Public Health Intervention: Cultural Practices, Evaluation and Ethical Considerations

This report discusses the impact of cultural practices on public health interventions in England, including the smoking ban. It evaluates the intervention qualitatively and quantitatively, and considers ethical considerations that could arise from its delivery. Additionally, it outlines two ways the intervention could benefit global health and two ways providers could be held accountable. Course code and college/university not mentioned.

Public Health

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Cultural practices in England which is supporting and creating hindrance to intervention-.......3
Qualitative and Quantitative evaluation of intervention-.............................................................6
Evaluate the ethical consideration that could arise from the delivery of this intervention.
Outline 2 ways the intervention could be of benefit to global health and 2 ways the providers
could be held accountable?........................................................................................................10
Discussing the effectiveness and efficiency of the intervention will be determined:................11
CONCLUSION..............................................................................................................................13
REFERENCES..............................................................................................................................15

INTRODUCTION
Public Health can be defined as the art or science for preventing the diseases, prolonging life as
well as helps them in promoting the health through the organized efforts which are made by the
society. The public health encourages the welfare for the overall population, considers there
safety and protection from spreading of any infectious disease as well as environmental diseases
which is beneficial for the population. The areas which comes under the public health are such as
chronic disease, the science of ageing, disaster response, refugee health, tobacco control, injury
prevention and many more (Peres and et.al., 2019). There are many interventions which has been
took by public health in England and one of them is The Smoking Ban. This intervention has
helped much in reducing the consumption of the cigarettes by the people in England. The
smoking has been considered as the leading cause of the preventable death as well as it is the
image for the health inequalities. This report will discuss the cultural practices which is
supporting and creating hindrance to the intervention as well as qualitative and quantitative
evaluation. Along with this, ethical considerations which could be raised by delivery of
intervention and the effectiveness of the intervention in country.
MAIN BODY
Cultural practices in England which is supporting and creating hindrance to intervention-
The cultural practices has very large impacts on the interventions for any such things
which are creating the health inequalities and worries for the people. The influence of the culture
on the health is very broad as it highly affects the perceptions and opinions of health, death,
illness as well as the beliefs for the causes of the diseases, approaches of health promotion,
experience of illness and pain as well as the forms of the treatments which are preferred by the

patients. There are various levels at which the culture impacts the health involves
communications and interactions with the nurses and the doctors, outcomes of healthcare, health
disparities as well as the experience of illness. For example, some culture has the belief that the
illness is will of high power and other may be much unwilling to receive the healthcare (Dugdale
and et.al., 2019).
The cultural practices of the England which can influence the intervention are such as
Morris Dancing in England and many more. The first thing which is considered in relation to the
culture and smoking is the smoking rates in overall world. 19.9% of the men in UK consume
cigarettes as the main cause of the smoking and the culture is the religion and every religion has
its own cultural practices. After the intervention of the smoking ban has implemented in year
2007, the number of the smokers in UK was decreased to 15% in year 2019. The decision of the
person who is smoking is largely determined by the culture of individual (Bonakdari, Pelletier
and Martel-Pelletier, 2020).
The cultural practices which are supporting the smoking ban are such as-
Governance and leadership:
The government of the UK has set many of the plans and ambitions for England which
enable them to create the awareness of the smoking in among the people for making smoke free
by year 2030. The ASH has published the roadmap for the smoke free England and this has been
promoted by the 74 organisations as well as the 604 individuals. The government of UK has
adopted the Road map's recommendations which will help them in controlling the consumption
of the cigarettes in England. The government brought many of the policies which has helped in
effectively working of The smoking ban interventions in England. The government of UK has
taken many number of the measures which includes advertising for the ban, restrictions on the
smoking at the public places as well as the workplaces, increased the taxations on such products
and many more (Anyanwu and et.al., 2018). This has highly contributed towards supporting the
smoking ban intervention in England.
After seeing the health impacts of the smoking on the public health, it became very
necessary for the health department to take the action against it. The culture practices which were
then followed by the UK government has helped the people to stop the consumption of cigarettes
and this has highly contributed towards helping the population of England to stop smoking. The

policies which were formulated by the government has the large influence on the banning of
smoke in England.
Medical Treatment Practices:
The NHS England has promised that by the year 2030, every patient who is smoking will
be offered such treatments which will help the patients to quit smoking. The patients will be
offered the treatments for quitting by their GP. The hospitals will be providing the best
treatments for smoking cessation which is NRT Nicotine Replacement Therapy as this therapy
involves the various formulations of the Nicotine which are available on the counter which
includes trans dermal patch, pray, gum as well as the lozenges which are highly effective for
smoking cessation. The NHS quit Kit has been developed by the experts, smokers as well as the
ex-smokers which contains the tools and the advices which helps the smokers for quitting the
smoking for good (Civljak, Bilic and Milosevic, 2018).
They are providing the services which helps the patients stop smoking as they are
provided by the experts by proven methods. They also facilitates the treatments for stopping the
smoke such as Varenicline, Bupropion as well as nicotine Replacement therapy. The plan of the
NHS is very long term and is contributing for making England smoke free till the year 2030.
There are many offers which are available to the public as the part of the mental health services
by the specialists. The Quit Kit which is offered by NHS includes the health wheel through
which the quitters can calculate the improvements, tips for improving willpower, MP3
downloads which reduces the cravings, wall chart for mapping the progress, tangle toy for
keeping the hands busy, tips for managing the cravings.
The above are the cultural practices which positively supports the public health intervention as
this is helping the government to effectively impose this on the public. Support from such
cultural practices as helped the overall country to successfully achieve this public health
intervention.
The cultural practices which is working as the hindrance for the smoking ban intervention are
such as-
Everyday life practices:
The people living in England is having the habit of smoking due to which this intervention of the
public health has seen sale of the cigarettes much. It is very important for the government to
taker the corrective measures and stop the young people to smoke. They must make the strict

guidelines that nobody can buy the cigarettes despite of there age and culture. The everyday life
practices is creating the barrier for the government to become smoke-free country till the next
coming years (Cadden and et.al., 2020). The cultural practices of the country is very different
that not even the parents are saying as this is very normal for them. Such type of the everyday
life practice and the habits of the individual is creating much difficulty for the country to become
free from smoking.
Medical Treatment practices:
It has been discussed above that the medical treatment practices of the nation is supporting this
public health intervention but it has been identified that the country requires more improvements
in the medical treatments in the country. They must provide the prevention as this will help them
in reducing the costs of NHS which is caused by the smoking every year. It is very necessary for
the NHS to consider and stay committed towards the long term goals as they must work more for
the prevention of smoking among the people. The NHS must ensure to provide the smokers
advices as those who will force them to quit smoking at each and every interaction when they
meet. They must invest huge amount into this as this will help them in providing the effective
treatments to the patients. The younger population of this country is much addicted to the
smoking habit so it is very necessary for the NHS to consider this and must take the measures to
solve this problem. They must pay attention towards prevention by taking the further actions sop
that people stops smoking as thus will provide the support and proper treatments. They must
integrate in all the hospitals for opting out the smoking cessation interventions into the daily care
of the patients (Malik, 2018).
The above are the cultural practice which will are not allowing the government to achieve the
goals of smoke-free within the overall country. The cultural practices which plays very
significant role in impacting the overall public health intervention.
Qualitative and Quantitative evaluation of intervention-
Qualitative Evaluation:
It has been found that the has totally changed the health of the people in UK. The Hazy pubs and
the cigarettes restaurants have just become the past in this country. IT has been ten years when
the cigarettes smoking was banned in the country which was on 1st July 2007 (Lucas and et.al.,
2018). From this day, it was considered smoking as illegal in the country in any of the public
place. After this legislation was imposed on the people, many of the people tried to quit smoking

and many of the people were found successful in this. It was identified that the level of the
patients related to the heartache were reduced as banning the smoking within the country has
improved the air quality. Before the smoking was banned in the country, the smoking has
achieved the heights as each and every individual of this country was involved in cigarette
smoking and this damaged the quality of air (Jones and et.al., 2019). As the children were getting
admitted into the hospitals suffering from the asthma as soon as the cigarettes god banned this
got reduced to high extent.
There are very active members of the Smoke-free Action Coalition which are providing the
funds to research the link between the air pollution and the premature deaths of the people. The
smoking ban when implemented, the transport of the London has announced that none of the
people will be permitted to sit in the taxis, private hired vehicles as well as all the London buses.
The number of the deaths in the country saw the major fall as there were large number of the
people who were suffering from the heart conditions. The main aim of the banning the smoke in
the country was to protect the non smokers as well as the people who are smoking from the
harmful effects of the cigarettes. The smoking ban was found successful in the country as the
patients of the heart attack has decreased as the environment of the country became smoke free
(Zhou and et.al., 2018). There has also been found reduction in the SHS exposure among the
small age children which are considered as the partial attributable for the social media campaigns
which will lead to smoking ban in the country. The number of the deaths which were caused by
the smoking were reduced till now after the smoking ban intervention was introduced in the
country.
Quantitative Evaluation of intervention:
It was found that the after the smoking was banned in the country, the air pollution was reduced
to 93%. According ton some research it was identified that the breathing of per second was
increased in the adult non smoker as there was much risks associated with this as it causes the
lung cancer as well as the heart diseases to the individual as this was also seen some fall of 30%.
It was estimated that there was 1200 less admissions found after the smoking ban was
introduced. IN the year 2006, 22% of the adults were smoking and according to the latest
statistics it was found that year 2015 18% of people were smoking as this shows that more
people started smoking after one year (Craig and et.al., 2020). After the ban of smoking, 18% of

the admissions of the heart diseases were reduced within three years and the 6% fall was seen in
the cigarettes volume which was sold within the overall country.
In 2009, the smoking was identified for around 81, 400 deaths and this cost huge amount for the
NHS. Through this it can be seen that smoking was a huge problem for the overall country.
There was seen 70% of the reduction between the year 1996 and 2007 in SHS exposure among
the children.
According to the above figure it can be identified that the prevalence of smoking within the4
overall country was reduced from 19.8% in the year 2011 to 13.9% in the year 2019 (Arack and
et.al., 2019).

The above figure shows the public attitudes about the government activities for stopping and
limiting smoking (Mulcahy and et.al., 2021). The responses were collected by the people as this
shows that money of the people are thinking that the government activities are not effective.
The Annual Population Survey (APS) states that in year 2019, 14.1% of the people who is
having the age of 18 years and above have smoked which is almost equal to the 6.9 million of the
overall population of the country. The current smokers in country has saw drop from 14.7% in
the year 2018. When compared according to the gender, 15.9% of the men and 12.5% of the
women were smoking within this country (Fichtenberg and Glantz, 2021). The polling was done
for cancer in UK and its was found that there was more than 4,300 people and they were in
favour of banning the smoking in country. The effect of smoking ban was effective as due to this
57% of the people were agreed that the hospitality workers has improved.

Evaluate the ethical consideration that could arise from the delivery of this intervention. Outline
2 ways the intervention could be of benefit to global health and 2 ways the providers could
be held accountable?
Impact on Freedom: Impact on freedom can be seen when The Smoking Ban intervention is
delivered in the general public because every individual have freedom to eat and consume
whatever they want. No international law prohibit consumption, implementing this intervention
may cause and impact harm to ethics. Individual who desire to consume smoking have freedom
to do so (Chapman, 2016). However, government can take certain measure to manage this issue,
government may ask individual to smoke outside premises or smoking restricted area or general
public area including park, attraction and buildings. Freedom and independence is one of the
most important ethic which need to be considered while implementing this intervention.
Human right: Human right is one of the most important thing, all ethics are related to human
right where individual are free to perform smoke. However, there is no human right that promote
smoking but human right on liberty allow individual to adopt the lifestyle the want which means
they can smoke as per their human right. When it comes to implementing this intervention to
general public, it becomes challenging to cover every important area. Ethics and human right
will going to become the biggest issue in the process of implementing smoking ban intervention.
Several human right push every individual to perform those task in public that promote respect,
protection and healthiness.
Outlining two ways the intervention could be beneficial to global health:
Control in chronic diseases: Control in chronic disease can be seen when government plan to
ban smoking including public smoking permission. This intervention may impact ethics and
human right but smoking ban intervention is beneficial which allow health authority to control
chronic disease cases in the country (Clarke and et.al., 2019). A nation with strict prohibition on
smoking face limited number of cancer cases because they have control one of the biggest factor
causing cancer in the society. The Smoking Ban intervention is beneficial in controlling global
health issue, control on chronic disease such as cancer, lung failure and other. It is very clear that
global health criteria is wide in which every individual contribute effectively, non-smoker
contribute in the betterment of global health. This intervention may bring control in chronic
disease and promote global health.

Global warming: Global warming is one of the biggest benefit to the world if smoking is ban in
the world, but this is not directly related to health. Control in pollution simply means air quality
will be improved, there will be better health quality and reduce in health cases. Smoking release
toxic smoke in the air, exposure of individual can be seen in which health is impacted (Halliday,
2016). Introducing The Smoking Ban intervention may allow nation to control pollution,
controlling pollution means there will be good health, impact can be seen on global health as
well. Nations who will be adopting this intervention may consider control on health issue,
smoking ban is beneficial for both smoker and non-smoker.
Outlining two ways the provider could be held accountable:
Health agency: The Smoke ban intervention is one of the most beneficial for the global health,
provider of this intervention are accountable in terms of effectiveness. For example; health
agencies are key provider who will be accountable for the action related to implementing the
smoking ban intervention, it is very clear that health organizations and agency can control cases
of chronic disease that often arrive from smoking. Health agency can provide better health care
awareness to implement this intervention in the society, these agencies have responsibility to
promote health care policy like The Smoke Ban. Provider of health care policy know the role of
health agency because they carry certain power to influence individual and patient.
Government: Government is one of the biggest health care provider in which they remain
accountable to measure effectiveness and answer query of individual regarding the intervention.
Government is key player or provider of The Smoke Ban intervention in which they will be
responsible for both negative and positive outcome, government involve themselves in the
implementation process allowing them to be accountable from the beginning (Mandelblatt and
et.al., 2017).
Discussing the effectiveness and efficiency of the intervention will be determined:
Change in health cases: Every health care intervention and policy is effective as government
examine the need of implementing these interventions to general public. Change in health cases
are sign of successful implementation of health care intervention, government can measure
effectiveness of the smoking ban intervention by analysing change and down fall in health cases
mainly related to tobacco. When planning and designing an intervention, government try to set
certain KPI which allow them to analyse effectiveness, change and downfall in cases are one of

the KPI (McLeod and et.al., 2019). Government can examine overall national health data and can
measure the effectiveness of the intervention.
Qualitative process: Qualitative is one of the most effective process in which government can
measure effectiveness and efficiency of the intervention, this simply means government
authorities can perform survey to gather viewpoint of health care professional, patient and other
key stakeholder. Designer of intervention keep qualitative process in their list when measuring
effectiveness, they try to perform survey regarding the efficiency of intervention. Survey is
conducted in several parts of the nation considering key member including professional, health
agency and stakeholder. Considering viewpoint of participant allow government to understand
that intervention is working as per the requirement, it is very clear that qualitative process is
expensive that is why government include this measurement process in the list while crafting
intervention. For example; determine effectiveness of smoking ban intervention, government can
perform qualitative process in which they can survey certain area of nation including health care
organization and agency, they can consider viewpoint of health care professional providing in
depth details of effectiveness of policy so that government can bring modification accordingly.
National health records: Considering national health record is one of the best way to determine
the effectiveness of the intervention, national health record keep every single data related to
health in the nation. This can be either health records focusing on intervention and its impact on
the nation, government can consider health record but they will not get exact idea about the
effectiveness of particular intervention because there are number of other intervention and their
impact is mixed in the record (Sekhon, Cartwright and Francis, 2017). However, effectiveness
can be measured in terms of drawback in one particular disease. For example; government can
analyse national health record allowing them to measure effectiveness of smoking ban
intervention, they can focus on statistical data on tobacco section, if the graph is showing down
fall then intervention was effective.
Change in economic outcome: Change in economic outcome is one of the most effective way
to measure effectiveness of the intervention, it is very clear that change in economic outcome
occur when government take major steps to manage critical situation in the country. For
example; to reduce health care cases due to smoking, government introduce intervention, this
intervention may ask cigarette manufacturing companies and tobacco companies to stop
manufacturing of products in the country impacting economic outcome but reduce health care

cases (Sekhon, Cartwright and Francis, 2018). If any nation agree to completely ban cigarettes
manufacturing companies then their economy will be impacted, they can analyse the outcome of
economic result to measure the powerful impact of the intervention. It is very clear that every
major intervention implemented by the government have major impact on the nation's economic,
if intervention is related to health care then impact can be seen on whole health care sector in
which government can measure and monitor the effectiveness of intervention.
Direct observation: Direct observation is one of the most effective way to measure
effectiveness on intervention, government can directly measure the efficiency by focus on
national health data. If there is change in smoking habit of individual then government can
determine that intervention is successfully implemented and its impact can be observed.
However, direct observation may be complex in terms of validity, observer need to monitor
individual, group or target community to measure the effectiveness of intervention (Viswanathan
and et.al., 2017). For example; the smoking ban intervention is implemented in the nation which
means government can perform direct observation allowing them to examine each individual,
group and community and mainly determine their behaviour regarding smoking habit. It is very
clear that direct observation in the case of smoking ban intervention is beneficial which allow
observer to smoke habit, they can examine large number of group and their habits to get clear
idea about the effectiveness and efficiency of the intervention.
CONCLUSION
From the above report it can be concluded that it was very important for the country to ban the
smoke. It has been found that almost every individual of UK was smoking and due to this many
of the people were dying. To stop this huge impacts of smoking cigarettes on the public health,
the smoking ban intervention was introduced by the legislative body of the country. This
intervention was found effective for the country as introducing this intervention many of the
people started quitting smoking as this has brought sales volume to decrease. By going through
the qualitative and quantitative research of this intervention, it has been identified that smoking
ban was quite effective for the company and through this they were able to save many of the
lives. This report has illustrated the the two cultural practices which are supporting this
intervention in the country as well as the cultural practices which are not supporting this
intervention and creating hindrance for the successful intervention.

Along with this, the above report has also covered the qualitative and quantitative evaluation of
the intervention through which success of the intervention was identified. Further, the ethical
consideration and benefits of this intervention on global health has been shown.

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