Problem:

Main Health:

Smoking of cigarette is related to serious health conditions like lung cancer, coronary artery

disease, and obstructive pulmonary diseases.

Burden of Disease:

The burden of disease is high due to associated high mortality rates which come due to cigarette

smoking.

Cause:

It can be attributed by utilizing some statistics like the incidence rates which indicate that lung

cancer rate is about 100 per one-hundred thousand. The rate of incidence and mortality are same,

and the relation depicts the chance of fatality due to cigarette smoking. People with the lung

cancers usually have shorter life spans; therefore, prevalence would be lower.

Distribution:

It can be based on the generation of hypothesis by the individuals about a disease. Males usually

have more mortality rates due to smoking because more males are involved with smoking as

compared to female.

Etiology:
Cause of cancer is cigarette smoking which is a contributory cause. There are very large risks of

lung cancers due to cigarette smoking. People with habit of cigarette smoking are ten times more

likely to have lung cancers. This explains the link between cigarette smoking and lung cancer.

People who quit the smoking reduce their chances of having lung cancer.
Association:

Studies conducted in the 1940s through 1950s indicated a strong relationship between

individuals with lung and smokers in comparison to nonsmokers. Cigarettes were also observed

to be risk among other factors for development of lung cancer.

Cause and Effect

Studies conducted in the period from 1950-60s found increased probabilities of lung cancer

development in cases of the initiation of smoking at earlier stages.

Changing cause to determine effect

No studies of such nature were conducted that involved allowing patients to smoke to cause lung

cancer based on ethical reasons. Additional criteria are therefore required in such cases to form

conclusions and scientific judgements. It has been found that smokers are 10 times at a greater

risk of lung cancer development than average nonsmokers. Quitting smoking is also associated

with a reduction in lung cancer development risks. A consistency in relationship has been

established based on the conduction of studies at varying locations and populations.

Recommendations
There could be several steps taken to reduce the number of people smoking like medical

practitioners warning people about the consequences, early treatment and detection of such

disease, developing support groups for people addicted to smoking, and spreading the warnings

about consequences. Evidence depends upon the efficiency of intervention in case of certain

population and research groups. For early detection of lung cancers, grade D is usually

recommended using the x-rays.

Evidence Quality

The basis for evidence quality is associated with research, expert opinion and intervention

effectiveness coupled with degree of influence of the intervention. For cigarette smoking, a grade

of A or B implying good or bad was followed in the interventions as recommendation.

Intervention Impact

The majority of interventions proved beneficial including emotional support, providing filtered

air indoor and community mobilization. Increasing taxes proved to be harmful for the smoker but

end results were indicated as desirable. Tests involving the early detection of lung cancer via X-

rays proved harmful to health due to radiation exposure.

Grading

A for Must (strong recommendation)

B for Should (contraindication)

C for May (Risk vs. benefit)

D for Don’t (Not enough evidence)

I for indeterminate (Inadequate evidence)

Implementation
Strong recommendations rooted in the evidence can be made basis for the implementation.

Interventions are done according to the timing and course of the disease. Primary intervention is

in which smoking can be prevented. Quitting or screening of cancer can be done during

secondary intervention. Disease can be minimized, and effects can be reduced by using the

tertiary interventions. Moreover, interventions are also dependent upon the nature of patients.
Implementation should also include the steps like changing the behavior, issuing the warning

signs through packing, and encouragement of anti-smoking campaigns. Moreover, steps like

motivating through potential health-hazards associated with smoking and incentives with non-

smoking can also be implemented. Companies should also pay heed to the health and safety

regulations and laws pertaining the issue.

Evaluation
Through intervention, understanding of problem, etiology, options of implementation, and

evidences can be enhanced. Interventions can be based on the target population, behavioral

interventions, smoking cessation, and novel methods for enhancing awareness. These ideas can

be effective for the new-comers and teenagers which care new with smoking. Interventions can

be evaluated by a framework known as the RE-AIM which can asses the long-term and short-

term effects.

Intervention impact on population

A reduction in cigarette smoking was observed after tons of studies conducted to ensure the link

between lung cancer and smoking. i.e. 50% reduction in the US.

Question 2
Since 1960s, the rate of smoking In the United States has been decreased to about 50 percent.

However, the smoking rates among females and teenagers have increase in this period. The

problem becomes worse when some females continue smoking even when pregnant. Resultantly,

it should be priority to deal with the teens and convince them of taking more care of their bodies.

Some considerations can be materialized about increasing the awareness in schools, colleges and

other institutions. They should be made aware of dangers associated with cigarette smoking and
serious diseases associated with it. Moreover, more strict rules should be implemented on public

smoking and taxes on cigarettes should be increases. Cigarette smoking should especially be

discouraged in pregnant female as it is dangerous for even the baby if mother keeps smoking

whole pregnant.