Project Details
Topic Background
Burden of Smoking
The burden of smoking is very high. The World Health Organization (WHO) reports that every year, about five million people die of diseases associated with cigarette smoking worldwide. In the period 2004-2005, an Australian government report estimated that about 15,000 lives would be lost to active and passive smoking (Colins and Lapsley, 2004-2005).
Causing a wide array of diseases, health smoking is the second cause of death in the world. It is responsible for one in every 10 deaths in adults. Cigarette smoking cuts short the smoker’s life by an average of 13.2 and 14.5 years for males and females, respectively (WHO).
Cigarette smoking is the fourth most common risk factor for diseases worldwide. It is a major cause of different types of cancer, such as lung cancer and cancer of the larynx, oral cavity, pharynx, and esophagus. It is also an important factor in the development of cancers of the pancreas, uterine, cervix, kidney, colon, and rectum, blood, and stomach. In fact, it is responsible for approximately 30 percent of all deaths due to cancer (WHO).
Cigarette smoking is also among the causes of bronchitis, heart diseases, stroke and emphysema, abdominal aortic aneurysm, acute myeloid leukemia, pancreatic cancer, pneumonia, periodontitis, and stomach cancer. It also causes low birth weight in infants and is one of the factors causing stillbirth, infant death, and miscarriage (WHO).
The World Bank reports that in developed countries like Australia, smoking-related health care accounts for 6 to 15 percent of the national health care costs. A 2001 estimate (published in 2004) by the Cancer in Australia series reported that cigarette smoking has “directly caused 10,592 new cases of cancer (54.6 new cases per 100,000 pop) and 7,820 deaths (40.3 deaths per 100,000 pop) in 2001. Between 1991 and 2001, the male incidence rate for smoking-related cancers fell by an average of 1.4% per year, while the rate for females rose by 0.7% per year” (AIHW, AACR, 2004).
Prevalence of Smoking in Australia
The problem of smoking is crucial for all countries, no matter developed or not because it is ruining the health of the citizens and future generations in favor of the bunch of tobacco corporations. In Australia, the problem of smoking is extremely burning due to the high rates of diseases and deaths among smokers, negative impact on the different spheres of life, public health stability, and the wide range of other spheres (Tyrrell, 1999; Butler, Rissel & Khavarpour (1999).
What is even more significant, smoking patterns of life are extremely widespread among youth, which can be a severe blow for future generation’s health. Modern neoliberal patterns of public policy recently resulted in significant neglect of these problems on the part of the governmental agencies, which in turn leads to further deterioration of the health situation.
As Lawson claims, due to increasing polarization between rich and poor in Australia as in the other Western countries, the patterns of life also significantly polarize with high-income people adhering to healthy life behavior and low-income people further neglect healthy way of life and consider smoking to be the source of psychological and moral relaxation (1999).
In this situation, more attention should be paid to the concerted actions of civil society, local communities, citizens, and other stakeholders directed at radically redressing the situation with smoking. In our research, particular attention will be placed on the analysis of smoking as a social phenomenon, which requires a complex approach to its resolution (Lewis, 2003).
Smoking Cessation
It is crucial that cigarette smokers would quit. However, smoking cessation is a big challenge, especially among hard-core smokers. Data from the American Cancer Society show that a big percentage of smokers (70 percent) want to quit. Every year, 35 percent of these smokers actually try to quit, but only a very small percentage (5 percent) are actually able to quit.
The Australian government has existing support systems and guidelines to help smokers quit smoking. One such support system is the Quitline (131 848) in each state or territory where smokers wanting to quit are offered counseling assistance over the telephone. In Victoria, South Australia, and New South Wales, smokers may also be offered to be called by the counselors so that counseling can take place not only at the initiation of smokers (Department of Health and Ageing, 2004).
Up to now, however, successfully quitting smoking still remains a struggle among many smokers.
Aims of the Research
The study aims to understand why some smokers could successfully quit and why others find it hard to quit, by identifying the factors that affect a smoker’s success in smoking. Specifically, the study will make a profile of the successful quitter vis-à-vis that of the unsuccessful quitter by answering the following research questions:
- Why do some smokers able to successfully quit smoking why do others find it hard to do so?
- What are the factors that help some smokers to successfully kick off the habit?
- What are the factors that hinder some smokers to successfully kick off the habit?
To answer the question of why others are successful in quitting smoking while others are not, the study will look at the possible factors affecting success in quitting such as reasons of the smokers for wanting to quit, whether they have community support or not, whether they have family support or not, whether they have sought medical help or not, as well as whether they use some medical aids, like nicotine replacement therapy.
Importance of the Study
The study is important because results could give insight into why some smokers could successfully quit smoking while others find it hard to quit smoking. The insights that could be gleaned from the study could be the basis for the designs of interventions that will be used to help smokers quit. Understanding the factors that are involved in the success of quitting smoking could help government agencies as well as healthcare professionals in designing activities that will help smokers.
Research Methodology
The study will employ a qualitative method. This method is more appropriate to understand the social factors and underlying reasons why smokers find it hard to quit as well as to gain insight into what could have been the reason for some smokers to successfully kick off the habit.
To conduct the study, the following methodologies will be employed:
Smokers in a community in Australia will be invited to join the study. The participants should be either former smokers (those who have successfully quitted) or current smokers who have tried to quit at least once but have not yet succeeded.
The participants will be classified into two groups. Group I will be the current smokers who have tried to quit but are not yet successful; and Group II will be composed of past smokers (successful quitters).
In this research, interview and survey methods will be used.
Participants will be asked to complete a survey questionnaire. In the questionnaire, they will be asked questions about how long they have been smoking, when they decided to stop smoking, the reasons for their decision to stop smoking, the steps they have taken to quit (whether they have approached medical professionals, enlisted the help of their family, have community support groups, and whether they use medical aids such as nicotine replacement therapy, and so on).
Questions about the smokers will also be included in the survey, like their age, employment status, whether they are married or not, whether or not they are involved in the community and/or professional organizations, and so on.
The participants will also be interviewed one on one by the researchers to verify the answers they have given in the survey, as well as to gain deeper insight into the answers they have provided. Why and how questions will dominate the questions that will be asked the participants to follow up to the answers that they have already given in the survey.
The survey and the interview are expected to yield information on the reasons smokers want to quit (their motivations), as well as the things that they have done in order to become successful.
The data between the unsuccessful smokers will then be compared against that of the successful smokers just to see if there is a factor that spells out the difference between successful and unsuccessful attempts at quitting.
The data will be analyzed using statistical methods.
Participants
This study shall make use of cluster sampling or two-stage sampling. Here, an area or community will be identified, most likely the one near the researchers. The respondents will come from the area chosen, which will be selected based on a previously established set of criteria. This method not only reduces travel and administrative costs, both for the researchers and the respondents, but it is also the best-suited sampling method for the type of study being proposed.
In this study, participants will be residents in an Australian community that has been previously identified, who are either former smokers (those who have successfully quitted) or current smokers who have tried to quit at least once but have not yet succeeded. Participants may be male or female, aged at least 30 years.
The study will need at least 400 hundred participants, the distribution of which should be optimally 50:50 so that the number of successful quitters and unsuccessful quitters will be equal. However, given that the statistics of successful quitters is very low, as mentioned in the Topic Background section of this research proposal, a ratio of 60:40 (unsuccessful: successful) may be enough.
Recruitment of participants will be done via announcements in local newspapers and media outfits, through health clinics, and other suitable places. The announcement will inform the public that there is a study being conducted which needs former or trying-to-quit smokers.
Ethical Considerations
The research participants will be informed of the overview of the study, which is about understanding the quitting process and looking into the challenges smoking quitters face and how they try to overcome these challenges. Smokers who are qualified to participate will be encouraged to join through a formal letter stating the importance of the study and why their participation is important.
Confidentiality will be ensured by stating in the formal letter that the profile of every participant will be kept. The study will not have any adverse effects on either the participants or researchers.
Appendix I: Information Sheet
Dear Prospective Participant,
You are invited to participate in the study that will look into the smoking quitting process. The study hopes to understand the experiences smokers trying to quit go through in their attempt to stop smoking, their struggles, their needs, and the things they do in order to overcome the stumbling blocks that hinder them from successfully quitting. The study will also look at the possible factors why some quitters are successful while others find it harder to quit.
The study will give insight into the needs of smokers trying to quit which, in turn, will aid stakeholders in formulating intervention strategies that will help smokers kick off their smoking habit.
During the course of the study, you will be asked to answer a survey form about your quitting attempts and your reasons for quitting, among others. You will also be interviewed one-on-one by a research staff to cross-check the answers you provided in the survey as well as to follow up some questions that will help us understand your quitting experience better.
We hope you would participate in the study. Participation is, of course, voluntary, and you may withdraw from the study anytime.
All information that will be collected in the course of the study will be retained for seven years and the details will be stored digitally.
Your personal information shall be kept confidential and no information which could lead to identification of any study participant will be released to a third party.
Should you wish to study your rights as study participant, you may speak with Director GGG, Executive Officer of the ethics committee on research.
Thank you so much. We look forward to conducting the study with you.
Very truly yours,
Appendix II: Survey Questions
Name: ________________________
Age: __________________________
- Successful Quitter?
- Yes
- No
- Member of Community Organization?
- Yes
- No
- Marital Status
- Single
- Married
- Divorced
- Highest Educational Attainment
- Elementary
- Secondary
- College
- University
- Graduate Studies
- Employment Status
- Fulltime
- Part time
- Unemployed
- Self-employed
- Number of Years Smoking
- Less than 5 years
- 5 to 10 years
- 11 to 15 years
- 16 to 20 years
- More than 20 years
- Number of Attempts to Quit
- One
- Two
- Three
- Four
- Five
- More than five. Please specify: _______
- For successful quitters: At what attempt were you finally become successful?
- First attempt
- Second Attempt
- Third Attempt
- Fourth Attempt
- Fifth Attempt
- Others: Please specify: _______
- For successful quitters: How long have you been smoking-free?
- Less than one year
- 1-2 years
- 3 -4 years
- 5 years
- More than 5 years. Please specify: ______
- Reasons for Wanting to Quit Smoking.
- Awareness of the negative effects of smoking.
- Desire to become healthy.
- Fear of developing diseases associated with smoking.
- Minimize or slow-down progression of my disease.
- Required by others (e.g. family members, girl/boyfriend, etc)
- As a self-challenge.
- Others. Please specify: ______________________________
- Things you have done to ensure success:
- Sought medical help.
- Sought family help.
- Used medical aids like nicotine replacement therapy.
- Sought professional counseling.
- Became active in community.
- Took cigarette replacements like candies and gum.
- Read medical literature on medical smoking and its negative effects on health.
- Threw away cigarette packs and ashtrays.
- Informed friends of my intention to quit and asked their help.
- Minimized going to bars and other places where smoking was allowed.
- Avoided activities I used to do whenever I smoked.
- Others. Please specify: ________________________________________________
- Things you did whenever you started having cigarette cravings.
- Ate something else, like gum or candy.
- Talked to a loved one to help me forget the craving.
- Engaged in another activity to forget the craving, like watch movie or play sports.
- Took nicotine-replacement therapy gum.
- Called a counselor.
- Others. Please specify: ________________________________________________
Appendix III: Interview Questions
On Smoking
- How long have you been smoking?
- How old were you when you started smoking?
- What were your reasons for starting smoking?
- How many sticks or packs per day did/do you consume?
On Quitting
- When did you contemplate quitting smoking?
- When did you actually start trying to quit?
- What inspired you to quit?
- What are the steps you did to ensure your success?
- Did you seek help? Who did you ask to help you?
- What were the greatest problems you encountered while attempting to quit?
For successful quitters
- How many times did you attempt to quit before you finally became successful?
- In your unsuccessful attempts, how long were you smoke-free before giving in to your cravings?
- What did you feel each time you failed?
- What do you think are the main reasons why you succeeded in smoking? Please explain.
- How did you overcome the stumbling blocks you encountered while attempting to quit?
For unsuccessful quitters
- How long have you been trying to quit?
- How many attempts have you done?
- How long are you smoke-free before giving in to your cravings? Shortest: _____; longest: ______.
- How do you feel each time you fail?
- What are the things you do to overcome the stumbling you encounter in your attempt to quit?
- What do you think are the main reasons why you are not yet successful in your attempt to quit?
- What are the help you need in order to become successful? From your family? From your community? From your friends? From the government?
Bibliography
Butler, C., Rissel, C., & Khavarpour, F. 1999. “The Context for Community Participation in Health Action in Australia” Australian Journal of Social Issues, 34(3), 253.
Collins DJ, Lapsley HM. The Costs of Tobacco, Alcohol and Illicit Drug Abuse to Australian Society in 2004/05. Canberra: Department of Health and Ageing; 2008. Report No.: Monograph Series no.64.
Department of Health and Ageing. 2004. Smoking Cessation Guidelines for Australian General Practice. Web.
Lawson, E. J., 1994. The Role of Smoking in the Lives of Low-Income Pregnant Adolescents: A Field Study. Adolescence, 29(113), 61-89.
Lewis, M. J., 2003. The People’s Health: Public Health in Australia, 1950 To the Present, Westport, CT, Praeger Publishers.
Tyrrell, I. 1999. Deadly Enemies: Tobacco and Its Opponents in Australia. Sydney, N.S.W., University of New South Wales Press.
World Health Organization. Why is Tobacco a Public Health Priority? Web.