Abubakar Binji
Environmental hazard is an ingredient or episode, which has the possible to impend the neighboring natural location and /or adversely affect population’s health. Tobacco smoking is an example of health hazard, a part of an environmental hazards. The Precaution Adoption Process Model (PAPM) is a convenient framework for assessing where a person is in the process of deciding to take action on a health behavior (Corner & Sparks, 1996). The addiction of tobacco smoking in the United States (US) is both a personal health-related problem and an environmental concern that affects persons and societies, in surprising ways. Behavior change theories are used to explain environmental and community impacts of tobacco smoking (Jamal et al, 2015). Many studies were done in finding the effects and impacts of tobacco consumption to human health. There were studies that aimed at finding the effect of tobacco usage in relation to environmental changes. The US strives to provide best public health policies guiding the environment and health hazards of tobacco consumption. Cardiovascular infection is one of the most common types of sickness related to tobacco smoke. The existence of heart infection attributable to environmental tobacco smoke is foreseeable to be about 10-fold higher than the frequency of ETS-associated lung infection (Smoking Cessation Interventions and Strategies, 2009). Most studies on health effects of cigarette smoking, exposure can be determined by asking the subjects if they smoke, and if so, how many cigarettes per day. Typically, smokers who recognize that smoking is unwanted, undervalue the amount they smoke. Some even claim to be nonsmokers. When we classify these people as light smokers or nonsmokers, we unintentionally mislabel them. This practice is an example of behavior changes that can be explained using PAPM.
The use of tobacco in US remains one of the single, largest and preventable cause of death and diseases (CDC, n.d.). Tobacco smoking is preventable because strategic government policies and processes could produce deterrence measures of tobacco use. As a result, people can voluntarily decide to stop tobacco consumption. Public consumption of cigarette can best be explained, using the theory of PAPM. This theory can explain how tobacco consumption is preventable in many communities. PAPM, as a tobacco-preventable model can reiterate the free-will of people to make their own decision, which can affect how they approach their health situations differently. Tobacco smoking slays more than 480,000 Americans yearly, with more than 41,000 of these deaths that has contact to second-hand smoke (CDC, n.d.). PAPM can explain how people close to tobacco smokers can voluntarily withdraw from them during their period of smoking or the location where they smoke. In the United States (US), smoking-related illnesses cost more than $300 billion yearly, plus practically $170 billion in unswerving medical care for adults, and $156 billion in lost output ( Xu, Bishop, Kennedy, Pechacek, 2015). The costs and care of tobacco-affected patients are outrageously discouraging, an extensive preventable measures are necessary.
Tobacco Prevalence
US Tobacco Prevalence by Race/Ethnicity3
| Race/Ethnicity | Prevalence |
| American Indian/Alaska Natives (non-Hispanic) | 29.2% |
| Asians (non-Hispanic) | 9.5% |
| Blacks (non-Hispanic) | 17.5% |
| Hispanics | 11.2% |
| Multiple Races (non-Hispanic) | 27.9% |
| Whites (non-Hispanic) | 18.2% |
By Sex3
| Sex | Prevalence |
| Men | 18.8% |
| Women | 14.8% |
By Age3
| Age | Prevalence |
| 18–24 years | 16.7% |
| 25–44 years | 20.0% |
| 45–64 years | 18.0% |
| 65 years and older | 8.5% |
By Education3
| Education Level | Prevalence |
| Less than high school | 22.9% |
| GED | 43.0% |
| High school graduate | 21.7% |
| Some college | 19.7% |
| Associate degree | 17.1% |
| Undergraduate degree | 7.9% |
| Postgraduate degree | 5.4% |
By Poverty Status3
| Income Status | Prevalence |
| Below poverty level | 26.3% |
| At or above poverty level | 15.2% |
Adoption of new provisions or cessation of risky performance like the consumption of tobacco, requires careful steps outside of conscious alertness. According to Weinstein, Sandman, Blalock, n.d, at some early point in time, tobacco smokers my not be aware of the health problems of cigarettes—stage 1 of the PAPM. Smokers may not be aware of the health consequences of tobacco, and its deadly impact in human’s health. When smokers initially learn about the health problems of tobacco consumption, they are no longer unaware. However, they may not act on their awareness—stage 2 of the PAPM. Smokers who reach the decision-making stage (Stage 3) have become involved by the health problems and are thinking of their reaction. This decision-making process can happen in one of three consequences: i.e. they may append decision of smoking, temporary staying in Stage 3. They may decide to take no action or continue smoking the tobacco, going to Stage 4 while breaking the PAPM, at least for the interim. Or, they may decide to accept the precaution of smoking tobacco, moving to Stage 5. For those smokers who decide to accept the precaution, the next step is to start the behavior of not smoking (Stage 6). A 7th stage, if pertinent to the case, indicates that the behavior of not smoking has been upheld over time (Stage 7). PAPM, as an interventional approach is very effective in decision-making, and on the effective cause to stop tobacco consumption.
PAPM has certain limitations in its application to behavior change. The central concern of health education is health behavior. If behaviors changed but health is not subsequently enriched, the result is an inconsistency that must be resolved by examining other issues, such as the link between behavior and health status or the ways in which behavior and health (or both) are measured (Conner, Sparks, 1996). PAPM seeks to only focus on the behavior change in explaining how smokers can stop smoking. On the other hand, PAPM can also assist in providing vital precautionary approach in which, if a person decides to quit, can utilize the available information to quit. The advantages of using PAPM is to allow patients or those who smoke tobacco or those with tobacco addiction to ask important questions for quitting smoking, and by following the 7 stages, such as (1) never heard of the damaging effects of smoking, (2) never believed about quitting, (3) determining about whether to quit or not, (4) decided not to quit, (5) decided to quit, (6) acting on quitting, and (7) maintaining vacating (Sharma, 2007). The results of this research suggested a framework approach that transition between stages of the PAPM happens on indirect change in personal thinking (Weinstein, 1988). I think changes in personal decision is one of the important deciding factors of using PAPM.
References
- Jamal, A., Homa, D. M., O’Connor, E., Babb, S. D., Caraballo, R. S., Singh, T., & … King, B. A. (2015). Current Cigarette Smoking Among Adults – United States, 2005-2014. (Cover story). MMWR: Morbidity & Mortality Weekly Report, 64(44), 1233-1240. doi:10.15585/mmwr.mm6444a2
- Weinstein, N.D., Sandman, P. M. & Blalock, S. J. (n.d.). The Precaution Adoption Process Model. Retrieved from http://www.psandman.com/articles/PAPM.pdf
- Centers for Disease Control and Prevention (2015). Current Cigarette Smoking Among Adults—United States, 2005–2014: Morbidity and Mortality Weekly Report 2015: 64(44):1233–40. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6444a2.htm?s_cid=mm6444a2_w
- Smoking cessation interventions and strategies. (2009). Australian Nursing Journal, 16(6), 29-32. Retrieved from http://search.proquest.com/docview/236577030?accountid=14872
- Conner, M., & Sparks, P. (1996). The theory of planned behavior and health behaviors. In M. Conner & P. Norman (Eds.), Predicting health behavior: Research and practice with social cognition models (pp. 121-162). Buckingham, England: Open University Press
- Xu, X., Bishop, E.E., Kennedy, S.M., Simpson, S.A., Pechacek, T.F. (2015). Annual Healthcare Spending Attributable to Cigarette Smoking: An Update. American Journal of Preventive Medicine;48 (3):326–33
- CDC. (n.d.). 2014 Surgeon General’s Report: The Health Consequences of Smoking—50 Years of Progress. Retrieved from http://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm
- Sharma, M. (2007). Precaution adoption process model: Need for experimentation in alcohol and drug education. Journal of Alcohol and Drug Education, 51(3), 3-6. Retrieved from http://search.proquest.com/docview/217443443?accountid=14872
- Weinstein, N. D. (1988). The precaution adoption process. Health Psychology, 7, 355-386.
