Assessment+3(chp+2)

In this chapter, we focus on the main points regarding our topic.There are include the factors of smoking, the effect of smoking and how to prevent from smoking. We are also discuss the relevant information related on our points from articles and journal and compiled them in this chapter.
 * 2.0 Introduction**


 * 2.1 The factors leading to smoke**

Factors such as peer pressure, influenced of smoking from family, factors of gender and races and personal behaviour are mostly lead youngsters especially students to smoke.


 * 2.1.1 Peer pressure**

Faucher (2003) emphasizes that youth are commonly start smoking and trapped to cigarette since they get along with some friends in school, street or in somewhere else. 'Peers' refer to friends, best friends, classmates, boyfriends, girlfriends or in the other word the people that we are close to. Faucher (2003) notes again that there is an experiment observed European American and African American to investigate on peer smoking really affect according to race and gender. The result states that the effect of smoking through peers is less for African American if compared to European American. However, the number of female to smoke is higher than the number of male smoker. Besides that, peer pressure often affect student to initiate smoking in college. Edward, et al. (2008) on page 300, clearly state that “an often large discrepancy between perceived peer tobacco use (descriptive norms) and actual tobacco peer use has also been shown among college students”. They are also noted in page 229, student in college years are in the climax time of easy to be exposed to cigarette. Besides that, it is the time where the students are facing the intermediate age between adolescent and adulthood period.


 * 2.1.2 Factors Influenced by Family**

Secondly is factors influenced by family. Family can be the most influencing matter because family is the person who we are most close to. Role of parents smoking and lacks of parent connectedness are the factors of smoking to adolescents. Faucher reported that "the family and school are the most important social contexts that influence adolescent risk behavior" (Faucher, 2003;cf Rutter, 1993). This statement is clearly state that adolescents are usually behaves like how the family does. According to Rutter's report (1993), families in which both parents smoke, 20.7% of girls was smokers, compared with 7.6% of girls from families where parent are not smoking. Thus, this report shows that family especially parents influenced their children most in smoking behaviour. “Both aspects to be prognostic of adolescent delinquent behavior” (Faucher, 2003; cf McCord, 2003) where she focused that disciplinary and involvement of parents to their children are very important in order to avoid their children to start smoking. Thereby, when the parents do not take care too much about their children, their children could feel lonely and their relation to their peer group become closer and easy to get approach with outsiders who could bring negative influences to the children. Besides that, Faucher (2003) mentioned again that adult are often busy nowadays would be the other factor of encouraging their children to smoke. Lack of supervision and responsibility to teenagers are the ‘free ticket’ for them to participate in some unhealthy behaviours.


 * 2.1.3 Factors of gender and races**

In addition, the relation between socioeconomic characteristic with smoking behaviour can vary with country. According to Cavelaars, et al. (2000) "the smoking rate was higher among women attaining a relatively low level of education in Great Britain, whereas it was higher among those attaining a relatively high level of education in Southern Europe". Thus, it can be said that gender and races are associated with smoking factor according to how their culture and ways of living as known as races.


 * 2.1.4 Personal Behaviour**

Koval, et al.,(2000) reported that "Stress and associated distress are known to be important factors in the inception and continuation of smoking". Stress are positively related with smoking to both men and women. People taking cigarette when they feel stress and assume that by smoking they can reduce their stress. On the other hand, Females develop self-concept in the context of relationships with others, whereas males develop self-concept around the idea of the body as an instrument reinforced through physical capability and efficiency (Faucher, 2003; cf Chodorow, 1987). Body image dissatisfaction was negatively correlated with internal locus of control and autocratic interpersonal styles, whereas positively correlated with submissive styles of interpersonal behavior (Faucher, 2003; cf Vinuesa, 2003).


 * 2.2 Effect of smoking**

The impact of smoking on smokers and those around them


 * 2.2.1 Lung Cancer**

With cigarette smoking, smokers are easily diagnosed diseases such as lung cancer and chronic obstructive pulmonary disease (COPD), this point out by (Punturieri, et al 2009). People today suffer from the disease is detected and the cause of death is highest in the world. Cigarette smoke exhaled by smokers contains more than 4000 toxic chemicals that can harm and even death. Every puff of cigarette will lead to dead. The contents of cigarette smoke include radioactive substances (polonium-201) and the materials used in paints (acetone), floor cleaner (ammonia), mothball (naphthalene), and pesticides (DDT), termite poisons. However, pesticides are the lowest tar, nicotine and carbon monoxide. The smokers not only are responsible to ourselves but to the community’s responsibility to wash away the toxic of smoking from community. With the exhaled cigarette toxins inhaled by smokers it themselves and those around him would go into the cavity of the mouth and nose through the throat and lungs. Content carried by the cigarette smoke will damage tissue in the body during the trip. As a result, it will cause various diseases in the mouth, throat, lungs and cancer.


 * 2.2.2 Diabetes**

Many diseases are classified as infectious diseases that can lead to death such as tuberculosis, malaria, H1N1, HIV, but some human diseases result from self-believer diabetes, cancer, heart disease and stroke. Of human diseases that result from some very dangerous disease known as ‘Chronic disease is not infectious' (CNCD). Between the diseases included in the category CNCD is related to cardio vascular diseases, diabetes type two classes that caused nearly twice the mortality in the world compared to other diseases. Smoking is an unhealthy practice and the most dangerous in the world because it will cause many diseases which result high risk to health. Therefore, we must refrain from smoking. Classes of diabetes type 2 which can lead to death are very feared by the world community but many still do not stop smoking on personal factors (Fagard, et al 2009). Smokers are more insulin resistant than non-smokers who also showed some aspects of insulin. Besides, that known as the smoker is more likely in increase in fat than non-smokers. This is associated with increased production of adipokines, cytokines and other signs of chronic opinion.


 * 2.2.3 Head and Neck Cancer**

The effects of smoking on human health are serious and in many cases deadly. Smoking also is associated with higher levels of chronic inflammation, another damaging process that may result in oxidative stress. Duffy (2002) comment previous research indicates that smoking and alcohol intake the main risk factors for head and neck cancer and depressive disorders often go undetected and untreated among these patients. For head and neck cancer patients, emotional status and mental health affect their global quality of life scores and disability status. Some people when they know they have cancer but still continued smoking the first diagnosis of head and neck cancer significantly increases the likelihood of developing a second malignancy. It also adversely affects survival after the occurrence of a second cancer. Tar in cigarettes was some effect can cause lung and throat cancer in smokers. It is also responsible for the yellow brown staining on smokers’ fingers and teeth. Carbon monoxide in cigarettes robs the muscles, brain and blood of oxygen, making the whole body especially the heart. Over time this causes airways to narrow and blood pressure to rise, and can lead to heart attack and stroke.

There are a few ways on how to prevent student from smoking such as school base education interventions, community Interventions, mass media and tobacco excise taxes.
 * 2.3 Prevention Of Smoking **


 * 2.3.1 School Base Education Interventions **

Muller-Riemenschneider, et al (2008) give the statement “Traditionally, school-based prevention programs have been used as a way to reach as many children and adolescents as possible”. Lantz, et al. (2000) give the statement “The primary premise of this approach is that youth are generally misinformed about the risks of smoking and that educating them on the health and social detriments of smoking will provide a deterrent”. School intervention in which can overcome this issue is it is important for schools to provide roles in providing information about the risks and negative effects of smoking to the students. Lantz, et al. (2000) also give the statement “The ﬁrst approach is an “information deﬁcit or rational model” in which the programme provides information about the health risks and negative consequences of tobacco, most often in a manner intended to arouse concern or fear”. Most of the students are lack of knowledge about the dangers of smoking. In order to give awareness to student, school can organize some programs for example anti-smoking programs, which can provide exposure to students about the dangers of smoking to health, how to prevent themselves from being drawn into the smoke and the contents of which are in cigarettes. With this exposure the students will stay away and not interested in the cigarettes. Lantz, et al. (2000) suggest stress management techniques. School also can organize session on how to eliminate stress without cigarettes. These programs must be carried out effectively. The school must also be strict in implementing and enforce the law to punish students who are found smoking. Strict law schools can provide a positive impact on students in addressing the symptoms of smoking.


 * 2.3.2 Community Interventions**

Muller-Riemenschneider, et al. (2008) give the explanation “In the community, alternatives to family interventions are interventions in the primary health care sector”. Instead of roles of schools, society, mass media and parents should also play roles in addressing this issue. Lantz, et al. (2000) give the strategies “to prevent and reduce youth tobacco use include, youth education, encouraging enforcement of laws restricting youth access, banning tobacco advertising that is youth oriented, environmental tobacco smoke restrictions, and increasing physicians’ role in youth tobacco prevention efforts”. Community must work together in combating this disease for example illegally used of cigarettes to teenagers, against advertising on cigarettes, restrictions of smoking in public, and the responsible party should monitor the youngsters, especially students. Ban the use of cigarettes among youth should be implemented to prevent youth from being involved in the symptoms of smoking.


 * 2.3.3 Mass Media**

Lantz, et al. (2000) give the statement “Mass media strategies have been used for broad based public education regarding a variety of public health issues, including tobacco use prevention and control.” Mass media also play a role in preventing symptoms of smoking among people there. By providing programs based on health issues, the hazards of cigarettes, how to overcome the habit of smoking, they give some effectiveness and impact on society not to engage in smoking.


 * 2.3.4 Tobacco Excise Taxes**

Lantz, et al. (2000) give a theory “Using both theory and the existing empirical evidence, these researchers conclude that partial bans have little effect because they afford cigarette companies the opportunity to switch advertising expenditures to other promotional media and methods”. Impose fines or taxes to smokers or students who are smoking also one of the steps from being expose to cigarette. It should be drawn into the community to overcome the problem of smoking. When there are tax laws imposed towards smokers, smokers will try to stop from smoking in order to avoid the tax hit. Other than that, the government should impose tax to cigarettes sellers. Increasing the price of the cigarettes as a result can be one of the factors the sellers avoid to choose cigarettes to be sold as they need to pay high tax for them. Besides that, the smokers who are particularly with low income will think carefully before buying cigarettes due to the expensive price of cigarettes which could ruin their financial. For students, they should be more concern about their financial as they still studying and has not get their income yet. Thus, this could decrease the number of smokers.

**2.4 Reference**

Chung, W., Lima, S., & Lee, S. (2010). Factors inﬂuencing gender differences in smoking and their separate contributions: Evidence from South Korea. //Social Science & Medicine 70 (2010) 1966-1973.//

Duffy, S.A., Terrell, J.E., Valenstein, M., Ronis, D.L., Copeland, L.A., and Connors, M., (2002), Effect of smoking, alcohol, and depression on the quality of life of head and neck cancer patients//. General Hospital Psychiatry 24,// pg140–147.

Edward, C. L., Bennett, G. G., Wolin, K. Y., Fowler, S., Whitefield, K. E., Askew, S., MacKinnon, D., McDougald, C., Hubbard, R., Wellington, C., Feliu, M., and Robinson, E. (2008). Misestimation of Peer Tobacco Use: Understanding Disparities in Tobacco Use. //Journal Of The National Medical Association, (VOL 100, No 3, p. 299-302)//.

Faucher, M. A., (2003). Factors That Influence Smoking in Adolescent Girls. //J Midwifery Womens Health//. 48(3)

Fagard, R.H., and Nilsson, P.M., (2009), Smoking and diabetes-The double health hazard!. //Primary care diabetes 3//, pg205-209

Glanz, K., Lunde, K. B., Leakey, T., Maddock, J., Koga, K., Yamauchi, J., Maskarinec, G., Shigaki, D. (2007). Activating Multi-Ethnic Youth for Smoking Prevention: Design, Baseline Findings, and Implementation of Project SPLASH. Cancer Research Center of Hawaii, University of Hawaii. //J cancer Educ. 2007; 22:56-61.//

Lantz, P. M., Jacobson, P. D., Warner, K. E., Wasserman, J., Pollack, H. A., Berson, J., Ahlstrom, A. (2000). Investing in youth tobacco control: A review of smoking prevention and control strategies. //Tobacco Control. 2000;9:47-63.//

 Punturieri, A., Szabo, E., Croxton, T.L., Shapiro, S.D., and Dubinett, S.M., (2009), Lung Cancer and Chronic Obstructive Pulmonary Disease: Needs and Opportunities for Integrated Research Needs and Opportunities for Integrated Research. //J Natl Cancer Inst//, pg554-559.