Smoking and Lung Cancer Among African Americans

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Introduction

According to DeSantis, Naishadham and Jemal (2013), the African Americans disproportionately carry the burden of cancer in the United States. Unlike other races, they have the highest number of cancer deaths as they are less likely to survive cancer. Lung cancer is mainly caused by smoking. It accounts for more than fifty percent of all cancers that affect the African Americans. For example, the State of Ohio records higher lung cancer death rates among African Americans than any other race. Evidently, the prevalence of smoking among African Americans living in Ohio is higher (30.1%) than that of Whites (27.3%). This is in terms of the types of cigarettes smoked and the intensity of smoking (Tyczynski & Berkel, 2005). This simply shows that targeting smoking can easily reduce the rate of lung cancers in African Americans. As Green and Davis (2004) note, unlike other cancers, lung cancer is highly preventable. The highly preventable nature of lung cancer and its prevalence in African Americans makes this topic suitable for research. Essentially, targeting smoking-related prevention strategies can significantly reduce lung cancer rates among African Americans and the overall rate of cancer at the national level.

In this respect, this research paper conducts a literature review to explore the topic. Primarily, the research paper provides insight on the significance of the issue to the African Americans and the community health nurses. Besides, the paper discusses why the issue is of major public concern and what exact implications it has for community health nurses. Ultimately, this research paper formulates preventative intervention strategies that focus on smoking to reduce lung cancer incidents in African Americans.

The Significance of the Topic to African American and Community Health Nurses

The research of Mina et al. (2011) indicates that the African American patients who have lung cancer show high rates of chronic obstructive pulmonary disease (COPD). In cancer patients, COPD is triggered when spirometry obstructs airflow or consistent changes with emphysema are recorded on CTs. This implies that African Americans with lung cancer also have to deal with COPD. Besides, African Americans consume more menthol cigarettes than any other ethnic group. Menthol cigarettes increase the risk of cancer among African Americans. According to a research that Brooks, Palmer, Strom and Rosenberg (2003) conducted, the combustion of menthol products results in carcinogenic effects on lung tissues. Furthermore, menthol has anesthetic and cooling effects that allow deeper inhalation, longer retention and larger puffs in the lungs. This exposes the African Americans to more carcinogenic elements. Moreover, most of the African Americans belong to the middle and low-income class. In addition, lung cancer is a terminal disease that may require long-term management. These two factors affect the African Americans’ quality of life, including their ability to cater for cancer medical expenses and conduct daily life activities. As a result, most African Americans with lung cancer receive insufficient or substandard treatment, thus increasing their mortality rate. Exploring this topic and coming up with smoking-focused preventative strategies significantly counter the negative effects of lung cancer by preventing its occurrence. This means that there are reduced rates of COPD, low cancer rates from menthol cigarettes, higher living standards and minimal loss of productivity. Hence, this issue is highly significant to the African Americans.

According to Meadows (2009), community health nurses (CHNs) have a responsibility towards the underserved populations that are at a high risk and the overall community health. African Americans are at a high risk of getting lung cancer because of their smoking behavior. However, they are underserved as little attention and help are directed to them. This topic provides a platform for the CHNs to advocate and help the African American population counter lung cancer. The remedies and recommendations herein provide insight on how, as a nurse, I can employ my community health nursing skills to work with the African Americans to reduce lung cancer incidences. This will contribute to the overall community health as overall cancer incidences will decrease within the community.

Effects of Smoking on Lung Cancer among African Americans as a Major Concern for the Public

According to Siegel, Ward, Brawley and Jemal (2011), an individual’s health is inseparable from the community’s health. Smoking related lung cancer is among the leading causes of death in the country with a record of over 440,000 deaths annually. Hence, the increased rates of African Americans with lung cancer contribute to enhanced mortality rates and cancer rates in the United States. Like other forms of cancer, lung cancer contributes to the increased cancer costs in the country. Fundamentally, in year 2008, cancer cost $201.5 billion. The direct medical costs amounted to $77.4 billion while indirect mortality costs amounted to $124 billion. This simply means that the public is being taxed more to cater for the increased African American lung cancer rates that contribute to increased cancers at the national level. In addition, the public is losing on economic growth due to loss of productivity ($124 billion) caused by premature deaths from the African Americans lung cancer. Besides, insurance companies have to contend with paying huge amount of money to cater for the increased costs in treating African Americans who have lung cancer. More so, healthcare practitioners and the government have to shift their focus on African Americans who have lung cancer to ensure that they are treated properly. Hence, the increased African-Americans smoking-related lung cancer affects everyone within the public domain.

Remedies

In collaboration with healthcare organizations and other interested parties, community health nurses should periodically offer free lung cancer screening to the African American smokers. This would be beneficial in detecting lung cancer at early stages, including the slow-growing lung cancer. This would enable health practitioners and CHNs to effectively treat lung cancer at a lower cost and reduce smoking-related cancer incidents among African Americans (Villanti, Jiang, Abrams & Pyenson (2013).

Effectively, health care policy advocates that including CHNs and healthcare agencies should rally the government to impose strict tobacco control. Underwood’s (2003) research shows how tobacco advertisements highly influence African American smoking behaviors. Tobacco companies conduct outdoor advertisements in African American communities and create brands, such as mentholated cigarettes that specifically target African Americans. Healthcare stakeholders should rally for tobacco controls that prohibit pervasive and specific advertisements due to the vulnerability of the group. In addition, any general advertisements should be mandated to warn African Americans concerning their high risk of getting smoking-related lung cancer.

More so, the government should help the CHNs and other healthcare professionals to set up free smoking cessation programs. CHNs have the greatest impact because they record increased interaction with community members. They should take the leading role in counseling those who smoke to encourage them to quit. Nurses who record high outcomes interact more with patients to persuade them to switch to the healthy lifestyle without cigarettes (Borelli, et al., 2001). Instead of ‘asking and advising’ patients, they ‘assist or organize’ follow-ups. Hence, to have effective outcomes, CHNs should ask, advice and assist African Americans to quit smoking. Nurses’ focus should be on assessing factors that motivate patients to cease smoking, organizing smoke cessation techniques and informing patients about the gains of quitting smoking. Besides, they should inform smokers about smoking-cessation aids, such as bupropion and Nicotine replacement therapy (Youdan & Queally, 2005).

In addition, healthcare stakeholders should create awareness among African Americans regarding the need to quit smoking among population. The stakeholders can do this at the community health centers during screening and normal visitations. Also, they can do this during community social events, including meetings and parties. Specifically, CHNs should take the leading role in creating awareness by increasing their rate of interaction during these events.

Implications for the Practice of the Community Health Nursing Now and In The Future

This research highlights the need for CHNs to focus on high risk, vulnerable and underserved groups to counter emerging health issues at an early stage. They should do this to mitigate cases similar to African Americans smoking-related lung cancer. Particularly, the remedies highlight the need for CHNs to access theoretical and practical training when it is necessary. This would enable them to offer opportunistic interventions, such as advice and counseling to the high-risk groups. Considering that CHNs interact with the community more than other healthcare practitioners do, they should take a leading role in community health issues.

Recommendations

Community health nurses should familiarize themselves with communities. They should study them to identify their immediate health concerns, risks and vulnerability. This would help them identify high-risk communities and counter the health problems that may place communities at risk.

References

Borelli, B., Hecht, J.P., Papandonatos, G. D., Emmons, K. M., Tatewosian, L. R., & Abrams, D. B. (2001). Smoking-cessation counseling in the home: Attitudes, beliefs, and behaviors of home healthcare nurses. Am J Prev Med, 21 (4), 272-777.

Brooks, D. R., Palmer, J. R., Strom, B. L., & Rosenberg, L. (2003). Menthol cigarettes and risk of lung cancer. American Journal of Epidemiology, 158 (7), 609-616.

DeSantis, C., Naishadham, D., & Jemal, A. (2013). Cancer statistics for African Americans, 2013. CA: A Cancer Journal for Clinicians, 63, 151-166.

Meadows, P. (2009). Community health nursing. American Journal of Nursing, 109, 19.

Mina, N., Soubani, A. O., Cote, M. L., Suwan, T., Wenzlaff, A. S., Jhajhria, S., Samarah, H., … Schwartz, A.G. (2011). The relationship between chronic obstructive pulmonary disease and lung cancer in African American patients. Clinical Lung Cancer [Clin Lung Cancer], 13 (2), 149-156.

Siegel, R., Ward, E., Brawley, O., & Jemal, A. (2011). Cancer statistics, 2011. CA: A Cancer Journal for Clinicians, 61, 212–236.

Tyczynski, J. E., & Berkel, H. J. (2005). Mortality from lung cancer and tobacco smoking in Ohio (U.S.): Will increasing smoking prevalence reverse current decreases in mortality? American Association for Cancer Research, 4, 1182.

Underwood, S. M. (2003). Reducing the burden of cancer borne by African Americans if not now, when? Cancer Epidemiol Biomarkers Prev, 12, 270-278.

Villanti, A. C., Jiang, Y., Abrams, D. B., & Pyenson, B. S. (2013). A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions. PLUSONE, n.p. doi:10.1371/journal.pone.0071379.t001

Youdan, B., & Queally, B. (2005).Nurses’ role in promoting and supporting smoking cessation. Nursing Time, 101 (10), 26.

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