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. Though the country may make millions of dollars selling tobacco, it spends several times more on treating diseases caused by the smoking habit.
Explain why sociology is useful in helping us to challenge the dominance of biomedicine and understand health and health care as shaped by biopsychosocial factors.
The society we belong treats scientific knowledge as proven and reliable information to improve once understanding about the world we live. Biomedical understanding of diseases has evolved with the social practices that existed at that time. Thus the knowledge and understanding generated by science have always remain socially embedded. In certain circumstances science influenced the society and sometimes the society influenced science. Research on smoking and its effects on health, is largely motivated by the vast prevalence of this practice and harmful effects in the society. Scientific studies suggest an inverse relationship between smoking and lifespan. ("Section 2: Sociological Conceptualisation of Medical Knowledge and Power", 2010)
With the advent of capitalism, industrial growth and development; scientific knowledge and explanations, have begun to dominate the functioning of the society. Science has become more object oriented. In the past, the access to scientific knowledge and information, were largely restricted to experts. With the advent of communication technologies, the access to science and medical information has expanded to the general public as well. Not just that, medical institutions have begun to adopt research as a part of its functioning. The medicalization thesis, deals with the effects of intervention of medical knowledge in a person’s life. Today, medical knowledge allows people to manage their own health and wellbeing.
Two popular models are used to explain patient health: biomedical model and psychosocial model. The biomedical model of health and illness, focuses only on the biological factors and does not consider psychological, environmental and social influence on health. In most western countries, biomedical model is the dominant way be which a disease is diagnosed and treated. In this model, only the biophysical and genetic aspect of the health is taken into consideration. Objective laboratory values are an important part of patient history and information. The social and psychological history of the patient was totally ignored by this model. In contrast to the biomedical model, the biopsychosocial model of health considers the social and psychological history of the patient, while making health plans and healing plans. ("Section 2: Sociological Conceptualisation of Medical Knowledge and Power", 2010)
The biopsychosocial model considers a much broader aspect of the patient, like the moods, intelligence, memory, perception, family, economic status and social class; while planning health and healing. This model helps to study the influence of culture, environmental and social changes on a person’s health and well-being. The biopsychosocial model, would the ideal way to study the smoking habit, its effect on health and its prevention. The root cause of smoking is the culture and the society that promotes this behavior in the individual. A holistic effort is required to prevent smoking in the population, rather than a model that labels people based on their habits and diseases.
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.
Synopsis of the epidemiological data found relating specifically to the health issue and relevant population groups in Australia (this can be adapted from the latter parts and conclusion of your Health Statistics Summary). This should explain clearly how the health issue impacts significantly on the relevant groups.
Epidemiology of smoking in Australia:
According to the estimates of the Department of Health, Australia, smoking kills close to 15,000 every year and cost $31 billion dollar in terms of health care and economic loss. In 2015, the country has spent $3.260 billion, towards the purchase of health care product. The smoking rates in Australia, are monitored by the Australian Bureau of Statistics (ABS) the Australian Institute of Health and Welfare (AIHW). According to the statistical information provided by these agencies, the prevalence of smoking rate among aboriginals in Australia was 38.9% in 2014-2015. The smoking rate is high among both males and females of the aboriginal population and a majority of them are daily smokers. ("Department of Health | Tobacco Control key facts and figures", 2016)
According to the nationwide survey conducted by ABS, only 52.6% of the Australian population never smoked. About 14.7% of the adults aged 18 years and above smoked daily. The male: female ratio of daily smokers was 16.9%: 12.1% respectively. The daily smokers were slightly higher in the age group 18-44 years, when compared to adults above 45 years of age. The smoking rate was higher in the outskirts and remote areas of Australia (20.9%), when compared to those in cities (13.0%). Likewise, the prevalence of smoking was higher in the most disadvantaged communities (21.4%), when compared to least disadvantaged communities (8.0%). Smoking was also reported among secondary school (12-17 years) children in Australia. Though it had reduced to 5%, when compared to 7% in the previous years, it is still a worrisome figure. ("Department of Health | Tobacco Control key facts and figures", 2016)
Socioeconomic and employment status, also has its influence on the prevalence of smoking. People of low socioeconomic status (19.9%), are three times more likely to be daily smokers when compared to people from high socioeconomic status (6.7%). Unemployment among young adults was also associated with higher likelihood of being a smoker, when compared to individual to individuals who were employed. ("Department of Health | Tobacco Control key facts and figures", 2016)
Review any existing sociological literature explaining the issue/population groups
Literature explaining the issue of smoking in the population:
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 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 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)
Detailed discussion of the relevant sociological concepts. This should:
o Introduce the reader to the relevant theorist (or theorists)
o Give a detailed history and definition of the concepts
o Explain how the concepts are useful in relation to health (provide examples of
how it has been used by others)
Social concepts on health and illness:
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)
Theoretical sociological perspectives explain social events as functions that help to maintain continuity within the society. According to the functionalist perspective, society is formed by the integration of many parts. Certain core norms and values, enable the integration of the society as one norm. An individual learns the norms and values of the society during the socialization process. These norms and rules of the society have a role in shaping a person’s behavior. In a society with a tradition that promotes smoking, the unhealthy habit of smoking can be identified as a social phenomenon. (Grbich, 2004)
According to the Marxist perspective, human activities in a society are directed towards material production: food, shelter and clothing. In a capitalist society, there is division of labor and this leads to the generation of social class. These social classes constitute the economic base of the society and all social infrastructures like political, legal, and educational system are devised based on the economic difference. According to Marxist perceptive, wealth and income are major determinant of standard of living and health. (Yuill, Crinson, & Duncan, 2010)
Interpretative perspective theories, identified society as subjective reality. According to this theory people engage in conscious activities and language and attach certain meaning to their action. Sociologist should try to define the individual perspective of the action, rather than expecting individuals to interpret the actions in the society. ("Section 1. The Sociological Perspective", 2010)
Application of the concept(s) to the chosen issue and population groups. This should:
Make clear links between the concept(s) and the data found
o Explain what power relations underpin the experiences of the health issue for
the specific population.
o Make reference to the structure-agency debate, using the chosen sociological
concept(s) to explain the structural factors that constrain individuals’ abilities
Provide a logical argument for the value of using sociology and the specific concept
in order to understand individual experiences of health
u Mention briefly any other relevant concepts and theorists that could be used as
alternative or complementary ways of framing the issue
Application of sociological concept to the population:
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, 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).
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. This is in accordance with Marxist sociological perspective of health and illness. 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 these 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 single adults aged 20–34 years when compared to 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 the child into the habit. ("9.7 Explanations of socioeconomic disparities in smoking - Tobacco in Australia", 2016)
Social modelling, by the portrayal of smoking habit in the media, pictures, news, magazine and by friends as something “very cool”, builds up the desire in the individual to adopt the habit. Social modelling is an important cause for the presence of smoking in aboriginal population. The symbolic, interactionist and functional perspective will help define the influence of social modelling on individual’s behavior. 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 and 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.
Provide a logical argument for the value of using sociology and the specific concept in order to understand individual experiences of health
Sociological concepts are important in predicting a person’s vulnerability to smoking and its ill effects. Vulnerability of a person to a risky habit is affected by his 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)
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. 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)
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)
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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