Tobacco Cessation 1

Tobacco Cessation in Young Adults and Adolescents

Meghan Clements Arrington

Health 634 B02
February 7, 2016

Tobacco Cessation 2
Introduction
Smoking among youth has been and continues to be an epidemic in the United
States1. For decades, public health officials, physicians, and researchers have been trying to
prevent underage smoking and finding out just how adolescents and young adults are being
exposed to and engaging in cigarette smoking1. The use of tobacco puts adolescents and young
adults at greater risks of immediate lung and heart damage and of an increased risk of addiction
to nicotine1. Smoking slows down the growth and development of the lungs and the damage is
permanent, causing shortness of breath and other pulmonary issues1.
Everyday across the United States 3,800 new youth under the age of eighteen start
smoking and more than 1,200 people die due to smoking related illnesses1. For every death of a
smoker, at least two new young people become a regular smoker with ninety percent of those
replacement smokers, smoking their first cigarette before the age of eighteen1. Only one out of
every three smokers will quit and of those two remaining, one of those individuals will die due to
a tobacco related cause or issues2. If smoking continues at the current rate among youth in the
United States, 5.6 million of todays Americans younger than eighteen will die early from a
smoking-related illness3. That statistic equates to about one of every thirteen Americans aged
seventeen years or younger alive today3.
I am proposing to use social media to create a health communication and promotion plan
to help educate adolescents and young adults on the health risks associated with cigarette
smoking and to help reduce the number of adolescent and young adult cigarette smokers. The
program I am planning on implementing will be through the means of a social media page on
Facebook. I believe my plan will be effective and helpful because most adolescents and young

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adults are very involved in social media and using this tool to implement a health communication
program is a way to stay current and connected with my target population. The Facebook page
will be free to users and it will include free information on cigarette smoking statistics, health
risks associated with smoking, resources on how to quit, free webinars, and open forums for peer
communication.
I plan to partner with the local Department of Health on my health communication
program. I believe partnering with the Department of Health will be an important part of the
program because it will allow program users to have access to health professionals, information,
and resources other than what I am providing to them through the other aspects of the program.
The health professionals at the Department of Health can help guide program users to their local
Department of Health facilities, give them information on programs or services they Department
of Health can provide to members of the community, and they can also be another educational
resource for the program members.
The next section will discuss the research and evidence that promotes the need for this
type of health communication and promotion plan. The evidence and research provided in the
next section was selected based on information from the last eight years and pertains to my
health communication and promotion plan by relating to the age of my target population,
program implementation style, and cessation methods. The following research highlights the
effectiveness of using social media outlets to promote health promotion programs.
Body of Evidence
The internet has emerged as a promising medium to deliver a range of treatments to
promote health, including smoking cessation4. Internet treatments have varied from chat rooms,

Tobacco Cessation 4
to tailored feedback based on questionnaire answers, to behavioral strategies to cope with
cravings4. Technology-based methods of communication such as podcasting, test messaging, and
email are important to adolescents because these media help adolescents overcome barriers to
health care such as confidentiality, lack of money, transportation, lengthy waiting room times,
and language barriers5. The teenage years are a time when young people often look to the
broader youth culture for their own sense of identity and belonging and because mass media are
a window for adolescents on that broader youth culture, they are ideal channels through which to
try to influence youth health behaviors6.
Contingency Management in the 21st Century: Technological Innovations to Promote
Smoking Cessation discussed the idea of internet based treatment plans and how the internet
provides unprecedented reach, convenience, and accessibility to health promotion and prevention
programs4. A main idea that was derived out of this article was that the internet, although there
are still some disparities, can actually reach populations that may have been previously in the
access gap and to help reduce the lack of access through the internet4.
Reduction of Cigarette Smoking via iQuit: A Web-based Program Using Podcasting and
Text Messaging in Adolescents was a study designed to evaluate an internet-delivered smoking
cessation program which measured reduction in smoking by using self-report surveys and carbon
monoxide monitoring5. The key topics that were discussed on the podcasts were: setting a quit
date, avoiding triggers, managing cravings, nicotine replacement, managing stress, and relapse
prevetion5. The study provided daily text messages as an additional support tool for the first
thirty days5. The outcome measures were reduction in number of cigarettes used per day,
reduction in the number of days per month smoking, and reduction in client CO levels5. The

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results of the study demonstrated a modest reduction in the number of cigarette used per day, and
the number of total days of cigarette use per month5.
Research shows that media could greatly influence adolescent behaviors7. In Media
Exposure and Smoking Intention in Adolescents: A Moderated Mediation Analysis from a
Cultivation Perspective, it discussed that in a previous study conducted in 2001 it was found that
media exposure has pervasive impact on a variety of behaviors such as increased aggressive
behavior and alcohol and tobacco use7. Even though there are some barriers for internet access
in rural areas the accessibility has come a long way. An Internet-based Abstinence
Reinforcement Smoking Cessation Intervention in Rural Smokers displayed in the study that
there was some feasibility and short-term efficacy of delivering reinforcement for smoking
abstinence over the internet in rural populations8.
In both Efficacy of a Text Message Based Smoking Cessation Intervention for
Adolescents and Young Adults: Study Protocol of a Cluster Randomised Controlled Trial and
Adolescent Smoking Cessation Methods: A Review Article, text messaging was discussed as a
smoking prevention and cessation intervention9,10. Both studies yielded results that a text
messaging intervention program is an inexpensive and effective way to reduce cigarette use
among young adults and adolescents9,10.
Summary and Conclusions
For future research and investigation, it will be beneficial for researchers to expand their
studies to other tobacco products and use such as the e-cigarette. Many youth are now
experimenting just as much with e-cigarettes as they are with cigarettes. Both forms of tobacco
use have negative health risks associations and are both forms of nicotine dependence.

Tobacco Cessation 6
From the information presented in the previous section it is clear to see that an social
media, internet based health communication program is an effective, inexpensive style that has
the ability to reach masses of individuals. By having my health communication program through
a social media outlet, it will be able to connect with individuals not only in the United States but
around the world. Also, even though the target population is young adults and adolescents, older
adults can also benefit from the information that will be presented.
A social media, internet-based intervention alleviates barriers such as transportation to a
program, allows for a sense of confidentiality but allowing users to view information at their own
pace and receive information without others knowing, and it will also serve as a means for peers
to come together to discuss the issue and to provide support to one another. Media outlets of all
kinds are used to promote smoking therefore it will be important to counteract those outlets by
promotion health promotion and prevention programs.
Cigarette smoking is the largest preventable risk factor for morbidity and mortality in
develop countries4. The key word here is preventable. There is a need for more health
promotion and prevention programs on cigarette smoking in order to prevent individuals from
even picking up and starting to smoke cigarettes. The health communication and promotion
program that I am proposing will aide in the prevention of cigarette smoking and it will also be a
resource for those individuals who already smoke to quit and stay abstinence from smoking.
Educating young adults and adolescents on the dangers of cigarette smoking is the first essential
step in cigarette smoking prevention.

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References
1. Benjamin, Regina M.. Surgeon Generals Perspectives. Public Health Reports. 2012;
127: 360-361.
2.

United States Department of Health and Human Services.Preventing Tobacco Use

Among Youth and Young Adults: A Report of the Surgeon General. Public Health
Service. 2012; 1-7: 1-1395.

3. Centers for Disease Control and Prevention. Smoking and Tobacco Use. Centers for
Disease Control and Prevention website. 2015.
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.ht
m. Accessed February 1, 2016.
4. Dallery J, Raiff B. Contingency Management in the 21st Century: Technological
Innovations to Promote Smoking Cessation. Substance Use and Misuse. 2011; 46: 10-22.
5. Pealstein I, Friedman S. Reduction of Cigarette Smoking via iQuit: Web-based Program
Using Podcasting and Text Messaging in Adolescents. Journal of Adolescent Health.
2009. 44; 2: S24.
6. Soloman L , Bunn J, Flynn B, Pirie P, Worden J, Ashikaga T. Mass Media for Smoking
Cessation in Adolescents. Health Education and Behavior. 2009. 36 (4): 642- 657.
7. Yang F, Salman C, Pang J, Cheng W. Media Exposure and Smoking Intention in
Adolescents: A Moderated Mediation Analysis from a Cultivation Perspective. Journal of
Health Psychology. 2015. 20(2); 188-197.
8. Stoops W, Dallery J, Fields N, Nuzzo P, Schoenberg N, Martin C, Casey B, Wong C. An
Internet-based Abstinence Reinforcement Smoking Cessation Intervention in Rural
Smokers. Drug and Alcohol Dependence. 2009; 105: 56-62.
9. Haug S, Meyer C, Dymalski A, Lippke S, John U. Efficacy of a Text Messaging Based
Smoking Cessation Intervention for Adolescents and Young Adults: Study Protocol of a
Cluster Randomised Controlled Trial. BMC Public Health. 2012; 12(51): 1-7.
10. Minor M, Sondike S. Adolescent Smoking Cessation Methods: A Review Article. West
Virginia Medical Journal. 2014; 110: 16-19.