Nobody would deny the fact that reducing the levels of smoking young adults is a priority in the United States. Young people are supported in their decision to quit smoking by various programs, such as telephone helplines and computer-based services. Nevertheless, most health promotion programs and interventions seem to have relatively modest results, so that it raises the question as to what should be done to help people quit smoking. Thus, the current paper attempts to describe and discuss the problem of smoking cessation in young adults.
The issue has grown in importance in the light of a recent decline in the adult smoking cessation rates. Most importantly, this age group is associated with many transitions, including changes in attitudes towards smoking. Statistically, adolescents’ experimentations to smoke intermittently progress to regular smoking in young adulthood (Backinger, Fagan, Matthews, & Grana, 2003). As a matter of fact, young adulthood is also a period when first attempts to quit smoking are made. Unfortunately, the smokers who decide to fight the addiction are more likely to relapse. Part of the reason for this is that they become aware of their addiction after their first attempts to quit, which makes them realize that they will not be able to stop smoking easily (Husten, 2007).
The problem of smoking cessation is one of the primary concerns within advanced practice nursing. More specifically, Advance Nurse Practitioners are educated and trained to provide health maintenance for all population, including young adults. They counsel and educate youths on health behaviors by providing information about serious consequences of regular smoking. Another role includes developing self-care skills, which help young smokers develop their self-esteem, thereby clarifying their values and attitudes. Also, Advance Nurse Practitioners provide treatment options in coordination with other physicians to attain thorough success in health promotion (Roberts, Kerr, & Smith, 2013).
Before proceeding to any health promotion theoretical framework of smoking cessation, it is appropriate to provide a definition of health promotion. The term refers to the process of enabling people to improve their health state. Health promotion encompasses such areas as health protection, disease prevention and health education (Roberts et al., 2013). With respect to smoking cessation in young adults, different approaches to health promotion should be discussed.
Four basic approaches can be applied: educational, preventative, client-centered, and social change. Health education is being increasingly recognized as the effective mechanism that focuses on prevention, thereby reducing the costs a young smoker would spend on medical treatment. The problem of smoking cessation can be addressed with two educational concepts that prevail today. The first is more immediate, as it considers the existing risks, while the second presupposes the long-term education about the impact of smoking. The preventative approach is closely related to health education. This approach is based on the belief that providing young adults with the information about negative effects of smoking will change their attitudes and behaviors. The method, however, can be clinically inefficient, as it does not take into account social, economic and cultural factors (Roberts et al., 2013).
Using the client-centered approach, young people are actively motivated to enhance a sense of self-worth and individuality. This model helps to develop critical thinking and problem-solution skills, which would appear useful in quit attempts. In social change an approach emphasis is placed on changing social environment, not on changing beliefs and attitudes of individuals (Roberts et al., 2013).
The present literature review gives a general overview of interventions that address the problem of smoking cessation in young adults. Most current literature on interventions pays considerable attention to the implementation of health education as an effective approach to facilitate smoking cessation. In the study of Roberts et al. (2013), an attempt has been made to reveal the most effective approaches and methods to promote health education to young people. The research promotes a certain view that information about negative effects of smoking is necessary, but not sufficient. The authors claim that improved knowledge does not necessarily mean improved behavior and attitudes. They also suggest that health education is fundamental but should be combined with the client-centered approach (Roberts et al., 2013). In such a way, such psychological skills as decision-making, communication, negotiation and problem-solving should be powerfully promoted. The arguments suggested in the study provide a framework for further research on client-centered approach.
Some studies have taken a different approach by orienting on preventative techniques of smoking cessation process. Parkes, Greenhalgh, Griffin, and Dent (2008) in their comprehensive research evaluate the impact of informing smokers about their lung age. Individuals, who participated in this randomized controlled trial, can be categorized into young, middle-aged and older adults. The main strength of the research is that quit rates were independently verified after 12 months of spirometric assessment. This work appears to be relevant to the area of interest, as the results show that young adults, whose level of addiction is potentially lower, are likely to quit smoking after the intervention. The research would be more comprehensive if the mechanism by which the preventive approach achieves its results has been explained.
Backinger et al. (2003), in their theoretical research, touch upon the impact of smoking cessation media campaigns on young adults and adolescents. According to the authors, education alone is proved to be insufficient in the long term in preventing young people from smoking, but sufficient when combined with social change approach, such as media campaigns and smoking-free policies. The study conducted by Husten (2007) corroborates the similar idea. Much of his research lingers upon the effect of social change on young smokers. He concludes with the important finding that media campaigns are particularly effective to best reach the young audience (Husten, 2007).
Needless to say, any type of intervention can be effective among young adults, especially when tailored to the level of motivation and education. However, all of the researches reviewed, support the hypothesis that education alone is not effective enough to reduce tobacco use prevalence among young adults. Since the approaches must be diverse, the social change approach should be implemented.
Historically, most young adults become addicted as adolescents, but smoking habits are entrenching in the age of 18-24 (Suls et al., 2012). Given the fact that smokers and adolescents are found to be users of television, media interventions are urgently required to maintain low smoking rates among young adults (Husten, 2007). Anti-smoking advertisements should be introduced, so that both educational and preventative functions are fulfilled. Young educated people, exposed to media interventions, are reported to be at a lower risk for regular smoking than adults, who ignore media campaigns and have been exposed to school-based programming only (Backinger et al., 2003). Many efforts should be made to transmit media campaigns in the prime time to reach more young adults.
It is worth admitting that many young people, who do not smoke on a regular basis, do not consider themselves to be smokers and, thus, may not respond to the cessation advertisements, particularly those emphasizing on the health hazards, associated with smoking (Husten, 2007). It is critical to highlight cessation messages about those young adults, who only begin to smoke. There is evidence that young adults want media interventions to be relevant to their group age and to highlight the benefits of quitting smoking. Apart from the positive aspects of quitting, the media intervention campaign should include information about health hazards. Using the randomized controlled trial, conducted by Parkes et al., as an example, it can be suggested to provide young adults with the information about correlation between the lung age and years of smoking. By means of emotional appeal, the media campaign will positively affect target audience.
The smoking rates will show the stagnation among young adults, who smoked intermittently and did not consider themselves tobacco addicted. After the exposure to media message about lung age, people with the lower level of addiction are more likely to quit after 12 months of intervention. Thus, approximately 15% of regular smokers and 24% of non-regular smokers will quit after a year of intervention program. The overall quit rates will reach 14% and 7% in the treatment and control group, respectively.
The primary means of measuring the efficacy of intervention program is to ask those who have participated whether they quitted smoking, and if so, what affected their decision-making. For this purpose, a questionnaire will be developed to measure a range of smoking behavior. A proportion of participants who achieve positive results immediately, following the intervention program, will relapse. Therefore, it would be appropriate to measure the impact immediately and three months after the intervention. The comparative experiment will help to best determine the impact of the program. Hence, both intervention and control groups will be interrogated to verify the intervention results.
The present health promotion proposal has showed that it is easier for young adults to quit, as their smoking experience is potentially modest. However, while very few of them try to quit, many tend to relapse. In such a way, it is medically critical to implement the social change approach, such as an anti-smoking advertisement. The suggested intervention campaign will positively affect young adults by highlighting the benefits of quitting, as well as health hazards of daily smoking.