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Health Promotion and the Nurse

Introduction to Tobacco Quit Campaign Analysis

There is a high proportion of smokers in the population of Aboriginal and Torres Strait Islanders living in western Sydney, which is an evident issue in this group concerning health issues (Golechha, 2016). As it poses a huge burden on the health system, this challenge has to be deemed severe. Tobacco usage is a crucial preventable component that leads to the life expectancy deficit. It is considered safe to quit smoking, particularly for those smokers who stop smoking before they turn 35 years of age. This holds their death rate equal to that of non-smoking people. Data shows that multiple smoking reduction interventions have been effective in lowering smoking rates in the United States (Sharma, Khubchandani & Nahar, 2017). This report would also investigate this health issue, create a health promotion project, and address the preparation of the project, its execution, and the assessment process.

Background of Tobacco Quit Campaign Analysis

Societal costs such as lost efficiency, health care pressure, insecurity, and environmental degradation are responsible for the use of tobacco (Golechha, M, 2016). In Aboriginal and Torres Strait Islander, adults who may be called frequent smokers, the smoking percentage is more than twice the percentage of non-Aboriginal adults in the population (Thomas, 2017). Therefore, the prevalence of smoking in Aboriginal and Torres Strait Islanders is unavoidable and should be prioritized as the most significant concern in the preparation of health strategies.

In general, cessation of smoking is synonymous with an intention not to smoke, any extra tobacco beginning at a certain moment, or maybe said an effort to stop. It leads to resistance from the temptation to smoke, which leads to the abstinence point. If the person begins to smoke regularly again, he/she will hit the stage of recurrence (Chamberlain, 2017).

Various other causes contribute to the practice of smoking, called social determinants that control people's actions and well-being, which occur in the physical and social environment. They are considered disadvantaged concerning Aboriginal and Torres Strait Islander residents, which may be a fundamental component of high tobacco use rates in this population category (Thomas, 2017). It has been found that all normal socioeconomic indicators, such as education, jobs, and housing, are poorer for this population group relative to other Australians (Thomas, 2017). Thus, when coping with tension, they smoke finding it a mechanism to cope. The stress-responsible components are linked to their environment which can include the absence of their friends or families, the absence of acceptance outside the group, or the absence of their land (Valera, 2020). Therefore, it should be prioritized in Tobacco quit programs to heal the stress of these individuals and try to alleviate their pain.

Public education is a crucial element in the attempts to discourage the initiation of smoking and also to promote the prevention of smoking concerning smoking cessation (West, 2017). Smoking and cardiac disorders such as coronary heart attack, stroke, subclinical atherosclerosis, respiratory diseases such as chronic obstructive pulmonary disease, pneumonia, and cancer have been shown to have a causal link (West, 2017).

Counselling, education, and nicotine replacement therapy can be used with smoking prevention measures. Different approaches are effective in therapy, including face-to-face therapy, mobile counseling, social media engagement, knowledge, and growth of health care personnel, such as front line workers, pharmacists or doctors, and health volunteer counseling (Sharma, Khubchandani & Nahar, 2017).

Aims and Objectives

This Tobacco Quit initiative seeks to minimize the incidence of smoking by 30 percent in the Aboriginal and Torres Strait Islander population, that lives in western Sydney. When opposed to other Australians, because of the high smoking percentage, the Aboriginal and Torres Strait Islander populations have a short life expectancy. Therefore, this campaign aims to reduce the consumption of tobacco and increase life expectancy (Sherman, 2019). There are further steps that would be necessary to achieve the fundamental objective. The campaign will concentrate on working for:

  • Attempting to raise the number of people who stop smoking
  • An increasing number of people who will never get started

The activities of the campaign will be based on achieving:

  • Improving group engagement and supporting residents to minimize smoking.
  • Improving public knowledge of the risks of nicotine and how it can affect people's health.
  • Helping health providers and health educators to better understand how smoking can have an effect on health and how people can be persuaded to stop smoking.
  • Showing the positives of never smoking for young people.
  • Limiting passive smoking.
  • Sharing best practices for their actions within the Aboriginal and Torres Strait Islander communities.

The Tobacco quit campaign will work until 30th June 2022.

Implementation Plan

To achieve success, preparing for the achievement of goals and priorities is important. To use existing resources efficiently for the implementation and execution of the health promotion program, coordination is required. Neighborhood locations such as institutions, community centers, libraries, malls, and health clinics may be the venue for the execution of activities. Stakeholders may be members of the society, volunteers, community officials, health employees, agents of the city authority. The stakeholders will be seen in the large setting and aim of the Tobacco Quit Campaign. Stakeholders can include volunteers or organizations from their environment to work on the initiative. Education on stopping smoking and how to promote campaign events will be offered to volunteers. The training course will be held at the nearby community center for 14 days, with a 90-minute session every day. Campaign activities will be based on evidence, to make them effective, and measurable to find their effectiveness.

Surveys will be performed at local health facilities and service facilities for smoking rates, associated awareness, and behavior, desire to stop smoking, and desired methods (South Western Sydney Local Health District, 2018). The campaign will also be based on marketing through social media. There will be a particular website and Facebook page for the campaign. The campaign will be advertised at numerous local events as well. Treatment for smoking reduction would be provided to strict smokers in social environments, including pharmacotherapy, to treat their nicotine dependency (Valera, 2020). It would ensure that midwives and health care staff are well aware of, for example, nicotine replacement treatment methods for smoking reduction (Harris, 2019). If required, increased growth tools would be provided to healthcare employees to make them successful. Also, the campaign will run motivational smoking cessation programs for Aboriginal and Torres Strait Islander pregnant women that can produce an effective outcome (Harris, 2019).

Participatory discussion or discourse can be considered as the first significant element in initiating tobacco cessation. It is really important to establish a two-way dialogue with the person who encourages smoking abstinence, who may be a psychologist or health care volunteer or instructor, and the smoker who wishes to stop, according to Freire's model for adult education. In that talk, the facilitator highlights the benefits of cessation of smoking against smoking-related drawbacks (Sharma, Khubchandani & Nahar, 2017). Via tailored group therapy via face-to-face contact or through social media or mobile, that communication can be accomplished.

Teaching/Activities–Resources

To fulfill the goals and priorities of the program, resources would be needed. Most notably, as well as preparation materials and treatment materials, support from stakeholders would be needed. For the promotion of initiatives, for the education and understanding of people who are ignorant of cessation methods and adverse consequences of smoking, informational materials are important. Brouchers, flyers, and pamphlets would be included with it. There would be a major aspect of community engagement and trust, which will be central to the success of this Tobacco Quit campaign. Besides, in producing the necessary outcomes, the investment made by health care staff, volunteers, government agencies, institutions, through their cooperation and participation would be very significant. There will be a strong need for consultation and collaboration from community groups and their interest in producing short-term outcomes.

Each training exercise will last 90 minutes in the Quit Tobacco campaign. The instructional material will be focused on smoking disadvantages, risk factors linked to smoking, adverse consequences of passive smoking, smoking prevention methods, techniques, and recovery alternatives (Patnode, et al., 2015). Volunteers and community members will be selected to engage in educational therapies for the target population based on their skill. Topics that will be discussed include smoking-related health hazards, lifestyle techniques, and strategies for stress management; and how to teach the target audience. In the formal curriculum, smoking, cultural, societal, and economic consequences, figures and information will be discussed. Smoking therapy drugs and their effective use will also be included in the instructional material (Sherman, 2019). The facilitators aimed to recognize common challenges that participants have with stopping smoking, address problems with the community, offer additional resources for recovery, establish stability in the community, encourage dialogue, and help the group learn the required coping strategies to move from becoming smokers to ex-smokers (Valera, 2020).

In 2010, 68.8 percent of adult smokers wished to stop smoking and 52.4 percent had made a stop effort in the past year, but only 6.2 percent had been successful in stopping, the Centers for Disease Control and Prevention (CDC) reported. It has been acknowledged that it can be productive to work by a stage-based therapy approach to avoid smoking (Sharma, Khubchandani & Nahar, 2017). Once those who wish to stop smoking are known, they may seek medication and behavioral treatment. Practical counseling can be given by counseling and therapies; peer support and social support assistance outside the therapy boundaries. To decrease smoking rates, behavioral therapies and pharmacotherapy may be effective alone or together (Patnode, et al., 2015).

A Model will be used for Smoking Cessation that will include the following steps:

  • Precontemplation (Before a plan of quit smoking):
  • When smokers are unwilling, unaware, or too discouraged to change their behavior towards smoking.
  • Contemplation (planning for quitting)
  • Individuals are smoking currently but thinking about stopping smoking within the next six months.
  • Individuals look for related information, re-evaluate their smoking behavior, and look for others' supp
  • Individuals may remain at this stage, for long periods, may be years.
  • Preparation (planning for quitting in next thirty days)
  • Currently, smoking but are ready to quit smoking, in the coming days and are confident about it.
  • Action (successful in quitting for about 6 months)
  • Patients are modifying actively, their environment, and habits.
  • They have quit smoking within the past 6 months.
  • Control of stimulus and emotions are required to prevent relapse.
  • Behavior change can be associated with feelings of fear of failure, guilt, and limitation on self-freedom.
  • At this stage emotional support from family or friends is vital.
  • Maintenance (no smoking for more than 6 months)

The above model is needed to manage the behavioral changes in individuals before, during, and after smoking cessation (Sharma, Khubchandani & Nahar, 2017). Advocacy is carried out by neighborhood health care professionals and volunteers before stopping, during abstinence, and after smoking cessation. There will be face-to-face target group interventions, as well as telephone counseling, so it will be impossible to access a wide portion of the population through face-face interventions, so it will be replaced by telephone counseling where possible. Telephone counseling may be initiated either by a psychologist or by a smoker (Hersi. Et al . 2019). Counseling by either medium can be highly productive as it has been studied that the incidence of smoking abstinence in women during pregnancy who received counseling was higher than other women who did not receive either form of counseling (Patnode, et al., 2015). Via guidance guides, brouchers, and program pages, patients can also access interventions without overt contact with healthcare professionals via self-help (Hersi. Et al., 2019). It has also been noted that in teenagers, smoking reduction practices focused on text messages can also be successful (Mussener, 2020). Text-messaging would also therefore be a medium for campaign marketing and more contact with the target audience.

Human behavior will be considered for "Emotional transformation” which is a term taken from the theory of Emotional intelligence. It suggests that bringing cessation is an individual’s ability that directs his/her emotions to reach the stage of being free from smoking. That emotional intelligence motivates one person to overcome fears and doubts concerning the cessation of smoking. In this regard, a role-play will be conducted as an educational intervention, to show how to manage with Emotional Intelligence (Sharma, Khubchandani & Nahar, 2017).

Evaluation Plan

The evaluation of the Tobacco quit campaign will be performed to find:

  • What was the effectiveness of the campaign?
  • Did it fulfill the needs of the Aboriginal and Torres Strait Islander communities?
  • Did it achieve its target for long-term aims and objectives?
  • The pattern of change, if any change occurred in the community through this campaign

This initiative would concentrate on the short to medium-term effects of the initiative, with a timeline of 1 year, to decrease smoking rates in unique neighborhoods. In 3 years or five years, the long-term effect will be measured (Circa, Final Assessment Report, 2018). The assessment will use a template of a mix of methods. For assessment purposes, the mixture of quantitative and qualitative data will be used as well as tracking data (data obtained in normal procedures) will be used in assessing the success of the campaign. Data will be obtained in two waves (October to December 2020 and October to December 2021) for the first year. Based on the success of the initiative, it will be determined whether to continue the initiative for the next two years or not (Circa, Final Assessment Survey, 2018). The assessment will also provide combined input from the two waves, which will be given by written responses. Both campaigns, their efficacy, and facilitators will be tested, as well as what obstacles have been faced during campaign implementation activities will also be tested. Besides, the campaign team member will also be surveyed by email to identify any defects, modification, or improvement expected.

Conclusion on Tobacco Quit Campaign Analysis

Current clinical evidence and literature have shown that tobacco cigarettes and nicotine dependency are unhealthy. Smoking is considered a risk factor for multiple cancers and is also the underlying cause of morbidity and mortality that can be avoided. However, it can be expected that the intended outcomes will be obtained by this Tobacco Quit campaign, through the implementation of correct intervention protocols to the target population. There are, however, some drawbacks that may have a profound effect, such as involvement by individuals and groups in society. For this campaign, their engagement would be extremely significant.

References for Tobacco Quit Campaign Analysis

Chamberlain, C., Perlen, S., Brennan, S., Rychetnik, L., Thomas, D., Maddox, R., ... & Eades, S. (2017). Evidence for a comprehensive approach to Aboriginal tobacco control to maintain the decline in smoking: an overview of reviews among Indigenous peoples. Systematic reviews6(1), 1-28. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504765/

Circa, 2018. Tackling Indigenous Smoking Program. Retrieved from https://www.health.gov.au/sites/default/files/tackling-indigenous-smoking-program-final-evaluation-report.pdf

Golechha, M. (2016). Health promotion methods for smoking prevention and cessation: a comprehensive review of effectiveness and the way forward. International journal of preventive medicine7. DOI: 10.4103/2008-7802.173797

Harris, B. M., Harris, M. L., Rae, K., & Chojenta, C. (2019). Barriers and facilitators to smoking cessation within pregnant Aboriginal and/or Torres Strait Islander women: An integrative review. Midwifery73, 49-61. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30878900/

Hersi, M., Traversy, G., Thombs, B. D., Beck, A., Skidmore, B., Groulx, S., ... & Selby, P. (2019). Effectiveness of stop smoking interventions among adults: protocol for an overview of systematic reviews and an updated systematic review. Systematic reviews8(1), 28. DOI https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-018-0928-x

Müssener, U., Linderoth, C., Thomas, K., & Bendtsen, M. (2020). mHealth smoking cessation intervention among high school students: 3-month primary outcome findings from a randomized controlled trial. PloS one15(3), e0229411.DOI: https://journals.plos.org/plosone/article/citation?id=10.1371/journal.pone.0229411

Patnode, C. D., Henderson, J. T., Thompson, J. H., Senger, C. A., Fortmann, S. P., & Whitlock, E. P. (2015). Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the US Preventive Services Task Force. Annals of internal medicine163(8), 608-621. DOI: https://pubmed.ncbi.nlm.nih.gov/26491759/

Sharma, M., Khubchandani, J., & Nahar, V. K. (2017). Applying a new theory to smoking cessation: the case of multi-theory model (MTM) for health behavior change. Health promotion perspectives7(2), 102.DOI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350547/

Sherman, J. J., & Smith, B. L. (2019). Effect of a smoking cessation educational intervention on knowledge and confidence of pharmacy students versus community leaders. Pharmacy Practice (Granada)17(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463408/

Thomas, D. P., Panaretto, K. S., Davey, M., Briggs, V., & Borland, R. (2017). The social determinants and starting and sustaining quit attempts in a national sample of Aboriginal and Torres Strait Islander smokers. Australian and New Zealand journal of public health41(3), 230-236. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/1753-6405.12626

Valera, P., Acuna, N., & Vento, I. (2020). The Preliminary Efficacy and Feasibility of Group-Based Smoking Cessation Treatment Program for Incarcerated Smokers. American Journal of Men's Health14(4), 1557988320943357.Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7383630/

West, R. (2017). Tobacco smoking: Health impact, prevalence, correlates, and interventions. Psychology & Health32(8), 1018-1036.DOI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490618/n

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