Introduction Of Public Health & Health Promotion
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Tobacco is one of the major causes of early deaths worldwide. Although there is a decrease in the number of smokers in Western European countries, there is a slow rate in increase in the number of non-smokers and is more prevalent in the higher social groups. This trend suggests that there is a need for smoking cessation programs that are effective and can reach a larger population. With this said, the study aims ate highlighting one of the cessation programs that is being carried out at a worldwide level which is the Stoptober which is mostly organized in October every year to encourage people to quit smoking through different approaches and theoretical frameworks which has also been discussed in the paper along with an analysis of the Campaign on its effectiveness. This paper also gives an idea of what public health is and how health promotion benefits society as a whole.
Public health and health promotion
According to WHO, Public health refers to all organized measures whether public or private to promote health, prevent disease and prolonged life as a population as a whole. Public health supports individuals help individuals, institutions, societies to handle any disease through preventive measures so that there is reduced mortality and disability. It consists of 3Ps which include, Prevention, Protection and promotion. Reducing the chances of ill health condition and improving the lifestyle into healthier lifestyle whereas protection and promotion signify checking and monitoring of infectious disease, emergency response and immunization and health education and service related to healthcare to meet the specific need of health issues.
Health promotion is a behavioural social science that is being extracted from environmental, biological, psychological physical and medical science to promote any health issue and prevention of disease (Dolley, 2018). Health promotion also includes reduction of disability, mortality and premature death through voluntary, educative behaviour activities for change. Health promotion also involves individual, institutional and communities through systematic planning so that there could be an improvement in the knowledge related to health skills, behaviour and attitude. The main aim of health promotion is to influence the individual and community positively as well as bring a positive change in the working and living condition of an individual which influences health.
Importance of public health promotion
Health promotion especially through media campaigns can reach out to a larger part of society in a short period and hence it is proved to be effective and efficient. For example, television campaign such as Cowpe’s Chip Pan Fire Campaign in Tyne tees area of television had largely reduced the fire of chip pan by 33% which has also proved to be time-efficient and its been viewed by millions of people within a minute (Song and Karako, 2020). Another importance of public health promotion is that the health promotion in the form of legislation can be imposed so that the people health behaviour is changed with the help of enforcement of heathy and positive behaviour while eliminating the unhealthy habits through these public health promotions. Finally, health promotion helps to arouse a sense of fear by showcasing some of the adverse effects of any unhealthy habits. For example, showcasing the causes of smoking such as scares or any damage caused to the individual. However, the level of appeal for any individual must be in the right way so that it is proved to be effective.
Criticism of public health promotion
One of the drawbacks of health promotion is that there are limited resources and health promotion requires access to the resources which are not available for every individual and the cost is of those resources are too high (Budd et al., 2020). Also, not every individual have access to television and there for a large population are deprived of information related to health promotion. Another criticism is that the population having access to the public health promotion does not necessarily impact the audience even if the audience knows, it does not mean that the behaviour will change. Also, public health promotion may become stressful resulting in reduced interest by the audience. Furthermore, the legislation framed against public health promotion is sometimes not followed by the individual and hence legislation is only effective if the same is abided and followed by an individual. The method of fear arousal while promoting the health issues can be a major ethical issue as this method goes against the protection of harm. Also, the different individual has a different perception of fear and therefore people may find this method as stressful and can often avoid the message related to health promotions (Stellefson et al., 2020).
From the above importance and critique, it can be observed that the public health promotion as there is a different form of campaign and the message is instantly seen by the larger population in a very short period. The fear-arousal method of promoting health issues can be not much effective as people are already aware of the result of their action and therefore seeing the impact is unlikely to make a major impact as what the person knows is already it's being repeated.
Overview of the campaign - Stoptober
Stoptober is a key program initiated by Pubic Health England for the use of tobacco. Created through marketing, its annual mass event is organized yearly. This program launched in the year 2012 and it is continuing every year and has entered in the year 2021. The ultimate aim of this program is to encourage smokers to quit smoking (Haugan and Eriksson, 2021). By using a strong combination of behavioural economics and insight of the consumers to restructure the usual call to action from the quit now to join the 28-day quitting challenge, it takes the revolutionary approach. This campaign helps smokers to inspire as many smokers to attempt to quit smoking from 1st October to at least 28th October as there is evidence that shows that if the person stops smoking for the 28th day will be more likely to quit smoking.
Critical Analysis of Stoptober
As per the evaluation of the 2018 Stoptober campaign, 19% of smokers completely quit smoking. This result was in line with the previous year results which was 16%. However, there were only 8% of smokers who were completely not smoking after the campaign i.e., after 4 weeks. This result was also much like the result of the previous year (Godziewski, 2020). It has also been reported that during the first two weeks of the campaign, half of the quit attempts have been ended. The service offered by the stop smoking campaign introduced the tool Personal Quit Plan which is important for short term self-discipline and improvement in quit rate however only 55% of the smoker encouraged this tool and the rest 41% still depend on the willpower to quit smoking.
Therefore an understanding needs to be developed as to why these groups of people do not encourage the tool offered by the campaign. If we look at the effectiveness of this campaign, the results are certainly positive in increasing the attempts to quit smoking. With the success of this campaign in the year 2012, this campaign had been launched in many countries such as New Zealand, the Netherlands and France but it is still difficult to find out that this campaigns have any positive impact on the people and has resulted in a long-lasting behaviour change (Kuipers et al., 2020).
As per the study of the campaign in the Netherlands, it was being found out that there is a need for continuous support from the Stoptober through offline and online groups and making a step ahead in ceasing the smoking habits even after the campaign and also making a way forward in following up with the participants in regular interval of time to check if there has been a cessation of the smoking. As per the same study, it was identified that the campaign did not follow through with the changing requirements of the participants during their journey in quitting smoking.
Finally, a conclusion can be drawn that the campaign has resulted to be effective in creating awareness and wish to quit smoking and has resulted in increased numbers of quit attempts. The reason for the success of this campaign is the underlying principles of behaviour change and positive messaging on the health-related issues caused by smoking (Chan et al., 2020). However, there is yet a conclusion to be made whether the Stoptober campaign has resulted in behaviour change in the long term.
Perhaps, underpinned by the behaviour change principles, there is a more prolonged, interactive and responsive service that is personalized to a changing needs and journey while quitting of an individual can reduce the relapse rate and result in positive behaviour change in the long term.
Approaches and Health promotion models associated with Stoptober
One of the leading risk factors for disability and premature death is smoking which is estimated to take a life of around 6 million people every year. As a part of comprehensive media programs, mass media smoking cessation campaign has been helping people in quitting smoking and reducing the burden of early deaths and other health issues associated with smoking. The mass media smoking cessation program Stoptober is one such media campaigns that have helped millions of people to quit smoking by challenging people to quit smoking in just 28 days (Deverick, 2020). The tremendous increase in the quitting rates and considerable decline rate raises the question of how Stoptober has achieved success and how there can be an improvement in the program.
Theoretically, the Stoptober success can be credited to the use of three social-psychological principles or theories associated with the campaign. The first theory is social cognition theory. According to this theory, the campaign Stoptober uses the social network to spread and intensify the message of quitting smoking by providing knowledge to the audience about different health issues associated with smoking. The main aim of this social network approach is to create awareness among any group of smokers who are interconnected so that they can quit smoking together. Stoptober makes use of social media effective by using both the traditional and modern mass media platforms and by focusing on a positive message that is required to be spread among smokers (Al-Helou, 2020).
This campaign also aims in creating a social movement and making smoking cessation a normal process. However, there is a certain limitation of the social cognitive theory. The social cognitive theory is loosely structured as theory is of broader aspects and is often criticized for lacking anyone unified structure. The behaviour of people is so dynamic that this theory is difficult to implement entirely.
The second theory that is associated with the Stoptober campaign is SMART theory which implies using a different component such as Specific, Measurable, Attainable, Realistic and Time-sensitive. If the goal of behaviour is SMART formulated then any difficult change such as cessation of smoking can be more easily achieved. This has been explained by challenging the smokers to quit smoking which is a behaviour specific approach and is measurable for 28 days in October. This approach has been considered an attainable, realistic and time-sensitive approach towards becoming a permanent non-smoker (Schunk and DiBenedetto, 2020). However, there are certain drawbacks of the SMART approach used in this campaign. There has been a various interpretation of the SMART goals which has made lose its effectiveness. It is believed that the SMART goals are not applicable for the long term goals as it lacks flexibility while it is being also believed that it might suffocate creativity.
The last key theory that is related to the Stoptober Campaign is the PRIME theory i.e., Plans, Responses, Impulses, Motives, Evaluation theory (Kuo et a;., 2020). The PRIME theory is also considered as motivation theory as it assumes that behaviour is determined by a large variety of motivational inputs which are given from time to time and when the system of motivation is unstable and hence this theory assumes that maintaining a specific behaviour requires a constant checking on behaviour and inputs such as in this campaign where there is the constant interference of the campaign service to quit smoking and offers a range of service which help an individual in providing support which triggers the motivational system of the individual as a whole rather than only one aspect (Yang et al., 2021). This support aims at weakening the unhealthy behaviour and create an urge to stay away from those unhealthy habits i.e., smoking in this case. Stoptober offers a range of supportive package which is based on the PRIME theory. As stated, the behaviour is determined by constant checking and providing inputs as a result the motivational system of an individual is inherently unstable which requires constant input to be in a specific behaviour pattern which is assumed to be a difficult process due to the different behaviour pattern of the individual and by constantly checking on the behaviour of a person can lead to reduce in the interest and increase in the frustration of the individual. Therefore, this approach should be applied in such a way that there is a balance between the constant checking and the behaviour of a person (Müller and Kotte, 2020).
From the above theoretical approaches/models, it is being understood that these approaches are way helpful in making the Stoptober campaign successful. For example, a population-level evaluation in the year 2012 held in England revealed that there is a 50% increase rate of the quitting of smoking. According to Addiction-ssa.org. 202, the rate of quit in October 2012 was 9.6% in comparison to the rest of 2012 which was 6.6% and for the previous year October, it was 6.4%. based on the observation of the quitting attempt and its effect, it was estimated that the Stoptober campaign can lead to change in the behaviour pattern of the individual and impact on public health. Another example is that as per the study in the 2016 edition of the Dutch campaign, after the two months of the campaign, there was a substantial increase in the quit rates from 40% to 60% which was conducted among 53000 participants (Hawkins et al., 2020). These all events and the figures associated with the campaign showcase that besides having certain criticism to the campaign and the theories related to it, there is evidence that all the events have been able to successfully reduce the rate of unhealthy behaviour and can increase the rate of quit in smoking (Public Health England, 2021).
To conclude, a prominent public health issue campaign Stoptober has been discussed in this paper along with different approaches and theoretical frameworks which has also been discussed in the paper along with an analysis of the Campaign on its effectiveness. This paper also gives an idea of what public health is and how health promotion benefits society as a whole. There is a critical analysis done to showcase the effectiveness of the theoretical approaches along with evidence on how these approaches have helped the campaign in becoming a successful event.
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