the effects when they start consuming the tobacco and its products.

Tobacco consumption leads to constricted blood vessels. “The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system and pave the way for a stroke”, This will increase the blood pressure leaving someone vulnerable to suffering stroke and even heart attack. It also lowers the HDL cholesterol and raises the LDL cholesterol. This is harmful as it lowers the efficiency of the heart in performing its functions. It also raises the fats in the body by raising the triglycerides in the tissues around the heart. This all amounts to exposing the heart to extreme dangerous conditions increasing chances of stroke and heart attack. Research also shows that, compared to people who don’t consume tobacco, people who consume are at a greater risk of blood cancer. This is evidence enough that tobacco is harmful to human health.

While it is true that tobacco has a higher monetary value which is good for the economy of the country, it is also true that some dangerous and harmful gases are reduced during the curing process. These gaseous substance affect the balance of the respiratory gases by contaminating the air. This has adverse effects as it aids the formation of acid rain which alters the pH of the soils and water bodies. Altered pH makes the ecosystem less conducive for the organisms that live in that habitat as organisms can only survive in specific pH. Another effect of the gaseous pollutants is destruction of the ozone layer which shields human skin from direct sunlight. This exposes people to danger of cancer from the direct sunlight rays.

According to the FDA, “Smoking is a major cause of cardiovascular diseases, such as coronary heart disease, high blood pressure, heart attack and stroke.” However. one can inhale the smoke even without actually smoking – secondhand smokers. Secondhand smokers are the persons who inhale smoke from the burning end of a cigarette or from the smoke exhaled by a primary smoker. A secondhand smoker can be anyone from a kid on his way to school to an old woman on her way from the store. It could also be someone with a heart disease. They are secondhand smokers because someone else is smoking around them even though they may not have intended to smoke. Some people argue that there are smoking zones to ensure there are no secondhand smokers but in reality, smokers exhale and other parties inhale the smoke. It is clear the ‘smoking zones’ solution is not working and it is clear that in order to really protect the secondhand smokers, banning tobacco is the best thing to do in order to protect secondhand smokers.

In the recent past, there have been cases of smuggling to tobacco across boarders done by criminal gangs and production of counterfeit cigarettes. First, all tobacco products, whether legitimately bought from the retailer or the illegal products from the black markets, contains over five thousand chemicals at least sixty of which are known to cause cancer. Secondly, the counterfeit products are much riskier to health compared to the legal products. This is because the illegal counterfeit tobacco products do not undergo standardization. The government does not verify whether or not they are harmful to health. The counterfeits may therefore contain dangerous and harmful substances for example, the level of tar and carbon monoxide found in them may be many levels more than the allowed levels which makes their effects far much extreme “and in some cases (they) can contain insects…”

Lastly, some scientists have argued that tobacco is not entirely bad. They have suggested that tobacco has some positive effects on the persons who smoke it. Wanjek(2011) says that it lowers risk of knee replacement surgery. He says, “results from a new study shows that men who smoke had less risk of undergoing total joint replacement surgery than those who never smoked.” In addition, smoking reduces risk of Parkinson’s disease and it reduces risks of obesity since it (tobacco) is an appetite suppressant. Parkinson disease is a disorder of the central nervous system that affects movement, often including tremors. Nerve cell damage in the brain causes dopamine levels to drop which explains the symptoms of the disease. The act of smoking triggers behavior modification that prompts smokers to snack less and may make food less tasty curbing the smokers’ appetite. This will make them eat less and less therefore losing weight. Although this relationship between smoking and weight loss works, no doctor would recommend smoking for the purpose of losing weight mainly because the bad effects of smoking are worse than being obese. It has also been said by some scientists that the nicotine has positive effects on cognitive functions. They suggest that nicotinic receptors may contribute to normal cognitive functioning and that smoking may help patients with Alzheimer’s disease. Alzheimer’s disease is a progressive disease that destroys memory and other important mental functions. In this disease, brain cells and their connections degenerate and die which explains the memory destruction and damaged mental functions.

However, it is a little disappointing that even with this entire knowledge, resources and many other alternative less harmful ways of generating incomes, some countries including the USA still have their focus on tobacco as a main source of income. In so doing, its effects and the dangers it poses are overlooked because of the economic gains from the tobacco. As seen in details, tobacco does not only affect human beings but also plants, animals, soil micro-organisms and the atmospheric gases. When the acidic rain which results from tobacco curing kills the soil micro-organisms the soil becomes less fertile. It is also true that the pH of the water in seas is altered by the rain which makes some species of fish disappear and become extinct. As small as the problem seems, it is not really small and the effects of tobacco production cut across all aspects of life from reducing the life expectancy, increasing mortality, reducing greatly the output of individuals in terms of labor, all types of cancer all through to reducing fertility of persons who smoke.

In conclusion, it is very clear that tobacco production and its ultimate consumption is dangerous to the health of people, plants and other animals. For these reasons, I strongly suggest that tobacco be banned, from its production all the way through to consumption. This will help protect the environment, plants, soils and soils micro-organisms, water bodies, water animals, respiratory gases. It will also protect human beings from the adverse effects of tobacco consumption that we do not admit we suffer from directly or otherwise. When tobacco is eliminated from the country and the entire world eventually, cases of cancer will drastically go down and the world will realize the true potential of its people. The world will become a safer place to live in and the productive population that is out there producing the dangerous tobacco which may affect them even without knowing will get different better and less hazardous jobs for a better unified country and a better world.

INTRODUCTION

While public perception of the tobacco industry has slowly deteriorated as social culture and research has condemned the consumption of their product, the new upstart e-cigarette industry is quickly taking its place without the same degree of public scrutiny. Specifically, this paper seeks to understand the ethical implications of the introduction of e-cigarettes, otherwise known as vaping products, to an isolated demographic: the youth market. Through our findings, we believe that the introduction of e-cigarettes to the youth market has ethical concerns due to its predatory marketing, societal trends and inherent health effects.

MARKETING TO YOUTH

E-cigarette usage almost doubled from 11% to 21% from 2017 to 20181 in 12th grade American students becoming the greatest increase in substance consumption in the history of the American National Adolescent Drug Trend survey. Other forms of tobacco consumption from this demographic either decreased or stayed the same, clearly indicating the prevalence of e-cigarettes as the preferred method of tobacco intake. Many e-cigarette companies advertise themselves as a healthier alternative to smoking with the leading e-cigarette company JUUL going as far as saying their mission statement is to “improve the lives of the world’s one billion adult smokers” and that “their product is meant for adult smokers only”2 however their intentionally devious marketing techniques signal otherwise. The issue with framing their products as being “healthier than cigarettes” without mentioning other effects is that it is deceptively misleading youth to believe that they are overall safe and harmless.

With JUUL making up more than half of the e-cigarette market in America3 and becoming the fastest start-up to achieve a $10 billion valuation4 they serve as a representative proxy on how they and their competitors built this billion-dollar industry off the naivety of youth. The 2019 systematic study on JUUL’s promotional efforts by Stanford University’s School of Medicine found that their “advertising imagery in its first 6 months on the market was patently youth oriented”3. The study analyzed the companies Twitter, Facebook, Instagram and customer directed marketing emails and found that JUUL primarily used techniques to appeal to the youth demographic. The company leveraged the growth of social media to target the mediums most active users, the youth5 through a campaign known as “organic social media marketing” where “social media influencers”, people who have large followings on social media serve as promoters of the product. These influencers have been shown to be more effective in promoting products than traditional celebrities with 70% of teenagers saying they relate to influencers more than traditional celebrities and 60% stating they would purchase products recommended by influencers6. Studies have shown that social media exposure from e-cigarettes evoked positive impressions of smoking from youth7, indicating that JUUL’s promotional techniques were highly effective on this demographic. Furthermore, the study found that the company advertisements “prominently featured sweet and fruity flavours”, which could suggest that they were specifically promoting products that appeal to the younger generation. Regardless of the company’s intent, it has been proven8 that youth believe that flavoured e-cigarette liquids (similar to the ones marketed by JUUL) are targeted towards them rather than older adults contradicting claims made by the company.

JUUL advertised itself as a start-up seeking to disrupt the tobacco industry by helping save the lives of the adults addicted to cigarettes with their revolutionary sleek product. In reality, by marketing themselves as an adversary to “big tobacco”, and a “champion of revolutionary change”, they likely attracted the youth market to their product. JUUL’s advertising techniques drew a lot of inspiration from past tobacco marketing strategies9, making it likely that they were attempting to replicate “big tobacco’s” past success with the youth. While newspaper articles and billboards have been replaced with Facebook and Instagram posts, the intent of their promotion remains; to promote their product to the youth to groom their next generation of customers for years to come.

Although JUUL maintains that they don’t market their products to the youth, their actions speak otherwise, with the majority of their incriminating social media history being wiped from the internet3. Their attempt to hide their wrongdoings along with their past promotional strategies provide close to irrefutable proof that their past actions had forceful intent and their demographic dominated by the youth10 was not created by accident. After all, if there was nothing wrong with their social media activity, why would they bother to wipe evidence?

One of the most prevalent reasons why corporations like JUUL were able to “recreate” the success they saw in tobacco products among youth is due to the lack of effective legislation upon introduction and the delay in updating laws. Existing legislation at the beginning were out-dated on the grounds that vaping products did not meet the existing definition of tobacco and it would take time and debate to classify the products. For example, the United States did not rule them as being treated as tobacco products until 2010 19. In Canada, the Tobacco and Vaping Products Act (TVPA) defines tobacco and vaping products separately, and vaping products have their own separate rules within the act 20. In particular, marketing is one of the legal areas where there were holes that paved the way for e-cigarettes. Just because an act is not explicitly illegal does not mean that it is ethical to do it, especially if laws change to assess it as illegal.

As at the time this report is written, Health Canada has proposed but not yet enacted additional limitations of e-cigarette marketing 21. Their four propositions are as outlined below. One major change is that “Vaping product advertisements would not be permitted at any point of sale where youth is allowed access, including online” 21. To capture even more advertising, there may also be a broader limit to prohibit vaping advertisements in any public areas available to youth, such as parks, malls, etc21. Heavy restrictions may be added to effectively prohibit broadcasting of commercials during youth programming across every channel 21. The last proposition is that entities are to be prohibited from digitally or physically promoting vaping in youth publications, including social media 21. As these propositions have not yet been implemented as at the time of this report, it’s clear that marketing regulation around e-cigarettes is significantly less restrictive from traditional tobacco, which has more bans on media and restrictions 22. In the past few years, the industry took advantage of these holes in Canadian laws by blasting vaping advertisements across broadcasted television, social media, and other media outlets 23. One article describes these advertisements as “slick, edgy, glamorous” and it can be easy to see that the industry is aggressively trying to rope in new consumers, including the youth 23.

With the youth marketing industry expanding more than 20 times between the 90s to 2000s11, it has become apparent that marketers are putting a strong emphasis on this demographic. Marketing to youth creates an ethical dilemma as it emphasizes the cognitive imbalance between adult marketers and the youth target. For marketing to be deemed as ethical, it must follow the power balance principle; that is the scale must not be tipped to favour the marketer nor the consumer12. In reality, this scale often favours the marketer given that their objective is to sell the product through any means possible. These power imbalance issues are further exacerbated by the advertising practises of the e-cigarette industry to the youth. JUUL specifically targeted social media mediums where youth would have no parental oversight, a strategy which is deemed unethical12 as the youth are unable to recognize the manipulation behind the advertising. By promoting their product with themes such as “pleasure”, “relaxation”, “romance”, and “holidays”3, the e-cigarette industry preys on the developing cognitive abilities of the youth and leverages the spikes in dopamine levels to entice them to purchase their product.

With traditional tobacco companies being phased out in favour of e-cigarettes, there are striking parallels between the marketing of the products to the youth demographic. The ethical issues that traditional tobacco companies used to face are clearly re-emerging in the promotion of e-cigarettes. The rampant marketing of the product to the youth has led to an incredibly high uptake of e-cigarette consumption and has thus created a false “positive” notion of the product in society.

PUBLIC PERCEPTION AND SOCIETAL TRENDS

With the e-cigarette industry’s use of predatory marketing in combination with poor youth education programs on the impacts of smoking to health, youth’s perception of e-cigarettes remains substantially at risk.

E-cigarettes have been proven to reduce the cigarette consumption of smokers without causing significant side effects as opposed to abruptly stopping13. As a result, the youth public perceives e-cigarettes as a healthier alternative to traditional tobacco use. Data from the 2012 National Youth Tobacco Survey, consisting of a sample size of around 25,000 students ranging from Grade 6-12, revealed that approximately “one-third of students viewed e-cigarettes as less harmful than traditional cigarettes”14. Even among the more recent studies conducting analyses from 2015-2016, youths perceived e-cigarettes as the least harmful and addictive of tobacco products15. Youth perception of relative harm from cigarettes and e-cigarettes is heavily based on frequency and intensity of cigarette smoking. According to the 2012 National Youth Tobacco Survey, “88% of participants believed that daily use of 10 or more cigarettes was correlated with a large amount of cigarette-related harm, while only 30% responded that non-daily use was associated with the same amount of harm”14. These findings are highly concerning as “low-dose cigarette consumption has been shown to substantially increase the risk of cardiovascular disease, cancer, and addiction potential”14. This perception of frequency and intensity being correlated with harm, in conjunction with the perception that e-cigarettes are less harmful than cigarettes, lead adolescents to be highly susceptible to e-cigarette/tobacco use.

Contrary to their image as a solution to tobacco addiction tobacco consumption for students in grade 12 increased from 23.7% to 28.5% between the years 2017 and 201816. This increase is a startling change from the anti-smoking trends in lawmaking and public perception and seems to indicate that smoking may be renormalizing amongst youth. Education and social progress had replaced the image of smoking and nicotine consumption being cool with an association with disease and addiction, but vaping has become seen as the new and exciting trend amongst youth. This could even potentially undermine the work done to reduce consumption of traditional cigarettes, as the younger generation becomes more accustomed to smoking.

To put in perspective the renormalization of vaping into society, we don’t need to look much further than the classrooms of schools, which has become ground zero for JUUL adoption. Due to its indiscreet form factor and lack of visible smoke trail, students have been able to use the product in various public areas; areas where smoking cigarettes has become taboo. When high school staff members were polled about JUUL consumption, they found that 48% of them have heard or seen students using JUUL in the bathroom and 40% has had heard or seen them using them beside the building or in the parking lot30. The consumption of JUUL has become so rampant in schools across America, schools have began taking extreme measures to the point where a school in Arkansas has “resorted to removing main entrance doors to student bathrooms” to dissuade students from vaping inside of them. The normalization of using their JUUL product in washrooms has led to the youth calling their washrooms the “JUUL room” indicating how pervasive the product has become in youth culture31.

In a specific case in North Carolina, a young high school student who became intrigued by vaping as a hobby ended up getting addicted to the nicotine, which began to adversely affect his life (Cite). The young teen was attracted to JUUL due to its approachability, attributable to the variety of interesting flavours and lack of smoke being produced when used(cite). The flavours that could be added made smoking much more enjoyable than it would be with normal cigarettes, and the small device was easily concealable (cite). The popularity of this product amongst older students also drove this interest, as if vaping had earned credibility for its image as hip and trendy. In reality, the nicotine content made it similarly addictive and harmful, and this misperception ended with the teenager in rehab for substance abuse (cite). This is just one of the many cases where youth have been enchanted by e-cigarettes and roped into a slippery slope of addiction.

Evidently, the youth have been significantly affected by the societal craze over e-cigarettes with many of them being un-aware of its harmful effects, being fooled by public perception. Schools have become a breeding ground for e-cigarette users as students promote the product to each other leading to an environment where peer pressure leads to an uptake in consumption. This renormalization of e-cigarette consumption is especially concerning due to the well-studied negative health-effects and its addictive properties.

HEALTH EFFECTS AND ADDICTION

E-cigarettes have been a huge success with adolescents, especially with 12th grade students, showing an increase in “vaping” from 11% to 21% in 2017 to 20181. However, with e-cigarettes being a relatively new product, studies around the effects of e-cigarettes on health, particularly the cardiovascular system, are only an emerging area of research. As smoking has been a common practice for many years, the effects of nicotine on the body are already known. Nicotine has been known to increase adrenaline levels, heart rate, and blood pressure in the body, and many new studies findings have been suggesting that e-cigarettes could be bad for health17. In a recent 2019 study posted in the Journal of the American College of Cardiology18, researchers tested ho w blood vessel linings (endothelial cells) reacted when exposed to six different e-cigarette liquids (e-liquids) of varying flavors and nicotine levels. Their findings revealed that any exposure to any of these e-liquids would result in cells being damaged and accelerating a process called “endothelial dysfunction” which is a preceding symptom to cardiovascular disease. Additionally, the findings showed that the cinnamon-flavoured e-liquid, which could debatably be marketed for youth, produced the largest amount of cellular damage of all six e-liquids.

This is especially concerning because of the lack of regulation around nicotine. The addictive property of nicotine is what drags youth down the slippery slope of continued smoking, whether that be through tobacco or e-cigarettes 25. Within Canada and the U.S., one major issue with e-cigarettes and tobacco products is that there is currently no legal limit for the amount of nicotine allowed within them 26. This is especially concerning because more than a decade ago, tobacco companies were found guilty for purposely designing their products with high amounts of nicotine to foster addiction 27. In the trial, U.S. Judge Gladys Kessler’s comments the following on their unethical practices, ‘profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year, an immeasurable amount of human suffering and economic loss and a profound burden on our national health care system’ 27. Not surprisingly, some e-cigarettes have nicotine levels close to traditional cigarettes, with JUUL going as far as advertising that their e-cigarette’s nicotine level is the same as cigarettes 28. To make matters worse, pre-mature use of nicotine at early ages alters a person’s addiction threshold, thus making youth more susceptible to being addicted to other drugs 25. Overall, the industry has shown that without a restriction to stop them from doing so, they will manipulatively design their products to be addictive to the core.

The U.S. Food and Drug Administration (FDA) has recently proposed setting limits on nicotine, reducing it to 80 percent of its current levels 26. The FDA has calculated that this proposal could cause 5 million individuals to stop smoking cigarettes within the first year of the legislation’s implementation 26. However, this proposal applies to just traditional cigarettes 26. While this may be a step in the right direction, it may unintentionally push vaping further to youth to satisfy their nicotine desire 26. Overall, it may be wise to also consider setting nicotine limits on vape products, given their addictive nature, negative health effects and how the industry’s manipulative practices impact youth.

CONCLUSION

While it is currently a popular product with many youth and adults, there are significant issues with the marketing, regulation, and effect on user health of e-cigarettes that strongly parallels that of the traditional cigarette industry. From a macro level, it’s interesting to see how quickly the youth have became accepting of the same sin-industry product; easily deceived by its new shiny packaging. Although they have been educated on the negative implications of consuming tobacco-based products, through the power of targeted marketing on an impressionable demographic, e-cigarette companies have been successful in creating a market in a space which before seemed dwindling with “big tobacco”. With JUUL being acquired by Altria, America’s preeminent cigarette company in 2018 for $12.8B, this is likely the first of many acquisitions done by “big tobacco” in the e-cigarette space 29. As more integration between the old and new occur, it becomes more and more likely that the “up-start” e-cigarette industry becomes a front for “big-tobacco” and allow them to continue with their unethical business practises. There is a reality where today’s youth allows history to repeat itself and subject themselves to the harmful effects of tobacco; except this time through e-cigarettes. The growth of this new industry is a concern to the youth in society, and it is strongly advised that work continues to be done by lawmakers, researchers, and the general public with regards to e-cigarettes to prevent what happened with cigarette companies from happening again.

The significance of the smoking cessation in the management of hypertension in a very vital and important issue in the current context of nursing practice. According to WHO 2014, smoking is one of the main risk factors for many chronic illnesses including cancer, lung diseases, and cardiovascular diseases, making it one of the largest preventable causes of premature death and disease across the world. Smoking kills nearly 6 million people each year and this could rise to 8 million by 2030.

Hypertension is one of the leading causes of death in the older adults. Smoking cessation is a lifestyle choice which is used in the management of hypertension in older adults. Smoking cessation is effective in the regulation of hypertension, and significant in the of management of Hypertension as lifestyle choices in the plder adults. Hypertension in older adults is highly prevalent and lifestyle choices for example smoking cessation is associated with effective management and regulation of hypertension.

The overall idea of the AIMS of the systematic critical review is highlighted in the study search using strategies for the search. This systematic review is aimed at identifying the effect of smoking cessation as a lifestyle modifications associated with the regulation and management of hypertension in older adults.

According to Higgins et al 2011, a bias is a systematic error or deviation from truth that can lead to underestimating or overestimating the true effect of a studied intervention in randomized controlled trials (RCTs). In the systemic review, the risk of bias is used to measure smoking cessation intervention in the management of hypertension in older adults. According to Higgins et al 2011, Cochrane’s risk of bias (ROB) tool is used in Cochrane systematic reviews to appraise methods used in RCTs (Higgins et al 2011). Higgins et al 2011 also indicated that Cochrane’s ROB tool has seven domains; for each of them, authors should make a judgment whether the ROB is high, unclear, or low and provide an accompanying comment to explain their judgment (Higgins et al 2011). Assessing ROB is standard procedure for Cochrane systematic reviews, as results of that assessment can influence the analyses of data and the conclusions drawn from a review.

In an overview of systematic reviews, evaluating the effects of smoking cessation in the management and regulating hypertension in older people, was reviewed. This involved randomized controlled trials. The search strategy involved the use of library search was considered for outcomes relating to benefits while randomized controlled trials, non-randomized controlled trials, and comparative observational studies will be considered for evaluating harms. In the search strategies will be developed and peer-reviewed by medical information specialists. The search strategy for the updated review on e-cigarettes will be developed using that of the candidate systematic review.

In the synthesis of the articles, the research questions and the critically analysed using the search strategy criterias to arrive at a meaningful articles that answers the research questions with the purpose of the synthesis of the articles. The synthesising of the systematic reviews of complex interventions is that data available for synthesis are often extremely limited, due to small numbers of relevant studies and limitations in how these studies are conducted and their results are reported.

In the synthesis of the articles, the study outcomes were measured in different ways and at different time points. The possible outcomes were discussed, with possible approaches when data are highly limited or highly heterogeneous, including the use of graphical approaches to present very basic summary results. The statistical approaches for combining results and for understanding the implications of various kinds of complexity was discussed.

The synthesis of the findings from the 3 original research articles based on the research question was presented. The synthesis of the findings derived from these research articles and the key recommendations. The articles are peer-reviewed, primary research articles relating to research question were presented in a literature review that synthesises the relevant research evidence related to the research questions.

Hypertension is one of the leading causes of death in the older adults. Smoking cessation is a lifestyle choice which is used in the management of hypertension in older adults. Smoking cessation is effective in the regulation of hypertension, and significant in the of management of Hypertension as lifestyle choices in the plder adults. Hypertension in older adults is highly prevalent and lifestyle choices for example smoking cessation is associated with effective management and regulation of hypertension. This systematic review is aimed at identifying the effect of smoking cessation as a lifestyle modification associated with the regulation and management of hypertension in older adults. The importance of education about smoking cessation will help patients to know how cigarette smoking impairs and exacerbate any existing respiratory and cardiac disorders (Koutoukidis, Stainto, & Hughson, 2013).

Literature search has been a vital aspect of this assignment especially with the use of systemic search strategy. Burns and Grove (2005) define literature searching as an organised search system which identifies information relevant to the topic of interest, in this case the use of smoking cessation in managing and regulating hypertension in older adults. Moreover, searching has an essential role in supporting clinicians who want to keep up with the development of evidenced-based practice in the healthcare professions. The term ‘evidenced-based practice’ has come to be used to refer to the combination of evidences which improve the quality of information in relation to clinical and patient interests (De Brun & Pearce-Smith, 2009).

In order to find the best medical resources, a good search technique is required for finding information more efficiently, otherwise the researcher could waste lots of time and find nothing. The aim of this essay is to describe an appropriate search strategy by defining databases and the reasons for choosing a particular one for this assignment. The essay will then go on to describe the search steps used to identify articles on the use of smoking cessation to manage and regulate hypertension in older adults.

Primarily, the fundamental part of searching is formulating a well-searchable question in order to be capable of sourcing an answer in the chosen database. For De Brun and Pearce-Smith (2009) ‘database’ refers to systemic reviews containing an electronic collection of information that is organised and accessible. There are various search engines in which research could be undertaken and each one of them identifies information and data in its own way.

In the study by Oncken et al, the study demonstrated 6 weeks of smoking cessation in postmenopausal women. In the findings Mann et al investigated that smoking cessation contributed to reducing hypertension as also suggested by other studies. In the study, it was deduced from the study that smoking cessation is an intervention for the management of hypertension. It was also investigated that smoking cessation contribute to management of hypertension. This was also further analysed that there was an “11 mm Hg difference in the awake systolic BP in hypertensive smokers versus non-smokers who had similar clinic systolic BP”. One of the bias shown in this study was that the magnitude of our effect was not as large as that found in this study, perhaps because BP values in our patients were lower at baseline.

In the study, it was evident that Poulsen et al showed that smoking was associated with increased hypertension compared with those in their non-smoking population. The bias also shows that study time before and after 6 weeks of smoking cessation. The study was randomised crossover study of 39 normotensive male population show that the BP is lower in the smoking cessation period compared with ongoing smoking period. The study result of was consistently deduced that hypertension was well managed and shows that hypertension is well managed with smoking cessation.

This study compared to the study highlighted above, showed that the treatment with “bupropion alone or in combination with a nicotine patch resulted in higher long-term abstinence rates than did the use of placebo or a nicotine patch alone”. It further shows that the “treatment with both bupropion and the nicotine patch was not significantly better than treatment with bupropion alone either at the end of the treatment period or during follow-up”. In this study, the treatments were compared with “the use of placebo, treatment with the nicotine patch, the nicotine patch and bupropion, and bupropion alone all resulted in less severe withdrawal symptoms and less weight gain after smoking cessation”.

According to Hurt RD, Sachs DPL, Glover ED, et al in the to the research carried out previously shows that bupropion and nicotine replacement therapies contribute to weight reduction after smoking cessation. The bias shows that, although the weight gain was lowest in the combined-treatment group, there were no significant differences in weight gain among the groups after week 7 of treatment” Hurt RD, Sachs DPL, Glover ED, et al.

Another bias to the study was that, it was discussed that the study population were “all volunteers and thus may not be representative of the majority of smokers.24 However, the smoking cessation rates could have been biased in the study, since the study population underwent weekly biochemical tests to determine whether they were still smoking. It was also indicated that 19.8 percent of the study population dropped out of the study and this may have affected the outcome of the study. This further indicates that the study group who dropped out of the study might have gone back to smoking hence, consideration need to be given to how this could have affected the outcome of the study.

The next study highlights cigarette smoking and hypertension through the research question was about smoking cessation and hypertension. According to the researchers, cigarette smoking is a powerful cardiovascular risk factor and smoking cessation, is the single most effective lifestyle measure for the prevention of a large number of cardiovascular diseases. Impairment of endothelial function, arterial stiffness, inflammation, lipid modification as well as an alteration of antithrombotic and prothrombotic factors are smoking-related major determinants of initiation, and acceleration of the atherothrombotic process, leading to cardiovascular events.

According to the study, cigarette smoking acutely exerts an hypertensive effect, mainly through the stimulation of the sympathetic nervous system. As concern the impact of chronic smoking on blood pressure, available data do not put clearly in evidence a direct causal relationship between these two cardiovascular risk factors, a concept supported by the evidence that no lower blood pressure values have been observed after chronic smoking cessation. Nevertheless, smoking, affecting arterial stiffness and wave reflection might have greater detrimental effect on central blood pressure, which is more closely related to target organ damage than brachial blood pressure. Hypertensive smokers are more likely to develop severe forms of hypertension, including malignant and renovascular hypertension, an effect likely due to an accelerated atherosclerosis.

Firstly, as indicated by the authors, the finding shows that, elevated blood pressure in older men is likely consequent to the well-known increased smoking-related aortic stiffness, a phenomenon which may produce isolated systolic hypertension Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. 2006 [60]. Secondly, the study shows that there is a difference between men and women in body mass index and alcohol intake.It was therefore suggested that the data analysis shows independent chronic effect of smoking on blood pressure is minimal. However, with smoking cessation and hypertension, the study population have to deal with their smoking to manage or regulate their blood pressure issues and to be able to monitor BP to ascertain the link between the cigarette smoking and hypertension. However, there is bias in the study, showing that the results are non homogeneous. The aim of the study compared the office and 24-hour ambulatory blood pressures of 59 untreated hypertensive smokers with 118 non-smoking hypertensive subjects matched for age, sex, and race Mann SJ, James GD, Wang RS, Pickering TG. (1991) [61].

The blood pressures were similar between the smoking and the non-smoking groups. In contrast, the daytime ambulatory systolic blood pressure, but not the night-time one, was significantly higher in the smokers, an effect observed among older patients but absent among younger. Similar results were obtained by Verdecchia et al. [62], assessed in a “case-control study the association between blood pressure and heavy cigarette smoking (20 cigarettes/day) in male and female essential hypertensive patients”. Blood pressure was significantly higher in the smokers than in the non-smokers, whereas night-time blood pressure did not differ between the two groups. In the study, these findings were not confirmed by another study, which compared 24h ambulatory blood pressure profiles and blood pressure variability of smokers, before and after a week’s abstention from smoking, and non-smoking controls [63]. All three groups showed similar ambulatory blood pressure profiles but smokers had significantly higher blood pressure variability. Moreover, a recent meta-analysis suggested that smoking is associated with masked hypertension, which is characterized by normal in-office blood pressure but elevated out-of-office blood pressure [64].

On the other hand, other studies reported even lower blood pressure in smokers. In a cross-sectional comparison, Mikkelsen et al. [65] found that a large age-range group of smokers was characterized by statistically significant lower daytime and night-time systolic and diastolic ambulatory blood pressure values as compared to an age-matched group of non-smoking controls. It appears evident that overall these data do not allow to drain conclusive information on a causal relationship between chronic cigarette smoking and blood pressure values. Although a definitive explanation of these contradictory reports cannot be extrapolated, there is no doubt that many discrepancies in the selection and characteristics of subjects among these studies occurs. Furthermore, one could also raise a doubt whether the cross-sectional comparison between smokers and non-smoking controls is methodologically correct.

Alternatively, interventional prospective trials have been proposed as a more appropriate tool to obtain conclusive information on smoking-related blood pressure. This methodological approach has been utilized in two studies, which assessed the effect of short-time or long-time smoking cessation on blood pressure, respectively. In the first study, the authors investigated, by a randomized crossover design, the effects of short-term smoking cessation on blood pressure and heart rate variability in a group of normotensive habitual smokers [66]. In the study, it was found that 24-hour blood pressure was significantly lower in the 1-week smoking-cessation period than in the 1week smoking-continuing period, whereas the night-time blood pressure did not differ significantly among the two groups. 24-hour heart rate also showed a significant reduction in the smoking cessation period [66]. In the second study, the authors prospectively investigated the effects of smoking cessation, up to 4 years, on changes in blood pressure and incidence of hypertension [67].

Adjustment covariates included age, body mass index, cigarette smoking, alcohol consumption, exercise, family history of hypertension, systolic or diastolic blood pressure, and changes in body mass index and alcohol consumption during the follow-up period. Results indicated an increment of blood pressure values among the quitters and current non-smokers, as compared to current smokers. Larger blood pressure increments were observed after 1 year of smoking cessation. These trends for increased risk of hypertension for longer periods of smoking cessation were similar among weight losers, as well as gainers and maintainers [67].

The impact of smoking cessation on blood pressure has been considered by these two studies in a different manner. Short-term (1 week), and long-term periods (up to 4 years) have been considered, respectively. Although very interesting and well-designed, these two studies do not allow definitive conclusions. Nevertheless, if considering the greater clinical impact of chronic smoking cessation on blood pressure values and increased risk of hypertension, results from Lee’s study [67] suggest that smoking cessation per se does not lower, but in contrast, it may result in increasing blood pressure.

In conclusions, available data on cigarette smoking habit and blood pressure values or risk to develop a sustained hypertension do not put clearly in evidence a direct causal relationship between these two cardiovascular risk factors, a concept supported by the evidence that no lower blood pressure values have been observed after chronic smoking cessation.

The proposal for Assignment 3 is to investigate by focussing on future research which will include additional studies of the effectiveness of smoking cessation on the regulation and management of hypertension and address the research methodological limitations and the sample size. The aim should be to identify the interventions using the RCT for 12 months in the stydy to be able to show the effectiveness of the smoking cessation in the management of hypertension. The sample size in the future study should be wider to look at the effect of smoking cessation amongst wider population.

The focus for future research will aim to identify specific impact of smoking cessation and also to study the areas of interest within the population. The study type should be addressed in the timing of smoking cessation as an intervention in the management of hypertension and whether other interventions should be studied in smoking cessation treatment should be included during the treatment and study period. There is also the possibility of investigating smoking cessation and the use of pharmacological treatment hand in hand during the study period as a suggestion for future research.

Tobacco is defined by the Cambridge English Dictionary as: ‘A substance prepared from the dried leaves of a tobacco plant. It can be chewed and smoked in cigarettes, cigars or pipes’ (“Tobacco”, 2019). Whilst tobacco remains a legal drug, the physical ramifications from using it can be catastrophic and lead long-lasting impacts on the smoker, their family and community. Tobacco is often perceived as a better drug compared to methamphetamine, cocaine or heroin. The purpose of this essay is to discuss the harm of tobacco use. It will look at three initiatives in Australia that have been implemented to curb the minimisation of harm associated with tobacco use. The chosen three initiatives are; education programs, mass advertising programs and changes to government laws in regard to smoking. The Australian National Drug Strategy Framework will examine these initiatives and discuss which pillar of harm minimisation each initiative addresses: demand reduction, supply reduction or harm reduction.

Tobacco is a legal drug made by drying the leaves of the tobacco plant. The tobacco plant makes a chemical called nicotine. The chemical nicotine isn’t excessively harmful or cancer-causing like people believe, but it is highly addictive. It is classed as a stimulant which means it speeds up the messages that travel between your brain and the rest of your body. Before it’s common use for smoking, tobacco had been used as a stimulant and medicine for the past 2,000 years. Medical News Today (2018) stated that by the end of the 19th century, politicians and lawmakers had begun to notice the harmful effects of nicotine and tobacco. By 1890, laws had been passed banning stores from selling nicotine to minors (Felman, 2018). Tobacco is most commonly smoked in a cigar or cigarettes but can also be chewed, although chewing tobacco is not commonly done in Australia. The harm associated with tobacco use can be catastrophic and can have a high cost of disease that a lot of people cannot recover from.

The harm associated with tobacco use can affect the user and everyone around them for years to come. To just name a few, there are financial harm associated with tobacco use, physical harm such as cancers, asthma and the physical aspects that come with dependency to tobacco and smoking. The ‘four L’s model’ adapted.by Ron Roizen, an American sociologist, adapted a shorthand model designed for people to consider the four major aspects of a person’s life that can be impacted by drug use. This model will be used to consider the aspects of a person’s life that can be impacted by the use of tobacco. The first of the four L’s is liver which is all physical and psychological problems caused smoking. According to the Centre for Disease Control and Prevention, these physical problems can include 16 different types of cancer including lung, oesophageal and mouth cancer to just name a few, lung issues such as emphysema and bronchitis, cardiovascular diseases, bone health, men’s fertility and increases the chance of women miscarrying and developing type 2 diabetes (“Health Effects of Cigarette Smoking”, 2019). Not to mention the mental health issues that can come with developing the previously mentioned illnesses or caring for someone who has contracted one of these illnesses. The second of the four L’s is lover which stands for the area of relationships with family or friends. Smoking for this area can put strain on relationships particularly if there are financial problems, or particularly if one person has quit smoking yet their partner still smokes, which will make it hard for the person who had quit to stand their ground and not relapse. The third of the four L’s is legal which can be the legal ramifications associated with smoking such as fines for smoking with children under the age of 16 in the car, littering the cigarette butts, fines for stores selling tobacco products to people under the age of 18 or smoking in a non-smoking area. The last of the four L’s is livelihood which can be the problems associated with employment, study or financial. There are huge financial problems associated with smoking such as the rising cost of cigarette packets, the fines associated with smoking in places you are not supposed to, the medical costs when you develop any of the physical illnesses attributed to tobacco use. A way to take all of these areas into account to help the user is to minimise harm associated with all these risks.

The harm minimisation approach does not condone drug use but acknowledges that some people will continue to use alcohol and other drugs, therefore it incorporates policies which aim to prevent or reduce drug-related harm. Australia’s National Drug Strategy is a government response that aims to reduce and prevent harm caused by a number of drugs such as alcohol, tobacco and ice. It is a 10-year strategy that is a framework for the government that looks at reducing the harm of specific drugs on three different pillars: demand reduction, harm reduction and supply reduction. Demand reduction is defined in the National Drug Strategy as ‘preventing the uptake and/or delaying the onset of use of alcohol, tobacco and other drugs; reducing the misuse of alcohol, tobacco and other drugs in the community; and supporting people to recover from dependence through evidence-informed treatment’ (“Department of Health”, 2019). Supply reduction is defined by the same source as “preventing, stopping, disrupting, or otherwise reducing the production and supply of illegal drugs; and controlling, managing and/or regulating the availability of legal drugs’ (“Department of Health”, 2019). Harm reduction again by the same source is defined as “reducing the adverse health, social and economic consequences of the use of drugs, for the user, their families and the wider community” (“Department of Health”, 2019). One initiative that the Australian Government has implemented to address these pillars in regard to tobacco use is to

Did you know smoking is one of the biggest contributors to illness and death in the uk? It is hard to understand why so many people make the choice to harm their body and health for a few puffs of poisonous chemicals that have such bad consequences as smoking. Smoking is not only a national issue but a global one that causes one person to die every 6 seconds. I will explore the many reasons why it is important to ban smoking and find out why people start such a dangerous habit that can cost them their health and even their life.

Tobacco is highly addictive! Cigarettes contain nicotine which causes a rush of adrenaline and a feeling of pleasure however this only lasts a few minutes which is why people become addicted to it and start smoking regularly. From the moment nicotine is inhaled it gives the smoker enjoyment and relieves them of some of their stress and calms them down, however the more a person smokes the more dependant they become and they require more nicotine to feel pleasure from it causing an addiction to occur. A shocking 75% of people who attempt to stop smoking relapse after few months! It is a very hard addiction to overcome as smokers find it challenging to focus if they have not smoked and experience withdrawal symptoms such as anxiety, depression, struggle concentrating, feelings of frustration, trouble sleeping and so much more unpleasant feelings that make them relapse in order for them to feel ‘normal’ again. If it was hard for smokers to get their hands on cigarettes it would force them to quit and overcome their addiction as smoking would no longer be normalised and accepted if it was banned.

One in ten deaths globally are caused by smoking! In Great Britain over 100,000 deaths a year are the result of smoking. Smoking contributes to illness and deaths because tobacco contains many chemicals which are poisonous and that increase the smokers chance of developing illnesses such as many types of cancer with the most common being lung cancer. However other illnesses which smoking causes or increases your chances of getting is type two diabetes, heart disease, blindness, colorectal cancer and many more serious disease. Did you know smoking also affects innocent children? You don’t need to be a smoker to get all the bad things that come along with it. The consequence of second hand smoke is just as serious as if the person was a smoker.

The fact that the chances of developing lung cancers increases by 30% because of second hand smoke should make people reconsider their bad choice! It was even proven that children of smokers get ill more often so why has this horrible cancer stick not been banned already? It’s time to stop endangering the health of children and other around us!

Introduction

The purpose of the inquiry was to investigate a drug-related issue affecting the health and wellbeing of young people in Australia. The drug I based my inquiry on was tobacco. Tobacco is the preparation nicotine-rich leaves which are cured by a process of drying and fermentation for smoking or chewing. It is a drug which negative impacts the body massively in the long and short term. My purpose for the inquiry was to research the long- and short-term negative impacts on the body, as well as what can be done to reduce these impacts. As well as researching these factors, I also researched why teens feel influenced to use tobacco as well as the social, economic and environmental impacts tobacco has on teenagers.

The reasons teenagers use tobacco

Teenagers feel influenced to use tobacco due to a variety of reasons. Tobacco acts as both a stimulant and a sedative. To teenagers, a stimulant is seen as a way to increase happiness due to incorrect knowledge given on the substance. This belief then leads to teenagers believing that it helps with stress and relaxation. With these perceived positives, tobacco is seen as a positive reinforcement. A reason why teenagers may feel influenced to use tobacco is due to peer influence. This is the most common reason for tobacco use within children and teens; especially girls. If the child has seen peers smoke, there is an increased likelihood that the child will begin to smoke as well. By friends being able to smoke together, it gives the children a sense of belonging within the friendship group. This is similar to adult smoking. If teenagers see adults/parents smoking, the child is more likely to smoke. By seeing the child’s ‘role model’ smoking, it can be seen as a positive/normal behaviour. From this, smoking can be perceived as grown up and mature. Advertising and media also influence the use of tobacco. For advertisers, tobacco companies aim their marketing towards teens and children. This is done as regular smokers begin smoking in their teenage years; which makes them the key demographic. Actors in movies also have a key influence. Teenagers and children look up to actors who smoke in movies and television. By the children seeing their ‘idols’ smoke, it increases the likelihood of teenagers trying to imitate their behaviour. Statistics which prove these perspectives is that 90% of smokers begin before the age of 19. This shows how the influence of adults can affect children. Tobacco is not only an addictive substance; it also increases the likelihood of teenagers experimenting which other illegal substances. Studies show that teenagers who smoke, are three times more likely to use alcohol, eight times more likely to use marijuana and 22 times more likely to use cocaine. This proves that if the encouragement of tobacco is continued, the addiction of other drugs is also increased. These factors show why teenagers feel the need to use tobacco.

The negative impacts on the body

Tobacco impacts the body massively in a negative way. It affects majority of the bodily systems. Overall, diseases caused by long term smoking include; cancer of the lung, mouth, nose, tongue, heart disease and stroke, ulcers in the digestive system, osteoporosis and hip fracture, poor blood circulation in the feet and hands, type 2 diabetes and rheumatoid arthritis. Tobacco impacts the respiratory system as the impairment of the lungs clearance system leads to a build-up of poisonous substances, resulting in an impact of lung irritation and damage. This damage can permanently destroy the air sacks of the lungs. The circulatory system is impacted massively as the effects of this system can lead to death and heart attacks. With using tobacco, it creates ‘stickier’ blood which is prone to clotting. This clotting can cause damage to the arteries; contributing to the factor of atherosclerosis. (Atherosclerosis refers to the build-up of fatty deposits on the artery walls.) This action which takes place in the circulatory system leads to an increased risk of a stroke and a heart attack due to the blockages of the blood supply. The effects on the immune system create more severe and longer lasting illnesses. By using tobacco, it makes the immune system less effective at fighting off infections as time goes on. As this process continues, it also continues to weaken the immune system making your body more vulnerable to autoimmune diseases. The musculoskeletal system is also affected as tobacco usage reduces bone density which can then later develop into osteoporosis. It makes fractures hard to heal and recover from as the oxygen delivery and cellular function can’t reach the site of the fracture. In general, these systems all lead to affects such as; higher risk of blindness, premature wrinkling of the skin and taste, gum disease and a reduced ability to smell. With tobacco use, all of these systems have long term effects on the body in a negative way.

The short term affects for tobacco use can affect an individual suddenly, or over time. By having these affects, it also decreases the individual’s standard of living. It affects the respiratory system as it causes irritation to the larynx (voice box) and trachea (windpipe). This can be due to the narrowing and swelling of the lung airways and excess mucus in lung passages. From this occurring, it leads to reduced lung function and breathlessness. Due to the narrowing and swelling, it can also lead to an increased risk of a lung infection and symptoms such as coughing and wheezing. Tobacco affects the circulatory system as it increases the individuals’ blood pressure and heart rate. At the time of inhaling the drug, there will be a decrease in skin temperature due to the tightening of the blood vessels in the skin. During exercise, less oxygen will be carried to the blood. This is due to the reduced blood flow to the extremities (fingers and toes). With tobacco affecting the immune system, it leads to an increased susceptibility to infections such as pneumonia and influenza. This is due to the drug lowering the individual’s levels of protective antioxidants (eg: vitamin C) in the blood. The use of tobacco impacts a person’s use of physical activity massively. The musculoskeletal system is impacted as it tightens certain muscles. With this tightening, it leads to increased joint activity and chronic lower back pain.

By smoking tobacco, it not only effects the individual short term, but it also effects the people surrounding you. This is called second hand smoke. Second hand smoke is the inhaling of another’s cigarette. The short-term effects on someone who has second hand smoke include numerous health problems in infants and children. These problems include more frequent and severe asthma attacks, respiratory and ear infections and sudden infant death syndrome (SIDS). Second hand smoke also affects newborns as smoking during pregnancy results on more than 1000 infant deaths annually. These short-term effects on the body and second hand smoke, massively effect the living of the individual taking the drug and the people surrounding the user.

Social, economic and environmental impacts on teenagers

Tobacco affects the lives of teenagers in several ways. Tobacco can socially, economically and environmentally change their lives. Social impacts have many factors which contribute to the increased usage of tobacco. A massive contributor is social smoking. Social smoking usually occurs at parties or in social situations. In these situations, sometimes alcohol is present. If it is present, the alcohol can also influence your decision making on where you decide to take tobacco. By using tobacco in social situations, it also impacts other teenagers. Second hand smoke is toxic and has been proven to lead to many health problems. By smoking around non-smokers, it puts yourself and your peers in danger. If an individual wants to become a non-smoker, it can be difficult to keep a relationship with friends. It can change your relationship if you want to quit but your friends don’t. By being smoke free, the individual would have to avoid social situations as it could make the person crave tobacco. However, many continue to smoke with friends as the individual doesn’t want to grow apart from the friends who do smoke. The economic effects of tobacco not only effect the user but also the world globally. WHO (World Health Organisation) estimates that globally, smoking causes over US$500 million in economic damage each year. The impact on the individual is that it can create a financial debt for teenagers to take into adulthood. As the product is addictive, the purchase of the product would occur more frequently. With teenagers going into adulthood, accessibility becomes easier; creating an increase in addiction. With smoking, there are many environmental impacts which negatively impact the pollution on Earth. Littering of cigarette butts isn’t just a nuisance, they are also toxic waste. They contain chemicals that contaminate our waterways, ground soil and they also harm wildlife. By teens smoking it effects the environment. The discarded lit cigarettes can cause fires, which can damage homes and land. These factors are what contributes to the social, economic and environmental impacts of teenagers who use tobacco.

Recommendations

1. (For parents): To set a good example.

   Teen smoking is most common amongst teens whose parents smoke. If the parent smokes, then try and quit. The parent should try and stop smoking in front of the teen and shouldn’t leave out smoking materials around the home. By doing this, it makes it harder to access. If the parent does smoke, the best way to set a good example would be to explain how unhappy smoking makes them and how difficult it is to quit. By explaining this, it shows your child the negative impacts from a ‘role models’ personal perspective. The parents’ opinion and perspective would be valued more.

2. Counselling from coaching staff about smoking. Awareness lessons to show the negative impacts on using tobacco. (influences teens decision):

   By having awareness lessons, it allows for a wide range of teenagers to get knowledge on the dangerous substance. By showing disturbing photos, videos and information it may change the teenager’s perspective and opinion on using tobacco. By having an expert talk about the issue, it allows the justification that these effects really can happen.

3. Higher taxation rates. Making tobacco products less affordable by raising taxes on tobacco products:

   By increasing the tax rates on tobacco products, access is limited to teenagers as they can’t afford the product. By having this limited access, it limits use. This will also decrease the amount adults spend on tobacco as well as they wouldn’t want to pay the high taxation number for tobacco.

Conclusion

Overall, I believe tobacco is an extremely dangerous substance which shouldn’t be inhaled by teenagers. In my personal opinion, I believe the parents have a massive influence on whether their child smokes or not. If a parent is a regular smoker, the act of smoking is going to be put into a positive light. By parents smoking, it makes the child believe that there is nothing wrong with it. This is shown with the statistic that 90% of smokers begin to start before the age of 19. If a smoker begins before the age of 19, it shows that someone over the legal age is purchasing the product for them. My opinion is that parents need to warn their children about the dangers of smoking and well as the negative effects it can have on the body.

References

1. Your Social Life | Smokefree Teen. (2019). Retrieved from https://teen.smokefree.gov/tobacco-triggers/your-social-life
2. Why teens and kids start smoking – Smoking – MedBroadcast.com. (2019). Retrieved from https://www.medbroadcast.com/channel/smoking/youth-and-smoking/why-teens-and-kids-start-smoking
3. Teen smoking: 10 ways to keep teens smoke-free. (2019). Retrieved from https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-smoking/art-20047069
4. Smoking – effects on your body. (2019). Retrieved from https://www.betterhealth.vic.gov.au/health/healthyliving/smoking-effects-on-your-body
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These days smoking has become more of a serious problem in New Zealand. People are getting more and more concerned about it. When you walk around the Auckland city centre, you can see that almost every twenty meters, there is at least one person smoking or preparing to smoke. This research proposal will discuss three reasons why people smoke; such as the psychological effects and how nicotine affects the human brain. Family influences, how seeing family members who smoke can influence one’s decision to smoke. Social influences, peer pressure and friends influence or does one simply decide if they want to start smoking on their own? Also, we will be seeing if there are any efforts made by smokers to quit smoking and are there efforts effective? We aim to answer the following proposed statistical research question: Why do people smoke? Based on our three focus areas we will conduct an online survey and analyse the findings to answer our research question. Variables that we plan to measure are age of smokers (What age did they start smoking?), what influences smokers to start smoking, how many times do they smoke a day and so on. The duration to collect responses would be approximately 8-10 days and our sample size will be 100, we plan to conduct a survey through random sampling process to reach our target of 100 people. Our concerns will be if people are going to be honest in answering the questions and if they will worry too much about confidentiality. Also, if survey questions along with choices of answers would relate to respondents and not be limited.

Discussion

Psychological Effects

Smoking addiction is caused by nicotine, nicotine is the main substance in cigarettes. Nicotine is a stimulating and potent sympathomimetic alkaloid that makes people addicted and difficult to quit (Volkow, 2012). Nicotine dependence is associated with tolerance, sensitivity, physical dependence, and psychological dependence. Nicotine increases the level of dopamine in the brain, making it pleasant, and excessive inhalation of smoke can cause nicotine poisoning. Another chemical that causes addiction in tobacco is called acetaldehyde, which enhances the effects of nicotine on the human brain.

Another side to the psychological effects is the withdrawal symptoms from trying to quit smoking. Nicotine withdrawals affect different people in many different ways. It can be quite the bad experience for some. This could be the reason why people continue to smoke instead of quitting. People who quit cold turkey usually have worse symptoms than those who take a cohesive approach, with counseling, support systems, and smoking aids (Martin, 2019)

Family and Social Influence

Family and social influence are quite important parts which will affect people to smoke. Some people started smoking at a very young age, the average age of starting smoking is 14.8 years-old. The study found that the smoking rate of children who started smoking in their 20 years old was 29 percent. The smoking rate among children whose parents have never smoked is 8 percent. As a result, we can see that most people who smoke are mostly influenced by their family.

Children’s curiosity and learning ability is very strong, so parents’ habits will affect children’s habits. “A new research shows adolescents whose parents smoke are more likely to become smokers, even if their parents quit smoking before they are born. Younger older siblings are also more likely to smoke” (Vuolo, 2013). In the long-term smoking of parents, the oldest siblings also smoke, which increases the probability that young siblings will smoke. On the other hand, a lot of harmful gases are produced in a house that has been smoking for a long time. The pollution left after the smoke is exhausted will accumulate on the sofa carpet, which will affect the health of the family.

Social influences is one of the most important aspects that makes people smoke. According to one 2009 report, there are at least one-third of all cigarettes smoked are smoked in social situations. Some people will be more likely to smoke by themselves when they see someone else is smoking. The report also shows that no matter that people is a frequent smoker or an occasional smoker, the pattern will still hold up. Depend on the recent surveys from the United Kingdom, socializing is one of their main reasons to smoke, this happens especially under the age of 35. Those “social smokers” don’t smoke when they are alone, they will normally smoke at parties to blend into the crowds.

People would like to develop the habits which most people do, so that they will not be isolated. Most “social smokers” will not consider them as a smoker, they only smoke occasionally and maybe they will only consume 1-2 cigarettes per day. Their reasons for smoking is to socialize and make friends. However, social smoking still impact on their own health. “When I ask parents if they smoke, the answer is often no. However if I drill down a bit further and ask “do you ever smoke occasionally?”. I tend to get a different answer and some parents admit to being a “social smoker”, or “only smoking when out socialising with friends”. (Dr Cox,2019). People are all aware that smoking is bad for them, but they should be aware that taking only one or two cigarettes is still harmful for their body. Another reason for social issue of smoking is social difficulties. In recent years, researchers have been taking a closer look at the emotional and social aspects of tobacco use. Studies show that people who have social difficulties or other disadvantages by society are much more easily to smoke. The people who have social difficulties are twice as likely to smoke compared to people without social difficulties.

Upon all the information above, we can know that children’s curious, socialize and social difficulties will influence people to smoke. If there are any efforts made by smokers to quit smoking and are there efforts effective? ‘Giving up smoking is the easiest thing in the world. I know because I’ve done it hundreds of times.’ —-Mark Twain

Nowadays, more and more people start to become aware that smoking is bad for their body, but with the effect of physiology, to quit smoking will make them feel uncomfortable. Smokers trying to quit only once every 2 to 3 years and most do not use proven treatments (Hughes, 2003). Smoking has to be one of the hardest habits to stop, along with coffee drinking. Once someone decides to stop smoking there seems to be too many alternatives to replace the so-called cancer stick. There are nicotine patches, nicotine gum, nasal sprays and so on. In my opinion, most people who try to quit smoking fail because they have trouble replacing one bad habit with a good one and/or because they are too afraid or too proud to ask for support. Being too proud is a common flaw in New Zealand culture. It is not uncommon for people to not honour their commitment to quit smoking, for most people it just isn’t realistic for them to quit. Smoking is bad for people’s health and environment. More than 8 million people die from tobacco use every year and non-smokers can also be influenced by tobacco. Second-hand tobacco smoke contributes to heart disease, cancer, and other diseases, there are approximately 1.2 million deaths annually caused by second-hand tobacco. The World Health Organization and global partners decide to celebrate World No Tobacco Day(WNTD). This activity is to raise awareness on the harmful effects of tobacco use and second-hand smoke exposure. Also, social smoking-cessation meetings start all around the world to give a further warning to smokers that cigarettes were endangering their health. The government also enforce the laws that people can’t smoke inside the room, public areas or at the smoke-free areas, and increase the price of cigarettes to stop people buying. These social activities and the support of government will help a lot of people to quit smoking or smokeless.

Methodology

Smoking has been around for a very long time. Through our research we will discuss the reasons why people smoke. Three variables we have chosen to focus our research on; are the psychological effects of smoking, the social pressures of smoking and smoking within the family. We will gather information by creating an online survey using survey monkey. We will be using survey monkey because it is easy to use for the participant as well as the researcher.

We will be using simple random sampling methods to ensure fair representation of our data. We will be sharing the survey over Facebook so a random group of people can complete it. We have a diverse group so we will have different responses from people of various backgrounds. Our group hopes to get 100 returned completed surveys. We will be using Lottery Random Sampling to generate the 100 surveys we hope to get for our sample size (Crossman, 2019). This is to ensure that despite how many responses each person gets we will have a fair representation across the total surveyed population. Each of us will choose 25 responses so that our results are random, non-prejudice and gives everyone an equal chance.

We hope to have a sample size of 100. We think this is a fair representation of data. However, we understand that it is entirely luck how many responses we get. To ensure we have enough data, we will be running our survey for approximately one week. We will then use the sample size equation to find the perfect sample size for our population of survey participants (Qualtrix, 2019)

We do have concerns about the methodology of this research proposal. Participants may be untruthful and may not want to answer all of the questions. This leads to compromised results. Another concern will be that we don’t reach our target of 100 responses. This means we are left with an inadequate amount of data to answer our statistical research question.

Conclusion

Our group are confident that the three areas we’ve chosen to focus our research proposal on will determine the answer to our statistical research question- Why do people smoke? To do so, we will create our online survey and gather enough data using all our variables that we have put in to the survey and with the hope our survey participants are honest, answer all the questions and our questions relate to all of our participants.

The world has this consistent tendency to overlook women in many aspects unfortunately this includes health situations. it is not as well-known of a fact that Women are at higher risk for things such as cardiovascular disease and stroke. Not enough studies are done regarding this and when they are done, they do not focus on women as much. Women are not being fully educated on these preventable dangers. The message is not being relayed enough to make it the majority aware of these issues. In the year 1917 the American Tobacco Company released an ad campaign that was specifically aimed at women. As decades went by women were used and targeted in all types of ads for different tobacco companies such as Marlboro and Lucky Strike. Although not as many women smokes as men Women are at a much higher risk of death caused by smoking related lung cancer or Cardiovascular disease. Fortunately, in result of smoking cessation the danger of smoking related diseases can be reduced significantly. The National Institutes of health reports that there have been differences in gender when evaluating smoking cessation. The studies done showed that women were less likely to find success in Tobacco dependence treatment clinical trials (Smith P. 2015). In educating the population the message should also include that it is never too late to quit. No matter if an individual has been smoking for six months or six years quitting can be beneficial, and differences can be seen over time. “Smokers who stop before their mid-30s have approximately the same life expectancy as never smokers” (West R. 2017).

Obviously, the sooner the better but tobacco users should not feel as though there is no hope. There are places to turn and many options and it is much easier said than done to just quit. So, what treatments are more commonly successful for women in smoking cessation and what types of health benefits can they have?

Every individual is different meaning what might be successful for some might not be successful for others. But there are many pathways that a smoker attempting to quit would be able to try. Some medications such as Zyban and Chantix can do some good as well as over the counter products such as the nicotine patch and nicotine gum. There are also options for those who would rather not try out medications. For many others group therapy and behavior therapy has been a success. Just being able to talk to other in a similar situation can be a crucial part of the process. Following processes like these or ones that are similar can lead to enormous benefits some are even quickly (West R. 2017).

Minian’s study (2016) came to this conclusion relating to Treatments: “All female clients had sought treatment in an outpatient smoking cessation clinic in Toronto, Ontario that provides individualized treatment to both women and men. A variety of services are provided by an inter-professional team, including support groups, educational workshops, brief individual counselling, pharmacotherapy, Nicotine Replacement Therapy [NRT], bupropion, and varenicline), and self-help materials. Clients seeking treatment in this clinic on average tend to be more heavily nicotine dependent, older, less educated, have a lower income, and report a greater number of previous unsuccessful quit attempts than the general population of smokers in Ontario [21]. Close to half of those who seek treatment in the clinic are women.”

The study not only strongly expressed the aspect of smoking cessation in Women, but it touched on how it was more difficult for people who were older and didn’t have privileges of education to see success in working to quit.

Minian’s study concluded with this statement regarding the subject: “An ideal program for women appears to be one that includes sufficient variety and choice to permit each woman to self-identify the particular combination of services that supports her own unique needs, flexible free pharmacotherapy, non-judgmental support, accessible services and clear communication of program options and changes.”

Minian and her colleagues found that although the treatment styles were not always successful, they were more likely to be successful when the treatment was able to be flexible and fit the needs of the individual. The study focused on smoking cessation in women and was done with a total of four focus groups with tobacco users.

Even for a long-term smoker deciding not to smoke for a day or too will receive results. The process will result in not only physical benefits but mental ones as well. Some physical examples will include not being out of breath as easy and cough much less. Quitting smoking can also reduce further damage to the lungs and lower blood pressure and heart rate. Smoking cessation can result in stronger immune system, muscles, and bones. In that it is possible to prevent Osteoporosis which is more common in Women especially those who smoke. Visual changes in result of smoking cessation include cleaner mouth and skin, reduction of belly fat and risk of diabetes, and improvements in sense of taste and smell. Cessation of smoking can increase the probability of a healthy pregnancy.

Smoking cessation not only benefits the body but can benefit the mind and one’s mental health. An increased energy and a feeling of control is a part of the success that would following with smoking cessation. Smoking cessation can also benefit an individual’s bank account. The cost of a pack can varies from five dollars to fifteen dollars. Organizations against underage smoking and tobacco products in general have gotten a smoking tax added in order to prevent young teens from attempting to purchase it. Those who smoke a pack a day could be spending three grand a year just on their smoking habit. Some Companies have added pay incentives that give employees who don’t smoke more money. This incentive is in hopes that employees will quit for a higher pay. Employees smoke breaks can add up to four hours a week just of smoking at work. Companies do this mostly for the sake of productivity but there can also be a hope that this can increase a desire for more people to quit smoking altogether or even lessen their tobacco usage.

This study done by the ACP (1993) found that: “Compared with continuing smokers, former smokers had a 24% reduction in risk for cardiovascular disease mortality within 2 years of quitting. The excess risks for total mortality and both cardiovascular disease and total cancer mortality among former smokers approached the level of that for never smokers after 10 to 14 years of abstinence. The health benefits of cessation were clearly present regardless of the age at starting and daily number of cigarettes smoked.”

The study found fast results in reductions and therefore an increase in the quality of life in those who quit smoking. Although it does not mention this information Women are at a higher risk for cardiovascular disease. The purpose of this study was to compare smoking Cessation in relation to total mortality rates in women. It was identified as a prospective Cohort study with registered nurses that had follow up going on for about 12 years. The conclusion that was come to be that following cessation decreased the total mortality rates at a drastic level (Kawachi. 1993).

In evaluation of all the research that has been done there is no question that women have a much harder time being successful in smoking cessation than men. But there is still hope if more research is done and better treatment plans are put into place. Health experts would be able to set up a proper treatment plan based on each individual and what works for them.

It is important that the world puts the same effort in research for women’s health as they do men’s health. It is crucial that women are made aware the dangers of smoking and the benefits that come with quitting. Health education is not where it needs to be and not just on the topic of the dangers of smoking. That is something that needs to be changed it should be a priority to make sure that people are educated as much as possible on their health. Especially in regards of preventable illnesses or death. Although women are at a disadvantage when it comes to smoking cessation there is a hope for success in changing that. If more time given by medical professionals can be put into making sure individuals are able to follow treatments fitting their needs, then there would be a higher success rate for smoking cessation in women. Being aware of the treatments that are more commonly successful for women in smoking cessation and what types of health benefits can they have would be a step in the right direction and from there getting to know the individual, their lifestyle, and any histories of health issues. Now society has reached a point in time where vaping has gained more popularity than smoking cigarettes, but it is a similar problem only adapted for 2019. The problem is only growing so what can be done. More research must be done, and all factors and all groups must be considered when doing so. As this issue changes and expands it is important it be taken seriously. The world needs to get ahead of this problem before it has higher rates of mortality caused by tobacco use. The entire population of women deserve the same attention to their health-related issues as men. the future of our world depends on making that shift. Equal rights can be talked about for a long time but action speaks louder than words.

References

1. Kawachi, I., Colditz, G. A., Stampfer, M. J., Willett, W. C., Manson, J. A. E., Rosner, B., … Speizer, F. E. (1993, November 15). Smoking Cessation in Relation to Total Mortality Rates in Women: A Prospective Cohort Study.
2. Minian, N., Penner, J., Voci, S., & Selby, P. (2016, March 12). Woman focused smoking cessation programming: a qualitative study.
3. Smith, P. H., Kasza, K. A., Hyland, A., Fong, G. T., Borland, R., Brady, K., … McKee, S. A. (2015, April). Gender differences in medication use and cigarette smoking cessation: results from the International Tobacco Control Four Country Survey.
4. Ussher, M., Aveyard, P., Manyonda, I., Lewis, S., West, R., Lewis, B., … Coleman, T. (2012, October 4). Physical activity as an aid to smoking cessation during pregnancy (LEAP) trial: study protocol for a randomized controlled trial.