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Public Health Promotion Project Plan for Smoking Cessation to Promote Improved Prognosis of Chronic Obstructive Pulmonary Disease among People Aged 40 Years and Older

Public Health Promotion Project Plan for Smoking Cessation to Promote Improved Prognosis of Chronic Obstructive Pulmonary Disease among People Aged 40 Years and Older

Introduction

                Smoking, has for a long time, been linked to the onset and exacerbation of chronic obstructive pulmonary disease (COPD). The current project intends to design and develop a plan for promoting smoking cessation and preventing the relapse of smoking behaviour among people aged 40 years and older among Aboriginal and Torres Strait Islander communities in the State of Queensland in Australia. Health promotion is a behavioural social-science that draws heavily from medical, psychological, environmental, biological, and physical sciences to prevent disease, promote health outcomes, prevent premature deaths and disability through-education driven voluntary activities and behaviour-change (Fleming & Parker, 2015).

Health Promotion and Target Group Outline

                The target population for this project are the Queensland-based Aboriginals and Torres Strait Islanders aged 40 years and older who have been diagnosed with COPD. Choosing to focus on a population of 40 years and older draws from the recent realization that Australians aged over 45 years are three-times more likely to die from smoking-related conditions compared to young people (Eades & Chamberlain, 2015). Pleasants, Riley and Mannino (2016) found out that such a population is at a higher risk of experiencing lung damage caused smoke from tobacco smoke, and consequently develop COPD.  They must also be characterised by COPD risk factors; especially smoking. On the other hand, the rationale for characterizing the population COPD risk factors – smoking – is that the primary objective of the project plan is to reduce not only the risk of developing COPD, but also its exacerbation, while improving treatment outcomes and prognosis of the disease. Both male and female patients aged over 40 years from either of the two communities in the state of Queensland will be the primary focus of the project.  The objective is to promote the overall wellbeing of individuals with COPD in the community.

                Smoking has been recognized as one of the key contributors of the increased burden of illnesses among the Torres Strait Islanders and Aboriginal people of Australia. The prevalence of smoking behaviour among Torres Strait Islanders and Aboriginals of Australia currently stands at 41.4%. On the other hand, the prevalence of smoking among Australians in general is at 14.5% (Lovett, Thurber, & Maddox, 2017). However, the rate of smoking in the two communities is more likely to drop in the near future since smoking behaviour has been on the decline for the past five years. Nonetheless, smoking behaviour among Torres Strait Islanders and Aboriginals remains a major problem compared to non-Indigenous Australians. The health impacts of smoking depend largely on intensity and duration. Sustained problem of COPD may still be observed in the community despite a substantial decrease of smoking behaviour because there is a significant lag time between smoking and manifestation of tobacco-associated health effects. However, this should not discourage efforts and progress that will be observed during the campaign (Lovett, Thurber, & Maddox, 2017).               

Benefits of the Health Promotion Plan

                Smoking cessation is set to reduce both the morbidity of COPD and deaths resulting from the diseased. This is underpinned by growing research evidence which has found a  positive correlation between smoking or tobacco use and the onset and exacerbation of COPD.  As such, the health promotion plan will add value to the recently observed trend where the prevalence of smoking in Aboriginal and Torres Strait Islander communities is declining steadily.  For instance, a study by Lovett, Thurber and Maddox (2017) found that the prevalence of smoking behaviour among Indigenous Australians dropped from 54.5% in 1994 to 52.1% between 2004 and 2005. Furthermore, the prevalence of daily smoking among the Indigenous Australians plummeted from 50.0%  in 2005 to approximately 41.4% between 2014 and 2015.  Data on daily smoking among both adult males or females from the Indigenous communities in Australia show a similar trend, which evidently explains why this project puts more focus on all Indigenous COPD patients aged 40 years and above, regardless of their gender (Lovett, Thurber, & Maddox, 2017).  Educating patients on the co-relation of COPD and smoking is regarded as a health promotion strategy that will improve outcomes in the management of COPD. Notably, an educated patient will see the need for not only stopping smoking but also advising friends and family members against the behaviour (Golechha, 2016).

Health Promotion Aims/Goals

The goal of any Public health promotion project or plan should be SMART; that is, Specific, Measurable, Achievable, Realistic, and Time bound. As such, the goals and aims of the proposed health promotion projected were designed in accordance with the SMART framework (Fleming & Parker, 2015).  The health promotion project seeks to provide socially and culturally-appropriate campaign, public education and awareness with particular focus on people aged 40 years and over from Torres Strait Islander and Aboriginal communities in Queensland. The population of interest are COPD patients.

1. Goal 1: Provide public education on the relationship between smoking and the onset or development of COPD.
2. Goal 2: reduce the prevalence of smoking among the target population in Queensland.
3. Goal 3: reduce incidences of COPD exacerbations and improve prognosis of disease among the target population as observed from reduced frequency of hospitalisation and the need for emergency care.
4. Gaol 4: reduce morbidity of disease and mortality among smokers.

Health Promotion and Prevention Management Perspective

                The health promotion and prevention management perspective of the proposed project will be required to meet both the primary, secondary, and secondary objectives of health promotion. The primary perspective aims to reduce or eliminate factors that influence the incidence of a disease. Similarly, the campaign aims to prevent or stop smoking due to its potential to cause or exacerbate COPD (Baumann & Ylinen, 2017). On the other hand, secondary perspective focuses on early detection and limitation of co-morbidities that may arise from a given condition. Similarly, the project aims to reduce incidences of hospitalisation due to COPD exacerbations and its related deaths (Fleming & Parker, 2015).  Lastly, tertiary perspective focuses on prevention of complications associated with the disease.

Stakeholders and Community Consultation

                Effective involvement of relevant stakeholders is one of the key success factors of any given project. As such, various stakeholders need to be involved in the project. One of the important stakeholders are the health care providers in Queensland, particularly those who serve the Aboriginal and Torres Strait Islander communities in the state due to their knowledge of the culture and socially-accepted practices of the target communities (Fleming & Parker, 2015). Moreover, community leaders of the Aboriginal and Torres Strait Islander communities in Queensland need to be involved in the project since they are aware of the necessary demographic and geographical information of the population. Additionally, community leaders may have power and influence to mobilise the target population to participate in the project. Community leaders will also be an important stakeholder because they adequately understand the community’s language and cultural beliefs. Media is yet another important stakeholder as it will help in disseminating the information regarding the health promotion plan and the benefits of smoking cessation, especially to COPD prognosis.

Health Logo

                A given health message ought to be captivating and appropriate for the target population.  With that in mind, the logo and health message in this case seeks to impart on the target population the importance and benefits of smoking cessation. Figure 1 below shows the logo that will be used in the proposed project together with the health message for the target population.

Figure 1: Project Logo: – Stop Smoking and Stay Healthy

Health Promotion Activity Description

Addressing Social Determinants of Health

                Smoking behaviour and/or tobacco use is influenced by certain factors, ranging from  environmental factors, cultural, economic and social factors. Tobacco use among Indigenous Australian communities is tied to the history of colonisation in the country. Indigenous Australians had experienced a long history of colonisation, discrimination, and abuse by the non-Indigenous colonisers. During the colonisation era, tobacco and cigarettes were used as forms of payment for services rendered by Indigenous Australians (Lovett, Thurber, & Maddox, 2017). Thus, there is need to address historical social issues as well during this campaign.

Improvement of Implementation of Tobacco Control Measures

                This project will involve engaging all the relevant stakeholders to tighten the control of tobacco use; especially in areas that inhabited by Aboriginals and Torres Strait Islanders (Buttle & Maklan, 2015). For instance, there should be improved monitoring of smoking prevalence in Indigenous communities in the State of Queensland. Moreover, there is need for improved monitoring of smoking behaviour as well as development of precise estimates of smoking-related morbidity and mortality, particularly in Indigenous communities in Queensland to inform policy and planning (Davey et al., 2015). Tobacco control strategies should also be socially acceptable and culturally appropriate for the Indigenous communities in Queensland. Furthermore, members indigenous communities and their leaders ought to the actively engaged in the tobacco control efforts (Lovett, Thurber, & Maddox, 2017). These strategies are important since Australia seems to lack a comprehensive framework that can monitor and guide the effectiveness of tobacco control efforts among Indigenous Australians at both the state, national, and the local level (Eades & Chamberlain, 2015). Lastly, indigenous communities should be involved in decisions pertaining to government-led antismoking measures such as banning advertisement or branding of tobacco, designing of health warnings, and communicating initiatives to stop or at least reduce smoking (Williams & Allan, 2019). For example, Indigenous people should champion for behaviour change over social media platforms such as Facebook, Instagram and Twitter (Brusse et al., 2014). Further control through increased taxation of tobacco products can also go a long way in reducing the prevalence of smocking (Hirono & Smith, 2016; Hoek & Smith, 2016).

Public Education and Improved Awareness of the Health Hazards of Tobacco

                There should be a multi-sectorial cooperation to help improve the level of knowledge and awareness of the health hazards related to tobacco use in the target population. Public education may include the use of the media to deliver health messages as well as healthcare providers and social workers to help educate and impart health information to the target population. Evidence indicates that smoking results in serious tobacco-associated consequences, such as cancer and COPD, among Indigenous Australians (Lovett, Thurber, & Maddox, 2017). Some smokers may require counselling, which  calls for the increased involvement of social workers and psychiatrists (Gould, Bittoun, & Clarke, 2015).

Health Promotion Evaluation Proposal

                Key performance indicators will be assessed to evaluate the success of this project. One of such indicators is the ability of a person from the target population to explain the relationship between smoking and COPD. Other indicators include prevalence of smokers, COPD exacerbations and COPD-associated hospitalisation and mortality compared to baseline. The last parameter for evaluation is the comparison of mortality and morbidity of COPD among Indigenous communities in Queensland with the non-Indigenous communities in Queensland.

Conclusion

                Health promotion campaign focusing on Indigenous Australians aged 40 years and over Queensland may help to improve smoking cessation, especially among COPD patients. Smoking is one of the risk factors for COPD exacerbation as well as increased morbidity and mortality. Since the project focuses on smoking cessation among COPD patients, it is set to play to a fundamental role in reducing the risk of hospitalisation and related healthcare costs. Success of the project in meeting its goals, however, requires active involvement of various stakeholders.