Health Promotion Report: Acheson Report and Smoking Cessation

This report delves into the realm of health promotion, focusing on the influence of the Acheson report and the Alma Ata declaration. It critically examines the impact of these documents on public health strategies, particularly in addressing health inequalities. The report investigates the application of health promotion theories, such as the Health Belief Model, in the context of reducing smoking prevalence among pregnant women. It proposes a detailed plan for a health promotion program, including implementation strategies and evaluation methods, aimed at promoting smoking cessation during pregnancy. The report also explores the connection between the Acheson report and the Alma Ata declaration, highlighting their shared emphasis on social determinants of health. Ultimately, the report offers a comprehensive overview of health promotion principles and their practical application in improving maternal and child health outcomes.

Health Promotion
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CONTENTS
Contents...........................................................................................................................................2
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
Q1 Using specific ‘intervention examples’, discuss how ‘The Acheson report’ was broadly
influenced by the Alma Atta declaration of 1978........................................................................3
Q2 The key/relevant theories and concepts that will inform health promotion approaches for
reducing the prevalence of smoking in pregnant women’...........................................................6
Q3 Plan, implement and evaluate about key health promotion programs for reducing the
prevalence of smoking during pregnancy..................................................................................10
CONCLUSION..............................................................................................................................13
REFERENCES..............................................................................................................................14
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INTRODUCTION
Health promotion is defined as the process through which people are being enabled to
increase their control over and improve their health for a better living. This mainly focuses
toward encouraging people as well as community to adopt healthy behaviour and make changes
in their habits to avoid developing the risk of chronic diseases and other morbidities. The current
report is based over the case study of the Acheson report published in 1998 about model of
health. Addition to this it also includes a case study of NHS about smoking among women
during pregnancy. This address detail about theories for health promotion in order to reduce the
prevalence of smoking among women. Other than this it also contain detail about creating a
health promotion, plan, implementation and its evaluation on theme ‘reducing the prevalence of
smoking during pregnancy’.
MAIN BODY
Q1 Using specific ‘intervention examples’, discuss how ‘The Acheson report’ was broadly
influenced by the Alma Atta declaration of 1978
The Acheson report, completely titled Independent Enquiry into Inequalities in Health Report
was published in year 1998 through United Kingdom enquiry. Similar to earlier reports in United
Kingdom on health disparities involving the Whitehall Study and the Black Report, Acheson
report depicts existence of disparities in health along with their relationship to social class. The
report finds out that despite an entire download in trend of mortality from year 1970 to year
1990, the high social classes experienced speedy mortality decline. 39 policy suggestions are
included in the report in areas from taxation to agriculture, for improving disparities in health
(Asaria, 2016).
The Acheson report was compared by professor Clare Bambra in year 2016 with earlier
Black Report as well as the later report through Michael Marmot. Then either, the Acheson
report was proclaimed in to more constructive climate. Between year 1997 and 2003, the policy
of health across the United Kingdom reflected some ideas developed in Acheson and Black
reports. A consistent focus was there on requirement to tackle economic and social
determinants of inequalities in health and commitment to using cross cutting policies of
government to handle health inequality. By year 2004, National targets to decline the inequalities
in health were also presented with an emphasis on infant mortality rate and life
expectancy. Many initiatives were presented - health improvement programmes, healthy living
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centres, new deal for communities and health action zones. But, perhaps due to these initiatives,
from year 2004 to 2007, the policy related to public health moved away from economic and
social determinants and instead emphasizes on lifestyle behaviours and health services. The
targets of health inequalities were abandoned across the United Kingdom in 2011. And in
reducing health inequality, the effect of policy was modest (Bell, Friel, and Marmot, 2016).
The Alma Ata declaration in year 1978 emerged as key milestone of 20th century in public
health area as well as this declaration identified Primary Health Care as a major source to
accomplish the goal of health for all. The excerpts from this declaration are discussed below:
 The existing gross inequality in status of health of individuals specifically between
developing and developed Nations and within Nations which is economically, socially
and politically unacceptable and is, thus, of common concern to all Nations.
 The conference reaffirms that the state of complete social, mental and physical wellbeing,
and not only the absence of infirmity or disease, i.e., health is the fundamental right of
human and its attainment is the most crucial social goal all over the world whose
realization needs actions of other economic and social factors along with health sector
(Scott, 2016).
 The Primary Health Care based on socially acceptable, scientifically sound and practical
methods is important health care and technology made it accessible to families and
individuals in community universally by their complete participation and at cost which
the country and community can effort in order to maintain at each step of their
development in self-determination and self-reliance spirit. It forms important part of its
central function and health system of country and of complete economic and social
development of community.
 It is the responsibility of government to ensure health of individuals which can be
accomplished only through provision of adequate social and health measures. In the
coming decades, the key target of international organisation, community all over the
world and governments must be the accomplishment by all individuals of the world a
level of health by year 2000 which will permit them to lead economically and socially
productive life.
 The individuals have the duty and right to participate collectively and individually in in
planning and execution of their health care (Mabhala, 2015).
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 The social and economic development on the basis of new international economic order
is of general significance to complete attainment of health for all people and to minimize
the gap between health status of developed and developing nations. The protection as
well as promotion of health of individuals is important to sustained social and economic
development as well as contribute to world peace and better quality life.
 All the nations must co-operate in partnership and service spirit in order to make sure
primary health care for all the individuals since accomplishment of health by individuals
in any one nation directly benefits every other nation. In relation to this, the joint report
of WHO/UNICEF on primary health care includes strong basis for further operation and
development of primary care all over the world.
 All the governments must develop national strategies, plans and policies of action to
launch as well as sustain primary health care is comprehensive national health system
part. To this end, it is crucial to mobilize the resources of nation, exercise political will
and utilize available extrinsic resources rationally.
 An acceptable health level of all individuals of world by year 2000 can be accomplished
by better and complete utilization of resources of the world, a considerable part which is
spent on military conflicts and armaments.
 Primary Health Care addresses health issues in community, giving preventive, promotive,
curative as well as rehabilitative services accordingly. It reflects and revolves from social,
cultural, political and economic conditions and characteristics of nation and its
communities as well as is based on execution of relevant outcomes of biomedical, health
and social services research (Gokani, 2018).
Similar to Black report, the Acheson report adopts social economic model of health
inequalities that traces the main cause of in health to determine its like employment, income,
education, lifestyle and material environment. The declaration in Alma-Ata emphasize on social
health determinants was followed in United Kingdom by Black report on inequalities in health in
year1980 and Whitehead report in year 1987. These reports alter the landscape of health policy
of United Kingdom through bringing inequalities in health to the top of agenda of policy. Some
of execution failure of Alma-Ata can be explained through competing imperatives, involving: the
leading emphasis on acute care in most of the nations, structural adjustment programmes in
developing nations and the spread of privatisation globally.
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Q2 The key/relevant theories and concepts that will inform health promotion approaches for
reducing the prevalence of smoking in pregnant women’
Smoking is considered to be one of the biggest cause preventable mortality as well as
morbidity within England. This is affecting the health of people around England and required to
be reduce to maintain well being of people in country. When it is about pregnant women, it is
also very much common among pregnant lady (Tsakiridis and et. al., 2018). Smoking remains
very much harmful to the mother and also unborn child as it creates the risk of miscarriage,
premature birth, low birth weight, infant death etc. In England each year around 80000 people
dies because of smoking ad this habit is getting spread among people of all age group. Other than
this the smoking during pregnancy is getting one of the biggest issues in England and also within
Barnet a borough of London.
The issue of smoking among the women during pregnancy is growing which in turn
affecting the future generation. As when women smoke during their pregnancy then the cause of
babies born with health issues is relatively higher. In year 2012-13 it has been found that around
12.7% of women within England were smoking when their baby was born which was shown
within the NHS digital show. When it is about the Barnet borough, support toward pregnant
women for stopping smoking is very much essential as it result into around 40% infant death
within borough Barnet. Other than this it increases around 12.5% of risk for premature birth and
around 26.3% risk of intrauterine growth restriction is also get increased. The smoking ratio
within Barnet did not change significantly from year 2012 to 2017, but when it is compared with
England and London the ration has significantly fall.
This graph shows that the trend within the ratio of mother who smokes at the time of
delivery or while pregnancy. From this it can be said that the ration of smoking among pregnant
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women has been increased by year 2017 which is higher than the England. Hence it is a point of
concern for Barnet borough as it increases several risks for women while pregnancy like it
reduce the lung capacity as it led to growing of uterus, so women who smokes are usually remain
at higher risk and take long time to get recover form surgery.
Health promotion theories
The health promotional strategies are consider to be very much effective practices that
support in health promotion as well as prevention of disease. These health promotion theories are
mainly used within the program planning so that better understanding can be develop about the
health behaviour and also provide an appropriate guidance about the identification, development
and implementation of interventions (Varpio, Paradis, Uijtdehaage and Young, 2020). By
making use of these health promotion theories it become easier to develop appropriate strategies
for preventing the smoking among women in pregnancy in a systematic manner. This in turn
further help in reducing the risks to infant child while and after birth due to smoking. The
commonly used health promotion modes are,
The health belief model:
It is a theoretical model which is used for guiding the health promotion planning in order to
prevent a particular health issue. This theory can be used explaining as well as predicting the
individual change within the health behaviour of women while they smoke during pregnancy.
The key factors involve within this model are explained below:
 Perceived susceptibility: This stage help in determining the perceived chances of
pregnant women about developing the smoking related conditions such as infertility,
miscarriage, premature delivery etc.
 Perceived severity: This stage includes the belief of women who are consuming tobacco
about the seriousness of several smoking related conditions and consequences of these
conditions.
 Perceived benefits: The belief of pregnant women who smoke about the efficacy of
advised actions regarding smoking cessation within reducing several health risks
(Cummins, 2020).
 Perceived barriers: The opinion of women about the tangible as well as psychological
costs of advised cations for quitting their habit of smoking.
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 Cues to action: Strategies to activate readiness about quitting the habit of smoking
among pregnant women.
 Self-efficacy: The confidence of tobacco users within their ability to eliminate the
consumption of tobacco.
By evaluating the information about the condition of pregnant women who smokes, an
appropriate strategy can be developed for helping them in quitting the smoking for giving birt to
healthy baby without nay kind of heath issues (Pahl and Wyles, 2017). Following are the
strategies that can be used to make the women quite smoking while their pregnancy,
 Communicate to them about the risk of smoking while pregnancy and several
consequences that they may face by doing so and along with that they must also be
provided information about the benefit of quitting the consumption of tobacco. When
women get realise about its consequences, they surely take action toward quitting it.
 Women must be provided with the cues of action that they can take to give up over their
habit of smoking. This mainly includes reminder about a health plan, recommendations
from doctor, medical campaign, medical symptoms etc.
Stages of change model
This is also termed as transtheoretical model which explains about the readiness of an
individual toward changing their behaviour. It describes about the process of behaviour change
that occur within stages, it mainly includes:
 Pre contemplation: There is no intension of taking decision toward better health. At
this stage, pregnant women must be provided with basic awareness about the risk that
they may face while smoking.
 Contemplation: At this stage the people get an intension to take action and preparing
plan to do something in near future (Tsakiridis and et. al., 2018). At this phase, women
must be further making aware about the benefit they will be getting after quitting
smoking.
 Preparation: At this point they get into an intension to take action and they take some
step in this regard. While getting at this stage more awareness must be created for
nicotine and other things which help women in overcoming from there craving of
smoking.
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 Action: While reaching to this point the women started changing their behaviour for
short time period. Here the pregnant women must be provided with several health care
plans and habit to be adopted for reducing smoking (Dhalwani and et. al., 2019). By
continuing this they would be able to get in a habit of reducing smoking for adopting a
better lifestyle.
 Maintenance: Once they take proper action toward reducing the smoking and feel great
with it they started continuing with this for long term period.
 Termination: This is the last stage of change, where the women totally get out of their
habit of smoking and also don’t remain at the desire to get to their negative behaviour
back which is harmful for them and their unborn baby.
These are the health promotion model that can be used in order to reduce the smoking habit
among women while their pregnancy as it is very much harmful to them and also cause several
issues at the time of delivery and create risk to the birth of a baby. But in order to create
awareness among them for quitting such habit there remains a need of adopting appropriate way
of communicating about its requirement. Following are the two best possible way of
disseminating the information about preventing of smoking among pregnant women,
Media campaign: As the smoking habit among the people of England and Barnet borough
is getting increased due to lifestyle pattern it is increasing the risk for unborn baby. Therefore,
for creating awareness about its consequences a media campaign can be launched where the
information regarding the negative impact of smoking over unborn baby can be circulated
(Breland, McCubbin and Ashford, 2019). This help in creating awareness among women about
the issues they may face in near future so that they take action toward quitting their habit of
smoking.
Doctor’s recommendation: This could be an effective method of making women concern
toward changing their habit of smoking. In this whenever a pregnant woman comes to clinic, a
doctor must inform them about the risk of smoking at this stage and outcome of it that they may
found. Other than this also help them in creating a healthy plan to give up this habit, so that the
ratio of women smoking can be reduced from England.
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Q3 Plan, implement and evaluate about key health promotion programs for reducing the
prevalence of smoking during pregnancy
The smoking habit is getting very much popular among the adults as well as teenager of
the England and per the study conducted by NHS it has been found that around 12.7 per cent of
women within England having habit of smoking when their babies were born. Currently around
10.5 per cent of women are known to be smoke at the time of delivery which is only drop to .01
per cent last year. So, it requires an attention toward taking corrective action for reducing
smoking habit about pregnant women for reducing the risk and health issues to new born babies.
So, it is decided to create a health promotion program on theme of “reducing the prevalence of
smoking during pregnancy”.
This plan will include a media campaign named as “Smoke Free lives”, which will be done
with the help of social media sites. In this campaign a survey will be performed over the people
who are habitual of smoking with an aim to create awareness about the consequences of their
habit and providing them a smoke control plan which they can adopt to deal with this smoking
habit by actively participating within this campaign. The health promotion program for reducing
women smoking will be performed by working over following steps,
Manage the planning process: This is the first stage where the planning about the health
program will be done by getting engaged with the stakeholders such as medical staffs, authorities
and clients in a meaningful manner (Nwosu and et. al., 2020). Other than this way of allocating
the material, human resource and fund will also be planned so that the aim of reducing smoking
among women can be achieve in systematic manner. So here the plan regarding how the program
will be executed get decided.
Conduct a situational assessment: In this step, the situation or severity of issue will be
analysed so that before starting work over this program appropriate information remain
available. For this a survey is to be made regarding the women that are consuming tobacco and
their health assessment report from several clinics and hospital present within Barnet borough, so
that health program campaign can be designed accordingly.
Identify goals, populations of interest, outcomes and outcome objectives: After
evaluating all the information related with situation gathered, the goals for this health program
will be identified. The main goal of this campaign is to remove the smoking habit among women
while their pregnancy (Amaral and et. al., 2017). The interested population would women who
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are pregnant and mother of infant. The outcome of this campaign is expected to reduce at least
50 per cent of women’s smoking habit in order to get a healthy born babies without any kind pf
issues that cause due to low oxygen or other issues due to smoking that reach to them in womb.
Identify strategies, activities, outputs, process objectives and resources: Under this
stage the strategies and activities to be performed for executing those strategies will get aligned
and resources required will be identified. For this health programme over “reducing the
prevalence of smoking during pregnancy”, resources like clinical instruments for health check-up
of women, IT staff members for handling social media platform, fund etc. will be required for
executing the plan effectively (Amaral and et. al., 2017).
The main strategy of this program is to ensure that women will be get encourage to join the
campaign and after getting appropriate information they must went to the doctors involve in
camp for getting their health plan to overcome their weakness of consuming tobacco. For this
following activity are planned,
 First of all the clinics of Barnet borough will be visited to gather the information about
the women who are pregnant and those who clearly get identified with their habit of
smoking so that they can be approached to spread information about the risk over which
they are living due to smoking.
 After gathering the data social media page will be created about this program “Smoke
Free lives”, and with the data gathered through survey those women will be approached
through their mail or phone number by providing them with this link.
 This link will contain of a basic video about basic tips regarding health habits to be
adopted and things to be reduce for healthy lifestyle while duration of pregnancy and
delivery (Tojal and Costa, 2020). This will also provide detail about smoking and its
negative impact over child so by getting influenced about it they get ready to fill up the
questionnaire that contains the symptoms they found in themselves.
 On the basis of score get through questionnaire, women will be provided with the
appointment to the doctors involve in campaign to provide recommendation, direction
and health plan to be adopted to overcome their habit of smoking.
 After the plan get developed for each women it again get consulted with the doctor with
whom they are having their regular check-up and after the approval, those women can
start their plan.
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Develop indicators: This stage is helpful in determining the progress of the program by
creating the indicators which shows whether the programme is moving as per planned or not.
This program “Smoke Free lives”, will be created for the women who intake tobacco while
pregnancy and for ensuring the progress of this program indicator would be number of women
fill up the survey question after viewing the video. Another indicator can be seen with the
number of women come to the clinic for taking doctor’s recommendation to deal with their habit
of smoking in order to adopt a healthy lifestyle.
Review the program plan: - This is the last stage when the program milestones and its
ongoing process will be reviewed and compare with the expected plan as that it can be assure
that things are moving smoothly. In case there remain any kind of gap among them so corrective
actions can be taken to reduce that gap (Greaves and et. al., 2016). The progress of program will
be assessed and reviewed on the basis of indicator which shows whether the women that are
expected to be involve in program have been get connected with eth health promotion program if
not than more efforts will be implement to influence more women to get aware about their
health.
This will be the Health promotion programme that will support in taking actions toward
reducing the consumption of tobacco among women during their pregnancy. This is so because it
gap in creating awareness about the benefit of quitting smoking by making people aware about
the consequences of smoking while pregnancy. This programme is expected to be successful as
its success can be predicted as per the similar program that was promoted within London which
was named as Stop Smoking London. In this programme around 30 boroughs of London
participated in order to encourage people to ditch smoking where some simultaneous digital
advertisement get run where people who click on ad taken to qualifying page where they were
asked for providing audience with some important information. This campaign was very much
successful as it was launched in year 2019 and within 5 month of its launch there were around
1.8 million views and 26500 ad click and now this website has 3000 identified smokers and
26500 are seen interested in quitting smoking (Case study, 2020). So, with this it can be said that
social media is best possible source to approach people for creating awareness and hence this
campaign of “Smoke Free lives”, over theme “reducing the prevalence of smoking during
pregnancy” is expected to be successful.
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CONCLUSION
From the above performed report it can be conclude that smoking among people is
getting more and more common which brings up several kinds of issues to health or smokers as
well as people came in contact with second hand smoke. It has been found that this smoking
habit is also common among women in England and even among pregnant women too. This
considered to be the main reason behind premature delivery of babies, miscarriage, low weight
birth and baby born with several health issues which sometimes result into infant death. These
can be reduced by promoting awareness among women regarding this and presenting a
appropriate doctor recommendation plan to get recover from their habit of smoking. For this
health promotion theories like The health belief model and Stages of change model can be
implemented which provide a step by step procedure to change the behaviour of people and
preventing them from disease.
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REFERENCES
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