Smoking, Hypertension, and Obesity Smoking

Smoking, Hypertension, And Obesity

Smoking Hypertension and obesity

Smoking, hypertension, and obesity: Bringing about lifestyle changes in afflicted communities

The association between smoking and lung disease, particularly cancer, is well-established in the minds of the public, largely due to a number of advertising campaigns waged by the American government as well as the American Lung Association. However, the association between hypertension and smoking is far more complex. On one hand, "with each cigarette, the blood pressure rises transiently and the pressor effect may be missed if the blood pressure is measured 30 minutes after the last smoke" (Kaplan 2009). This means that smoking is particularly deadly for individuals with a genetic or lifestyle (such as obesity) predisposition to hypertension, more commonly known as high blood pressure. Tobacco use is cited as "the most common cause of avoidable cardiovascular mortality worldwide" (Kaplan 2009). Yet, ironically, "habitual smokers generally have lower blood pressures than nonsmokers" because in general they tend to be of lower body weight than the smoking population (Kaplan 2009). This is likely due to the appetite suppressing and metabolically stimulating effects of nicotine.

But despite this correlation between lower blood pressure and lower body weight in smoking, populations that have high rates of smoking also tend to have high rates of obesity and hypertension. For example, in a study of chronic obesity in three Native Indian tribes in Northwestern Ontario, over half (56.4%) of the study population were smokers, well above the Canadian national average, and (McIntyre & Chandrakant 1986, p.345). Additionally, 70% of women aged 35 to 64 years and 50% of men aged 35 to 44 years were obese and 13% were diagnosed with hypertension (McIntyre & Chandrakant 1986, p.345). Poverty, a lack of economic opportunity, poor access to health resources (particularly in rural and inner city areas) are all linked to hypertension, smoking, and obesity, even if the causal relationship between smoking and hypertension and smoking and obesity is not perfect. There is a general 'lifestyle' of unhealthy behavior that is often characterized by these elements in many communities.

These indicators suggest that a holistic lifestyle change is necessary to bring about smoking cessation, reduce hypertension, and to reduce the obesity that does have a distinct causal role in promoting hypertension. Reducing obesity and smoking incidence in high-risk populations is also vitally important given that smokers do tend to gain weight at a swifter pace than nonsmokers, especially after quitting. Positive lifestyle and dietary changes are required to counteract this, to prevent further weight gain and associated risks, or the replacement of one coping mechanism (smoking) for another (overeating).

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Smoking is notoriously difficult to quit -- even the current, notoriously disciplined President has had trouble 'kicking the habit.' Drugs, nicotine patches and gum, but above all social support is vital in bringing about a lifestyle change. An effective program to reduce smoking must help community members; particularly those on low incomes, to obtain the resources necessary to get the needed drugs to enable them stop smoking. Recently, there have been calls to expand private and public (such as Medicare and Medicaid) coverage of smoking counseling and drug treatments (Practical guide, CDC, p.40). Having a program that enables community residents to navigate the complex bureaucracies of the healthcare system and obtain treatment is essential.

An ideal community program to bring about a lifestyle change should have frequent meetings between participants committed to smoking cessation and weight reduction and/or maintenance lead by a trained counselor or counselors who are responsive to the specific needs of the community. The counselors should be able to offer themselves as informational resources for the participants if the needed additional help or aid.

The effectiveness of such support programs is suggested by the success of initiatives like Not On Tobacco (NOT) an anti-smoking program created for teens in West Virginia, a state which has a particularly high tobacco use rate amongst young people. "NOT consists of ten 50-minute, gender-specific group sessions usually held in schools during school hours and led by trained facilitators (although NOT has also been used in community settings). The sessions are developmentally appropriate, expressed in teen-friendly language, and conducted in small groups (no more than 10-12 teenagers). Topics include motivation, stress management, the effects of smoking, preparing to quit, relapse prevention, dealing with peer pressure, media awareness, support networks, and healthy lifestyles. Four optional booster sessions are offered after the program's conclusion" (NOT, 2009, CDC).

The success of the NOT program is attributed to the way that the facilitators 'speak the language' of the participants. However, the need for having counselors who are familiar with the culture, lifestyle, and economic resources of the community is not limited to teen programs, rather this policy of having counselors know the population they service is a necessary component of all anti-smoking initiatives. Counselors must be able to compellingly demonstrate that they can truly understand the unique stressors that affect that community -- and share, if relevant, their own success stories about quitting with participants. Connecting quitting smoking to a series of positive lifestyle changes, such as reducing body weight, and reducing foods in the diet that contribute to hypertension is also important.

The proposed program would consist of weekly support meetings for community volunteers, who would also be able to access a 'hotline' when they felt moments of weakness. Guest speakers would attend the meeting to provide additional support for nutritional and lifestyle choices to make both quitting and maintaining a healthy weight more feasible. To recruit individuals, flyers will be posted regarding the proposed beginning of a formal support group for individuals seeking to quit smoking and engage in weight reduction strategies.

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