BSc Adult Nursing
Scotland’s health is improving, according to the Scottish Government (2010) but still remains poor compared to other countries. Scotland’s life expectancy rates are consistently lower than most other European countries (Scottish Government 2010). The Scottish Government (2008) identify Cancer, Coronary Heart Disease and Stroke as the ‘big three’ preventable causes of death in Scotland and attribute smoking and poor diet as being the most significant contributors to Scotland’s poor health. This essay will discuss these two risk factors and the health promotion measures put in place to address them. Cigarette smoking has clear health risks and accounts for one in five of all deaths in Scotland, (Scottish Government 2010) costing NHS Scotland £409 million per year. The three main diseases associated with smoking are Chronic Obstructive Pulmonary Disorder (COPD), Heart Disease and Lung Cancer (GASP 2006). Over 95% of cases of COPD are caused by smoking (Scottish Government 2007). Smoking damages the cilia and mucous membrane lining the lungs, causing mucous to build up (Waugh and Grant 2009). This increases the risk of infection and the development of a ‘smokers’ cough as the body struggles to clear the airways, leading to Chronic Bronchitis (Banning, 2006). The airways then become inflamed and the alveolar sacs break down resulting in emphysema, a distressing and irreversible condition (Edmond et al, 2006). Carbon monoxide in cigarette smoke reduces the blood’s ability to transport oxygen (Croghan, 2010). This causes the blood to thicken and can clog smaller blood vessels. Nicotine and carbon monoxide increase fatty deposits on blood vessel walls, leading to the formation of atherosclerosis (ASH 2011), which can result in thrombosis and lead to Myocardial Infarction, aneurysm or Stroke (Waugh and Grant 2009). Peate (2005) adds that reduced blood flow can also cause erectile dysfunction in men. Cigarette smoke contains over 4000 chemicals, including 50 known carcinogens (World Health Organisation 2009) which damage the cells lining the respiratory tract leading to the development of cancerous cells.(Lakasing and Tester, 2006) Edmond et al (2006) explain that lung cancer is often undetected until it has spread to other parts of the body, and the survival rate is low. Cancer causing chemicals can also spread throughout the body increasing the risk of other types of cancer. (GASP 2006) The Scottish Government has used various health promotion interventions to tackle the problem of smoking. Health promotion is defined as ‘the process of enabling people to increase control over, and to improve, their health.’ (The World Health Organisation 2011) Smoking in enclosed public spaces became prohibited by the Smoking, Health and Social Care (Scotland) act (2005) and came into effect in March 2006. It was introduced in order to protect people from the proven health risks of passive smoking. The Scottish Executive (2005) estimated that 1000 non smokers died yearly as a result of passive smoking. One year after the smoking ban was introduced, there was a 17% fall in the number of heart attack admissions in Scottish hospitals, indicating the success of the legislation. (Scottish Government 2007) A 39% drop in second hand smoke exposure was also reported. In 2007, the minimum age for buying cigarettes was raised from 16 to 18. In May 2008 the Scottish Government published its new Smoking Prevention Action Plan ’Scotland’s future is smoke free’ (Scottish Government, 2008). This is a programme of health promotion measures aimed at children and young people and aims to dissuade them from taking up smoking. It intended to alter the cultural attitudes to smoking which exist in Scotland. This plan adopted the approach of education and promotion of a healthy lifestyle among young people, and reducing the attractiveness, availability and affordability of cigarettes to young people. The Tobacco and Primary Medical Services...
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