::written circa. Fall 2013.
Tobacco use, in the United States, has been drastically reigning supreme over lives in this great nation. In 2006, it was estimated that 174,470 people were newly diagnosed with lung cancer, due to a cigarette smoking correlation (Yoder, 2006). Unfortunately, this was in addition to the 162,460 individual deaths already ensued by the same causation. Lung cancer, associated with smoking, is the number one preventable cause of death in the United States (Goljan, 2011). A health determinant is defined as any major factor that can contribute to the health of an individual (Shi & Singh, 2012). And, by this definition, tobacco-use is certainly one of them.
With an abundant amount of various life threatening contents, the use of tobacco can lead to a wide range of systemic affects (Goljan, 2012). Though, for all intents and purposes of this paper, “tobacco-use” and “smoking” at certain times may be used interchangeably. The most widely known chemical component of the tobacco plant is nicotine, a highly addictive compound that is rapidly absorbed within our epithelial tissues. In addition, Cotinine (a metabolite of nicotine) is a chemical indicator that is clinically used to detect tobacco use. And although nicotine is heavily ranked in popularity, it is the many chemicals associated with the actual cigarette smoke that is of much greater concern (Goljan, 2012). Polycyclic hydrocarbons, Tar, Phenol, Nitrosamine, Carbon monoxide all contribute to life threaten DNA damage, mucosal oxidation, and oxygen desaturation. Cigarette smoking, as a whole, contributes to a vast array of systemic effects including those of (but not limited to) the cardiovascular, central nervous and respiratory systems.
In relation to the respiratory system, tobacco-use can lead to chronic obstructive pulmonary disease (bronchitis, emphysema), and inevitably increase the risk for lung cancer (squamous cell carcinomas, small cell carcinomas, and adenocarcinomas). The most common symptom in 75% of cases for primary lung cancer is progressive coughing, which is then followed by weight loss, chest pain, and hemoptysis (bloody sputum).
Clinically relevant diagnoses for lung cancer include (but not limited to) chest x-rays, sputum cytological examinations, fine needle aspirations and bronchoscopy. However, those only account for secondary prevention mechanisms, which aid in the process of detection and screening (Shui & Singh, 2012). Currently, the most clinically beneficial treatment to lung cancer is the cessation of smoking, a primary preventable health determinant. However, due to the highly addictive nature of nicotine, as well as pro-activists of tobacco use, such health dreams are hard to come by.
For healthcare administrators, advocating for the greater good of smoking cessation entails many obstacles. “Large corporations use increasingly sophisticated marketing strategies to promote products to children, which includes marketing techniques that rely on imagery relating to lifestyle or social norms” (BMC Pediatrics, 2011). Interestingly, the basis for their study was to evaluate the psychological perceptions of children, in regards to marketing campaigns. In addition, bars, entertainment nightclubs, social events, etc., are just a few examples of the many venues that are considered transition markers into adulthood (Sepe & Glantz, 2002). With that said, this just adds on to the elaborate pool for marketing tobacco-use towards younger adults.
Needless to say, tobacco-use has been embedded as social norms into cultures all over the world, for thousands of years. As a result, healthcare advocates have thrived into bringing the primary cure to lung cancer to light. Today, due to federal and state program initiatives to advocate on increasing taxes on cigarette sales, “according to the Monitoring the Future Study, smoking rates from 1997 to 2010 declined among 8th, 10th, and 12th graders by 63%, 54%, and 47%, respectively” (American Journal of Public Health, 2013). Keeping this in mind however, though it is thought to save individuals from expressing the need to purchase cigarettes, a high increase in taxations still holds many implications against the pockets of consumers. Though the Cigarette Tax Act may show to decrease the prevalence of lung cancer, due to the enforcing repercussions of consumer economy, there is still an infinite abyss and time for healthcare administrators to determine whether or not this will inevitably be a cure for lung cancer or a social & psychological spark for another issue.
Rollins, G. (2003). Succession planning: Laying the foundations for smooth transitions and effective leaders. Health Executive, 18, 14-18.
Goljan, E. (2011). Rapid review: pathology. 4th edition. Philadelphia, PA. Elsevier & Saunders.
Shi, L., Singh, D. (2012). Delivering healthcare in america: a systems approach. Burlington, MA. Jones & Barlett Learning, LLC.
Yoder, L. (2006). Lung cancer epidemiology. MEDSURG-Nursing. Vol. 15. No. 3
Auger, N., Daniel, M., Knauper, B., Raynault, MF., Pless, B. Children and youth perceive smoking messages in an unbranded advertisement from a NIKE marketing campaign: a cluster randomized controlled trial. BMC Pediatrics. (11) 26.
Farrelly, M., Loomis, B., Han, B., Gfroerer, J., Kuiper, N., Couzens, G., Dube, S., Caraballo, R. (2013). A comprehensive examination of the influence of state tobacco control programs and policies on youth smoking. American Journal of Public Health. (103) 3.