JOURNAL REPORT

YOUNG PEOPLE & SMOKING:

A GLOBAL CONCERN
 Smoking and Diseases

The WHO (World Health

Organisation) director said that the
consumption of tobacco was more
than two-and-a-half million deaths
each year (Nakajima, 1990).
Moreover, it is also estimated that
the deaths because of smoking are
three million deaths per year during
the 1990s, 10 million deaths per
year by the 2020s.
 Lung disease

 The Royal College of Physicians

(1983) has estimated that 90% of
all lung cancer mortality, 90% of
all bronchitis and emphysema
mortality and 20 % of all coronary
heart disease (CHD) mortality is
attributable to smoking.
 Heart disease
In 1989 in England, there were 140.509 deaths
from CHD-77.095 men, 63.414 women (OPCS,
1990). There are two principle constituents of
tobacco smoke which contribute to heart disease:
nicotine and carbon monoxide. Nicotine stimulates
the production of adrenaline which increases heart
race and blood pressure. Meanwhile, the carbon
monoxide binds to hemoglobin much more readily
than oxygen to form carboxyhaemoglobin; this
reduces the amount of oxygen carried in the blood
to the heart and the other parts of body.
Moreover, there is a research from Barry
et al (1989) which shows that the
patients with coronary artery disease
who also smoke, have significantly and
substantially more active angina during
daily life than patients who do not
smoke. Craig et al (1989) stated that of
the 70% excess risk of coronary artery
disease faced by smokers, the increased
serum cholesterol concentration in
smokers may account for at least 9% of
that excess risk.
 Other vascular diseases

 In the journal stated that smokers are

more likely than non-smokers to have
hardening of the coronary arteries and
the aorta; in addition, the disease is
likely to be worse in smokers than in
non-smokers. Besides that, smoking is
also associated with arterial disease
elsewhere in the body, most notably in
the legs and commonly requiring
amputation.
 May be in our society some of the smoker
think that cigarette with low tar is safer, but it
is wrong because based on Wynder (1990), a
reduction in tar yield of cigarettes has been
shown to lead to a reduction in one type of
lung cancer, but it has also been
demonstrated that there is no such benefit
for cardiovascular disease. Meanwhile,
based on RCGP (1981), women who smoke
and take oral contraceptives have ten times
the risk of a heart attack, stroke or other
cardiovascular disease. In addition, smoking
during pregnancy poses special risks to the
developing foetus and is an important cause
of low birthweight and infant mortality (US
Department of Health and Human Services,
1989).
 Smoking and Young people

There are some immediate short-term effects of

smoking:
 Increased heart rate
 A rise in blood pressure
 Increased mucus resulting in coughing
 Cilia damage which makes smokers more prone
to chest infections
 Reduction in fitness because of increased
levels of carbon monoxide in the lungs
 Reduction in steadiness of the hand
 Addiction to nicotine, leading to difficulty in
stopping smoking
 Reduction in skin temperature.
Some of the reasons why children smoke are:

 To look grown up
 To be different
 Family and peer pressure
 Advertising and sponsorship
 Cheapness of cigarettes
 Availability (illegal sales)
 Flay et al (1983) has separated the stages of becoming
smoking, they are:
 The first stage or ‘preparatory stage’, attitudes
towards early smoking are formed by influences
from friends, family, and media.
 The second stage or ‘initation’ of smoking, the
chances of becoming a regular smoker increase if
early attempts at smoking are repeated more than
four or five times—this can lead to addiction for 70-
90% of those involved, especially if the times
intervals between the first and few cigarettes are
short.
 The third stage or ‘experimentation’ stage, the young
person really learns how to smoke—the negative
(physical) effects recede and the positive
(psychological) experience is strengthened during
this stage.
 Charlton (1983) suggested key questioned to
be used by the teacher in teaching their
students. The key questions are:
 Is the threat to health serious?
It is important to provide an understanding of
the health risks of smoking and their
seriousness at about age 9.
 Is the threat personal to me?
Using techniques to show the immediate
effects of carbon monoxide, nicotine, and tar
on the body, teachers can demonstrate just
how harmful smoking is and it may allow
young people to see that the threat is
personal to them.
 If I smoke already, what will I lose by
deciding to give up smoking?
Deciding to stop smoking involves
accepting the loss of the perceived benefits
of smoking. This can mean fear of
alienation from friends and family if they
are smokers.
 What will I gain by deciding to stop
smoking?
It is important to discover the gains from
being a non-smoker which are relevant to
young people.
 Primary school

 Based on research that doing by William et al

(1989a, 1989b), stated that perception of health
among primary school children offers a broad
framework for teachers working in that phase of
education.
 * Age 4-8
From age 4-8 children’s perceptions about what
they can do to make themselves healthy revolved
around positives ideas.
 * Age 8-9
By these ages the children in the study were
beginning to mention items which could have a
negative effect on health, and began to recognize
that substances could be harmful.
 * Age 10-11
 At these ages many children experiment
with a first cigarette, the number of times
cigarettes were mentioned as being
harmful to health was considerably less
than with the 8-9 age group. At age 10, the
children seemed to think that it was
someone else’s responsibility to keep
them safe, but at age 11 they were
beginning to realize they have some
degree of responsibility for looking after
themselves.
 Secondary school

A study conducted by OPCS (Goddard,

1989) showed that 52% of secondary
school pupils remembered having a
lesson about smoking during the
previous year. However, of the ‘first-
year’ pupils (e.g. age 11/12), only 29%
had remembered receiving lesson about
smoking compared with 53% of ‘third-
year’ pupils (age 14) and 65% of ‘fifth-
year’ (age 16) who had done so.
There is a broad consensus about the ideal
timing and content of health education about
smoking (Charlton et al, 1990; Glynn, 1990;
Bellew and Ramsay, 1991). The consensuses
are:
• Health information and attitude formation
before the age of onset of smoking
• Lessons about social influences at the age of
onset
• More sophisticated health information and
lessons about social influences to maintain
non-smoking
• Early cessation support, both in and out of
school
• At a minimum, concentrate on the age where
risk of onset of smoking is the greatest.
 There is a broad agreement that education
about smoking should feature:

 Information about the short-term health effects

and the consequences of smoking.
 Exploration of social influences to smoke,
particularly in relation to peers, parents, and
media.
 Correction of adolescents’ overestimation of
smoking among their peers, so that they are aware
that smokers are in the minority.
 Development of skills in decision making, problem
solving and resisting unwanted pressure from
others.
 Development of coping strategies to
replace cigarette smoking.
 Lessons designed to meet the different
needs of boy and girls in relation to their
attitudes to smoking and their smoking
behaviour.
 A positive approach emphasizing what
pupils can do to be healthy; this may be
more effective than negative instructions
which seem to have very little impact,
particularly on young children (Charlton et
al, 1990; Glynn, 1990; Bellew and Ramsay,
1991).
In conclusion, Health Education
Authority (1990) revealed that all of
the teachers are responsible for the
coordination of health education in
secondary schools almost of one-
fifth (19%), were biology specialist,
with a further 12% being specialist
in a science other than biology.