Community Health Project: Smoking Cessation

This BSc Nursing (Adult & Mental Health) Level 5 assignment centers on a community engagement project aimed at reducing smoking prevalence. Students will research effective interventions, engage with local stakeholders, and develop an implementation plan for their chosen community. The project encompasses literature reviews, data analysis, communication strategies, and collaborative efforts with inter-professional colleagues.

Community Engagement
Project Portfolio
Level: 5
Cohort:
BSc Adult Nursing
BSc Mental Health Nursing
Student No:
Portfolio Checklist
Part One – Essential Scrapbook Evidence
N
o
Content (1500 words) 
1. Patient/service user profile
2. Community profile including qualitative
and quantitative data
3. Identified public health challenge
4. Record of person centred narrative
5. Reference list of data sources
(electronic and published data)

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Part Two – Systematic Summary Report
Written Assignment (1500 words)
To include:
 Introduction
 Statement of learner’s intent
 Key issues identified through portfolio
 Conclusion and recommendations
 Reference list
Appendices
Part One – Essential
Scrapbook Evidence (1500 words)
1. Patient/Service User Profile (200 words)
Write a brief profile of someone you have cared for whose health has been
affected by at least one of Public Health England’s priority public health
challenges (PHE 2014, 2016):
 Obesity
 Smoking
 Harmful drinking
 Harmful drug / substance use
 Social disadvantage in early years
 Dementia
 Self-harm / Suicide
 Antimicrobial resistance
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N
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Content 
1. Log of activities demonstrating
understanding of the topic
2. Log of meetings/discussions with
supervisor
3. Log of meetings/discussions with inter-
professional colleagues
4. Supplementary material
(additional/optional)

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 Tuberculosis
You should indicate how a range of determinants of health have impacted on this
person’s experiences and summarise their resultant needs for care.
Make sure that you observe anonymity and confidentiality.
Public Health England (2014) From Evidence into Action: Opportunities to Protect and Improve the Nation’s
Health. London: PHE.
Available at:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/366852/PHE_Priorities.pdf
Public Health England (2016) Strategic Plan for the Next Four Years:Better Outcomes by 2020. London:
PHE.
Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/516985/
PHE_Strategic_plan_2016.pdf
2. Community Profile (600 words)
Include information here from the Public Health England ‘Health Profile’ regarding
the area in which your chosen person lives.
Available at: www.healthprofiles.info
Compare the experiences of this local population with the UK population overall in
relation to health and well-being and health inequalities. Summarise what you
think are the local health needs and priorities for services.
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This is the brief profile of Mr. John Reed, who suffers from atherosclerosis. He is
a 50 year old individual. He was an avid smoker from his teenage years.
Recently, he has suffered from a stroke. Smoking is known to be a significant
determinant of development of atherosclerosis (Messner and Bernhard 2014).
Tobacco smoke is known to damage the blood vessels as well damage the
heart, thereby increasing the risk of developing atherosclerosis (George 2014).
Due to his advanced atherosclerosis he suffers from frequent chest pain and is
unable to walk properly due to pain in his legs, a condition called claudication
(Fritschi et al. 2013). He suffers from sudden leg cramps and rest pain. Lack of
oxygen and blood supply to his legs causes rest pain. Recently, he has
developed ulcers in his feet, which is a complication associated with rest pain.
He needs changes in his lifestyle in order to improve his health, which includes
cessation of smoking, eating a healthy diet, carrying out exercises. Moreover, he
also needs to be given statins, which will help to increase the blood supply to the
extremities of his body. He is currently on anti-platelet medication after suffering
from a stroke (De Martino et al. 2014). If his symptoms persist he needs to go for
angioplasty or bypass surgery.

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The health of the population of Basildon varies when compared with the health
of the rest of the population of England (Essexinsight.org.uk 2016). 21% of the
children live in poor socio-economic conditions. The most deprived areas of
Basildon has a life expectancy, which in the case of men is 7.6 years lower
than normal and for women it is 9.5 years lower than normal or from the other
least deprived areas of the region. With respect to child health in Basildon,
18.4% of the children have been found to be suffering from obesity. The rate of
alcohol consumption is also high among adolescents but is far better than the
rate observed for the rest of England. The rate of alcohol associated hospital
stays for Basildon is 11 per 100,000 population, which results in 4 hospital
stays per year. Apart from alcohol consumption, teenage pregnancy rates,
grades for the general certificate of secondary education are very poor when
compared to that of the rest of England. Although initiation of breast feeding is
essential for both infant and mother health but the level of breast feeding
initiation is also low in the case of the population of Basildon as compared to
the rest of the England. With respect to adult health, the alcohol related harm
and subsequent hospital stays has been found to be 541 per 100,000
population in the case of Basildon. This rate accounts for 918 hospital stays for
the alcohol related harm per year. The rate of hospital stays as a result of
suicidal attempts or self harm was found to be 88 per 100,000 population. This
in turn accounts for 158 hospital stays due to self inflicted harm per year. The
population of Basildon is associated with low levels of physical activity, thereby
resulting in presence of excess weight among the adults. The level of physical
inactivity and excess weight among the population of Basildon is worse than
those compared for the rest of England (Essexinsight.org.uk 2016). Moreover,
the rate of hip fractures is also high in the case of the population of Basildon as
compared to the rest of England. However, the rate of spread of sexually
transmitted diseases and tuberculosis is better as compared to the rest of the
England. Compared to the rest of England, most of the population of Basildon
live in the most deprived areas. The most deprived population of Basildon also
suffer from early deaths that is death of individuals below the age of 75 years
(Basildon.gov.uk 2018). Early deaths due to stroke or heart disease as well as
cancer was also found to be high with respect to the population of Basildon as
compared to the national average of England. The health summary of Basildon
as compared with that of the average of England shows that the children in
poor economic conditions, GCSE achievements, presence of violent crimes,
initiation of breast feeding, teenage pregnancy rates, physical inactivity among
adults, presence of overweight adults, increased rates of hip fractures among
individuals who are 65 years or above and cancer mortality rates among
individuals who are below 75 years have been found to significantly worse.
Smoking status, presence of obese children, prevalence of smoking among
adults, presence of diabetes, life expectancy of males and females, infant
mortality rate, road accidents, suicide rates, cardiovascular mortality rate below
75 years of age and winter deaths have been found to be more or less same
when compared to the rest of England. However, presence of long term
unemployment, alcohol and self harm associated hospital stays, incidences of
tuberculosis and presence of sexually transmitted infections are better than the
England average. The priorities or the local health needs are reduction of child
and adult obesity, improvement of socio-economic conditions, promotion of
breast feeding, reduction of crimes, decrease in teenage pregnancy, hip
fracture and cancer mortality cases (PHE 2018; Gov.uk 2018).

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3. Identified Public Health Challenge (600 words)
You should provide an outline of your chosen health issue and examine how and
why it poses a challenge to your chosen individual and the wider community. In
relation to both an individual/family focus, and also a population/community focus,
what health promotion strategies are being used to improve health and well-
being?
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Smoking associated illness and deaths are one of the most biggest significant
concerns gripping the population of the United Kingdom. More than 100,000
people in the United Kingdom die every year as a result of smoking and many
suffer from debilitating diseases associated with smoking (Nhs.uk 2018).
Smoking creates health risks not only for the smoker but also for those who are
around at the time of smoking. This is called passive smoking. Smoking is
generally associated with 90% of lung cancer cases and can also cause
cancers of other parts of the body like the mouth, throat, liver, kidney, pancreas,
bladder, and stomach. Moreover, smoking is also associated with the
development of coronary heart disease, strokes, heart attacks, peripheral
vascular disease and cerebrovascular diseases (Daskalopolou et al. 2016).
Smoking also increases the risk of development of lung diseases like
pneumonia and chronic obstructive pulmonary disease, which includes
emphysema and bronchitis. Smoking can also intensify and enhance the
symptoms and associated conditions of asthma, respiratory tract infections like
the common cold, among others. Passive smoking also has associated health
risks, which are more or less similar to that of smokers. According to the NHS,
passive smoking enhances the chances of developing lung cancer among non-
smokers by about a quarter. Children are particularly at risk of developing chest
infections, cough, meningitis, asthma, glue ear, among others due to passive
smoking. It also increases the risk of cot death in infants as a result of passive
smoking. Smoking during pregnancy is associated with various complications
like miscarriages, still births, premature births and low birth weight babies,
among others. Thus, smoking poses a serious threat not only to the individual
described in this report but also to a wider population. Moreover, smoking not
only causes harm to the smoker but also others as well (Cancer Research UK
2018). Childhood smoking is associated not only with effects on respiration but
also has non-respiratory effects. Youth smokers have a low level of lung
function and also reduces the rate of growth of the lungs. Smoking also affects
the physical fitness of the youth with respect to endurance and performance.
Moreover, smoking also results in increased resting heart rates, increased risk
of lung cancer, and shortness of breath, among others. The factors influencing
smoking are environmental like parental smoking, sibling smoking, family
environment, peer smoking, socio-demographic factors like age, socio-
economic status, ethnicity, personal finances, behavioural factors like school
performances, self esteem, lifestyle, stress, attitudes. Evidence has suggested
that increased rates of smoking among individuals living in low socio-economic
conditions is due to lack of social support to quit smoking, lack of motivation,
psychological differences like self efficacy, among others (York.ac.uk 2018). In
England, the socio-economic classifications are “routine and manual”,
“intermediate” and “managerial and professional”. The highest rates of smoking
were found in the population belonging to the low socio economic strata that is
“routine and manual” followed by “intermediate”. The lowest were found among
the “managerial and professional” populations (Ons.gov.uk 2018).

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Figure 1: Medical conditions in children resulting from passive smoking.
(Source: Digital.nhs.uk 2015)

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The rates of smoking is significantly increasing among the younger population.
Increased rates of smoking during teenage years contributes to adult smoking
rates. Family members and peers play an important role in the decisions taken
by the youth to initiate smoking (Subramaniam et al. 2015). School based
intervention programmes have been administered but with limited success and
social norm based programmes or social reinforcement programs play an
important role and have been found to be more effective in reducing the rates of
smoking among individuals as well as in the community. Mass media
campaigns also play an important role in influencing the smoking behaviour of
the youth and also to reducing the rates of smoking. Apart from these law
enforcement on cigarette sales can also help to reduce the rate of smoking.
Community interventions involve health education, “Smoke buster club”, non-
smoking and healthy eating policies, anti smoking curriculums, anti smoking
media campaigns, community based cardiovascular disease prevention
activities, youth anti tobacco activities, among others. Due to social, individual
and environmental factors that influence smoking, multi faceted interventions
have been introduced in order to curb smoking at both an individual and
community level in the United Kingdom (York.ac.uk 2018).
Figure 2: Prevalence of cigarette smoking among adults with respect to
age in England.
(Source: Digital.nhs.uk 2015)
Figure 3: Prevalence of cigarette smoking in England based on socio-
economic classification.

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4. Record of Person Centred Narrative (100 words)
Include a person-centred narrative here related to the health challenge. This can
be a link from literature, documentary, NHS choices, or a summary of a real-life,
face-to-face conversation (must be anonymised). Discuss this narrative with your
supervisor and the narrative discussion must be entered onto the supervision
record and signed by your supervisor.
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This is the story of Mike Smith, who had suffered from 3 heart attacks. He had
experienced discomfort due to heartburn but later on he had to be admitted to
the hospital due to heart attack. He was given medications and did not suffer
from any more events of heart attacks for 14 years. After his first attack, he had
quit his smoking habits but he again regained his smoking habits and this led to
his second and third heart attack within a span of a few months. He underwent
a bypass operation and had to be looked after by a cardiac nurse and
according to him “I had to hold a cushion every time I was about to sneeze
because it hurt”. On recovering, he joined a gym in his local community takes 3
tablets in the morning and one tablet at night. However, he is hopeful and full of
life even after his heart attacks (Nhs.uk 2018).

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References list (Harvard Style)
Basildon.gov.uk (2018). Basildon District Profiles. [online] Basildon.gov.uk. Available
at: http://basildon.gov.uk/CHttpHandler.ashx?id=3196&p=0 [Accessed 1 Feb. 2018].
Cancer Research UK (2018). Passive smoking. [online] Cancer Research UK.
Available at:
http://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-
cancer/passive-smoking [Accessed 16 Jan. 2018].
Daskalopoulou, M., George, J., Walters, K., Osborn, D.P., Batty, G.D., Stogiannis,
D., Rapsomaniki, E., Pujades-Rodriguez, M., Denaxas, S., Udumyan, R. and
Kivimaki, M., 2016. Depression as a risk factor for the initial presentation of twelve
cardiac, cerebrovascular, and peripheral arterial diseases: data linkage study of 1.9
million women and men. PLoS One, 11(4), p.e0153838.
De Martino, R.R., Eldrup-Jorgensen, J., Nolan, B.W., Stone, D.H., Adams, J.,
Bertges, D.J., Cronenwett, J.L., Goodney, P.P. and Vascular Study Group of New
England, 2014. Perioperative management with antiplatelet and statin medication is
associated with reduced mortality following vascular surgery. Journal of vascular
surgery, 59(6), pp.1615-1621.
Essexinsight.org.uk (2016). A profile of people living in Basildon - May 2016
Organisational Intelligence. [online] Essexinsight.org.uk. Available at:
https://www.essexinsight.org.uk/get/ShowResourceFile.aspx?ResourceID=374
[Accessed 1 Feb. 2018].
Fritschi, C., Collins, E.G., O’Connell, S., McBurney, C., Butler, J. and Edwards, L.,
2013. The effects of smoking status on walking ability and health-related quality-of-
life in patients with peripheral arterial disease. The Journal of cardiovascular
nursing, 28(4), p.380.
George, P., 2014. Effects of smoking on cardiovascular function: the role of nicotine
and carbon monoxide. Health science journal.
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Gov.uk (2018). 2017 Health Profiles - GOV.UK. [online] Gov.uk. Available at:
https://www.gov.uk/government/statistics/2017-health-profiles [Accessed 16 Jan.
2018].
Messner, B. and Bernhard, D., 2014. Smoking and cardiovascular
disease. Arteriosclerosis, thrombosis, and vascular biology, 34(3), pp.509-515.
Nhs.uk (2018). Mike's story. [online] nhs.uk. Available at:
https://www.nhs.uk/conditions/heart-attack/mikes-story/ [Accessed 16 Jan. 2018].
Nhs.uk (2018). What are the health risks of smoking? - Health questions - NHS
Choices. [online] Nhs.uk. Available at: https://www.nhs.uk/chq/Pages/2344.aspx?
CategoryID=53 [Accessed 16 Jan. 2018].
Ons.gov.uk (2018). [online] Available at: http://www.ons.gov.uk/.../cigarette-smoking-
status--by-socio-economic-classification--great-br... [Accessed 16 Jan. 2018].
PHE (2018). Public Health Profiles. [online] Fingertips.phe.org.uk. Available at:
https://fingertips.phe.org.uk/profile/health-profiles [Accessed 16 Jan. 2018].
Subramaniam, M., Shahwan, S., Fauziana, R., Satghare, P., Picco, L., Vaingankar,
J.A. and Chong, S.A., 2015. Perspectives on smoking initiation and maintenance: A
qualitative exploration among Singapore youth. International journal of environmental
research and public health, 12(8), pp.8956-8970.
York.ac.uk (2018). Cite a Website - Cite This For Me. [online] York.ac.uk. Available
at: https://www.york.ac.uk/media/crd/ehc55.pdf [Accessed 16 Jan. 2018].
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Part Two – Systematic Summary Report (1500)
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Introduction
Smoking results in the release of active substances like aerosol
particles, gases, and the pharmacologically active alkaloid named nicotine into
the lungs and subsequently into the blood stream. Smoking is generally
associated with negative impacts on health. These include cardiovascular
diseases, peripheral vascular diseases, heart attacks, strokes, lung cancer,
chronic obstructive pulmonary diseases, among others (Singh, C.R. and
Kathiresan 2015). Smoking also imposes health risks on pregnant women
(Anblagan et al. 2013). Passive smoking also impacts the lives of individuals
associated with smokers and increases the risks of developing lung cancer,
respiratory distress, among others (Cao et al. 2015). Smoking is the most
significant cause associated with preventable deaths in England. Each year
80,000 individuals die in England due to long-term effects of smoking. The
poison present in the tar of the cigarettes when enter the bloodstream causes
clot formation, increases the blood pressure as well heart rate and causes
narrowing of the arteries resulting in reduced amount of oxygen reaching the
various organs of the body. This in turn increases the risk of heart attacks or
strokes (Nhs.uk 2018). Other diseases include stomach ulcers or cancers,
kidney cancer, premature ageing, osteoporosis, brain aneurysms, mouth and
throat cancers, reduced fertility, cervical cancer, among others (Cancer.ie
2018). Studies have revealed quitting smoking can reduce the risks associated
with development of various forms of cancer and thereby increases life
expectancy rates (Holford et al. 2014; Jha et al. 2013). This report provides an
outline of the negative impacts of smoking; the key issues associated with
smoking in England and lastly provide a conclusion or recommendation based
on the available facts.
Statement of learner’s intent
The learner’s intent is to link the effects of smoking with various health
consequences. The intent is to provide the details of the effects of smoking on
the cardiovascular activity based on an individual as well as a community level
perspective. The region selected for this report is Basildon. The report provides
a health summary of the region of Basildon when compared to the national
average of England. Moreover, the learner’s intent is also to identify the various
intervention strategies associated with the aim to reduce smoking rates and the
smoking related diseases in England.
Key issues identified
The key issues identified is with regards to smoking and the associated
consequences. Smoking has been found to be associated with various factors
such as environmental, socio-demographic and behavioural (Al-Kubaisy et al.
2017). The environmental factors that were found to influence the smoking
rates among the youth in the United Kingdom were parental smoking and
attitudes, sibling and peer smoking, family environments and peer norms or
attitudes. The socio-demographic factors influencing smoking were found to be
age, socio-economic status of parents, personal finance and ethnicity. The
behavioural factors were found to be school performance, self esteem, lifestyle,
attitudes towards smokers or smoking, health concerns and stress (York.ac.uk
2018).

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The region of Basildon in England had majority of the population living under
poor socio-economic conditions. Socio-economic conditions plays an important
role in influencing smoking rates particularly among the youth. This is due to
the fact that poor socio-economic conditions is associated with lack of social
support, lack of education and motivation, poor finances, psychological
differences like self efficacy, among others. In England, increased rates of
smoking is particularly observed among the working population belonging to the
low socio-economic strata (Hiscock et al. 2012). Moreover, smoking is
associated with increased rates of deaths in the United Kingdom and one of the
principal cause is heart attacks and strokes. Smoking not only affects the
cardiac functions but also blocks the arteries that transfer blood to the various
parts of the body. This in turn leads to atherosclerosis and other conditions
associated with peripheral vascular diseases. Smoking prevalence among the
adults were also found to be high among the population of Basildon. The
population of Basildon were also found to suffer from reduction in life
expectancy rates among both men and women and this was particularly
applicable in the case of the most deprived regions of Basildon. The rate of
premature deaths of individuals below the age of 75 years due to
cardiovascular diseases and cancer was also a cause of concern for the
population of Basildon. Another health issue identified in the region of Basildon,
which was a cause of concern, is physical inactivity and increased cases of
obesity among both children and adults. Another key issue is increased rates of
hip fractures among the individuals, which could be due to high rates of
smoking. Smoking is known to make the bones brittle and increase the chances
of developing osteoporosis. Moreover, other issues gripping the youth of
Basildon were found to be enhanced teenage pregnancy rates, reduction in the
attainment of GCSE and the rates of breast feeding initiation is also far worse
as compared to the rest of England. The priorities that were identified and
needs to be tackled are child and adult obesity, health inequalities caused as a
result of poverty, low socio-economic conditions, among others
(Fingertipsreports.phe.org.uk 2018). Some of the smoking statistics of England
provided by the NHS reveals that in 2016 smoking prevalence among the youth
was 15.5%, which is significantly less than the previous years. However,
smoking related hospital admissions were far greater and was found to be
474,000 in 2015 and 2016. Smoking related deaths in England contributes to
16% of the total deaths reported (Gov.uk 2018).
Apart from the health issues identified, the report also describes the
various strategies that have been undertaken in order to reduce the rates of
smoking among the population of England. Smoking is particularly prevalent
among the youth and it has been found that 82% of the individuals take up
smoking as a result of initiation of the smoking habits from their teenage years.
Various school intervention programs, community prevention strategies, mass
media campaigns, health policies and law enforcements strategies have been
applied to reduce or influence the rates of smoking behaviour among the
population of England, particularly the youth. School and community based
interventions not only provides education about the ill effects of smoking but
also helps to provide strategies that can help the individuals to quit smoking
(York.ac.uk 2018).

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Anti-smoking campaigns, health education, mass media campaigns, strict
policies in schools and workplaces were also identified to reduce the rates of
smoking. Law enforcement strategies have also helped to reduce the smoking
rates particularly among the youth. In the United Kingdom, it is illegal to sell
cigarettes to individuals below the age of 16 years. Community interventions
were also found to support non-smoking behaviours among the youth. The
NHS has also developed a Stop smoking service and their main objective is to
provide smoking cessation services to the local population of England. This
service carries out regular supervisions, develops generic risk assessments,
provides informational materials and medications to patients and others
individuals. Nurses have a significant role to play in preventing smoking. The
efficacy of nurse’s role in smoking cessation is based on smoking cessation
interventions like quit smoking advices, counselling, among others. Studies
have shown that training nurses in carrying out smoking cessation programs
are a cost-effective technique to reduce the rates of smoking (Rice, Hartmann‐
Boyce and Stead 2013; Richards et al. 2014). The Nursing and Midwifery
council also plays an important role in carrying out smoking cessation programs
and its main function is to protect the public and the key areas of principle are
preparation, service, recognition and responsibility. The NMC helps to identify
the various environmental factors associated with the health and well-being of
individuals and it has identified smoking as one of the behavioural factors
associated with poor health of individuals (Nmc.org.uk 2018).
However some of the barriers to prevent smoking could be associated
with the daily lifestyle of an individual. Individuals in the United Kingdom believe
that smoking forms an integral part of their social, domestic and working lives
and that they cannot go about a single day without engaging in smoking. Some
workplaces where smoking is the norm can act as barriers, additionally, some
men consider it their right to smoke and considered it a part of their masculine
identity. Addiction to smoking is an important barrier to smoking prevention
programs. Some consider it a means to reduce stress and maintain emotional
stability (Flemming et al. 2015).
Figure 4: Smokers in UK who found difficulty in quitting smoking
(Source: Digital.nhs.uk 2015)

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Conclusion and Recommendation
This report therefore provides an outline of smoking and the various
health related issues associated with it. This report also indicates that smoking
is one of the most important causes associated with preventable deaths in the
United Kingdom. The region of interest for this report was Basildon and various
health inequalities were found in this region thereby resulting in premature
deaths and decreased life expectancies of this region. These health inequalities
were found to be much higher than the national average of England. Poor
socio-economic conditions was found to be one of the most important causes of
the health conditions prevailing in Basildon.
Some of the recommendations that can be provided is positive thinking,
changes in diet, changes in the choice of drinks, identify the times associated
with cigarette cravings and engage in other activities in order to distract the
mind, getting support from family members and friends, among others.
Exercises can also help to reduce the cravings associated with smoking. Peer
pressure plays an important role in influencing smoking rates. Thus, it is
necessary to engage in activities with non-smokers in order to reduce the rates
of smoking. Nicotine replacement therapy or the use of nicotine patches also
plays an important role in reducing the rates of smoking and thereby
decreasing the smoking associated health concerns. E-cigarettes, nasal sprays
and nicotine gums also play an important role in reducing the rates of cigarette
smoking. Reports have also revealed that apart from the NHS stop smoking
services se of E-cigarettes by smokers enabled them to quit smoking effectively
and successfully. Moreover, use of the medication Champix also helps to
reduce the nicotine cravings (Nhs.uk 2018). Moreover, nurses play an
important role in promoting and supporting smoking cessation programmes.
Since, nurses have access to patients situated in community settings as well as
in hospitals, they can utilize their counselling skills in encouraging patients to
quit smoking. Moreover, the nurses can also describe about the health
challenges associated with smoking the subsequent adverse outcomes in the
future. In primary care, nurses have to follow the smoking cessation guidelines,
which enable them to encourage the smokers to quit smoking and participate in
smoking cessation programs. Nurses are also required to advice patients to
use nicotine replacement therapy or NRT. In secondary care, nurses are
required to record the smoking stats of both inpatients and outpatients and this
in turn will enable them to offer suitable advice to the patients. Nurses can
communicate with patients and discuss about their experiences, which in turn
will enable them to assess the patients and provide motivation, education and
support that would ensure the overall well-being of the patient (Lindson‐Hawley,
Thompson and Begh 2015). Thus, it can be concluded that smoking is one of
the most important factors that have caused a serious health concern among
the population of England and extensive prevention strategies are needed in
order to reduce the smoking rates and smoking related health issues.

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References
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Al-Kubaisy, W., Abdullah, N.N., Al-Nuaimy, H., Halawany, G. and Kurdy, S., 2017.
Factors Associated with Smoking Behaviour among University Students in
Syria. Journal of Asian Behavioural Studies, 2(3), pp.53-61.
Anblagan, D., Jones, N.W., Costigan, C., Parker, A.J., Allcock, K., Aleong, R.,
Coyne, L.H., Deshpande, R., Raine-Fenning, N., Bugg, G. and Roberts, N., 2013.
Maternal smoking during pregnancy and fetal organ growth: a magnetic resonance
imaging study. PloS one, 8(7), p.e67223.
Cancer.ie (2018). Cite a Website - Cite This For Me. [online] Cancer.ie. Available at:
https://www.cancer.ie/sites/default/files/content-attachments/hp_smoking_cancer_bo
oklet.pdf [Accessed 16 Jan. 2018].
Cao, S., Yang, C., Gan, Y. and Lu, Z., 2015. The health effects of passive smoking:
an overview of systematic reviews based on observational epidemiological
evidence. PloS one, 10(10), p.e0139907.
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Singh, C.R. and Kathiresan, K., 2015. Effect of cigarette smoking on human health
and promising remedy by mangroves. Asian Pacific Journal of Tropical
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Appendices
1. Log of activities
Activity no: Date Activity
1.
2.
3.
4.
5.
6.
7.
8.
2. Log of meetings/discussions with supervisor
Activity no Date Activity Notes
1.
2.
3.
4.
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3. Log of meetings/discussions with inter-professional colleagues
Activity no: Date Activity
1.
2.
3.
4.
5.
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