Research Project on Smoking
Smoking is the largest single preventable cause of death and disease in Australia. With an increase in public awareness and research, prevalence of smoking is slowly making a decline. (Quit Victoria, 1995)
Interventions are used to aid people with the cessation of smoking, and through either independent quitting or using the help of programs around 150,000 Australians successfully quit smoking each year. Looking at a case study of a twenty five year old office manager Ellen we can consider whether she is likely to have the qualities to categorise her as a typical smoker. These factors include her age, gender and motivation for beginning to smoke which can all help to determine the best cause of action and possible suitable interventions to aid Ellen in successfully quitting smoking.
Australian statistics indicate that the prevalence of smoking amongst women is lower than it is for males, but the difference between the two sexes has considerably lessened over recent years. (Allen, F, 2000) These statistics suggest that gender plays only a small role in the likeliness of taking up smoking, which means that Ellen's sex is irrelevant in her behaviour of smoking. Ellen is now twenty- five years old but began smoking when she was only eighteen. Statistics suggest that young people who have gone on to complete a tertiary degree are less likely to take up smoking than those who did not finish year twelve or who went straight into the workforce after school. (Evans, M 2000) Ellen entered the workforce at a young age suggesting she could be more likely to take up the act of smoking than someone who went on to further studies.
The reasons that people begin smoking and continue to smoke are varying from each individual to the next. (Brannon, L. 2000) With an increase in public awareness of the risks and potential life threatening diseases associated with smoking a majority of young people begin smoking very much aware of the potential risks.
People begin smoking for an abundance of different reasons. The most popular reasons are associated with rebelliousness, social pressure and tension control.
(Allen, F. 2000) Television often portrays images of smoking being associated with young people who are being rebellious and cool. This imagery can appeal to some children making the behaviour of smoking seem desirable. Social pressure is also a factor that contributes to why people begin smoking. Ellen clearly feels pressured to continue smoking in social situations because her friends do so, thus making quitting harder. Peer pressure to try cigarettes or to be accepted are also reasons children often turn to smoking. Tension control uses cigarettes as a way of dealing with anxiety, stress and worry. Smoking may be used to calm or relax after some sort of tension or anxiety has been experienced. (Allen, F. 2000) Ellen's case seems typical of others smokers as she initially began using smoking as a way of dealing with the confrontations she has with her co-worker. Ellen found that smoking had a calming effect on her after the stress of an argument, therefore smoking became a way of controlling tension.
Interventions are used to provide individuals wanting to quit with the best possible strategy for successful cessation. The most common and well - known intervention is Nicotine Replacement Therapy. (Evan, M 2000) This method if used for Ellen would involve using either a nicotine chewing gum or a nicotine patch that releases a small continuous dose of nicotine into the body. The aim of the patches or the gum is to gradually decrease the amount of nicotine entering the body until the individual is no longer dependant. (Ellen, F. 2000) This type of therapy is generally used for heavily addicted individuals and is generally quite successful.
Although Ellen has tried unsuccessfully before to use this type of intervention, her consumption of a packet a day of cigarettes suggests that this type of intervention could be potentially successful. Psychological based Interventions to aid the cessation of smoking include different strategies such as behaviour modification, cognitive- behavioural approaches, group therapy, social support, relaxation therapy and stress management. (Brannon, L. 2000) Behavioural approaches involve changes in behaviour, such as avoiding certain situations that act as cues for people to light up a cigarette. Emotions such as stress and anxiety can be related with the behaviour of smoking and these stressful situations also provide cues for someone to desire a cigarette. (Brannon, L. 2000) In Ellen's situation she originally began smoking due to a particularly stressful day in the office and an argument with a co-worker. Assuming this approach for Ellen, She would need to be taught that such stresses initiated the act of smoking for her and contributed to her addiction. Group Therapy is aimed at people who wish to quit smoking with the assistance and encouragement of others in similar situations. These groups can be successful in helping people to quit cigarettes but generally are more successful if a nicotine replacement therapy is used as well. (A.C.O.S.H, 2001) Relaxation Therapy and Stress management are interventions that allow individuals to control their stress levels and reduce their need for smoking. Relaxation techniques such as deep breathing, visual imagery are used as stress coping skills that divert the attention off smoking and on to the underlying problem. (Ellen, 2000) Ellen became stressed resulting from an argument with a co- worker and turned to smoking, when the same situation arose she repeated the behaviour of smoking to relax her. Using this type of intervention would allow individuals to self manage their stress without the use of cigarettes. This type of intervention is generally successful if used with another approach, such as Nicotine Replacement therapy. Social support encourages smokers to inform their family and friends of their intentions to give up cigarettes. This sort of support may be as simple as friends not smoking while they are around you, or encouraging you to stay on track. The support of close friends and family gives the individual the best chance at successfully quitting. (Brannon, L 2000) Ellen's friends are smokers and one possible form of social support would be ensuring that they are aware of her desire to quit and respecting her decision by not smoking around her. Ellen had previously tried using Nicotine Replacement therapy and was successful in her attempt for three months before going straight back to a full pack a day. This type of intervention although unsuccessful on the first attempt for, could potentially help Ellen successfully quit if teamed with another Intervention. The behaviour of smoking for Ellen was induced by stress, and she found that cigarettes had a calming effect on her nerves therefore she began to smoke after any stressful situation. Relaxation therapy and stress management could also potentially aid Ellen in the cessation of smoking. Learning this type of management would teach Ellen the coping skills to deal with anxiety without turning to a cigarette. With the aid of both of these approaches and the social support of her friends and family, Ellen can learn to use relaxation to cope in stressful situations while nicotine patches or gum dulled the cravings, until she could decrease her dosage and no longer be dependant on cigarettes. Previous attempts at quitting proved to be unsuccessful for Ellen. Nicotine Replacement Therapy was successful for three months and on her second she attempt completely cut out any intake of cigarettes which proved to be successful for only three weeks. Although Ellen generally believes that cigarettes are unhealthy, she is optimistic in believing that these risks and dangers will not apply to her but rather other smokers. This belief does not positively reinforce Ellen to change her behaviour thus making cessation of smoking more difficult. (Brannon, L. 2000) Ellen's behaviour of smoking is cued when she endures stressful situations at work. Without dealing with the underlying issue, which is Ellen's stress and anxiety, it will be hard for her to successfully give up cigarettes. According to Australian statistics Ellen is what society would call a “typical smoker”. Her age and career path make her more susceptible to begin and continue smoking. The stress placed on Ellen from her workplace and peer pressure from her social circle, are all negative reinforcers to the continuance of smoking. Interventions such as Nicotine Therapy replacement, stress management and social support are therapies that would be of the most potential for Ellen's lifestyle. These Interventions team together to give Ellen the best chance for cessation of smoking.
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