Abstract and Introduction 3
Significance of the Study 5
Definition of Terms 7
Review of Literatures 7
IV. Research Methodology 17
V. Limitation/Delimitation 21
VI Data Analysis: 21
VII Data Verification: 24
VIII Summary and Conclusions: 25
Recommendations 26
Appendices 27
Research Questionnaire 27
References 34
Bibliography 35
Abstract and Introduction
Smoking has been regarded as one of the primary causes of preventable diseases and deaths not just in the United States but worldwide according to recent statistical information released by the American Lung Association (2015). In the United States alone, it is estimated that more than 400,000 American lives get lost every year as a result of smoking and smoking-related diseases. When it comes to the cost of healthcare and the opportunity cost as a result of smoking-related illnesses which also includes possible loss of productivity, the United States government allegedly suffers from more than 193 billion USD in losses.
When computed, it would appear that the government spends more than 4,500 USD per year per adult who has been diagnosed with a smoking-related illness. These statistical data and information about smoking only aim to describe the problem that is smoking macro economically, that is from a larger perspective.
However, when assessed, in an individual level, the associated problems and its effects, especially on the individual and that individual’s family, may only be more severe. The objective of this paper is to determine the reasons why and how cigarette smoking has become so prominent within the American culture. In order to arrive at an objective solution to this research objective, the researcher used a quantitative descriptive type of research design.
A customized questionnaire was made and was used as the primary research instrument. A total of one hundred participants aged between eighteen and sixty coming from different American cultural minorities and majorities were recruited as the study subjects. The questions in the questionnaire contained different choices that the respondents may pick depending on what most perfectly applied to their condition and or situation, in relation to the topic which was smoking and the research question which was to determine the reasons why and how cigarette smoking has become so prominent within the American culture.
The researcher then gathered the results, tabulated them, and statistically presented the number of respondents who picked certain questions. In the end, the results of the data analysis were used to answer the research question. Results of the study suggest that the major reasons why and how cigarette smoking has become so prominent within the American culture include the individual’s cultural minority, age, gender, occupation, stress levels, and perceptions on health. The researcher also concluded that the decision on whether to smoke or not to smoke most likely comes as a result of a complex interaction between these factors.
All in all this study presents empirical data and evidence that would surely help the readers and future researchers determine the reasons why and how cigarette smoking has become so prominent within the American culture.
Significance of the Study
One of the major reasons behind conducting a research, especially if the topic and or subject of the research being proposed is related to socially relevant issues such as healthcare, education, safety, and peace and order, is to educate the public, the government, and the policymakers on how and why certain phenomena occur. Researchers that describe certain phenomena (i.e. descriptive researches) often lead to the creation of more goal-directed researches which would not aim to describe certain phenomena anymore but rather to find the perfect (i.e. most effective and most efficient) solutions to those phenomena (assuming that they are considered as problems. In this case, the research problem that is being studied is the one that asks “why has cigarette smoking become so prominent within the American Culture”.
This two-step process often becomes a cycle that continues often until the socially relevant problem that has been caused by a certain phenomenon has already been resolved. In this case, the research problem that the author is trying to address is smoking. Smoking is a socially relevant problem because a lot of people die as a result of the complications of smoking-related diseases.
At the same time, the government, and hence the economy suffers as a result of the lost productivity (secondary to the loss of lives), and of the healthcare, and medical equipment and supplies bought in order to provide the necessary treatment for the patients diagnosed with the smoking-related diseases. In the end, smoking, although it is a personal decision committed by the citizens, is a phenomenon that leads to a situation where the government (including its economy) suffers from a net loss (i.e. in productivity and healthcare costs).
It makes sense to think of the net effect of smoking in society as a loss because the productivity and financial costs and expenses incurred as a result of smoking could have been used by the government to solve other socially relevant issues, perhaps the ones that did not come as a result of the citizens’ voluntary decision. Considering these data and information about smoking, the information that can be obtained from this study can serve as an effective eye opener to the public, the government, and the policymakers on the subject of smoking.
They would be enlightened as to what the factors that contribute to the prominence of smoking in the American culture are; and also how those factors interact with each other and how such interaction lead to the creation of a society that is more liberated when it comes to smoking. By finally being aware of those information, the smokers themselves (as long as they would be able to read the results and findings from this research) would be able to understand and explain their decisions and behaviors in relation to smoking; the government agencies and policymakers would be able to localize the real possible sources of the problem and from that point, make more effective and meaningful solutions to it; and the future researchers would then be able to have a more abundant source of empirical evidence and information on the subject of smoking, should they decide to pursue a somewhat similar research trajectory.
All in all, the author of this paper believes that this research is a socially-relevant one because it tackles one of the greatest and longest lasting problems that the American culture and society have ever had. It has been long known that smoking, especially chronic smoking has been the leading cause of preventable diseases worldwide. However, the problem appears to be persistent despite different combined government and citizen efforts to contain and mitigate it and its effects, if not to totally eradicate it.
Definition of Terms
Smoking – the act of buying and consuming tobacco products; be it sourced from a wholesaler or retailer
Second-hand smoke – cigarette smoke that affects other people aside from the person who is actually smoking the cigarette
American Culture – may pertain to mainstream practice, actual culture, ethnicity, or race.
Review of Literatures
Smoking is considered in the American society as great health hazard that exposes the smoker to diseases. It also brings a huge financial cost or burden over the budget of the American government. In terms of its implication on the health of an individual, chronic smoking evidently gives rise to fatal diseases. As per a report by the US Human services and Health Department, the agency gathered data pertaining to different studies about how smoking causes various health issues.
The study reports of U.S. Department of Health and Human Services, (2004) concluded that smoking habits were initiated some 50 years back. Some of them were based on randomized control trials and some were based on longitudinal studies. The findings of these studies concluded that smoking was a major cause of cancer diseases, and the cancer deaths, along with cardiovascular diseases and other causes of mortality. The type of cancers that were found attributable to smoking included pharyngeal cancer, lungs cancer, and esophageal cancer (U.S. Department of Health and Human Services, 2004).
In general, there are a lot of other health issues that are caused by smoking. Some of such health effects are mild i.e. pulmonary tract irritation and temporary coughs. However, some of the issues are highly severe such as lungs cancer, esophageal cancer, chronic obstructive pulmonary diseases, emphysema, along with other fatal effects .
Other studies on smoking also support the presented facts. In a study that was published in 2004 by WHO, the researcher investigated the effects that are caused by secondhand smoke. For this purpose, the author (K M Cummings, 2002) carried out an investigation of the effects of secondhand smoke on the health of those wives whose husbands are heavy smokers. The subjects that were observed under this study were followed up for 14 years to arrive to conclusions. About 540 wives of heavy smokers who were above the age of 40 were studied in the investigation. The most important indicator that was utilized in the study was the status of the subject through using a comprehensive assessment of lungs cancer. The author tried to establish the factors that increase risks of developing the lung cancer disease due to exposure towards secondhand smoke.
The results of the study evidently indicated that the wives who had heavy smoker husbands were more vulnerable to develop cancer as confirmed with the research findings of Lee, (2005). The dose-repose relation studied in the research showed that the higher the exposure to secondhand smoke aggravates the wives’ risks of developing lungs cancer. The author also established the fact through the study that exposure of the wives to secondhand smoke also increased the risks of developing conditions such as asthma, emphysema, and other diseases related to organs such as heart disease, stomach cancer, cervical cancer and ischemic heart disease .
The important thing to note here is that the primary or the direct smokers who inhale firsthand smoke are more vulnerable to diseases such as lungs cancer , as compared to their wives or their families who are only effected when they are exposed to secondhand smoke.
Another study conducted by British Medical Journal as reported by SG Spiro, (2005) focused towards the mortality rate among the primary smokers. The purpose behind this study was to observe and compare the health hazards due to smoking, among those who followed an unprecedented patterns of smoking, and those who eventually quitted it at a later point in their life. The study was based on a vast time scale as it was initiated in 1951 and concluded in 2001. The study comprised on 34,439 British doctors who were all males. Their smoking information and habits as to when they started smoking and when they left it was obtained and analyzed over the next 50 years.
The main outcome of the study that the author used was the resulting rate of mortality in the participants due to smoking. Two results were concluded from the study. The first result was that there was a progressive and substantial decrease in the mortality rates of those smokers who turned into non-smokers over the span of time. This was due to improved treatment and prevention. However, the decrease in the mortality rate was less as compared to the smoker versus the smoker death ratio due to early start and an intensive use of cigarettes .
In another study that was published in the Mortality and Morbidity Weekly Report, CDC (2002) carried out a study focusing on the mortality due to smoking, the economic costs for the US government over the period 1995-1999, and the potential life years lost. CDC basically calculated the potential life years lost (YPLL), the medical expenditure attributable to smoking by adults (SAM), and the mortality rates attributable to smoking. The results showed that during the period 1995-1999, smoking resulted in about 440,000 premature deaths throughout US on an annual basis. The second result was that it resulted in an economic health related loss of about 157 million dollars on an annual basis. The results also showed a loss of productivity among labor who smokes (CDC, 2002).
It is evident that over the start of the 21st century, the commercials related to cigarette smoke or tobacco products have gone extinct. Similarly, these were not advertised in print media or on the radio (DF Sly, 2002). It has been a part of the government effort to discourage the masses from smoking or using tobacco products. They have also taken steps to propagate the potential health effects of smoking and tobacco products. The cigarette packing are also labeled with the potential health hazard warnings that result from smoking (D Zucker, 2000). This gives rise to the question that whether such measures have been effective in discouraging the public at large form smoking.
When it is about the labels and the warning signs pertaining to the cigerrates, it should be the duty of the manufacturers to provide all relevant information related to the health hazards of smoking, and should place such labels and signs at places on the packs in a manner that they are clearly visible and readable for the smokers (MC Farrelly J. N., 2003). Those who buy cigerrates should be well aware of the potential health effects of smoking before they carry out the purchase of such tobacco products.
The studies that have been conducted up till now have shown that the warning labels on the packing of cigerrates have not been effective in meeting their purpose (J Niederdeppe, 2004). It can be construed as one of the reasons why smoking has become so common in the American culture. The reason is that a truly effective warning campaign pertaining the health effects of smoking would have resulted in significantly reducing the smoking habits and the numbers of smokers.
A study on the effectiveness of tobacco control initiatives in USA was carried out in 2000 by Wakefield & Chaloupka. The research method used was the secondary sources analysis of various research articles, literature review, and reports on the effectiveness and outcomes of different anti-tobacco program in the US. The research showed that despite the different combinations and strengths of programme strategies and messages used on a statewide level throughout USA, there is significant evidence that such initiatives lead to changes in the factors that cause smoking behavior in teenage. The study also indicated towards the evidence that such initiates also lead to reducing smoking in the teenage. The research can have a lot of policy implications towards reducing the consumption of tobacco in USA (Wakefield & Chaloupka, 2000).
In another study conducted by (Siegel & Biener, 2000) the impact of a statewide media campaign of anti-smoking was analysed, a sample of 592 Massachusetts youth of age 12-15 was used in a longitudinal survey. The effect of the baseline exposure towards radio, television, outdoor smoking, and the outdoor antismoking advertisement on the progression towards establishing smoking was examined. Multiple logistic regression was used for this purpose. The study revealed that the television component in the statewide antismoking campaign in Massachusetts made an impact in terms of reducing the progression to establish smoking among the adolescents (Siegel & Biener, 2000). The referred findings indicated that television serves as the most important medium in developing an antismoking attitude among the youth.
Studies have also been carried out to investigate the factors that have caused the increase in smoking over the years on cultural and behavioural grounds. A study investigated by Hall & Valente, (2007) published in Journal of Addictive Behaviors and carried out by Hall and Valente investigated such factors. In this study, they investigated the impact of peer selection and peer influence on the smoking behavior of the individuals.
According to the outcomes of the study, the factors of peer influence and peer selection play a significant role in terms of smoking susceptibility and smoking behavior in the individuals (Hall & Valente, 2007). To put it simply, the study showed that those individuals who befriend with smokers have more tendencies to become smokers in the future. The same was the result in other studies and researches like those carried out by .
A study focusing on the cultural diversity and the influence of the peers on adults in terms of smoking cigarettes was carried out on wide scale by Landerine, Richardson, Klonoff, & Flay, (1994). The study included a culturally wide sample comprising of 4375 adolescents including America and UK, along with the Asians and the blacks. The study assessed the levels of smoking among these participants and various psychological predictors of smoking i.e. stress, anger, depression, and smoking among peers. The results of the study showed that the rate or level of smoking is more among the white adolescents than the Asians and the blacks. According to Landerine, Richardson, Klonoff, & Flay, (1994) the best predictor of smoking among the whites was the peer influence. This means that the white culture which includes US is influenced by social interactions in terms of indulging people towards smoking. These results can have an implication in terms of policy making (Landerine, Richardson, Klonoff, & Flay, 1994).
Studies on ethnic variation and peer influence on smoking among the adolescent in America has only been limited to the Hispanics, the whites, and the African American, as says BG Simons-Morton, (2010). Only a few have included the Asian Americans and the Pacific Islanders, and other multi ethnic groups. Therefore, a 2001 research by Unger, Criz, Baezconde-Garbanati, & Johnson included the referred groups, as a sample of 5870 8th grade adolescents in California was used. The research studied the ethnic differences in association with the smoking behavior susceptibility and the peer influence. Informational and normative peer influence was analyzed for this purpose. The study showed consistent results with the previous studies, as it indicated that the friends smoking behavior had more influence on the whites as compared to other groups. The research indicated that the cultural influences play basic and significant role in terms of peer influence for smoking (Unger, Criz, Baezconde-Garbanati, & Johnson, 2001).
Another research to investigate how cultural diversity and ethnicity influence the smoking behavior among the American adolescent was conducted in 2003 by Mark. The author focused on how different variables of culture and ethnicity cause to effect the smoking pattern among such adolescents.. This research also witnessed that cultural and ethnic diversity are a significant factor in enticing the adolescent towards smoking. The research of Mark (2003) concluded that productive ways of investigating the patterns of smoking that attend to different classes, gender norms, ethnicity, popular culture and modernity, and an investigation of the needs of the youth can help in devising various policies towards molding adolescent behavior towards smoking .
Parent-child communication related to the use of alcohol and tobacco was assumed to be critical towards the use of this substance by the children (L Mercken, 2009). However, it has not been described and systematically analyzed in terms of the adolescent use. In a study conducted by Ennett, Bauman, Foshee, Pemberton, & Hicks in the year 2001, a sample of 537 pair of parent-adolescent were interviewed through telephone at a base line, and again after a period of 1 year. Factor analysis of the parents communication report revealed about 3 domains i.e. discipline, rules, media influences, and consequences and circumstances. Under these domains, communication varied among the family characteristics that included the substance use among the parents, and the educational level of the mother. Contrary to the original assumptions, the study found that parent-child communication did not initiate drinking or smoking initiation. Additional analysis on the subject, however, suggested that such communication related to disciplines and rules predicted the escalation of the use (Ennett, Bauman, Foshee, Pemberton, & Hicks, 2001).
Apart from the role of media campaigns and antismoking programs, the government also has a significant role to play in reducing the overall consumption of tobacco (K Fujimoto, 2012). This role can be demonstrated through state regulation and laws in the form of taxes and price policies. A 2010 research conducted by IARC and published in the Journal of Tobacco control studied the strength of available evidence that price policies and taxes can cause to reduce and prevent the use of tobacco as mentioned in a research study by Chaloupka, Straif, & Leon. Experts on economics, public health and epidemiology were asked by the IARC to carry such assessment. The different aspects or variables that were focused on in this investigation included the pricing strategy in the tobacco industry; tax related lobbying, aggregate demand and price of tobacco, tax avoidance, and the economic and health impact pertaining to tobacco taxation. Supporting 12 out of 18 conclusions drawn in the study, experts (Chaloupka, Straif, & Leon, 2012) came to a consensus that there exists sufficient evidence in terms of effectiveness of the increased excise taxes and increased prices, for reducing the overall tobacco consumption and improving the public health. The study also showed that increased prices also have an influence in reducing the initiation of smoking or tobacco usage among the youth who cannot afford smoking at an early age. This evidently points towards the fact that government in USA can play a vital role in reducing the overall consumption of Tobacco in the American culture (Chaloupka, Straif, & Leon, 2010). The presented study aims to explore the research question, “Why has Cigarette Smoking become so Prominent within the American Culture” over the studied guidelines for refined analysis of the implications.
IV. Research Methodology
Subjects
A total of one hundred participants aged between eighteen and sixty coming from different American cultural minorities and majorities were recruited as the study subjects. The questions in the questionnaire contained different choices that the respondents may pick depending on what most perfectly applied to their condition and or situation, in relation to the topic which was smoking and the research question which was to determine the reasons why and how cigarette smoking has become so prominent within the American culture. The researcher then gathered the results, tabulated them, and statistically presented the number of respondents who picked certain questions. In the end, the results of the data analysis were used to answer the research question.
Data Collection
A custom-made questionnaire was used to collect data from the participants. A copy of the unanswered version of the questionnaire is provided in the appendix section of this paper. The method that the researcher used in the subject selection process was a combination of random sampling and convenience sampling. Basically, the convenience sampling part of the sample population selection process was initiated when the researchers decided to select the groups of people where they were going to source the respondents from. Most of the respondents were friends of friends and of the researcher’s family members.
Normally, in a truly randomized method of sample population selection process, the researcher would be forced to select a certain percentage of the sample population from different locations in the target country, or in this case, the United States. However, since the method of respondent selection was a hybrid between the convenience and the random sampling method, it has been allowed, at least based on theoretical basis that the researcher pick the most convenient geographical location where the respondents would be recruited from.
The random selection process part of the subject selection process, on the other, was initiated when the researcher randomly selected individuals aged eighteen to sixty five coming from different cultural minorities and majorities within the geographical location that was initially selected. Another sampling method requirement that the researcher followed was the equal distribution between the male and female subjects.
The total number of subjects recruited for the study was one hundred. In that case, there was supposed to be fifty randomly selected males and fifty randomly selected females who participated in the study.
Role of the Researcher
The role of the researcher would be the following:
Facilitator of the entire research implementation process
They will also be the one who will gather information from the respondents
They will also be the one who will analyze and interpret the results and findings from the subjects’ responses.
The objective of this paper was to determine the reasons why and how cigarette smoking has become so prominent within the American culture. In order to arrive at an objective solution to this research objective, the researcher used a quantitative descriptive type of research design. A customized questionnaire was made and was used as the primary research instrument.
Results of the study suggest that the major reasons why and how cigarette smoking has become so prominent within the American culture include the individual’s cultural minority, age, gender, occupation, stress levels, and perceptions on health. The researcher also concluded that the decision on whether to smoke or not to smoke most likely comes as a result of a complex interaction between these factors.
A 23-item survey questionnaire was used to gather the necessary information from the subjects. Each question in the survey questionnaire was meant to be answered separately. This meant that the researcher could not analyze the answers collectively as in the case of survey questionnaires that make use of a five or three point likert scale-based choices.
Although there are choices for each question that the respondents can choose from, their number varies per question. One implication of this would be on the data analysis part. This means that the researcher would have to analyze each of the 23 questions separately. Below is a copy of the survey questionnaire that will be used in the study.
