Healthy People 2020 MAP IT Module 3 self-learning project

Healthy People 2020 and Tobacco Use

The Healthy People 2020 initiative provides a set of goals to improve the health of American citizens. The science-based goals set out ten-year targets to be achieved by 2020 across a wide range of health issues. One health issue included in the initiative is tobacco use with a target to reduced tobacco use to a "point that it is no longer a public health problem" (DHHS, 2012).

Over the last forty years there ahs been a wealth of research examining the health impacts associated with the use of tobacco, with tobacco use being cited as being the single most preventable cause of death in the United States (DHHS, 2012). Tobacco has a negative impact on those who smoke as well as those who do not smoke but are exposed to the second hand smoke. The health problems associated with tobacco use in cancer, heart disease, lung diseases and when the tobacco is used by a pregnant mother there are also risks of premature births, low birth weight and still births (DHHS, 2012).

The problem is not only the proven causation link, but the scale of the problem. For example, the World Health Organization (WHO found that in the U.S. It 80% of women and 90% of women diagnosed with lung cancer contract the result as a direct result of smoking

(WHO, 2003). This is significant as the CDC estimated that in 2007, the latest year for which statistics are available, 203,536 people were diagnosed with lung cancer and 153,683 died from the disease (CDC, 2012). Furthermore lung and bronchus cancer were the second most prevalent cancer in the U.S. (CDC, 2012). Overall, it is estimated that in the U.S. 443,000 people die every year as a direct result of tobacco use (CDC, 2005). The problem is not only seen in terms of mortality, but also morbidity, as it is estimated that for every death another 20 people are suffering at least 1 serious tobacco related illness (DHHS, 2012). The financial cost is also high, it has been estimated that the total annual health costs associated with smoking amount to $96 billion, with $4.98 billion associated purely with second hand smoke exposure (Guilfoyle, 2011).

When looking at the risk factors tobacco use of an action that is undertaken initially as a result of a personal decision. However there are a number of factors which may impact on that decision. With many individuals taking up smoking while still at school it is notable that social pressures appear to have an impact, research indicates those exposed to smoking by parents, siblings and friends show an increased probability of taking up smoking (Frieden, 2004). The behavior in terms of smoking may also impact on the health risks; the younger age at which an individual starts using tobacco and the higher the level of tobacco use are both positively associated with exponential health risks (Tsevat, 1992). The environment created by smokers will also increases risks, it is estimated that there are approximately 4,000 deaths every year in the U.S. directly attributed to passive smoking (Guilfoyle, 2011; Stayner et al., 2007). The problem with smoking is the difficulty faced when giving up the habit, as biologically it can be addictive.

The aims of the Healthy People 2020 include the reduction of " illness, disability, and death related to tobacco use and secondhand smoke exposure" and reducing tobacco use so it is no longer a health issue (as seen above)(DHHS, 2012). This is to be achieved through a number of objectives, including "Implementing policies to reduce tobacco use and initiation among youth and adults" and "Adopting policies and strategies to increase access, affordability, and use of smoking cessation services and treatments"(DHHS, 2012).