Applying the principles of EBPH to Approach a Specific Health Problem or Situation
Evidence-Based Public Health Tobacco Use Prevention
Joseph Toole
Evidence-Based Public Health
6 February 2017
The purpose of this research paper is to provide justification for the need of evidence based public health for tobacco usage, more specifically, smoking in Alaskan adults who are 18 years of age and older. In providing research for this justification, it will discuss the specific health condition or health risk. By discussing, it will provide information regarding tobacco usage and some of the health related risks surrounding it. It will also cover the target population of those being affected by tobacco usage as well as the size and scope of the issues revolving around tobacco usage. This research paper will conclude with some prevention opportunities and potential stakeholders.
Tobacco use can take place in a variety of forms such as cigarettes, cigars, hookah and smokeless tobacco also known as chew or dip. It has been discovered that there are at least 250 of the 4000 chemicals identified in cigarette smoke alone which is the form of tobacco usage this research is primarily focused on. In regards to cigarette smoking, it has been found that some of the most toxic chemical associated with it are hydrogen cyanide which is a chemical primarily found in weapons. Another toxic chemical associated with cigarette smoking is carbon monoxide which is a chemical primarily found in automobile exhaust. Additional toxic chemical found in cigarette smoke include formaldehyde which is embalming fluid used to preserve the death of loved ones, ammonia which is found in common household cleaners and toluene which is used in paint thinners (Oregon State University, 2015). Tobacco use is considered to be the leading cause in preventable illness as well as death in the United States. It has be known to cause a wide variety of cancers which also include chronic lung disease such as bronchitis and emphysema. It also causes pregnancy related complications, heart disease and can potentially cause other serious health issues (Department of Health and Human Services, 2017). As mentioned, the reproductive effects include ectopic pregnancy, premature birth, low birth weight, reduced fertility in women, stillbirth, erectile dysfunction in men, birth defects which include clept lip and or cleft palate. Other effects associated with smoking tobacco include type 2 diabetes, age related macular degeneration, rheumatoid arthritis, cataracts, blindness, impaired immune functions, hip fractures, periodontitis and just an overall diminished health status (Healthy People 2020, 2017). The same causes are found in Alaskans. Research shows that on an annual basis, more Alaskans die from the direct effects of smoking tobacco then HIV/AIDS, homicide, motor vehicle crashes, chronic liver disease and cirrhosis combined. In 2012, it was reported that tobacco usage in Alaska cost an estimated $538 million dollars in medical expenditures as well as an additional $231 million dollars in productivity reduction as a direct result of tobacco related deaths. This is a total of $769 million dollars and it underestimates total costs which include a loss in productivity as a result of tobacco related illness as well as the costs in secondhand smoke exposure related illness and death which are not included in these costs.
As mentioned in the introduction, the target population selected for this research are adult smokers who are 18 years of age and older. Current research shows that 1 in every 5 adults in Alaska are currently smoking. It is the first time since 1996 because the trend in smoking has decreased a significant amount in younger adults from 27.7% in 1996 to average of 32.6% from the year 1997 to 2006 back down to 21.0% in 2014. In adults who are the age 30 to 54, smoking has been reduced significantly from 29.6% in 1996 to 23.9% in 2014. In adults who are 55 years of age, smoking has also decreased significantly from 21.4% in 1996 to 14.9% in 2014. The scope of the issue in tobacco usage is not quite as significant today as it was years ago but the numbers in health complications and deaths relating to tobacco usage needs to continue to decrease (Department of Health and Human Services, 2016).
In regards to preventing tobacco usage, there are plenty of opportunities to do so. One strategy that could be used is in the form of providing information associating the effects of using tobacco. The strategy is primarily focused on community education in an effort to increase the awareness of the general public regarding the effects of tobacco usage and try to come up with solutions to tackle the issue. The strategies involved here include informing the community about the dangers of tobacco use and educating adults about marketing and advertising techniques used by tobacco companies to persuade individuals in using their products. Another opportunity is in the form of providing support. This strategy focuses on providing resources, encouragement and reinforcement for the coalition members, members of the community and organizations that are tied up in implementing tobacco prevention as well as cessation strategies. This coalition has the potential in supporting through activities that educate, build public awareness alternate activities, mentoring, referral services, support groups and tobacco retail sale enforcement activities. An additional opportunity is changing the actual physical design if what is in place currently in regards to prevention. This strategy focuses on working with local governments, schools, businesses, recreation facilities as well as any other organization in an effort to identify methods for modifying the environment which could be moving tobacco products out of the stores and placing more tobacco free zone signs up in that community as well as removing any advertising or promotional material from that community (CADCA, 2016).
In regards to the stakeholders associated with preventing tobacco usage in adults in an effort to reduce the amount of individuals using and to reduce health complications associated with using, there are a wide variety that play crucial roles. Stakeholders include public health officials, local, state and federal governments, policy makers, communities in the state of Alaska such as businesses, hospitals, schools and even law enforcement officials. Stakeholders can even be found in other states across the United States to help implement a prevention and control program for the use of tobacco as the program will be used for a wide range of reasons. The reasons include educating Alaska on tobacco use and the health complications associated with its use. Local, state and federal government in conjunction with policy makers can aid by enacting policy on the use of tobacco. Schools and hospitals can educate adults as well as children of the risks associated with tobacco use. Businesses and the local community can advertise and push awareness of the prevention program being implemented so that there is full coverage in Alaska (CADCA, 2016).
After researching tobacco usage, the effects and health complications of tobacco use has been identified. The target population has also been discussed which are adults who are the age of 18 and older. Prevention strategies and stake holders have also been discussed. Prevention opportunities included providing information, support and physical change. The stakeholders included public health officials, local, state and federal governments, policy makers, businesses, schools, hospitals and local law enforcement, all of which play a crucial role in a successful justification for the need of an evidence base public health prevention program for tobacco use.
References
CADCA. (2016). Prevent Tobacco Use. Retrieved from http://www.preventtobaccouse.org/prevention-strategies/provide-support/
Department of Health and Human Services. (2017). Tobacco Facts and Figures. Retrieved from https://betobaccofree.hhs.gov/about-tobacco/facts-figures/
Department of Health and Human Services. (2016). Alaska Tobacco Facts. Retrieved from http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&ved=0ahUKEwiajen_9fvRAhXBU7wKHbrFBz0QFggrMAM&url=http%3A%2F%2Fdhss.alaska.gov%2Fdph%2FChronic%2FDocuments%2FTobacco%2FPDF%2F2016_AKTobaccoFacts.pdf&usg=AFQjCNFNmuuqZKvPEB713djB1-2p2Ghi4g
Healthy People 2020. (2017). Tobacco Use. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use
Oregon State University. (2015). Types of Tobacco. Retrieved from http://studenthealth.oregonstate.edu/book/export/html/91
