e Health Counselor

Either involuntarily or deliberately, we expose ourselves to many social poisons and hazards. Smoking is the most important of them because of its passive (or ‘secondhand’) adverse effects in human.

When the bad effects of smoking were first discovered, policy-makers imagined that warning people about the dangers of smoking would result in them giving up. An initial decline in smoking rates in the 1960s suggested that these assumptions were correct, but in most countries of the developed world this decline has since slowed, while rates are increasing amongst young women and in many developing countries where tobacco companies have found their new markets. World-wide, there are 1 billion smokers, and 3 million die prematurely each year as a result of their habit. In the USA, it has been estimated that >5 million years of potential life and $90 billion of productivity are lost each year due to smoking.

In reality, there is a complex of systems that interact to cause smokers to initiate and maintain their habit. At the molecular and cellular levels, nicotine acts on the nervous system to create dependence, so that smokers experience unpleasant effects when they attempt to quit. So, even if they know it is harmful, the role of addiction in maintaining the habit is important. Influences at the personal and social level are just as important.

For example, research has shown that many individuals bolster their denial of the harmful effects of smoking by focusing on someone they know personally who smoked until he was very old, went to the pub every day and died peacefully in his bed at home.

Such strong counter-examples help smokers to maintain internal beliefs that comfort them when presented with statistical evidence. Young female smokers are often motivated more by the desire to ‘stay slim’ or ‘look cool’ than to avoid an illness in middle life.

Even if a smoker decides to quit, there are a variety of influences in the wider environment that alter the chances of sustained success, including peer pressure, cigarette advertising, and finding oneself in circumstances where one previously smoked. The tobacco industry works very hard to maintain and expand the smoking habit and its advertising budget is much greater in the society.

The majority of adult smokers say they would like to give up smoking but only 2% of smokers per year manage by will-power alone. The strategies commonly employed to stop smoking and their impacts are shown in and Health professionals can work with the individual smoker to understand his or her beliefs and motivations. Participation in groups has also been shown to be effective. Nicotine replacement therapies can reduce cravings. If intensive support is combined with pharmacological aids, quit rates are significantly improved. Although the absolute quit rates seem modest, smoking cessation interventions are cost-effective and, if widely available, can contribute to reduction in smoking prevalence.

However, action at the societal level, such as bans on tobacco advertising, increasing taxation on tobacco, regulation of the sale of tobacco, making sure all workplaces and public spaces are smoke-free, and placing clear warnings on cigarette packets, may be more effective. Countries that have adopted these policies are being rewarded by falling smoking rates.