Running Head: PHOTO VOICE ASSIGNMENT

Photo Voice Assignment: Smoking NSG3123 October 10, 2012 University of Ottawa Craig Phillips

PHOTO VOICE ASSIGNMENT

Figure 1: Cigarette buds littering a sidewalk in Ottawa

Figure 1 shows a numerous buds of cigarette that have been discarded by smokers on a sidewalk in Ottawa. This is a common occurrence on the streets of Ottawa and reflects the high number of smokers in the city. From looking at the picture, it can be determined that smoking is a major health issue in Ottawa and it needs immediate intervention to reduce the risk of major health problems in both smoker and non-smoker population. This paper explores tobacco use from the Population Health Perspective using the Population Health Promotion Models three dimensions. It will also discuss the epidemiology of tobacco use. The Population Health Promotion (PHP) model is a three dimensional model, which includes the determinants of health, the levels of action, and comprehensive action strategies (Public Health Agency of Canada, 2001).

PHOTO VOICE ASSIGNMENT Smoking is connected to the health of the University of Ottawa community because many of the university students are between the ages of 20-24 years and the current smoking prevalence for this age group is 21%, which is almost twice as high as the adolescent age group (Health Canada, 2012). Students are also more likely to be

exposed to second hand smoking from their smoker friends that put them at a greater risk because they are inhaling the chemicals from the cigarette without the filter. A rising trend among young smokers is to use alternate tobacco products such as smokeless tobacco, and waterpipes while cigarette use has been declining. These alternate tobacco products contain additives/ flavorings such as cinnamon, and herbs, which promote their continued use among young smokers. (Nasim, Khader, Blank, Cobb, Eissenberg, 2012). Smoking is a determinant of health through personal health practices and coping skills. Cigarettes have chemicals such as nicotine, an addictive agent and carcinogens (cancer-causing) that can lead to several forms of cancer mainly lung cancer because the smoke from cigarette is inhaled directly to the lungs. Smoking was used as a coping mechanism for social anxiety among university students in United States when they were shown a series of pictures that disturbing (Watson, VanderVeen, Cohen, DeMarree, Morrell, 2012). Tobacco use is identified as a risk factor contributing to chronic illnesses in the Ontario Public Health Standard (OPHS, 2008). Some of the chronic illnesses that can be caused by the use of Tobacco are cancer, cardiovascular diseases and pulmonary diseases (World Health Organization, 2012). Tobacco kills nearly six million people each year, of whom more than 5 million are users and ex users and more than 600 000 are nonsmokers exposed to second-hand smoke (WHO, 2012).

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The level at which the action is going to be taking place towards tobacco control is society; although smoking is world-wide health issue, it needs to be dealt with on a community because each community has different dynamics and therefore functions differently. Therefore, it does not necessarily mean that an intervention that obtained results in one community will also obtain results in another. Tobacco products are addressed by two federal acts: Tobacco Act, and Nonsmokers Health Act and eight regulations. The Tobacco Act governs the

manufacture, sale, labelling and promotion of tobacco products (Health Canada,

2010), while the Non-smokers Health Act restricts smoking in federally regulated workplaces and public places under federal jurisdiction (Health Canada, 2010), and the Governor in Council is authorized to make regulations regarding these acts. The regulations can be enforced in the City of Ottawa (community) to control tobacco use. The comprehensive action plan against tobacco use is to create supportive environments that help tobacco users with cessation and provide them with alternate methods that do not involve smoking. Nicotine replacement therapy is best practice among adult smokers attempting to quit (Fiore et al., 2000), it comes in the form of patches, gum as well as inhalers. The nicotine patches are placed on skin, which releases nicotine continuously throughout the day, the inhalers are good for people who wish to perform the act of holding a cigarette to their mouths and inhaling the nicotine through it. Smokers can chew the nicotine gum and it releases nicotine into the buccal mucosa. Nicotine gum can also be used in combination with the patch because it releases nicotine faster into the blood stream and with the inhaler if it does not satisfy the cravings (Centre for Addiction and Mental Health).

PHOTO VOICE ASSIGNMENT Another strategy to decrease the exposure to second hand smoking is to base a community intervention of smoke free homes. Research supports the fact that through this intervention smokers in families are able to place smoking restriction in their homes because information provided to them through organized activities such as information

packages at schools and community events. Although the rise in the smoke free homes at the end of the six-month trial was not statistically significant, the most important finding was the effectiveness of interventions performed at school (Alwan, Siddiqi, Thomson, Lane, Cameron, 2010). Another intervention can include the board of health working with post-secondary settings using a comprehensive health promotion approach, to influence the development and implementation of healthy policies, and the creation or enhancement of supportive environments to address comprehensive tobacco control (OPHS, 2008). In conclusion, tobacco use is a major risk factor for many chronic illnesses and needs to be addressed quickly. The population health promotion model provides a framework for action that can be taken to reduce the risk presented by the use of tobacco. The interventions can be implemented in Ottawa to create a supportive community for the smokers who wish to quit and by providing them with the necessary resources. Although the smoking behaviour of people has decreased a lot in the last several years, many people still continue to smoke which maintains lung cancer as the major problem.

PHOTO VOICE ASSIGNMENT References Alwan, N., Siddiqi, K., Thomson, H., Lane, J., Cameron, I. (2010). Can a communitybased smoke-free homes intervention persuade families to apply smoking restrictions at homes? Journal of Public Health 33(1), 48 54

Centre for Addiction and Mental Health. Nicotine Replacement Therapy. Retrieved from http://www.smokefreeltc.ca/auxiliary/NRT.aspx Fiore, M.C., Bailey, W.C., Cohen, S.J., Dorfman, S.F., Goldstein, M.G., Gritz, E.R., et al. (2000). Clinical practice guideline: Treating tobacco use and dependence. Rockville, MD: U.S. Department of Health and Human Services. Health Canada. (2010). Federal Laws Tobacco Legislation. Retrieved from http://www.hc-sc.gc.ca Health Canada. (2012). Canadian Tobacco Use Monitoring Survey (CTUMS) 2011. Retrieved from http://www.hc-sc.gc.ca Nasim, A., Khader, Y., Blank, M., Cobb, C., Eissenberg, T. (2012). Trends in

alternative tobacco use among light, moderate, and heavy smokers in adolescence, 19992009, 37, 866-870.
Public Health Agency of Canada. (2001). Developing a Population Health Promotion Model. Retrieved from http://www.phac-aspc.gc.ca Watson, N.L., VanderVeen, J.W., Cohen, L.M., DeMarree, K.G., Morrell, H.E.R. (2012). Addictive Behaviours: Examining the interrelationships between social anxiety, smoking to cope, and cigarette cravin,, 37, 986-989 World Health Organization. (2012). Tobacco. Retrieved from http://www.who.int/