Longitudinal Study Of The Tobacco Smoking

Longitudinal Study Of The Tobacco Smoking

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Longitudinal Study Of The Tobacco Smoking

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Longitudinal Study Of The Tobacco Smoking

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Discuss about the Longitudinal Study Of The Tobacco Smoking.

Screening Report

Screening Questions

Response and Supporting Facts

Project and Timing
Has a project, plan or policy been proposed?
Is there sufficient time to conduct an analysis before the final decision is made?

The concept of preventing tobacco smoking in Australia using the framework “The National Tobacco strategy” 2012-2018 is proposed (www.nationaldrugstrategy.gov.au. 2018).
Together with the group of 10 stakeholders, I have proposed to start with Queensland to assess the health impact of the people involved with tobacco smoking
The parameters for the project is yet to be defined
With the help of the HIA, it is possible to identify the needs of the improvement in regards to tobacco smoking and preventing the consumption.
HIA will help in supporting the community to prevent the tobacco smoking in Queensland and gain support for the project
The project is of long duration and is multi-jurisdictional
It make take more than one or two  years

Health Impacts
Does the decision have the potential to affect environmental or social determinants that impact health outcomes? If so, which determinants and which health outcomes?
Would health inequities be impacted? In what ways?
Are the proposal’s impacts to health likely to be significant in terms of the number of people impacted, the magnitude, breadth and/or immediacy of impacts?
Do evidence, expertise, and/or research methods exist to analyze health impacts of the decision?

Queensland is still recognised to be area with high degree of tobacco smoking despite decline in smoking rate in last decade (Leung et al. 2012)
The policy implemented stringently may have positive impact on the health of the tobacco smokers by eliminating the harmful exposure to tobacco, reduce the health affects associated with it and protect the at risk group of people
The policy is based on the National Tobacco Strategy
The plan is likely to proceed as physical improvement project where the initial target is to reduce the adult smoking rate to 10% of the population in that region currently.
 It also aims to strengthen the mass media campaign to quit smokers and reshap the social norms related to the tobacco consumption
It may impact the health inequities by more number people improving in health outcomes and determinants like  poor health awareness or lack of resources in tobacco prevention (Mindell et al. 2010)
A significant impact is expected in regards to total number of people affected and immediacy of the impact
Our team consist of statistics and research scholars to analyse the change in regards to health outcomes
Data is mostly collected in the form of surveys and interviews. It includes both quantitative  and qualitative data.

Potential Impact of HIA Findings
Is health already being considered in the proposal or as part of the decision-making process?
Are the links between the proposal and health or health determinants clear?
Is the decision-making process open to the HIA and/or recommendations for changes to design, mitigations and/or alternatives?
If applied, would HIA findings and recommendations potentially improve the impact that the proposal has on health

Health is already considered in proposal in the decision-making process.
 The proposal to prevent smoking in Queensland is not directly related to health outcomes. Decrease in tobacco smoking will have positive impact on health but it is thee long process and not immediate outcome of the project.
Presently, the decision making is open to HIA
The other  parameter will be taken care while conducting the HIA
The proposal is not too closely related to health. Also it is not too distantly related.
It is the physical intervention with long term goal to engage locals in smoking prevention habits and clinical interventions
However, the HIA findings will potentially improve the health outcomes.
For instance, increase in tobacco smokers joining the anonymous programs
More than 50,000 people in the remote and disadvantaged location would have awareness and increased access to clinical intervention

Potential Impact of the HIA Process
What are the potential impacts of the HIA process? (e.g., building relationships, empowering community members, demonstrating how health can be used in decision making)

HIA helps create awareness among the stakeholders about the  needs of the tobacco smoking people in the selected area, change in the health outcomes,  and need of anti-tobacco initiatives or campaigns needed  or resources required by the people to take anti-tobacco initiatives  (Mindell et al. 2010)
The HIA help build; public trust on quitting tobacco. It is advantageous in strengthening relationship through public interaction. 
The other potential impact involves empowering the people on taking care of their health by demonstrating healthy lifestyle strategies.
The HIA process also involved in building relationship with the stakeholders.  
This process has the potential to enlighten the stakeholders. The stakeholders may integrate the outcomes in the development process as well as design criteria

Stakeholder Interest and Capacity
Have public concerns about the health impacts of the decision been voiced or documented?
Who are the stakeholders and interest groups involved in the decision-making process?
Do stakeholders have the interest to participate in the HIA?
Do stakeholders have the capacity (resources, skills, etc.) to participate in the HIA?
Would stakeholders use the HIA to inform or influence the decision-making process? How?

Public concerns are documented and some have been voiced
Stakeholders such as Quitline (13 78 48), Cancer council QLD, local health and well being community, high schools, national park, picnic spots, and Community health centre, The Australian Customs and Border Protection Service,
The stakeholders are supportive and cooperative in decision-making
The stakeholders are highly interested in participating in the decision making process as it is directly related to the community well being.
The stakeholders have the skills and resources to participate in the HIA. It can be used to inform the decision making process by supporting and cooperating.
The recommendations for design related changes, mitigation and alternatives by the stakeholders can be considered during process 
The stakeholders may use the information or findings to develop free health checkups or increase referral programs to refer community people to rehabilitation centre or arrange for more physician in remote areas or consultation over the phone.
The stakeholder has the resources to increase the mass media campaigns and other health related facilities needed when people quit tobacco consumption. The stakeholders has the power to partnership to reduce the smoking rate among the Indigenous communities
They had the power to reduce the exceptions to smoke-free workplaces
The long term goals of the project is the major challenge as it has the large scope owing to Queensland being highly populated 
The other challenges comes from the communications in media campaigns due to multilingual population
Moreover, Indigenous communities have high rate of smoking than the normal counterparts.

Refelctive report
The rationale for the HIA was to recognise the needs of the people in the community in the process of quitting the tobacco consumption and deliver appropriate strategies that can help to prevent the tobacco smoking. Doing the HIA would have helped me understanding the public needs in accessing the tobacco prevention facilities by both the remote and the urban areas in Queensland. Considering the increasing death and disability rate in Australia due to smoking-related illness, the aim of HIA is justified.   
My initial assumptions were getting clear statistics on the public perception regarding the process and obstacles in quitting tobacco. I assumed gaining plenty of information on the need of the facilities required by the people, rehabilitation program and need of the other clinical interventions to quit tobacco smoking. I assumed a low percentage of people to be aware of the smoking consequences. I expected high need of attending counselling sessions or prevention sessions.
The data obtained from screening was surprising. More number of people than I assumed had the good awareness of the smoking consequences. However, the same was not the case of people in the remote and disadvantaged areas. It was due to lack of education and poor access to health facilities. More people in urban than in remote areas were ready for interventions and discussed their barriers in accessing the public health service in this regard. HIA would have impact on the number of people involved in smoking. It will eliminate the determinants like poor access to tobacco smoking interventions. People were responsive than before. They were proficient in explaining the health outcomes as a result of the smoking interventions accessed by them. The stakeholder was more cooperative and enthusiastic than I had assumed. It was easy for me to gain the public trust and bond with them. They were attentive to me when discussing about the referral programs. Most of the people also gave the evidence of quitting tobacco smoking. Parents were trying to protect the children from second hand smoke in their house. There were some people who have completely quit smoking and were experiencing the health outcomes such as improvement in asthma symptoms, and lung perforations. 
The factors that influenced my screening and scoping are the cooperation and interest of the stakeholder. They were open in communication and accepted my ideas and viewpoints.  Awareness and responsiveness of the public was the factor that made HIA a quick process. The other parameter that was an added advantage is the use of existing tobacco control policy and framework.
Screening and scooping was influenced by the support from the stakeholders and knowledge of the people in Queensland. It was easy to communicate with the people in urban areas, However, the same was difficult when dealing with people in remote areas. Lack of skills in dealing with the multilingual population was a bigger challenge. Lack of awareness and   impact of the HIA on health outcomes was a barrier that delayed the process. Other barriers were housing, transport, economic conditions and education. There is a need of better framework in integrating the different types of research evidence in decision making (Hyland et al. 2016).
The tight timescales has made the review of the HIA evidence difficult. Further,  different stakeholders, need to make recommendations for them, lack of specific expertise in remote areas, diversity of the health impacts and complex casual pathways, and at times difficulty conducting high quality HIA were also barriers.  
Given an opportunity to advice someone else who was about to undertake the screening and scoping steps of a HIA, I would recommend them to public health centres and community care centres. I would  suggest them to evidence based cessation services to support smokers to quit.  
It can be concluded that the HIA is an important tool to inform the decision making by policy makers. Although it may be subjected to criticism for lacking the use of evidence in decision-making, it is useful in influencing the health outcomes. Policy making is required as the individual’s health is influenced by range of factors. HIA is important in gaining better information on public health and develop appropriate strategies. I agree that policies have significant impact on the public health. HIA helps improving the health care provision.  I have learned that HIA has the potential to change the health determinants. Screening and scoping are practical approach to identify the positive and negative impact of health proposal. This flexible approach is effective in maximising the health gain opportunities. Overall, my knowledge in this subject has enhanced.
Hyland, A., Ambrose, B.K., Conway, K.P., Borek, N., Lambert, E., Carusi, C., Taylor, K., Crosse, S., Fong, G.T., Cummings, K.M. and Abrams, D., 2016. Design and methods of the Population Assessment of Tobacco and Health (PATH) Study. Tobacco control, pp.tobaccocontrol-2016.
Leung, J., Gartner, C., Hall, W., Lucke, J. and Dobson, A., 2012. A longitudinal study of the bi-directional relationship between tobacco smoking and psychological distress in a community sample of young Australian women. Psychological medicine, 42(6), pp.1273-1282.
Mindell, J., Biddulph, J., Taylor, L., Lock, K., Boaz, A., Joffe, M. and Curtis, S., 2010. Improving the use of evidence in health impact assessment. Bulletin of the World Health Organization, 88(7), pp.543-550.
www.nationaldrugstrategy.gov.au. 2018. National Tobacco Strategy 2012–2018. [online] Available at: https://campaigns.health.gov.au/drughelp/resources/publications/report/national-tobacco-strategy-2012 [Accessed 3 Feb. 2018].

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