Smoking is one of the main factors behind increment in diseases throughout the world, especially chronic and non-communicable diseases like cardiac arrest, cardiovascular diseases, respiratory disease and cancer. According to World Health Organisation, tobaccos kill half of its user. More than 8 million people die every year by smoking tobacco. 7 million deaths are the result of direct tobacco smoking while 1.2 million deaths are caused by the second-hand smoke (WHO, 2020). There are over 1.2 billion tobacco users out of which 80% lives in low and middle-income family (WHO, 2020). Tobacco not just degrades health but also causes poverty. The spending which should be used for household purpose is diverted toward buying tobacco. There are many campaigns, launched by various Governments and organisation to spread awareness about the harms caused by smoking tobacco and help people to quit smoking. With all these efforts, smokers still find it difficult to cease smoking.
The biological understanding of the adverse effect of nicotine and its impact and smoking behaviour well known but the biopsychosocial understanding of smoking tobacco is still under study. The biopsychosocial framework includes biological, psychological and social-environmental aspects. A framework that analyses the biological impact which life experience effects on smoking tobacco and health outcomes would explore the biopsychosocial interaction (Fernander et.al., 2007).
There are many models which are used to evaluate health within the framework of psychology. One such model is the Health Belief Model is widely used to investigate within the framework and identify key health benefits. It succeeded up to some extent in predicting a range of health behaviour (Norman & Conner, 2017). This model theorises that health-related behaviour depends upon sic factors, namely; perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy.
Perceived susceptibility is the person’s judgement of chances of getting infected with a disease. Perceived severity is the consciousness about seriousness of the diseases in an individual. Perceived benefits are the belief of an individual about the effectiveness of the recommended health behaviour in lowering the risk caused by the disease. Perceived barriers are the insight about the price related with obeying recommended health behaviour, whether it can able enough to prevent or reduce the apparent threat. Self-efficacy is the confidence status in a person’s capability to perform health behaviour question. Those who have low self-efficacy will have low self-confidence therefore this will affect their chances of behaviour being performed to avoid or reduce the threat (Kagee & Freeman, 2017).
Using the health belief framework in analysing the tobacco smokers and their health threat:
The Full Frame Initiative presented the five domain of well-being. Regardless of a person’s background, race, gender or culture, everyone shares some common needs. Everyone’s need is driven within five domains or well-being namely, social connectedness, stability, safety, mastery and meaningful access to relevant resources (The Five Domain of Well-Being, 2015). The experience of each domain may unique for each individual. A smoker who wants to quit smoking also requires the accomplishment of these five domains to successfully cease smoking. A brief review of each domain is as below (The Five Domain of Well-Being, 2015):
The Australian Government launched ‘National Tobacco Campaign’ in 1997 aimed to reduce smoking in Australia. This campaign successfully reduced smoking by 3.7% within 5 years (Department of Health, Australian Government, 2020). The goal of this campaign was to demotivate people from smoking, implement stronger tobacco control policy, help people to quit smoking and change public attitude towards smoking.
The campaign was conducted through TV ads, social media, prisoner’s resource kit, mobile phone apps, advertising in different languages and partnership with health organizations and dedicated programs for aboriginal people and pregnant women.
Currently, this campaign is targeting aboriginal and Torres Strait Islander people. This campaign is hosted by an aboriginal person who talks about his smoking experience and how he quitted and its benefits.
This campaign is using perceived benefit framework of Health Belief Model. The person who talks with aboriginal people actually explains them the benefits of the health behaviour. Also, the people self-efficacy is uplifted to quit smoking.
Centre for Disease Control and Prevention (CDC), in the USA, initiated a campaign- Tips From Former Smokers (Tips) in March, 2012. This campaign helped people with illness caused by the long term smoke exposure and second-hand smoke exposure. From 2012-2018, approximately 16.4 million people attempted quitting, while 1 million people became successful.
The goal of this campaign was to build awareness about the long-term smoking and second-hand smoke exposure, help people quit smoking and encourage people for avoiding second-hand smoke especially from a family member. The target audience were smokers of age 18-54 years and their families, and healthcare provider.
The campaign successfully helped smoker to cross perceived barriers by providing proper support and motivation. The campaign included many doctors, nurses, pharmacists and health care provider who helped their patients to quit smoking. They were motivated to not smoke while around their families or non-smoker so that the risk of second-hand smoke exposure may be reduced.
The tobacco smoking had taken millions of lives every year. This problem is prevalent in every corner of society, mostly in lower-income and middle-income family. The psychology of health behaviour tells the reason why smokers find the cessation very difficult. For the well-being of those individuals it is really important to help them out as a society and provide them such environment which helps them in quit smoking. The withdrawal phase is crucial and smokers is most vulnerable at this stage. Many campaigns are using biopsychology to promote harms of smoking and help them to quit smoking. Not just smokers, their families and other people in their vicinity are affected.
About the Campaign. (2020). Centre for Disease Control and Prevention. Retrieved on 19 August, 2020 from https://www.cdc.gov/tobacco/campaign/tips/about/index.html
Chean, K. Y., Goh, L. G., Liew, K. W., Tan, C. C., Choi, X. L., Tan, K. C., & Ooi, S. T. (2019). Barriers to smoking cessation: a qualitative study from the perspective of primary care in Malaysia. BMJ open, 9(7), e025491.
Fernander, A. F., Shavers, V. L., & Hammons, G. J. (2007). A biopsychosocial approach to examining tobacco‐related health disparities among racially classified social groups. Addiction, 102, 43-57
Kagee, A., & Freeman, M. (2017). Mental Health and Physical Health (Including HIV/AIDS). International Encyclopaedia of Public Health, 35–44. doi:10.1016/b978-0-12-803678-5.00282-4
Nagle, A., Schofield, M., & Redman, S. (1999). Australian nurses' smoking behaviour, knowledge and attitude towards providing smoking cessation care to their patients. Health Promotion International, 14(2), 133-144.
National Tobacco Campaign. (2020). Department of Health, Australian Government. Retrieved on 22 July, 2020 from https://www.health.gov.au/initiatives-and-programs/national-tobacco-campaign
Norman, P., & Conner, M. (2017). Health Behaviour. Reference Module in Neuroscience and Biobehavioral Psychology. Doi:10.1016/b978-0-12-809324-5.05143-9
Pardavila-Belio, M. I., Canga-Armayor, A., Duaso, M. J., Pueyo-Garrigues, S., Pueyo-Garrigues, M., & Canga-Armayor, N. (2019). Understanding how a smoking cessation intervention changes beliefs, self-efficacy, and intention to quit: a secondary analysis of a pragmatic randomized controlled trial. Translational Behavioral Medicine, 9(1), 58-66.
The Five Domain of Well-Being. 2015. Full Frame Initiative. Retrieved from https://dmh.mo.gov/sites/dmh/files/media/file/2019/01/mhc-meeting-five-domains-of-wellbeing-10132016.pdf
Tobacco. 2020. World Health Organisation. Retrieved on 27 May, 2020 from https://www.who.int/news-room/fact-sheets/detail/tobacco
Usman, S., Notoadmodjo, S., Rochadi, K., & Zuska, F. (2014). Changing Smoking Behaviour of Staff at Dr. Zainoel Abidin Provincial General Hospital, Banda Aceh. Advances in Public Health, 12. Doi: https://doi.org/10.1155/2014/316274
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