The harm of smoking to the human body lies in its ability to stimulate the development of severe systemic diseases, which can be fatal. Today, smoking is the most widespread harmful habit that claims many lives and causes concern for both smokers and non-smokers in society. In this case, it becomes essential to establish a system of continuous monitoring of the problem of tobacco smoking, the ultimate goal of which is to combat it, as well as to prevent the issue from motivating today’s smokers to fight tobacco addiction and lead a healthier lifestyle, which is unthinkable without smoking cessation, and in the future to form a new generation of people with anti-smoking consciousness.
There is no denying that smoking tobacco causes health problems. The tobacco product landscape has changed to include smokeless, heated, and electronic nicotine vaping products due to commercial and regulatory demands to lessen the adverse effects of nicotine delivery via burning (Prochaska & Benowitz, 2019). The primary cause of smoking-induced illness is the byproducts of tobacco combustion, and nicotine addiction supports tobacco usage. To guide pharmacologic and behavioral therapy objectives, it is crucial to comprehend the biology and clinical characteristics of nicotine addiction and the conditioning of behavior that happens via stimuli combined with repeated nicotine doses, such as smoking a cigarette. Therefore, this paper presents treatment and wellness models based on recent developments in the study of nicotine addiction therapy and recovery, emphasizing the usage of traditional combustible cigarettes.
Smoking tobacco continues to be a leading cause of early disability and mortality worldwide. The use of combusted tobacco has health risks that are now beyond dispute. The tobacco product landscape has changed because of demand from the market and regulations to lessen the adverse effects of nicotine delivery via burning (Prochaska & Benowitz, 2019). About 500,000 Americans per year die from tobacco usage, of which 50,000 are nonsmokers who are exposed to secondhand smoke. Moreover, with an average life loss of at least ten years, tobacco smoking causes more than half of all long-term smokers to pass away (Prochaska & Benowitz, 2019).
Smoking is more common among people who live in socioeconomically challenged areas. For instance, more than 60 percent of smokers have only completed high school, and more than 25 percent are considered below the poverty level (Denney et al., 2022). Moreover, there are still differences based on racial and ethnic identity. In other words, 16 percent of Blacks and Whites smoke, compared to 10 percent of Asians and Hispanic and 32 percent of Native American smokers (Denney et al., 2022). Another characteristic of the affected community is age. Over 15 percent of American adults smoke cigarettes, even though smoking rates have steeply decreased over the past three decades (Denney et al., 2022). However, smoking morbidity kills close to 500000 people annually.
Meanwhile, among teenagers in the United States, e-cigarettes are more prevalent than traditional cigarettes. In 2018, 21 percent of high school and 5 percent of middle school students were reported using e-cigarettes (Prochaska & Benowitz, 2019). Moreover, e-cigarette use among high school students has increased further to 27.5 percent, while in contrast, the use of combustible cigarettes has decreased to 5.8 percent.
Among social determinants that affect individuals’ smoking behavior is socioeconomic well-being. In other words, smoking and neighborhood surroundings have both been linked to harmful health (Denney et al., 2022). Local social norms more commonly influence smoking habits, and in less affluent areas, smoking-friendly settings are significantly more prevalent. Indeed, the tobacco business has historically advertised to lower-income groups, which looks to have had a detrimental influence on disadvantaged areas for decades (Denney et al., 2022). Beyond financial and social factors, there is also a connection between smoking cigarettes and how other social traits structure societies. For instance, Denney et al. (2022) claim that inhabitants in more socially cohesive areas, characterized by high levels of trust, helpfulness, and connectivity among neighbors, had a lower likelihood of smoking. Smoking is a social behavior that is more common and encouraged in social networks that are more pro-smoking. Additionally, neighborhood social organization, financial well-being, and social stresses influence smoking behavior.
Individual, interpersonal, social, and organizational factors may impact smokers’ health needs. For instance, individual elements may include age, race, sex, beliefs, genetics, socioeconomic income, and attitudes, while interpersonal factors are determined by friends, family, and coworkers’ smoking behavior. Social factors include advertising, education, taxes, and smoke-free laws. Organizational factors include the healthcare system, schools, workplaces, and media (Kalkhoran et al., 2018). Over one billion people use tobacco products worldwide, and the incidence varies significantly by sex and region (Kalkhoran et al., 2018). Although high-income nations used to have higher rates of tobacco use, the burden has now moved to low- and middle-income countries, where an estimated 80% of smokers live today. Adults with comorbid mental and other drug use problems, lower education levels, and poorer incomes had disproportionately greater smoking prevalence (Kalkhoran et al., 2018). In the case of health needs, compared to never smokers, tobacco smokers have an increased risk of dying from ischemic heart disease and considerably higher chances of myocardial infarction. Furthermore, smokers with documented coronary artery disease had a greater risk of sudden cardiac death and smoking roughly doubles the chance of dying from a stroke.
Reducing smoking prevalence and the accompanying harmful health effects requires prevention of smoking start and smoking cessation. Pharmacotherapy and behavioral assistance are proven methods of quitting smoking; they work best combined (Kalkhoran et al., 2018). The first stage is the development of motivation in a smoker to quit smoking. The second stage is an assessment of smoking status, conducting behavioral therapy sessions, assessing the degree of nicotine addiction and choosing a pharmaceutical product, setting a date for quitting smoking and a schedule of visits to the physician, and developing a general treatment plan. The third stage is implementing the treatment plan, evaluating the effectiveness of the selected interventions, and, if necessary, correcting the treatment plan. Smokers who give up after turning 65 or contracting a tobacco-related ailment get health advantages, lowering their risk of total mortality among adult smokers (Kalkhoran et al., 2018). Smokers who give up before age 40 have the highest mortality benefit since they have a 90% lower chance of dying from a smoking-related illness. Still, smokers over 70 can also benefit from quitting smoking. In addition to reducing mortality, quitting smoking lowers the risk of tobacco-related conditions such as heart disease, lung disease, and cancer (Kalkhoran et al., 2018). Smokers of all ages should thus give up smoking as a top priority.
Clinical practice guidelines support providing in-person, individual, or group cessation therapy to address smoking in clinical, behavioral, or community settings. Although alternative clinical techniques are being included more often, the counseling framework is typically cognitive behavioral and motivational (Prochaska & Benowitz, 2019). Intensive counseling only without medications, provided by a cessation counselor on a one-to-one basis, was more effective than minimal contact and had more significant effects when combined with cessation medications. Contrary to the health advantages of quitting smoking, reducing cigarette usage seems to have a minor positive impact on health. Smoking cessation has not been linked to a decrease in overall mortality or death from illnesses attributable to tobacco use (Kalkhoran et al., 2018). Even one cigarette smoked daily increases the risk of stroke, so quitting altogether should be smokers’ main health-related objective.
Meanwhile, the wellness model for treating the effects of smoking can include policy-level measures. A vast body of data backs the effectiveness of government measures to reduce tobacco consumption. Most tobacco control measures lower consumer demand for tobacco products (Kalkhoran et al., 2018). These actions include raising the tobacco excise charge on cigarettes, enacting smoke-free indoor rules, requiring health warning labels on tobacco packages, and assisting mass media efforts to inform the public and encourage quitting. By increasing the legal age of tobacco purchases and vigorously enforcing these rules, other initiatives seek to lessen the supply of tobacco to children and adolescents.
Moreover, Prochaska & Benowitz (2019) suggested that mobile technologies could be used to promote health cheaply, with a vast potential reach, and with evidence of success. These technologies include internet interventions, email, chat, and texting. For instance, smoking cessation apps can be downloaded from online stores on mobile devices. These apps have the potential for more dynamic interactions. Apps are particularly well suited for serving remote and resource-limited environments due to their broad reach and excellent scalability. Benefits include self-tracking and customized feedback functions, cheap or no cost to the user, and graphics and video to improve health literacy (Prochaska & Benowitz, 2019). In addition, social media can also be used as a part of the wellness model because different levels of anonymity may be found on social media, which could be appealing. For instance, internet forums may promote the use of therapies without supporting research (Prochaska & Benowitz, 2019). Regarding the most effective methods for maximizing the reach and effectiveness of mobile technology for treating nicotine addiction, as well as their comparative effectiveness to in-person methods, there are still a variety of new applications and information gaps.
In addition, prevention efforts may be made in communities and schools. It hasn’t worked to inform potential smokers of the health dangers simply. Even though older kids are more likely to smoke than younger teens, addiction is more likely to develop the sooner a person begins using tobacco or any other addictive drug. Based on research showing that messaging visually displaying the physical effects of smoking-related disorders might inspire stop efforts, Tips features actual people living with significant long-term health repercussions from smoking and second-hand smoke exposure (Prochaska & Benowitz, 2019). Although Tips’ primary focus is adult smokers, it also reaches out to family members, healthcare professionals, and communities of religion. The campaign’s goals include educating the public about the adverse effects of tobacco on oneself and others, enticing smokers to stop, and providing free support.
The main difference between treatment and wellness models is that the treatment model aims to prevent the harmful effects of smoking. In contrast, the wellness model includes steps to prevent the development of the problem. Identifying the treatment model’s characteristics for reducing tobacco smoking’s effects involves the techniques that would replace the nicotine and restrictions on the policy and community level. Meanwhile, the wellness model is a belief in patient and client care that shifts the emphasis from treating existing illnesses to preventative care. Wellness is a change in lifestyle rather than merely a collection of medical procedures.
The advantage of the wellness model is that it is suitable for everyone. It is often used in addition to receiving regular treatment. Some customers experience newfound freedom from drugs, persistent pain, and recurrent medical visits after years of battling health conditions. The treatment model, in turn, is more patient-directed as it is based on individual characteristics and needs of the health issue. Meanwhile, the biggest drawback of both the wellness and treatment model is that the absence of responsibility for tobacco dependence is its fundamental flaw. Although it is a medical issue, substance misuse takes more than simply medicine and physical therapy to be treated. Treatment challenges may become much more challenging when substance misuse coexists with a mental disorder. Taking care of all the underlying causes of substance misuse, including the psychological, spiritual, and physical problems that contribute to it, is the best way to combat it. Even with the medical treatment strategy for tobacco addiction, a full recovery cannot be achieved without a wellness model approach.
Denney, J. T., Sharp, G., & Kimbro, R. T. (2022). Community social environments and cigarette smoking. SSM – Population Health, 19.
Kalkhoran, S., Benowitz, N. L., & Rigotti, N. A. (2018). Prevention and treatment of tobacco use: JACC health promotion series. Journal of the American College of Cardiology, 72(9), 1030-1045.
Prochaska, J. J. & Benowitz, N. L. (2019). Current advances in research in treatment and recovery: Nicotine addiction. Science Advances, 5(10).