An In-Depth Critical Analysis of a Public Health Policy Implementation within the Last 15 Years
Tobacco Control Policy (Plan 2011)
Introduction
Public health entails the ability to sustain the health of a given populace by the application of appropriate measures by the national institution. The effectiveness of the public health system is usually equal to the general stability of a given nation. Thus, most governments consistently strive towards the decrease, monitoring, and prevention of the major forces that are established to be affecting the health of the public in an undesirable manner. Tobacco has remained as the country’s health epidemic for the longest time. Tobacco, unlike other legal drugs such as alcohol, is widely consumed by individuals of varying ages, which is accounted for addiction. Being the major cause of illnesses that can easily be prevented, the consumption has been part of controversial debates for the longest period. It is without a doubt that tobacco is not important for the country as it brings no health benefit despite being a major source of revenue for the government and stakeholders. This report will focus on conducting an in-depth analysis of the tobacco control policy plan in the United Kingdom. This will be achieved by analysing the achievements, failures as well as proposing some practical and viable solutions for the policy developers.
Background
The amount of tobacco that is consumed on a daily and annual basis in the United Kingdom and across the globe is overwhelming. In, fact tobacco is the most consumed legal drug which acts as the source of relief from the consumption of other substances for countless individuals. Modernity has widely been blamed as being the cause of early death and the rise of illnesses. However, human actions also count towards this negative trends since the regulation, consumption, and production of such substances is worrying. Since 2016 post the implementation of the policy plan in 2011 the prevalence rate with regard to smoking has decreased notably in UK (Parliament, 2017 p.1). Most people believe that cigarettes smoking has fewer health harms when equated to other drugs such as marijuana on the basis that it has been made legal. However, this is not the case since tobacco is the source of most chronic illnesses such as diabetes, lung diseases and so on.
Despite the achievements that have been achieved through the application of control mechanisms smoking is still the leading source of preventable illnesses and mortality. For instance in 2015 close to 16 percent of those that died from 35years and above in the UK which represent 79,000 people were established to have had heavy smoking reliance (Parliament, 2017 p.1). Smoking prevalence is more within the poor settings based on the convenience and low knowledge level. It is reported that tobacco smoking is responsible for close to 50 percent of the life expectancy rate that is amid the wealthy and poor people (Ciapponi and WHO, 2014 p.1). The UK’s government fresh policy plan referred as Tobacco Control Policy was implemented in 2011 and 2017 respectively with the aim of lowering the general smoking rate and targeting to strike the inequality smoking (Parliament, 2017 p.1). Since the original policy was implemented there has been a significant reduction but the smoking prevalence has been more dominant among youths which have become the source of increased health defects (ASH, 2016 p.1). The intention of implementing the plan was lowering smoking among young, elder and pregnant women while still creating an enabling setting for those with mental issues and offering support to innovative measures that seek to lower the consumption.
Smoking represents one of the major public health issues in the world. Smoking is related to toxic substances that lead to the destruction of the human body. The negative implication of tobacco on individual’s health works beyond the actual implication on the persona’s health but also contributes to environmental and socio-economic degradation. Smoking damages close to all the major organs from the lungs to the kidney thus creating opportunities for the dominance of various illnesses and lowering the general quality and expectancy of life. It has been projected that more than three hundred thousand people in the UK are admitted annually in hospitals due to smoking connected illnesses which accounts for about one thousand people daily. Some of the premature deaths that are driven by smoking are caused by illnesses such as heart failure, cancer, and lung failure. In fact, tobacco is known as the source of high risk for debilitating illness such as infertility, tooth decays, asthma and so on. Based on research it is not just the smokers that are exposed to such risks because even the non-users being passive smokers are affected.
It is without a doubt that smoking is high in the poor communities based on their socioeconomic status. Those that are engaged in the act do it for a number of reasons such as escapism from the actual issues that they experience socially, peer pressure, weight reduction, and stress liberation. The perception that smoking is less harmful has been the cause of increased smoking among young individual (Pirie, 2013 p.134). Several measures have been implemented in the past in tackling the issue such as changing the branding where warning labels have been included and marketing ban so that individuals might not be encouraged to partake in the act. However, it has been established that the awareness campaigns have proved to be less effective based on the fact that stricter measures that will force compliance are absent. As a result, the disparity amid the wealth, poor, young and older individuals have been on the rise (Pirie, 2013 p.134).
The intention of the policy is to lower the disparity and discourage the general consumption of tobacco within a wider range so that a healthier nation can be developed. The policy was proposed by the government based on the plan that was implemented in 2011 (Parliament, 2017 p.1). In this context, the proposal received much criticism from the manufacturers and forest organization (Forest, 2011 p.1). The organization argued that the government should not continue with the application of further measures above those that had been developed in 2011 without making consultation with the consumers. On the other hand, the investors held that the policy would generally discourage the buying of cigarettes which would affect them and the government economically. The practicality of the measure was tested through the success that the previous policy that was acquired by the original measure (Forest, 2011 p.1). The policy plan was implemented by the national government. Based on the implementation much success has been achieved. In that close to three million smokers have quit smoking and focused on E-smoking which is associated with no unnecessary health effects but leads to psychological stability (Hammond et al., 2006). The public has been the major beneficiary of this program with most individuals acknowledging it as a success based on the high reduction level that has been achieved.
Public Health Policy Evaluation
Policies play a major role in creating stability and promoting wellness in a country (SAPRU, 2004 p.173). The United Kingdom has been a major developer of Public health policies (PHP) with the aim of addressing health-related issues within the public domain. Due to several standards, some of these policies have not been successful in meeting the set objectives. Thus evaluation of the performance of each policy is essential in determining whether it has succeeded or failed. In this case for the Tobacco Control policy plan, a mixture of relevance, effectiveness and efficiency criteria was chosen. The rationale behind the section is based on the fact that performance cannot be established from a single dimension and the criteria offer a more reliable and accurate assessment that is not biased or based on assumptions. Also, the flexibility, convenience, and ease of use of the criteria played a role (SAPRU, 2004 p.173). This is because the criteria would seek to ensure that maximum information that supports the assessment needs is acquired.
With respect to the relevance criteria, it is worth establishing that the aim of the strategy is to establish the level in which the smoking control intervention has met the needs of the populace and the priorities of the nation (SAPRU, 2004 p.174). To begin with, it is certain that the implementation of the control measure was relevant in lowering the smoking rate and preventing the prevalence of smoking-related illnesses. The measure in this context was mainly serving a health-based agenda by preserving the wellness of the public. The country has always placed public health as a major priority an aspect that the policy has adhered to. The reduction of health illnesses among individuals across all adult ages is a positive and relevant matter. The issue is smoking is one that holds health-related implications in general which also affects the economy and social wellness. In short, relevance in the case revolves around the usefulness of the policy in handling the underlying public health problem. Based on the application of the policy it is evident that the policy should continue handling the underlying issues. The agreed aims and intentions of the policy plan are still valid and they depict an adequate reason for the continuity of the activities since the problem is one of the major health issues that is currently being experienced in the state. The policy fits well within the set health focuses by the government and the needs by the affected populace.
On the other hand, efficiency refers to the extent of the association between the resources, intervention, and output. In that, if the input and the services provided exceeds the output then the policy can be classified as inefficient. The output indicates the achieved results from the applied effort (SAPRU, 2004 p.174). This is the actual observable findings for the intervention procedure in which the policy implementers holds some degree of regulation. Any policy as an intervention measure to an existing issue is termed as efficient in the instance that it demands less expensive materials and resources that are easily accessible to the achievement of the desired results. In that, this can be measured with regard to superiority and amount. The result and input quality is also an essential aspect of achieving efficiency. In that, the use of the most affordable inputs is not a recommendation but in general, the performance should be appealing. In addition, the evaluation of a policy intervention necessitates conducting a comparative operation to establish the success. In the case of dealing with smoking issues, the efficiency of the intervention can best be measured by the associated cost and results. In that, the intervention must have resulted in smoking and illnesses spread reduction under minimal expenses for it to be efficient. This is similar to production where quality and productivity are the basis of the assessment. Also if the outcome of the measure is higher when equated with those of another program then the initiative is efficient.
Effectiveness is also a viable criterion for performance assessment of the policy in this case. Effectiveness refers to the level in which the anticipated results ranging from the set aims and outcomes have been obtained. Precisely, this is the association amid the results of the intervention and the ultimate results which means that the target beneficiaries have acquired certain benefits (SAPRU, 2004 p.175). In this case, the policy plan intervention was aimed at lowering smoking and the spread of illnesses. It means that for the plan to be categorized as effective the aims must have been achieved even though not comprehensively. A policy is termed as effective if it benefits the public in terms of guarding their wellness while its efficiency lies in quality, affordability, convenience, flexibility and so on. In other words, if an intervention is effectual it does not imply that it is effective. In that even though the plan may be implemented within an economic range it might lack the quality of lowering the smoking rate. The evaluation process through the criteria will, therefore, incorporate measuring the achieved change, the outcome as positive and assessing the acquired value through a comparative analysis of the previous policies.
Since the implementation of the policy plan in 2011, close to a five million usage reduction has been encounters in support of e-cigarettes and quitting (Forest, 2011 p.1). These reduction practices have been effective in changing the trend by offering the users with safe options to smoking. In my opinion, based on the achievement that the plan has achieved over the years it is evident that it has worked. In that, although the actual aims and objectives have not been met fully it has been a success. The original objectives included reducing the smoking rate to the lowest level amid all genders as well as preventing the spread of smoking-related illnesses that are associated with rampant individual’s death and health defects. This objective has been achieved since close to over fifty percent smoking amid adults has been achieved in the last five years. However, the problem has become more diverse as it has created a disparity among the wealthy and poor persons (Ciapponi and WHO, 2014 p.1). In that, the poor people tend to suffer more when compared to the rest of the populace. Based on statistics before the plan close to over one thousand persons were being hospitalized for tobacco connected defects but after the decrease has lowered significantly. This is a good thing given that some of these illnesses tend to affect individuals after individuals are over 40 years (Forest, 2011 p.1). In other words, stating that the policy has been effective is accurate because the original objectives have been met which has led to an expansion to cover the issue of disparity and the prevalence among young individuals.
Most critics argue that rather than lecturing to the consumption on what they should do, the government should focus on the development of policies that seek to create healthier and safer commodities. The implementation of the policy plan was developed after the original policy proved to be effective even though partially. The notion that the measures act a form of dictatorship to the public is inaccurate since this is only a measure to protect individuals from any form of harm that might result from the consulting. Tobacco contains some harmful substances such as nicotine which are the actual ingredients in the production of the substance. Thus, I do believe that the policy is relevant and well positioned within the health needs of the nation. Since there are regulations regarding the consumption of the products the obligation of the government with regard to the provision of protection is a necessity. The government has therefore acted within its mandates to creating wellness and ensuring that some of the tobacco-related illnesses are prevented (Scarborough et al., 2011 p. 526). The placement of the restrictive measures targets both the consumers and the producers which makes it effective.
Based on the evaluation criteria, the policy is relevance, effective and efficient. In that the policy plan is useful since it considers the needs of the populace and the health priorities of the country. So that stability in any given context can be achieved health stability must come first. Cigarettes smoking has remained to be one of the leading health epidemics in the country due to its ability to causing the rise of other illnesses (Scarborough et al., 2011). Several measures ranging from branding, to marketing have been implemented in the recent as the means of informing and discouraging the public from the extensive consumption of tobacco but less success has been achieved. Thus, targeting the whole populace is not only relevance but it is an approach that has decreased the use significantly. On the other hand, the policy is also efficient because it does not require the use of more resources and the outcome is as desired. With the reduction of the general consumption rate, which refers to quality performance then the policy is efficient. It is also effective based on its general capability to meeting the set objectives (Allender et al., 2009 p. 263). The set aims have been met even though in terms of efficiency the performance cannot be validated since even though the performance has been positive the services that the government offers are more demanding.
Discuss Evidence-Based Solutions for Its Better Achievement
According to, Scarborough et al., (2011) tobacco is a major cause of chronic illnesses. There is a risk of about 40 percent in developing diabetes among the active smokers when equated with those that do not smoke. Smoking leads to severe effects on an individual’s health. The plan acts as a form of measure that seeks to constrain individuals from the increased consumption. The major positive aspects are the fact that it seeks to lower the smoking rate in order for health wellness to be achieved. The process is a gradual one that will seek to create change over time rather than immediately. Since the program also incorporates an awareness program. This can mean that it seeks to inform and create familiarity to the public about the existence of the issue and how it can be solved (French, 2010 p.36). The effectiveness of the program depends on the participation of all the involved parties such as the stakeholders, consumers, and the government. The aspect is important as it does not only call for collaboration but also integrative working.
The Tobacco control policy intervention represents one of the most essential policies that seek to enhance the public health of the nation. Extent of smoking in the country is rampant and worrying despite the fact that a significant reduction among adults has been achieved. In fact smoking is the actual source of the rising health bills given that the chemicals destroy some of the major organs in the body thus leading to chronic defects. The undesirable nature of chronic illnesses such as diabetes that are fuelled by smoking is not that it leads to high financial burden but on the fact that it disorganizes the health of the country (French, 2010 p.34). Despite the reduction of tobacco consumption in the recent the average consumption by the active smokers is above the normal rate. This normally translates to early death in every year. It is estimated that the highest populace of those that smoke are also active alcohol consumers which further worsens the state. The intake is higher among young which is attributed to the perception that has been developed that the substances are less damaging when the consumption is regulated. The assertion and perception is misdirected as it does not matter how the substance is consumed since in the long run it will lead to the dominance of illnesses that cannot be cured.
The policy has also restrained the marketing and branding of cigarettes. This is a positive move since it is quite obvious that the commercial makes it quite clear that the general use of cigarettes despite the warning is good. By changing the branding the consumption is one that will be voluntary since the users are fully informed of the associated defects. The measures are not aimed at lowering the purchases but ensuring that awareness is achieved. Most young individuals tend to engage in the consumption on the ground that they lack the needed information for making informed choices. In addition, this justifies the disparity in mortality amid the wealthy and poor individuals in the community. In that, those from the poor setting are less educated in addition to being unemployed. Since their choices are not usually informed it, therefore, implies that the vulnerability in addition to the socio-economic stressors contributes to the dominance. Since cigarettes smoking is considered to be an effective mode of liberating from stress, individual’s will certainly turn to its use in relieving stress. The situation is not similar to those from the comfortable setting because the environment is enabling and the populace mainly comprises a health-conscious community that will not engage in such activities. Thus, the focus of the policy on addressing the underlying disparity in addition to lowering smoking and preventing illnesses is a positive and relevant approach (French, 2010 p.36).
The approach has been effective in minimizing the resulting effects in general terms which makes it effective. Reducing the consumption to a zero point is something that cannot be achieved in the short run based on the critic that the approach is receiving. In that, such a move will lead to a negative economic implication that is not favourable (Chaloupka, Straif and Leon, 2010). However, the fact that the approach is seeking to achieve health steadiness by lowering the extent of chronic illness. The intention of the initiative is to establish whether focusing on non-branded tobacco items would be an effective approach in discouraging the use among young individuals. The strategy seeks to offer support to the adult consumers who need to quit through some of the established health supporting measures. The best thing about the policy is that it does not affect the economic aspects of the matter but mainly centres on enhancing the health of the people.
However, several barriers and challenges to the effectiveness of this policy exist. To begin with, since the policy has been implemented on a national scale, it means that more funds and resources are required in fulfilling the objectives. In that, the number of users in the country is too many and the intervention requires more restrictive measures in general for the goals to be achieved. The participation of the government and that of the consumers and producers is a necessity. However, for the investors within the manufacturing industry, they have been consistently rejecting the measures by asserting that the government is only focusing on getting rid of their activities by discouraging consumption. The criticism is justified given that the lowering of the general consumption will also lead to a decreased buying which is unfavourable economically. In this context, the populace is constantly involved in protesting any move by the government as well as failing to comply with such measures. While the government seeks to safeguard the health of the populace this cannot be achieved without a number of economic implications (Chaloupka, Straif and Leon, 2010). The government acquires substantial revenue from the operation in general and thus if the business is affected its revenue will also decrease. However, the change is positive rather than what people see because it means that fewer funds will be used in supporting the individual’s health issues. The reduction of smoking will lead to a decreased health defects.
On the other hand, even though that most of the consumers understand that the intake of tobacco is not favourable, it is evident that quitting for them is not an option. Poverty dominates in different settings where the usage is high. In such an environment these people can only relief their worries and socio-economic pressures by smoking (French, 2010 p.38). This means that even though the need to create awareness plays part in changing perception for those within such environment achieving the objective is hard. In addition to poverty, the education level of these people is lower which best illustrates the existing disparity. Knowledge leads to consciousness. Among the wealthy, they are fully informed about the health implication of such intakes and thus most will prefer to take the safe choices (Ciapponi and WHO 2014 p.4). This is different to the lowly educated people since their decisions are based on needs rather than what is required. In other words, even though the policy has been a success in the achievement of the set aim there are several barriers that must be overcome. In that the issue of resources and resistance that the policy has been getting from those in the industry as well as socio-economic disparity. The measures have resulted in efficiency as the results have been positive in general. In other words since a notable decreased has been achieved the focus lies in creating more benefits for the beneficiaries. The policy appears to be benefiting the public part.
Conclusion
In summing up, it is evident that the policy has been effective in meeting the set aims. It is without a doubt that smoking is one of the most dominant health issues of the contemporary society. The measures that the government has implemented seek to reduce the consumption as well as prevent the spread of illnesses that are caused by tobacco use. The policy was developed after the prevalence of diabetes and other chronic illnesses that are triggered by smoking began to rise rather rapidly. Smoking had begun to rise in the past leading to a rather unstable surrounding. The promotion of this substance throughout the modern media is attributed to be the primary driver to the increased consumption among young individuals. In addition, the use is higher within the poor environment due to the lack of education and high rate of poverty. Despite the success that the policy has achieved over the years, it is evident that the existing challenges should be addressed. The government should focus on lowering the poverty rate along with the implementation of the program. Poverty creates intense pressure for individuals and they tend to acquire relief from the high consumption of nicotine. Also, the financial aspect of the investors should also be considered. Rather than forcing people to lower the consumption, more effective options in addition to e-cigarettes should be developed.
References
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