Tobacco use remains a major health concern in the United States. The number of smokers continues to increase due to changes in technological and social patterns that impact tobacco use in unpredictable ways. Although cigarette smoking remains the most commonly used tobacco product, other alternative products have emerged, such as vaping e-cigarettes, chewing tobacco, and hookah. Exposure to and use of tobacco products is linked to serious health problems and diseases such as cancer and respiratory problems (US Preventive Services Task Force, 2020). Therefore, there is a need to design and implement health promotion initiatives to control tobacco use. These measures involve voluntary patient-centered behavioral acts and legislation policies that minimize the selling and use of tobacco products. Thus, with the increasing number of smokers worldwide and the rapid emergence of flavored tobacco products, creative efforts are needed to protect adolescents from tobacco use and promote cessation programs to achieve a smoke-free world (Navas-Acien, 2017). More than 480,000 people lose their lives due to tobacco use, while most continue to smoke due to addiction (CDC, 2021). The plan will seek to effectively stop tobacco use and promote the users’ health and wellbeing, thus reducing tobacco-related diseases and death.
The Chosen Population and Characteristics
The health promotion plan focuses on young African American adults aged between eighteen and forty. These individuals have mostly been introduced to tobacco products in their teenage, especially during social associations. Approximately 25 percent of the users consume tobacco products for leisure or as a stimulant (Navas-Acien, 2017). Considering gender orientation, there are more males than women who smoke cigarettes or vape. As part of recreation, the young adults engage in poly tobacco use that combines smoked products such as cigars and kreteks. Another characteristic of the Africa-Americans tobacco users is that they are economically disadvantaged (Stokes et al., 2021). They live in low-income areas, and the majority are jobless. They are exposed to high poverty levels characterized by low living standards, where drug and tobacco abuse is prevalent. The low-income levels make the majority uneducated or drop out of school due to a lack of school fees (Stanton & Halenar, 2018). They become predisposed to drug abuse to cope with stress and emotional burnout. Therefore, there is a need to address the social and economic factors among this population to address the issue of tobacco use.
Why are African Americans Predisposed to Tobacco Use?
The high rate of tobacco use among African-Americans young adults can be attributed to various factors that increase their vulnerabilities. First, the group uses the various cigar flavors for multiple purposes. Flavors mask the bitter taste of tobacco and reduce pain sensations and throat irritation caused by combustible tobacco products (Stokes et al., 2021). Therefore, flavored cigar smoking is most prevalent among young African American adults who smoke and drink alcohol. These dual users use flavored alcohol cigars for recreation and mood-boosting (Chen-Sankey et al., 2019). The availability of flavored cigars is appealing to the youths (Stokes et al., 2021). Besides, tobacco is considered a stimulant; thus, college students have the notion that vaping and smoking will increase their concentration resulting in gradual addiction.
Moreover, across all ethnic and racial subgroups, there is a notable decrease in tobacco initiation age. Most people, including African Americans, are exposed to tobacco products through direct consumption or passive use. Therefore, based on an individual survey done from 2005 to 2015, 77.66 percent of the participants began smoking between the ages of twelve and fifteen, while 83.87 were between the ages of eighteen and twenty-five (Cantrell et al., 2018). Early initiation age predicts greater future dependence, low chances of quitting, and a high risk of tobacco-related health conditions. Comparing the whites with Africa Americans, the former are initiated early than the latter. However, studies have shown that African Americans have low chances of successfully quitting tobacco use (Nargis et al., 2019). There is a need to design targeted tobacco prevention and control policies to include the age of purchase restriction.
Additionally, surveys have indicated that African Americans and Hispanics with low socioeconomic status are likely to use cigars and cigarillos. These products are cheaper than other substances as they are sold in smaller packages and attract low taxation rates (Stokes et al., 2021). Again, tobacco advertisements and purchasing outlets are common in Hispanic and African American low-income communities (Stokes et al., 2021). The proximity to tobacco shops and access to marketing decrease the initiation age and negatively impact cessation strategies.
Based on these social and economic vulnerabilities, a health promotion education program will benefit the African American population. The cessation of tobacco use plan will significantly impact reducing tobacco-related diseases. According to US Preventive Services Task Force (2020), tobacco cessation improves health and quality of life by preventing addiction and dependency. Again, educating the youths and adults will create awareness of healthy living, thus reducing the costs related to healthcare, minimizing the risk of premature death, and lowering the rates of tobacco-related diseases such as cancer and respiratory problems.
Sociogram
A sociogram is a representational tool that shows inter-relationships within a specific community or group. Healthcare workers utilize the sociogram to identify the social links between people and the patterns that characterize a targeted population. For the tobacco cessation educational plan, the sociogram will include the group’s age, education level, living conditions, and proximity to tobacco outlets (Cantrell et al., 2018). Culturally, the sociogram will include knowledge about tobacco use and its health effects, attitude towards quitting, tobacco initiation age, and the risky behavioral activities predisposing the population to smoke. In addition, the plan will incorporate lifestyle elements such as cigarette packs smoked daily, the type of tobacco product consumed, and the reasons for smoking (Rigotti, 2022). Besides, the sociogram will economic behaviors such as governmental policies on tobacco taxation, individual income, packaging, and size requirements of cigarettes.
Potential Learning Needs
The tobacco use cessation health promotion plan can educate young African Americans about the adverse effects of tobacco use. By the end of the education session, 95 percent of the participants will know and understand tobacco-related health conditions and the need to prevent these illnesses. The second learning need is defining tobacco-use risk behaviors. The goal will be: by the end of the session, 95 percent of all participants will be able to identify risky and lifestyle behaviors predisposing them to tobacco use. The third learning need is understanding addiction and dependence and the importance of quitting. The corresponding goal is: by the end of the training session, all participants will be able to discuss the benefits of quitting and planning for cessation exercise and nursing follow-up achievable in six months. These objectives align with Healthy People 2030 goals to reduce tobacco use among adolescents and adults and improve health and wellbeing (Healthy People.gov, 2022).
Current Behaviors, Expectations, and Suggestions for the Educational Session
The current behaviors of African Americans include early-age tobacco initiation, vaping and smoking for recreational purposes, use of e-cigarettes to boost moods, and developing an addiction that makes quitting difficult (Zhang et al., 2021). The promotion plan will help identify addicts, equip them with knowledge of the health effects of tobacco use, and motivate users to quit smoking. Recommendations for tobacco cessation are to come up with clinics that provide supportive services for tobacco users, including nicotine replacement therapy to addicted smokers, and enforce the tobacco control policy of age 21 purchase restriction (US Preventive Services Task Force, 2020). Smokers should be involved in the planning process for the program to be effective.
Tobacco use is a major health problem among the young African American population. The socioeconomic factors that influence living standards and the availability of cheap tobacco products predispose the group to health issues. There is a need to promote health by developing and implementing an educational program to create awareness about tobacco use and negative health impacts, and the need to quit smoking.
References
Cantrell, J., Bennett, M., Xiao, H., Mowery, P., Rath, J., Hair, E., & Vallone, D. (2018). Patterns in first and daily cigarette initiation among youth and young adults from 2002 to 2015. Plus One. https://doi.org/10.1371/journal.pone.0200827
CDC. (2021). Health effects of cigarette smoking. Smoking & Tobacco Use. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm
Chen-Sankey, J. C., Choi, K., Kirchner, T., Feldman, R., ButlerIII, J., & Mead, E. (2019). Flavored cigar smoking among African American young adult dual users: An ecological momentary assessment. Drug and Alcohol Dependence, 196(1), 79-85. https://doi.org/10.1016/j.drugalcdep.2018.12.020
Healthy People.gov. (2022). Tobacco use. Healthy People 2030. https://health.gov/healthypeople/objectives-and-data/browse-objectives/tobacco-use
Nargis, N., Yong, H.-H., Driezen, P., Mbulo, L., Zhao, L., Fong, G., & Siahpush, M. (2019). Socioeconomic patterns of smoking cessation behavior in low and middle-income countries: Emerging evidence from the Global Adult Tobacco Surveys and International Tobacco Control Surveys. PLoS ONE. https://doi.org/10.1371/journal.pone.0220223
Navas-Acien, A. (2017). Global tobacco use: Old and new products. Annals of the American Thoracic Society, 15(2). https://doi.org/10.1513/AnnalsATS.201711-874MG
Rigotti, N. (2022). Patient education: Quitting smoking (Beyond the Basics). Nursing Update. https://www.uptodate.com/contents/quitting-smoking-beyond-the-basics
Stanton, C., & Halenar, M. (2018). Patterns and correlates of multiple tobacco product use in the United States. Nicotine & Tobacco Research. https://doi.org/10.1093/ntr/nty081
Stokes, A., Wilson, A., Lundberg, D., Xie, W., Berry, K., Fetterman, J., . . . Sterling, K. (2021). Racial/ethnic differences in associations of non-cigarette tobacco product use with subsequent initiation of cigarettes in US youths. Nicotine & Tobacco Research, 23(6), 900–908. https://doi.org/10.1093/ntr/ntaa170
US Preventive Services Task Force. (2020). Primary care interventions for prevention and cessation of tobacco use in children and adolescents. JAMA, 323(16), 1590-1598. https://doi.org/10.1001/jama.2020.4679
Zhang, L., Huang, X. L., Luo, T. Y., Jiang, L., Jiang, M. X., & Yan, H. (2021). Impact of tobacco cessation education on behaviors of nursing undergraduates in helping smokers to quit smoking. Tobacco Induced Diseases, 19(58). https://doi.org/10.18332/tid/139024.
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