Evaluating Health and Education Interventions for Smoking in UK Adults

This literature review critically assesses the effectiveness of health and education interventions aimed at preventing and stopping smoking among adults in the UK. The review highlights the significance of addressing smoking due to its substantial health implications, including increased risks of heart disease, stroke, lung diseases, and various cancers. It delves into the prevalence of smoking in the UK, noting that a significant percentage of adults are smokers. The study explores factors influencing smoking behavior and examines health problems associated with smoking. The methodology involves a qualitative approach, utilizing secondary data sources such as PubMed, Science Direct, and Google Scholar to identify relevant research articles published between 2015 and 2022. The review also uses the PICO framework to formulate a focused research question and ensure ethical considerations are met. Ultimately, the review aims to inform the development of effective health and education strategies to reduce smoking rates among UK adults.

Research methods and
critical appraisal

Table of Contents
Topic: Smoking................................................................................................................................1
Introduction......................................................................................................................................1
Chapter 1: Background and rationale..............................................................................................1
Chapter 2: Methodology..................................................................................................................3
PICO Question........................................................................................................................4
Chapter 3: Results............................................................................................................................5
Chapter 4: Critical appraisal............................................................................................................5
Chapter 5: Emerging themes............................................................................................................5
Chapter 6: Recommendation and conclusion..................................................................................5
REFERENCES................................................................................................................................5

Topic: Smoking
Title of the research - “To effectively assess and evaluate about the success and
effectiveness level of the health and education intervention which are tend to working for
the prevention and stopping of the Smoking in the Adults of UK”.
Introduction
The current assignment is based on the aim of the reviewing the effectiveness of the
health promotion intervention for which the selected public health topic is Smoking. Further, the
concept of Smoking is defined as inhaling the smoke of any substance through the use of
smoking apparatus including, but not limited to, cigars, cigarettes, or pipes (Lippi and Henry,
2020). This project is a narrative literature review about smoking. The selection of smoking as
the selected public health topic is effective and vital as smoking is quite commonly seen within
UK and it tend to have many bas effects on the health of public. It has been seen and analysed
that the cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive are some of
the most common form of the pulmonary disease (COPD) which are tend to be caused by the
Smoking (Warner and Mendez, 2019). Beside this, the negative impact of the Smoking also
tends to includes and comprises of the emphysema as well as chronic bronchitis and also tend to
enhanced the risk of the issue for tuberculosis along with certain eye diseases, as well as the
problems of the immune system loss that also includes rheumatoid arthritis. Further, the structure
of the current project is being divided into 6 main chapters out of which chapter 1 comprises of
the background and rationale for the project. Further, the 2nd chapter comprises of the discussion
about the research methodology while the while the 3 chapter tend to includes the information
about the results and analysis of the selected article. Finally, the 5th choate comprise of the
emerging themes while the last chapter 6th includes of the recommendation and conclusion.
Chapter 1: Background and rationale
It has been seen and analysed that use of the smoking is highly increasing within the
society of UK and it tend to crate and lead to the risk of the developing of the higher heart
disease as well as the risk of stroke of is also greater. Thus, selection of current research topic is
vital and significant as it supports implication of better health creation and prevention of many
diseases associated and caused by the smoking. The data has shown and reflected that the more
than 14% of the adults in England are addict to smoking which tend to also account for the more
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than 7 million adults who are cigarette smokers in UK (Uçar and et. al., 2019). Thus, an analysis
can be made that Smoking has become a common issue within the society of UK.
(Smoking ration in UK, 2020)
(Source: Smoking in UK, 2020)
In the UK, in 2019, 14.1% of people aged 18 years and above smoked cigarettes, which equates
to around 6.9 million people in the population, based on our estimate from the Annual
Population Survey (APS). The proportion of current smokers in the UK has fallen significantly
from 14.7% in 2018 to 14.1% in 2019. Of the constituent countries, 13.9% of adults in England
smoked, 15.5% of adults in Wales, 15.4% of adults in Scotland and 15.6% of adults in Northern
Ireland.
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Therefore, reviewing about the main consequences and impact of smoking on health of people is
vital and significant. Further, it has also become vital and important that the government and
well fare organisation and health care servants should also emphasis and focus in the ways that
can be effectively adopted to have a check and reduction of issue of smoking in adults to reduce
the risk of diseases carted by the Smoking (Savin and et. al., 2018).
It has been also seen and observed that smoking is dangerous for health and can also
leads to exposure to death and some serious disease such as the lung cancer, stroke, heart
disease, respiratory illness and many more. Therefore, current project and study is undertaken
with the following main aim and objectives:
Project aim
The main aim of the current project and study is, “To effectively assess and evaluate
about the success and effectiveness level of the health and education intervention which are tend
to working for the prevention and stopping of the Smoking in the Adults of UK”.
Research Objectives
The current project and study on the health significant topic of Smoking is having
following research objectives:
 To get a better and deeper understanding about the Smoking within the adults of UK.
 To determine about the main factors and reasons that tend to influence and attract adults
of UK towards smoking.
 To evaluate about the main health problems and issues that are being caused by the
smoking within the adults of the UK.
 To recommend and come out with some effective health and education intervention and
strategies which tend to supports better prevention and check on the rising issues of the
Smoking within the adults of UK.
Research questions
 what is meant by the concept of the Smoking within the adults of UK?
 Which can be the main factors and reasons that tend to influence and attract adults of
UK towards smoking?
 What are the main health problem’s and issues that are being caused by the smoking
within the adults of the UK?
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 Which can be the some effective health and education intervention and strategies which
tend to supports better prevention and check on the rising issues of the Smoking within
the adults of UK?
Chapter 2: Methodology
It tends to forms out one of the most crucial and vital section of research project as it tends
to provide information about the key approaches and philosophies that are used and applied for
undertaking any investigation. The key research approaches and method that are being used
within a research project are discussed and provided as below:
Research Philosophy- there are two main set of research philosophy comprises of the
positivism and interpretivisim from which the study and content based on interpretivisim
philosophy are tend to be selected for current study. The reason behind making use of the
interpretivisim philosophy tend to base on the fact that it supports better implication of the
human behaviour and attitude (Leite and et. al., 2018).
Research approach- inductive and deductive are two main types of the research approach
out of which making use of inductive approach is more reliable and suitable for health
intervention study as it in line with interpretivisim philosophy and support better generalisation
of fact.
Choice of method- There are two main types of research method comprising of the
qualitative and quantitative research method out which qualitative tend to base on in-depth study
while quantitative support numeric selection of data. Thus, for current study based on health
education and programmes in support of restricting smoking use of literature review analysis.
Data collection- with respect to a study collection of data could be made from primary as
well as secondary sources (Lawrence and et. al., 2019). For current study use of only secondary
sources of information is made a discussion of which is provided below:
The method used in his research is PubMed along with the Science Direct as well as the
use of the Google scholar by the way of using generic terms to identify the relevant and valid set
of research article. Further, after making the search the abstract of article has been read with the
of these research engine to review about the relevancy and effectiveness for current project.
Beside this, while selecting and making choice of the article, it has been ensured that study
which are authentic and up to date are only get selected ranging from the year 2015 to 2022 to
ensure up to fate information about the educational interventions. Along with this, the selection
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of article is also tending to be based on the description of study, along with the location and
sample size. Implication of both inclusion and exclusion criteria are taken into consideration as
article older than 7 years are excluded and article are selected on the basis of proper copyrights
and authentic of information. Further, use of the Boolean Operators that tend to simple words
(AND, OR, NOT or AND NOT) used as the conjunctions to combine or exclude keywords in a
search, resulting in more focused and productive results has been also made. The data base
selected for current study based on key terms Smoking, health issues, health intervention and
education, etc. a set of 30 article has been selected and after removal of duplicate articles 6 has
been short listed that are provided as below:
PICO Question
PICO is a framework that is commonly utilized and adopted in order to effectively
formulate a focused clinical question for systematic review. It tends to stands for population,
intervention, comparison and outcome. The review question that is created in context of current
study is based on “Is the health and education intervention are tend to effectively working for
the prevention and stopping of the Smoking in the Adults of UK?”. This research question is
framed by utilizing PICO framework that administers an adequate criterion to develop a
dissertation question. By the assistance of this approach, researcher will be able to search the
answer to the question easily. The four components of PICO framework in relation to this
specific study is provided below:
Population (P) Adults having the habit of Smoking
Intervention (I) Health Education Interventions
Comparison (C) No comparison
Outcome (O) Prevention of Smoking in adult
Further, it has been ensured that all the set ethical consideration is meet while
undertaking current study and only reliable and authentic set of articles are selected for current
project to meet ethical consideration.
Chapter 3: Results
Addiction to nicotine is caused by smoking, and the research examined in this paper
demonstrates that this addiction can develop in infancy and adolescence. Adolescents become
hooked to nicotine in varying degrees as their smoking intensity increases. Peer and parental
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influences have been frequently identified as risk factors for smoking initiation, and new data
suggests that genetic factors may also play a role (see Chapter 4). Adolescents and young adults
who try to quit experience side effects, albeit they are not uniformly equivalent to those
experienced by older smokers who quit.
Article 1:
Tobacco smoke contains chemicals that raise the risk of heart issues and cardiovascular disease.
Smoking promotes atherosclerosis, a condition in which plaque accumulates in the circulation
and adheres to the artery walls. This narrows them, decreasing blood flow and raising the risk of
blood clots. Smoking also causes blood vessels to become thicker and narrower. This makes
blood flow more difficult and raises blood pressure and heart rate (Lippi and Henry, 2020).
Tobacco use has been linked to the following cardiovascular diseases: One of the primary causes
of death is coronary heart disease. A heart attack, as smoking doubles the risk of a heart attack,
obstructions that restrict blood flow to the skin and legs. Stroke caused by blood clots or burst
blood arteries in the brain.
Article 2:
Cigarette smoking imposes a significant burden of death and disease on the public's health. The
primary focus of this chapter is cigarette smoking because it is the most serious public health
issue, but secondhand smoke exposure, consumption of other forms of tobacco, smokeless
tobacco, and nicotine delivery systems ( ends (ENDS) are also addressed. The extent of the
public health concern posed by smoking tobacco arises from two factors: the ubiquity of
cigarette smoking and the numerous negative health impacts of smoking (Warner and Mendez,
2019). A policy adjustment that reduces cigarette smoking prevalence will result in a
proportionate reduction in the societal incidence of disease and mortality smoking - induced
smoking.
Article 3:
Cardiovascular disorders, particularly atherosclerosis, are the main causes of death in
industrialised cultures. Indication of the rate, which also causes degenerative aortic and
microvascular disease, is the most common underlying cause of atherosclerosis (CAD). Cigarette
smoking contributes to the formation and progression of the atherosclerotic process, both alone
and collaboratively with other hypertension and hypercholesterolemia (Uçar and et. al., 2019).
Several studies have found that the risk of developing CAD increased with the quantity of
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smoking habits per day, the total number of years smoked, and age of initiation, demonstrating a
dose-related response. Smoking cessation, on the other hand, has been shown to lower morbidity
and mortality from coronary artery disease.
Article 4:
Skin: Impaired supply of oxygen to the skin due to poor blood circulation caused by chronic
vascular insults causes long-term damage to protein and epithelial tissue. This condition also led
to poor tissue regeneration, making elective and emergency procedures riskier.
Smoking can cause foul breath, mouth and jaw cancer, recurring pharyngitis, a loss of taste and
smell, as well as stained, yellowed teeth and plaque. Smoking lowers the flow of saliva, which
encourages infection since saliva scrubs the lining of the teeth and defends the teeth from decay.
Article 5:
Smoking is extremely addictive. Nicotine is the primary substance responsible for a person's
addiction to tobacco products such as cigarettes. Nicotine's addiction to cigarettes and other
tobacco products is similar to the addiction caused by narcotics such as heroin and cocaine.
Nicotine is found naturally in tobacco plants. Tobacco corporations, on the other hand,
purposefully construct cigarettes with enough nicotine to establish and perpetuate addiction.
The amount of nicotine absorbed by the body is determined by the manner in which a person
smokes a tobacco product, as well as the nicotine concentration and design of the product.
Nicotine enters the bloodstream via the mouth and lung linings and goes to the brain in a couple
of seconds.
Article 6:
The Food and Drug Administration has issued a warning to the public after receiving hundreds
of complaints of serious lung ailments linked to vaping, including several deaths. They're
collaborating with the Centers for Disease Control and Prevention (CDC) to figure out what's
causing these infections. Many of the questionable goods evaluated by state or federal health
regulators have been identified as vaping devices containing THC, marijuana's major
psychoactive component. Some patients reported vaping a combination of THC and nicotine,
whereas others reported vaping only nicotine. There is no one ingredient that has been
discovered in all of the samples studied, and it is unclear whether the diseases are linked to a
single compound.
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Chapter 4: Critical appraisal
Smoking has an immediate impact on a young person's health, but it also has a long-term impact
on their future. When compared to adults, youth smokers are more prone to develop severe levels
of nicotine addiction, which leads to ongoing tobacco use as they grow older. Nicotine constricts
blood arteries, raises blood pressure, and puts additional strain on the heart. This includes
shortness of breath, asthma and respiratory ailments, as well as cancer and other chronic
conditions. Aside from the health consequences, smoking has a slew of negative societal
consequences. It can foul up your hair and clothes, discolour your teeth, and produce terrible
breath. Furthermore, smokeless tobacco can cause split lips, blisters, and bleeding in the mouth
(Savin and et. al., 2018).
Chapter 5: Emerging themes
Cardiovascular disease accounts for 40% of all smoking-related deaths. 53 Coronary heart
disease, the biggest cause of death in the United States, is caused by smoking. Smoking has also
been related to a variety of serious health issues, including osteoarthritis, inflammation, and
reduced immune function. According to a merge population survey, even cigarette smokers aged
26 to 41 had lower health-related quality of life than their nonsmoking peers. 54 Recent animal
study has also discovered a relationship between the pancreatitis and a portion of the brain
involved in nicotine intake, perhaps tying cigarette smoking to an increased risk of Type 2
Diabetes (Leite and et. al., 2018). Cigarette smoking has been related to between 80 to 90 percent
of all occurrences of lung cancer, the leading cause of cancer death in both men and women, and
is responsible for approximately 80 percent of deaths from this disease. Smoking increases the
risk of lung cancer five to tenfold, with heavy smokers being at a higher risk. Smoking is also
linked to mouth, pharynx, larynx, oesophagus, stomach, pancreatic, cervix, kidney, and bladder
cancers, as well as acute myeloid leukaemia. Cigarette smoking isn't the only type of tobacco
consumption linked to cancer. Tobacco use has been related to pharyngeal, esophageal, stomach,
and lung cancer, as well as colorectal cancer. Cigarette smoking damages nearly every organ in
the body1,44, and smoking is the largest preventable cause of death in the United Kingdom.
Although smoking rates have decreased, it is estimated that it causes approximately 480,000
fatalities each year (Lawrence and et. al., 2019). Smokers aged 60 and up have a twofold
increase in mortality as compared to nonsmokers, dying an estimated 6 years sooner. Quitting
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smoking results in immediate health advantages, and depending on the age at which the person
quits, some or all of the lower life expectancy can be restored.
Chapter 6: Recommendation and conclusion
Tobacco use is a serious public health issue as well as a substantial risk factor for fatalities from
heart disease and various types of cancer, including lung, head and neck, and colorectal cancers.
Over the previous six decades, the prevalence of smoking has decreased. However, nicotine
addiction is still seen as a widespread and serious clinical issue. Despite the existence of a
number of effective therapies, treating patients for cigarette cessation remains a difficulty, not
only for individuals but also for doctors, who may be unaware of helpful therapies and hence fail
to offer therapy. As a result, professionals must get acquainted with the therapy choices available
to each smoker.
Recommendations
 Consider using nicotine replacement therapy.
 Consult physician about nicotine replacement therapy. Among the alternatives are:
 Nicotine on prescription in the form of a nasal spray or inhaler
 Nicotine patches, gum, and lozenges are available without a prescription.
 Non-nicotine stop-smoking drugs on prescription, such as bupropion (Zyban) and
varenicline (Chantix)
 Stay away from triggers - Tobacco cravings are most likely to be strongest in situations
when one smoked or chewed tobacco the most, such as at parties or bars, or while
worried or sipping coffee. Identifythe trigger circumstances and make a plan to avoid or
get through them without using tobacco. Don't put yourself in a position to relapse. If
you used to smoke while talking on the phone, for example, keep a pen and paper
nearby to busy yourself with doodling instead of smoking.
 Delay - If one is about to succumb to your tobacco need, remind yourself that you must
first wait 10 minutes and then do something to distract yourself during that time. Try
going to a public, no-smoking area. These easy tactics may be sufficient to quell your
cigarette need.
Due to high mortality rate in the people living in UK from smoking, few
recommendations have been suggested for improving the condition as well as the state of a
person so that they lead safe and healthy life. The health practitioners play very vital role in
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regulating the condition of smokers and making their physical and mental status normal. Such
care providers are suggested to make each and every patient more aware about the after effects of
the smoking on the body. The nurses who are working in the health care department have the
capability to maximise the prevention measures and promote such strategies which clearly cease
the habit of smoking in UK. The health providers are always at the place where they can keep the
track of smokers and make such high end evidences for promoting the better clinical practices
which rely on tobacco dependent consumers which eventually aids in eliminating the chances of
making more addiction and render chance to quit smoking. Pregnant women living in the UK,
must get aware about the ill effects of smoking on the baby, such women are recommended to
regularly get in touch with the health providers for making their condition stable with respect to
their health.
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REFERENCES
Books and journal
Lippi, G. and Henry, B.M., 2020. Active smoking is not associated with severity of coronavirus
disease 2019 (COVID-19). European journal of internal medicine, 75, pp.107-108.
Warner, K.E. and Mendez, D., 2019. E-cigarettes: comparing the possible risks of increasing
smoking initiation with the potential benefits of increasing smoking cessation. Nicotine
and Tobacco Research, 21(1), pp.41-47.
Uçar, S. and et. al., 2019. Mathematical analysis and numerical simulation for a smoking model
with Atangana–Baleanu derivative. Chaos, Solitons & Fractals, 118, pp.300-306.
Savin, Z. and et. al., 2018. Smoking and the intestinal microbiome. Archives of
microbiology, 200(5), pp.677-684.
Leite, F.R. and et. al., 2018. Effect of smoking on periodontitis: a systematic review and meta-
regression. American journal of preventive medicine, 54(6), pp.831-841.
Lawrence, H. and et. al., 2019. Cigarette smoking and the occurrence of influenza–Systematic
review. Journal of Infection, 79(5), pp.401-406.
Online
https://www.medicalnewstoday.com/articles/10566
https://www.ncbi.nlm.nih.gov/books/NBK310413/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2733016/
https://journalofethics.ama-assn.org/article/health-effects-smoking-and-benefits-quitting/2011-01
https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cessation-fact-sheet
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/
healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2019
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