United Kingdom Government’s Definition of Public Health
According to the United Kingdom government, public health entails protection of the masses and citizens from factors that would pose a threat to their health and well-being. It is in the government’s interest to ensure that citizens, despite of prevailing circumstances, ensure that they minimize the event of occurrence of health risks and impact of disease, at large.
The government is well organized to ensure effective dissemination of public health information thus ensuring safety of citizens. The government in the dissemination of public health services, is largely divided into, public sector institutions (PHE) and Independent public health institutions such as the Royal society of public health (RSPH). The public-sector institution in England is subject to political bias and the Royal society of public health are greatly involved in charity, have an informative function and serve with utmost impartiality. Both institutions reach to communities, with public sector institutions using local authorities, service providers and numerous organisations to reach the community, while the latter directly reach the communities in the ground.
The public-sector institutions, issue both information and directives, while the royal society only use information in dissemination of public health awareness. Both have a legislative function, on the other hand, the government funds the public-sector institutions which then fund local authorities while the community issues funding and services to the Independent public health institutions, such as Royal society of public health. Some of the public-sector institutions involved in public health awareness include; Medical Research Council, Public Health England and Medicines and Healthcare Products Regulatory Agency. Examples of local authorities are the Barnet council and Lambeth Council while the local service providers include Chase Farm Hospital. The government plays a role in legislature, funding and policy making.
Successful public health policies involve four elements, in what is referred to as the public health cycle. (Brownson et al., 2017 p.14). The cycle begins with assessment, then policy development procedures, implementation of the policies developed and finally evaluation of the implemented policies.
Assessment before policy development is key, since it is through this step that a problem statement can be accurately defined in respect to medical, social and epidemiological aspects at large. Assessment calls for investigation of existence of the problem in the first instance, and determination of whether the problem exists. Further investigation into the aetiology of the problems is done, populations affected and the extent of the problem in question and the overall effect of the problem to the society and environment.
Public Health Institutions in the UK
Existence of a problem, calls for immediate calculated mitigation to curb the derogatory results. It is at this juncture that policy development is called for. Policy development presents options available to adequately tackle the problem in question with an aim of alleviation. The best course of action from a variety of solutions presented is selection. The cost to be incurred in the implementation of the action is calculated and the long-term effects of the action are considered and factors as to whether the solutions presented are sustainable are considered. Policies are usually used in development of various procedures and often present a reflection of the values the institution involved holds dear. An example of a policy is ban on indoor smoking by the government, which will further involve legislation process and different collaborative actions to make the policy a reality.
A plan is just theoretical, up to the point of implementation. This is the next step in the public health cycle, the directives from the policy are affected. Here, delegation of duties to the respective relevant people is done. There is distribution of the resources necessary for the project to be conducted and methods of ensuring adequate and efficient communication between different public health service delivery bodies is implemented.
The next step in this cycle is the evaluation of the effects of measures implemented in the preceding stage. Reassessment of the initial health problem is conducted, which then leads to an adaptation and improvement of the strategies implemented and the measures taken. Reassessment of the workability of the implemented policies is done and accurate measures are taken.
However, despite the positive effects that implementation of different steps of the public health cycle, it often comes with difficulty in its application. The challenges in the application arise at different steps and due to varying reasons, that could be societal, environmental or financial. Poor assessment may result, this will have a general impact in the development of the problem statement and thus affect general implementation of the solutions created. Development of poor policies would also go a long way in hampering the implementation of policies, since the policies will inadequately tackle the community public health problem presented after assessment. Financial factors are also key since inadequate funding would disable implementation of adequate and effective workforce at the ground and researchers.
Smoking, evidently has a holistic negative impact on the health of an individual. Smoking is a public health issue that requires awareness intervention due to the health risk it poses to the people indulging in the practice and people involved due to passive smoking. (Dawes et al.,2014 p 663-674). Smoking largely has general negative outcomes to an individual’s health, presents no benefit and has widespread consumption. Smoking is largely related to reduction in lifespan levels (Popova et al., 2018 p.85-92) and increase in susceptibility to some oncology conditions such as mouth and throat cancer, notwithstanding ,lung cancer.(Samet , 2016 p.127 )Smoking further predisposes development of dementia (Batty et al., 2018,p. 3).Avoidance of smoking is the most preventable way of evading oncologic complications .Smoking itself leads in premature mortalities and health inequalities in the United Kingdom (Hunt et al .,2018 ,p 129).All this factors contribute to the need of public health awareness campaign against smoking habits as it is a major health problem.
The Public Health Cycle
A public health awareness campaign is aimed at altering mindset to positively influence an individual choice towards avoidance of smoking. Initially, before the development of the campaign against smoking, assessment as to whether it is a problem that warrants smoking to be a rampant public health issue and whether intervention is needed to initiate mitigation procedures for the benefit of the public. Further research should be conducted on whether ,a campaign against smoking has been previously done, its effectivity ,the strategies implemented and whether the campaign was a success and if not the reasons for failure should be well stipulated for the purpose of avoidance .The problem in question which is smoking is assessed, and after confirmation of existence of a smoking menace and relation to the smoking menace having negative impact on health and defining the problems it causes a statistical count of populations affected is taken into consideration to aid in determination of the scope of the campaign to be conducted. Further assessment of the cost the smoking problem causes is done and further consideration of the environmental detrimental effects.
Upon identifying smoking as a challenge, policies are developed in a bid to curb the menace in the long run. As a public health official, I would ensure adequate research into the reasons as to why people indulge in smoking in the first place. Reasons such as smoking being a physiological necessity for sound mind sustenance is major (Jancey, et., al 2014 p 976-983). Further research into places where people prefer to indulge in the practice is taken into consideration, this way appropriate strategies can be implemented. The policies developed should be aimed at informing the masses on the effects of cigarette smoking, at the same time demystifying the myths that exist about smoking. Facts such as smoking causing 96000 deaths annually in the United Kingdom, (Whatling ,2017 p.36-74) should be incorporated in the information campaign. In policy development, methods to curb smoking are discussed, the methods that can be considered include, an age limit set on purchase of cigarettes, just like alcohol. This could be done placing in consideration the rampant smoking during adolescence. (Green et al.,2016 p.203-210). Elaborate warnings on the cigarrete packs could also be implemented, such as smoking cigarette causes throat cancer, such that as the smoker purchases the cigarrete he or she is aware of the health risks involved with a single puff. (Nonnemaker et al.,2016 p.15-22). This may not be effective to addicts, since they heavily depend on the tobacco for sustainability. There could also be hiking in the prices of the prices of the cigarettes to limit buyers due to the cigarettes being expensive and the government could hike the taxes on cigarettes attributing to the detrimental health effects tobacco causes. (WHO,2015 p.26) Also in vending shops, cigarettes should be placed away from direct view, this could go a long way in assisting recovering addicts in overcoming the temptation to smoke. Another policy that could be considered for legislature, is the banning of smoking in public places and work and in the presence of children under 18 years old. Failure of which, fines and other forms of punishment are imposed. Policies on helping people hooked to the habit can also be implemented.
Challenges in Public Health Application
Upon drafting of the policies, implementation of anti-smoking campaigns aimed to deliver information to the public about smoking is done. The anti-smoking campaign could be dubbed a name related to the cause of the campaign, which in this case could be, ‘quit the cigar’. The campaign can disseminate relevant information through various media to sensitize the public. Sensitization could be done through televisions, radio, printed literature such as magazines, posters, flyers and newspapers to reach the readers. Peer education programs can also be used. (Dickerson et al., 2016 p.5). Local groups could reach communities through a sensitization forum on days such as national smoking day.
These mechanisms implemented, are pivotal in the reduction of development of chronic disease resulting from tobacco from halting initiation of tobacco smoking and cessation of affected parties. Of all these methods, a single method that would offer maximum effectivity should be considered and used extensively. A method as such is the use of media, media advocacy would reach a greater population thus target population. The information is disseminated in the media with a sole purpose of altering the public opinion and thoughts. Dissemination should be goal oriented, objective efficiently deliver the target message to the target group. The media is especially important in anti-smoking awareness among the youth. In a previous study, this measure significantly decreased smoking among young girls and boys.
Tobacco use in shisha pots, commonly known as water pipes reduces markers for proper lung function predisposing onset of respiratory diseases such as bronchitis. (Buss and Hurst 2015, p.499). Of public health concern is the transmission of infectious diseases such as hepatitis C and tuberculosis. (Braun et al.,2014, p 661-667) This is another tobacco smoking component that needs to be adequately addressed due to increasing consumption, most especially by young people.
The final step in a public health campaign is the evaluation on the effectiveness of the policies implemented. During evaluation critical thinking is key on the general outcome of the campaign. However, making a correlation may not adequately indicate a causal relationship. Evaluation on whether tobacco smoking has received a declining response or there has been a shift or stagnation after the policy implementation. This can be done using a public survey and in collaboration with health facilities. During evaluation, factors such as fulfilment of the campaign objective, which was cessation and stopping initiation of smoking practices. Failure of which, other strategies can be implemented for a favourable outcome.
Smoking as a Public Health Issue
In the public health campaign, upcoming problems such as the use of E-cigarettes should be considered. The use of E-cigarettes, is common among middle and high-school students, this ever-increasing trend making it crucial to come up with intervening measures. (Kong et al., 2014, p 847-854). According to research conducted, various reasons have come up from correspondents indulging in E-cigarettes. some of the reasons include; that the e-cigarettes aided in quitting of smoking tobacco. Others said that they had already tried to quit smoking tobacco, so used the e-cigarettes to aid the process. Reasons such as saving on money, avoid the risk of passive smoking involved in smoking actual tobacco, to reduce amount of tobacco smoked and the urge to smoke tobacco and ending up using e-cigarrete as a substitute, arose. It is clear that the dangers associated with vaping is not well known. According to researchers-cigarrete vapour causes DNA mutation causing cancer complications. (Yu et al.,2016, p .58-65) Despite the Public Health of England urging smokers to revert to vaping arguing less risk involved, the world health organization still insists that the e-cigarettes have overall health detrimental effects. Public Health campaign intervention measures against smoking, has previously and will continue making milestones in a future tobacco free United Kingdom.
References
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Blachman-Braun, R., Del Mazo-Rodríguez, R.L., López-Sámano, G. and Buendía-Roldán, I., 2014. Hookah, is it really harmless?. Respiratory medicine, 108(5), pp.661-667.
Brownson, R.C., Baker, E.A., Deshpande, A.D. and Gillespie, K.N., 2017. Evidence-based public health. Oxford University Press.
Buss, L. and Hurst, J.R., 2015. A review of the health effects of smoking shisha. CLINICAL MEDICINE, 15(5), pp.499-499.
Dawes, P., Cruickshanks, K.J., Moore, D.R., Edmondson-Jones, M., McCormack, A., Fortnum, H. and Munro, K.J., 2014. Cigarette smoking, passive smoking, alcohol consumption, and hearing loss. Journal of the Association for Research in Otolaryngology, 15(4), pp.663-674.
Dickerson, F.B., Savage, C.L., Schweinfurth, L.A., Medoff, D.R., Goldberg, R.W., Bennett, M., Lucksted, A., Chinman, M., Daumit, G., Dixon, L. and DiClemente, C., 2016. The use of peer mentors to enhance a smoking cessation intervention for persons with serious mental illnesses. Psychiatric rehabilitation journal, 39(1), p.5.
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Kong, G., Morean, M.E., Cavallo, D.A., Camenga, D.R. and Krishnan-Sarin, S., 2014. Reasons for electronic cigarette experimentation and discontinuation among adolescents and young adults. Nicotine & Tobacco Research, 17(7), pp.847-854.
Nonnemaker, J., Kim, A., Shafer, P., Loomis, B., Hill, E., Holloway, J. and Farrelly, M., 2016. Influence of point-of-sale tobacco displays and plain black and white cigarette packaging and advertisements on adults: Evidence from a virtual store experimental study. Addictive behaviors, 56, pp.15-22.
Popova, Lucy, Johannes Thrul, and Stanton A. Glantz. “Effects of Large Cigarette Warning Labels on Smokers’ Expected Longevity.” American journal of health behavior 42, no. 2 (2018): 85-92.
Samet, J.M., 2016. Smoking and cancer. Oxford Textbook of Oncology, p.127.
Whatling, A., 2017. Incentives to reinforce positive patient behaviour. Practice Management, 27(6), pp.36-37.
World Health Organization, 2015. WHO report on the global tobacco epidemic 2015: raising taxes on tobacco. World Health Organization.
Yu, V., Rahimy, M., Korrapati, A., Xuan, Y., Zou, A.E., Krishnan, A.R., Tsui, T., Aguilera, J.A., Advani, S., Alexander, L.E.C. and Brumund, K.T., 2016. Electronic cigarettes induce DNA strand breaks and cell death independently of nicotine in cell lines. Oral oncology, 52, pp.58-65.
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