Cigarette smoking in the USA causes approximately 443,000 deaths annually. Secondhand smoke exposure causes more than 49,000 deaths. In the world, the number of cigarette smokes is averaged at 1 billion annually. Despite more than 6 million annual deaths from tobacco-related diseases and 120 million people who suffer from the tobacco-related disease, the number of users is constantly increasing. Although tobacco use is the largest preventable cause of death, there has not been any notable positive progress despite heavy investment. Serious health effects associated with tobacco use; either directly or indirectly include heart disease, pulmonary diseases and cancers (Jamal et al., 2018). The United States government has invested heavily in the medical expense to treat tobacco-related diseases. This investment is estimated to be $300 billion annually. Apart from medical expenses, there is also cost related to loss of productivity, which is estimated to be $156 billion annually (Xu et al. 2015).
In Florida, 15.5 percent of adults smoked cigarettes, while the average number of smokers in the United States was 17.1% in 2016. In 2006, Florida State passed the law that resulted in the implementation of Tobacco Free Florida, an intense tobacco control program. The percentage of tobacco users in 2006 was 21. Following rigorous prevention strategies and heavy funding, the data from 2016 showed that the percentage of users decreased by 6%. Despite the progress, there are still 7,400 Floridians that use tobacco on a daily basis (Florida Tobacco Use Fact Sheet, 2018).
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Orlando is a cosmopolitan city in Florida. One of the major community problems is housing. In Orland, there is a lack of affordable housing, resulting in many poor residents being homeless. At least one in five residents live below the federally designated poverty line. Metro Orlando, for example, is ranked third nationally for lack of housing. The high cost of housing affects the majority who are having extremely low income.
Research indicates that there is a positive correlation between economic status and tobacco use. Vulnerable and marginalized groups use tobacco at higher rates. The use of tobacco is high among people with low income as compared to high-income earners. The most probable reason is that most cigarette smokers use it to relieve stress. In the US, 75% of the homeless are cigarette smokers (Drope et al., 2018). Tobacco use is regarded as a stress reliever and thereby using a cigarette will help them forget the psycho-social problems they are facing.
Strategic plan
A workable and effective strategy in reducing the number of adult tobacco users requires a holistic approach. Having deep knowledge of factors that affect the use of cigarette among adults is the key. For this case, cigarette use is affected by age, gender, and race, socioeconomic and cultural factors. The following plans if implemented well will reduce tobacco use among adults.
A Total Ban on Smoking in Bars and Casinos By 2020
Not all people who go to bars and casinos are smokers. To reduce the percentage of secondary exposure, a total ban on smoking in public places should be enforced. A public place should also include bars and casinos. At the moment, bars and casinos are not considered public places. This strategy was arrived at after taking into consideration the fact that any serious government that cares for its citizens encourages banning of smoking in public areas since this act will reduce secondhand exposure to non-tobacco users. Despite this provision being somewhat hectic and inconvenient, the ultimate goal is that the secondhand exposure would be minimized and consequently, tobacco-related health effects and social issues would be reduced. Considering the finances pumped by the Florida state towards treating tobacco-related diseases, the state’s legislature will consider the total ban as an effective and easy to implement the strategy.
Multiculturalism in the Health Sector By 2030
Targeting tobacco users from lower social status, mostly the African-Americans, and incorporating them into the health sector. The most effective way is to have healthcare professionals from the most vulnerable communities. Health care providers need to understand the social backgrounds and the problems the person is undergoing. Mutual understanding form both parties is key to finding the respective working solution. A tobacco addict will argue that he is compelled to smoke the cigarette as a stress reliever. If the healthcare giver is from the same social background as the victim, it will be easier for him/her to prescribe tailor-made practical solutions. Players in the health sector need to identify the right person, from the same background to be in the forefront in achieving the objective. Increasing healthcare educational institutions that cater specifically for vulnerable communities is the best way of encouraging the number of healthcare professionals from that community.
Increased Taxation
One of the important strategies used in the reduction of tobacco use is through taxation. The strategy has been effective since its inception, in 1970. The average tax per pack in 1970 was $0.18, but as per the data of 2016, the average tax per pack of cigarettes was $2.85 (CDC, 2018). Florida State in 2006 through Free Tobacco Florida program channeled funds received from taxation of tobacco to prevention strategies. Funding is the key issue when it comes to prevention strategies. Despite the increased tax, Florida State is still ranked 30 th in cigarette taxation nationally. New York City has the highest tax of $4.35 while that of Florida is $1.339. The goal is to make tax of tobacco and tobacco-related products the highest in the USA by 2022.
Conclusion
Tobacco use among adults is still on the rise, especially from the vulnerable communities in Orlando. Social problems like lack of housing and high poverty index make it hard to curtail the number of cigarette users in Orlando. Secondhand exposure still poses the biggest problem among non-tobacco users. Having a total ban on smoking in casinos, having multiculturalism in the healthcare sector as well as increasing tax on tobacco-related products are some of the strategies that can lead to a reduction of tobacco use among adults.
References
2018 Florida tobacco use fact sheet. (2018). Retrieved from
https://truthinitiative.org/tobacco-use-florida
CDC - Fact Sheet - Economic Trends in Tobacco - Smoking & Tobacco Use. (2018). Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/economics/econ_facts/index.htm
Drope, J., Liber, A. C., Cahn, Z., Stoklosa, M., Kennedy, R., Douglas, C. E., … Drope, J. (2018). Who's still smoking? Disparities in adult cigarette smoking prevalence in the United States. CA: A Cancer Journal for Clinicians , 68 (2), 106-115. doi:10.3322/caac.21444
Jamal, A., Phillips, E., Gentzke, A. S., Homa, D. M., Babb, S. D., King, B. A., & Neff, L. J. (2018). Current Cigarette Smoking Among Adults — United States, 2016. MMWR. Morbidity and Mortality Weekly Report , 67 (2), 53-59. doi:10.15585/mmwr.mm6702a1
Xu, X., Bishop, E. E., Kennedy, S. M., Simpson, S. A., & Pechacek, T. F. (2015). Annual Healthcare Spending Attributable to Cigarette Smoking. American Journal of Preventive Medicine , 48 (3), 326-333. doi:10.1016/j.amepre.2014.10.012
APPENDIX A
Community Strengths and Concerns
I live in Orlando, Florida. This is a relatively large area especially when one wants to carry out a community assessment and table the findings of the exercise. The most important resource includes the community assets. A community asset varies from one community to another. It ranges from a business, person a landmark or anything that brings positive transformation in that particular community. For instance in Orlando, there are various community benefit programs.
Financial resources are essential for a successful community assessment. This is because even with the availability of the community asset, money needs to be channeled to the personnel involved in the exercise. Time is an essential resource in community assessment (Posavac, 2015, p.173). This is because when the exercise is carried out for a longer period, better substantial results are accomplished. The team is thus able to unearth more community assets and challenges in a particular region. Lastly, a team of experts is needed in order to complete a reliable community assessment, this can be done either through collaboration with other stakeholders or embarking on the exercise on your own.
In Orlando, housing is a major concern in all counties. Homelessness continues to impact the community in a negative way. It has led to an increase in drug and substance abuse together with the rise of crime. Lack of access to nutritious and healthy food is another concern in the community. Poverty is a great concern as it mainly affects the youth in the community (Jacobs, 2012, p.44). Most school going children from poor families have a high chance of absenteeism, low graduation probability and a higher likelihood of being part of a violent gang. There are also health concerns on an increase in the rate of HIV and STI infections in the community. Lack of access to mental health is a major community concern as there is an increase in the cases of suicide. This is because of the low number of professionals as compared to the patients.
On the brighter side, Orlando residents have access to childhood immunization together with communicable diseases such as Influenza flu. Women in this community have access to Pap smear tests and mammogram checkups (Jacobs, 2012, p.98). This has helped in reduction deaths to cancer since there is early detection. Family planning services are offered at affordable rates in this community. In most hospitals, they are actually free! This helps women to be able to balance both their careers and families simultaneously. The community also enjoys great inter-agency cooperation. This is because most organizations collaborate in order to come up with solutions to benefit the community.
There are barriers that come up when implementing healthy plans in Orlando. Health illiteracy together with incomplete perception of an individual’s health is one of the major hindrances ( Barnidge et al, 2013, p.37) . Most residents do not seek medical attention until the disease is advanced due to the lack of understanding of symptoms. Linguistic and cultural disparities are also a major barriers. Orlando is a cosmopolitan region with people from all origins around the world. Some people do not feel included if they do not feel represented in the agencies that are involved in these community programs and thus abandon the idea of participation. Insufficient resources lead to the collapse of health plans in Orlando.
Creating awareness campaigns on the signs and symptoms of various diseases will help community members to understand and fully participate in the implementation of health plans. The fair inclusion of employees of all races and religion will create unity in the community and consequently lead to the success of health plans implementation (Boswell et al, 2015). Welfare programs together with the government should be involved in order to collect enough funds to cater to a successful community health plan.
References
Barnidge, E. K., Radvanyi, C., Duggan, K., Motton, F., Wiggs, I., Baker, E. A., & Brownson, R. C. (2013). Understanding and addressing barriers to implementation of environmental and policy interventions to support physical activity and healthy eating in rural communities. The Journal of Rural Health , 29 (1), 97-105.
Boswell, J. F., Kraus, D. R., Miller, S. D., & Lambert, M. J. (2015). Implementing routine outcome monitoring in clinical practice: Benefits, challenges, and solutions. Psychotherapy research , 25 (1), 6-19.
Jacobs, M. T. Community Assessment-2012.
Posavac, E. J. (2015). Program evaluation: Methods and case studies . Routledge.
