Assessment 1 Health Promotion Plan

Tina Nalbandian

NURS-FPX4060

Linda Warren

10/10/2023

Assessment 1 Health Promotion Plan

Tobacco use is a significant health concern among adolescents. The fact that most people who consume tobacco products start in childhood or adolescence suggests there is a need to promote cessation of tobacco use in adolescents. However, reducing current tobacco use is one of the worsening Healthy People 2030 objectives. The health promotion plan aims to promote tobacco cessation in a hypothetical youth community to eliminate or minimize potential long-term adverse effects of tobacco products on the target population.

Health Concern: Tobacco Use in Adolescents

Tobacco use is a significant health concern in adolescents. The National Institute on Drug Abuse (NIDA) (2023) indicates that tobacco use increases the risk of nicotine dependence in adolescents. Tobacco use is currently the leading cause of preventable deaths, accounting for approximately 480,000 deaths in U.S. adults (NIDA, 2023). Additionally, 5.6 million adolescents who are presently alive will die prematurely from a smoking-related illness (NIDA, 2023). Therefore, tobacco use in adolescents increases the risk of early death.

Tobacco use is a key health concern because it causes long-term adverse effects on the adolescent’s brain development and behavior. The use of tobacco products in adolescence, for instance, affects the development of prefrontal cortical activity, increasing inattention and impulsivity (Leslie, 2020). Leslie (2020) further indicates that there is a strong association between adolescents’ use of tobacco products and depression and anxiety. Nicotine exposure increases long-term vulnerability to negative emotional states and effects of stress in adolescents (Leslie, 2020). Therefore, tobacco use in adolescents increases healthcare risks.

Despite the potential long-term adverse effects of adolescent tobacco use, a significant number of adolescents continue to use tobacco products. For instance, approximately 1,600 12 and 17-year-olds start smoking every day (NIDA, 2023). Whereas cigarette use has gradually declined over the years, the use of e-cigarettes and other tobacco products is growing tremendously (NIDA, 2023). The Healthy People 2030 statistics indicate that 18.3% of students in grades 6 to 12 were using e-cigarettes, cigarettes, hookah, smokeless tobacco, or bidis 30 days prior to the study in 2018 (Office of Disease Prevention and Health Promotion, n.d.). However, the most recent 2019 data indicates that the figure has increased to 23.0 percent (Office of Disease Prevention and Health Promotion, n.d.). Hence, the statistics reveal that the Healthy People 2030 objective of reducing the current use of tobacco products in adolescents is not being met. 

Scenario and Target Audience

Students in grades 6 to 12 in a local poor and underserved community at X location are the target population for the tobacco cessation promotion. The group is selected considering the Healthy People 2030 statistics indicate a worsening of the rate of tobacco use cessation in individuals in the 12-19 year age bracket. Most of the adolescents are primarily of Hispanic origin, their parents are mostly in low-wage employment, and have limited education. The group is composed of slightly more males than females and has a mostly positive attitude towards the use of tobacco products.

Reasons Why Tobacco Cessation is Important for Health Promotion in Adolescents

Characteristics and Relevance of the Hypothetical Group

The selected adolescents from the hypothetical scenario have multiple characteristics that contribute to the smoking cessation health concern. First, tobacco use is higher among adolescents experiencing high levels of psychological distress (NIDA, 2023). For example, adolescents who have experienced recent adverse life events and emotional problems such as depression are at increased risk of tobacco use. The targeted group is exposed to multiple stressors and emotional problems due to the family’s poor background. Hence, they are expected to have a higher risk of tobacco use. Besides, the social and cultural norms in the target population may affect tobacco use cessation. For instance, schoolmates’ perceptions and beliefs about the use of tobacco products can influence the risk of nicotine product use and dependence (NIDA, 2023). Adolescents’ decisions are significantly influenced by their social peers. For instance, smoking within one’s social groups and peers is recognized as a critical environmental factor that motivates adolescent smokers and hinders smoking cessation in adolescents compared to adults (NIDA, 2023). The selected group has positive perceptions toward the use of tobacco that can increase the use of tobacco products. Therefore, social and psychological factors influence health behaviors in adolescents using tobacco products.

Various other factors predispose adolescents to tobacco use and cessation challenges that explain why they can benefit from a health promotion education plan. First, nicotine changes the brain regions involved in cognitive and emotional functions. The brain reward system perpetuates the risk of tobacco use into adulthood (NIDA, 2023). For instance, individuals who start using nicotine at a younger age are more likely to use illegal drugs, develop nicotine dependency, and have difficulties quitting (NIDA, 2023). In one study, researchers found that adolescents who started using tobacco before 15 years were eighty times more likely to use illegal drugs such as cocaine than those who did not (Leslie, 2020). Therefore, an adolescent’s tobacco use cessation effort can be hampered by multiple factors.

A sociogram reveals the social structures and the role of social, economic, cultural, lifestyle, and genetic factors that impact the health of the group members. First, tobacco use is higher among adolescents whose parents earn lower incomes and in marginalized communities such as bisexual, gay, transgender, and lesbian adolescents (NIDA, 2023). The low incomes of parents from the selected group increase the risk of tobacco product use and reduce the likelihood of cessation due to inadequate access to preventive resources. Additionally, an intergenerational pattern involving environmental, epigenetic, and genetic factors influences adolescent smoking (NIDA, 2023). For instance, the current nicotine dependence in parents is an environmental factor that is strongly linked with adolescents’ dependence. Parents’ parenting behavior, education, and marital factors also influence teenagers’ tobacco use and cessation (NIDA, 2023). The low parental education levels, for example, limit adolescents’ access to educational resources on the risks of smoking. Hence, the targeted adolescents face myriad factors that limit access to health services and health outcomes and explain why a tobacco cessation promotion is necessary in the target group.  

Potential Learning Needs

The potential learning needs of the target group are helpful in establishing the health goals. A learning needs assessment indicates that adolescents need more knowledge of the risks of e-cigarettes and other sources of tobacco. The adolescents also have positive attitudes towards smoking and believe smokeless tobacco is safe. Hence, there is a need to correct misconceptions while providing knowledge on the risks of tobacco use. 

Importance of Establishing Health Goals in Collaboration with Hypothetical Participants

Collaboration with the hypothetical participants is essential in establishing health goals. The collaboration will facilitate the identification of risk factors that can influence the attainment of the goals. Collaboration will also facilitate community input and stakeholder engagement, identification of constraints and resources, and determination of the incidence and prevalence of the health issue. For instance, collaboration with the individuals identified that the participants consider use of e-cigarettes as less dangerous than smoking. Hence, one of the goals focused on educating the participants on the dangers of all types of tobacco products, including e-cigarettes.

Goals

The goals for the targeted group are:

Reduce the prevalence of smoking among male and female adolescents aged 12-19 years from 20% in October 2023 to 11% in December 2023.

Decrease the percentage of adolescents using e-cigarettes from 28% in October 2023 to 10% in December 2023.

Reduce the percentage of adolescents using any tobacco product from 23% in September 2023 to 11% by December 2023.

Assessment of Behaviors

Several behaviors will also be assessed prior to and after the education intervention to establish whether the education program was successful in promoting tobacco cessation. First, the educator will establish the number of days in the previous month that the individuals smoked, the number of tobacco products used in a day, attempts to quit in the previous three months, and changes in smoking patterns. The information will determine whether there is a change in behavior toward attaining the established goals.

References

Leslie, F. M. (2020). Unique, long-term effects of nicotine on adolescent brain. Pharmacology Biochemistry and Behavior, 173010. doi:10.1016/j.pbb.2020.173010

NIDA (2023). Tobacco, nicotine, and e-cigarettes research report: How many adolescents use tobacco? https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/how-many-adolescents-use-tobacco

Office of Disease Prevention and Health Promotion (n.d.). Healthy People 2030: Tobacco use

https://health.gov/healthypeople/objectives-and-data/browse-objectives/tobacco-use

U.S. Preventive Services Task Force (2020). Primary Care Interventions for Prevention and Cessation of Tobacco Use in Children and Adolescents: U.S. Preventive Services Task Force Recommendation Statement. JAMA, 323(16):1590–1598. doi:10.1001/jama.2020.4679