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Introduction: Smoking Kills is a well-known fact that almost everybody in the society are aware of. Despite of the harsh truth that smoking is responsible for many severe heath consequences people very often tries to ignore the truth and enjoy smoking. Sometimes people become so addicted to smoking that even if they are aware that it is causing harm to them, they are unable to stop smoking. Smoking is one of the major causes of health problem globally. There are more than one billion smokers worldwide (WHO 2015). Within high income countries, such as the UK, smoking rates are declining. Nevertheless in 2016 16% of people in the UK smoked (18% of men and 14% of women), which equates to approximately 7.6 million people, and smoking remains a leading cause of preventable deaths in the UK. But it is observed that now a days a section of people is becoming more conscious about their health. They are becoming aware and conscious that their addiction to smoking is not only destroying their own life but also effecting their family, children and the society in large. People are trying to quit smoking and motivation from the family, friends and society associated with medical support can really play a major role in smoking cessation
Social Determinants: Smoking Cessation is a decision to stop smoking which can improve the quality of life and bring improvement in the society. Society comprises of public and if the public stops smoking, they are getting rid of many harmful diseases which in turn is making a healthy society. Healthy society with heathy people can work efficiently which will bring upliftment of not only individuals but also the society. So, it is the responsibility of each and every individual in the society to help the person to take a decision of smoking cessation. There are different factors in the society that directly or indirectly influence Smoking Cessation.
Social-economic factors: The social status of an individual is responsible for addiction of smoking. It is often seen that smoking cessation is dependent on the persons socio economic status. A person from upper class or middle-class society can easily take the initiative to stop smoking if the conditions are favourable and supportive. Sometimes work stress and competition in the work place act as a hindrance and the person cannot stop smoking. Person from lower class society due to lack of knowledge and less income gets more addicted to smoking. Education plays a major role as the person can understand the consequences and quit smoking
A person can get addicted to smoking at any age but the decision in smoking cessation is very challenging and achievement of success is dependent on many social determinants. Most of the time males of the age group 18-25 are more addicted to smoking. The association, new environment, suddenly feeling free acts as a cause of addiction. A person at the young age are more confident and can easily stop smoking if they want. There are five stages of change during smoking cessation: pre-contemplation, contemplation, preparation, action, and maintenance (Prochaska JO et.al 1991). Stress can impact the action and maintenance stages and result in relapse to cigarette smoking. This relationship between stress and smoking may be a result of the impact of stress on hypothalamic-pituitary-adrenal axis function and the autonomic nervous system. (Richards JM 2011). Help and support from the public along with government strategies and policies can make the society free of smokers. It is like a disease, smoking cessation may be “contagious” in community clusters of smokers, moving quickly through a community or social network in a ripple effect once a few smokers quit, demonstrating how shifts in social norms may occur. (Christakis NA et.al 2008).
Genetic and environmental factors: Smoking addiction are heritable, and are determined by a complex interplay of polygenic and environmental influences. The ability to quit smoking are influenced by a range of environmental factors like parental and peer influence, background from which the person belongs,the place in which he or she is residing etc A person belonging to a place where there is no addiction and people are aware of their responsibilities ,it is unlikely that person will get addiction and even if they got addiction they can easily quit smoking due to the influence of the environmental factors.
Genetic influences may affect the ability to stop smoking. Some genotypes may not be susceptible to nicotine addiction, while others become either slowly or rapidly dependent. The interaction of the genotypic constitution of an individual with the environmental factors are the determinants in smoking cessation. But more research in this field are to be carried out to measure the extent to which these factors are responsible in smoking cessation It is quite evident that socio-economic factors are vital determinants in smoking cessation.
Social determinants affecting health: Cigarette smoking is a well-characterized underlying cause of cardiovascular and respiratory diseases, neoplasias, and depression (Kotlyar M et.al 2017). Cessation of smoking is therefore recommended and is associated with many advantages. The risk of both smoking-related cancer, such as lung cancer, and other cancers is reduced by about 18–45% in one study that followed the health outcomes of former smokers (Choi S et.al 2017). Smoking cessation also reduced symptoms of depression and anxiety, while improving the overall quality of life for former smokers (Taylor G, et.al 2014). Smoking cessation medications approved by the FDA and behavioural counselling are cost-effective cessation strategies and the implementation of this strategies have given success which definitely indicates improvement in public health. It has been observed that combining the medication compared to using a single form of nicotine replacement therapy (NRT) increases the chance of quitting. A socio-economic environment in which there is no health inequality can definitely help in improvement of health. Economic stability, family support, support from the society will make a person more mentally strong and smoking cessation becomes very comfortable due to the interplay of the suitable social determinants.It makes them more confident and dedicated for their work and family.
CONCLUSION: Counselling, behaviour therapy, medicines, and nicotine-containing products, such as nicotine patches, gum, lozenges, inhalers, and nasal sprays, may be used to help a person quit smoking. Despite the availability of smoking cessation treatments that increase long-term quit success (Cahill K et.al 2013), a majority of quit attempts are made unassisted (Edwards SA et.al 2014). It is very important that there is a formal assistance along with mental support which can make the process easier. The decision of quitting smoking is very hard as the person faces physical, mental and emotional challenges. It is difficult to stop smoking alone. Stop smoking programs offered by hospitals, health departments, community centres, work sites, and national organizations can be helpful.
In spite of the facts smoking is still the biggest public health threat. Smoking-related disease is responsible for about 41 million deaths in the United States, United Kingdom and Canada, cumulatively, from 1960 to 2020. (Prabhat Jha 2020). It is quite challenging to change the mindset of public. But combined effort comprising of medication, counselling and motivating the smokers can be helpful in the future. Several strategies are to be formulated to help people. It is noticed that most of the time an individual become addicted to smoke at a very early age when they consider it to be a way of enjoyment with friends. So, campaign at the school and colleges regularly can reduce the smokers in the educational institute. It is also the duty of the parents, teachers and other family members to convince the student that they never go into that path which can destroy their career and quality of life. Smoking cessation can bring changes in our society and everybody as a responsible part of the society must encourage, motivate and help every individual who got addicted to smoking. A joint effort can definitely bring changes in the future where each and everyone will be free of smoking.
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