Introduction: Smoking is a learned habit that has existed in the society for long. This allows us to understand how the habit affects health and wellbeing both in the short term and in the long term. This injurious habit of smoking has taken a commonplace in our culture. Tobacco, the key ingredient in cigarettes, is the leading cause of avoidable illness in the world. A person who smokes 2 packs of cigarette per day, spends ~ 3-4 hours per day on smoking and inhales 1000mg of tar each day. The health care cost is several times higher for smokers when compared to nonsmokers. Though the country may make millions of dollars selling tobacco, it spends several times more on treating diseases caused by the smoking habit. Tobacco is the leading cause of pulmonary disease, cardiovascular disease and accounts for 30% of all cancers. Studies also suggest an inverse relationship between smoking and lifespan. Many teenage smokers are quite complacent about their habit, as they expect to quit smoking and get away with its harmful effects. However, studies suggest that it is very difficult to quit smoking once addicted. Nicotine addiction is common among smokers and this prevents them from breaking away from the habit.
A number of health inequalities have been identified in the Australian population, smoking is one of them. The incidence of smoking is high among lower socioeconomic category of population, when compared to the affluent category of people (Siahpush, Borland, & Scollo, 2008). The incidence of smoking is high among people belonging to disadvantaged communities. Though there has been a significant effort to reduce smoking incidence in Australia, the socially and economically backward section of the population, are largely untouched by these efforts. The data from the Australian Bureau of Statistics (ABS) has also identified the high prevalence of chronic illness in this population (Glover, Hetzel, & Tennant, 2004). The prevalence of high risk behavior in this population, predisposes them to chronic diseases. Likewise, the incidence of mental health problems is high among socioeconomic backward communities (Glover, Hetzel, & Tennant, 2004). Mental health problems are positively linked to smoking habit (Lawrence, Mitrou, & Zubrick, 2009). Smoking is often sought by individuals as a respite to escape tension, anxiety and depression (Tsourtos et al., 2010). The report delves into various aspects of the population that makes it vulnerable to the injurious habit and also looks into sociological concepts that helps explain the issue.
Vulnerability to smoking: Vulnerability can be defined as the characteristic feature of a group or people that affects their ability to anticipate, cope, resists or recover from a hazard. The social, economic and institutional capabilities in a region, can determine the vulnerability of the people belonging to the region. Factors like age, gender, income, mobility and health can indicate a person’s vulnerability to smoking in a social set-up. Social vulnerability, when confounded by economic vulnerability and environmental hazards, increases the risk for unhealthy habits like smoking. People cope with adverse situations in life, by seeking immediate solution. Smoking offers immediate relief from tension and stress. The addiction to nicotine that happens in the process, prevents long term adaptation. Long term adaptation processes have a more determining role in the progressive approach of the community. (Schneiderbauer & Ehrlich, 2004)
Income, inequality, lack of proper sanitation, improper living conditions and lack of access to proper nutrition/ health are some of the economic indicators of vulnerability in a population. Social inequality and vulnerability is positively associated with low income. Unemployed and single parent household, are highly dependent on the social security system of the country (Siahpush, Borland, & Scollo, 2008). The people belonging to this category, also score low on level of education. This prevents them from getting better opportunities. The socioeconomic backwardness also denies the individual to various goods and community services. Denied access to social support services and lack of opportunities to improve, is very severe in remote communities, when compared to urban communities. In addition, the presence of mental disorders like anxiety and depression is high in the backward communities. Targeted marketing of tobacco products in the community, popular culture; out-door works and social models, are linked to high smoking rates in the backward population. (Pierce, Macaskill, & Hill, 1990)
The odds of being a smoker were high among young adults aged 20–34 years and among not married adults. Children born to parents who smoke are more likely to become smokers themselves. Low performance or achievement at school and conduct problems, can mediate smoking habits in children. In addition, presence of smoking among peers and parents also encourages them into the habit. ("9.7 Explanations of socioeconomic disparities in smoking - Tobacco in Australia", 2016)
Social modelling, by the portrayal smoking habit in the media, pictures, news, magazine and by friends as something positive, builds up the desire in the individual to adopt the habit. The desire in further promoted by the availability of pocket money and access to buy cigarettes. Children who spend more time unsupervised and who have peers with smoking habit are more likely to end up becoming smokers. Disturbed family environment and the stress associated with the situation, can influence the child into smoking or other kind of drug abuse. (Waa et al., 2011)
A majority of the smokers, often start smoking as a child. Once addicted, it is very difficult to give up on smoking. Children usually looking up to adult for ways to cope up with stress that arises in day to day life. When there is a lack of a proper family support system, the child becomes psychologically and emotionally unstable. This psychological instability and the need to adapt to the needs of the society, can pressurize children into the unhealthy habit of smoking. Children from low socioeconomic groups need the right kind of support and knowledge that can help them resist unhealthy habits.
Smoking is a learned habit. The introduction to this habit begins as a cultural phenomenon. Peer pressure has a significant role in motivating children into smoking. Likewise, family and social modelling of the habit also influences the child. The need to fit in or attract attention could also prompt children into this habit. Lack of resistance and family’s acceptance of this behavior, encourages the child to continue with the habit. Genetic and psychosocial factors may increase the dependence of the individual on nicotine. For many teenagers, smoking acts as an entry habit before they proceed to other serious substance abuse like alcohol, cocaine and marijuana.
The incidence of smoking is high among men, when compared to women. Men who are native of western European countries are more likely to some, when compared to men of other culture. On the contrary, women with origin from UK/Ireland are more likely to smoke when compared to other Australian women. Culture has a significant influence on smoking behavior. There are evidences that support the positive association of stress in life and smoking. High level of tension and demands of the job was reported by most current smokers. People in low rewarding jobs are more likely to be smokers, when compared to people in satisfying jobs. (Phung et al., 2002)
The level of education and literacy level, has an important influence in deciding the prevalence of this habit. Psychological distress among people belonging to the socioeconomic backward community, aided by the cultural pressure is the main driving force that promotes the smoking habit in this population. Proper community support system and the feeling of trust and safety is very important in reducing psychological stress in the society. People belonging to a low socioeconomic background, receive very less support from the society to resist the smoking habit. The intent to quit smoking, is low in the socioeconomic background population, when compared to the mainstream population. (Phung et al., 2002)
Harms caused by smoking habit:
Nicotine a key ingredient in tobacco smoke, is not a carcinogen nor a toxic compound in itself. Nevertheless, it has the ability to cause addiction to smoking. Inhalation of the tobacco smoke is the harmful component of the habit. Tobacco smoke has a number of pharmacologically active compounds that can alter the way the body functions. Further, tar that is inhaled along with the smoke, gets deposited in the lungs of the smoker. Over a period of time, it impairs lung function and predisposes the individual to a number of lung diseases. Tar from tobacco smoke, carries with it carcinogenic compounds. It also causes chronic irritation to the lung tissue, predisposing the individual to cancer (Australia, 2016). Smokeless tobacco is free of tar and CO. It produces less harm than tobacco that produces smoke. (Bell & Keane, 2012)
Nicotine inhaled through the smoke, can reach high levels in the blood within seconds. Nicotine inhaled in this manner is sufficient to alter the way the person thinks and feels. It offers many subjective benefits like: provides better control over once mood, improves vigor and alertness. It improves concentration, attention and arousal. It can also reduce anger and tension, enabling the person to handle situations in a better way. Nicotine helps reduce anxiety and provides a general sense of wellbeing to the smoker. At the molecular level, many of the effects of nicotine in the body, are mediated by catecholamine, endorphins, acetylcholine, glutamate, serotonin, vasopressin and other neurotransmitters. Nicotine can act as an agonist of acetylcholine and in small doses can stimulate both sympathetic and non-sympathetic nervous system. However, in large doses, it was found to have an opposing effect. (Grief, 2011)
Chronic nicotine consumption, increases the number of nicotine receptors in the brain. With time, smokers will require high quantity of nicotine to achieve the feeling of well being that was initially achieved with a low level of smoking. The powerful addictive action of nicotine prevents the smoker from quitting the habit. Though nicotine may act as an immediate stimulant, it has a delayed sedative effect as well. The depression and fatigue symptoms that follow the dipping blood levels of nicotine, leads the smoker to seek more tobacco smoke, making them dependent on nicotine. Lower the socioeconomic status of the population, the lower is the awareness about the harm caused by tobacco smoking. The expenditure on tobacco is higher in households of poor socioeconomic groups. The household in which its members smoke or headed by a person with no educational background, spend 34% more on tobacco when compared to household headed by a university degree holder. (Siahpush, 2003)
Smoking from sociological context:
When compared to the past, today’s society is more open to concepts that can help improve their life and wellbeing. They look up to science to offer solutions for their day to day problems. Modern sociologists explain the influence of society on the individuals in terms of three perspectives: symbolic perspective, conflict perspective and interactionist perspective. Of these three, the interactionist perspective is more concerned with individual experience and beliefs that affects the way they perceive themselves in the society. Society has an important role in influencing its members to become smokers. (Emily, 2003)
In certain cultures, smoking is perceived as cool and sexy. It helps the person to define his persona. The way people perceive and interact with smokers is in itself the primary motivator of this deadly habit. Smoking is often linked to rebelling attitude and this attract teenagers towards the habit. The feeling of tasting the first cigarette with once peers, is often cherished as a precious memory by many adults. The concept of phenomenological sociology can help understand how the subject views his habits in the world. Smoking cigarettes with friends is considered as a socialization process. Though it begins as an arranged process, most of the individuals who begin to smoke are eventually addicted and are unable to give up on the habit. Gradually, it’s become a part of their life and individuality. (Phongsavan, Chey, Bauman, Brooks, & Silove, 2006)
Individuals form an opinion about themselves, based on how the society react to them and how they experience social interaction. So, when people in one’s social group are smoking, the social force of smoking is imposed on the individual, as this enables him to fit in. The fact that the habit is reinforced by social relationship, makes it even harder to quit. People very often tend to associate with the short term benefit of the habit, rather than basing their action on the long term side effects. The immediate environment has the most imposing influence on the person’s behavior. Thus, social interactions in the community influence the person’s vulnerability to smoking. (Siahpush, 2006)
Recommendation: The Australian Medical Association has recognized that tobacco smoking is harmful at all levels and its use should be discouraged. There is a need for a change in social outlooks and social interactions that promotes smokers in the population. There is also a need for a social support system that can benefit the low socioeconomic community and help them quit the dangerous habit. Lifestyle changes and environmental modifications may benefit the people in this community to engage their leisure’s in healthy habits, rather than on unhealthy social interaction. Improving the access of the community to addiction centers can also benefit smokers who want to quit. Media and social interactions play a dominant role in promoting the smoking habit. Avoiding smoking advert and social interactions that support the practice, can help to change the outlook of the person towards this habit.
References:
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