Overview
Lung
cancer is the uncontrolled growth of abnormal cells in the lungs; it can affect
one or both lungs. These cells do not develop into healthy lung tissue like
normal cells do which can lead to tumors, causing the lungs to function inappropriately.
The two most common types of lung cancers are Non-small cell lung cancer
(NSCLC), and small cell lung cancer (SCLC). Lung cancer is one of the most
common cancers in the world. According to the American Cancer Society “Lung
cancer accounts for about 27% of all cancer deaths and is by far the leading
cause of cancer death among both men and women” and for 2014 there will be an
estimated 159,260 deaths from lung cancer. This is a huge problem that we are
facing and a lot can be done to bring these numbers down. Preventions are
available in many different methods from the help of the government to community and individual interventions. Lung cancer is treatable and curable, and in some cases preventable.
There
are many causes of lung cancer but the main risk factors are
cigarette smoking, secondhand smoke, radon, and personal or family history. The
leading the cause of lung cancer in the United States is smoking; the Centers for Disease Control and Prevention (CDC) states that “cigarette smoking is linked
to about 90% of lung cancer”. You can find a toxic mix of more than 7,000
chemicals in tobacco smoke. The smoke from cigarettes, cigars or pipes can
cause lung cancer; people who inhale this smoke are practically smoking. According to the CDC (2014) “In the United States,
two out of five adults who don't smoke and half of children are exposed to
secondhand smoke, and about 7,300 people who have never smoked die from lung cancer
due to secondhand smoke every year”. The sad fact is that tobacco is killing
our population. Radon is another risk factor; this gas comes from rocks and
dirt and can be found in homes and buildings, it cannot be smelled or seen. The
CDC states that “Nearly one out of every 15 homes in the U.S. is thought to
have high radon levels” and many people are not aware of the deadly killer.
There are other substances that can be found in many workplaces like asbestos,
arsenic, diesel exhaust, some forms of silica and chromium. Many
of these risk factors can be avoided by changing your lifestyle or making sure
policies are put in place so people can live and work in clean environments.
Social
Determinants Linked with Lung Cancer
The social determinants of health are the
conditions in which people are born, live, work and age. These circumstances
are shaped by the distribution of money, power and resources at global,
national and local levels. Social determinants encompass social and economic
conditions such as poverty and the conditions of work and healthcare delivery;
also the chemical and pollutants associated with industrial developments and
the environments where we work. Social determinants play a significant role
because of their indirect effects through individual risk factors and behaviors
that correlate (WHO, 2014).
All of the social determinants
influence us and the way we grow up and the decisions that we make. Whether we
realize it or not, everything is affecting us and the behaviors we chose to act
upon. Behaviors are often the mediating steps
between social determinants and cancer outcomes. Some behaviors long-recognized
as important contributors to cancer include tobacco and alcohol use, poor diet,
physical inactivity, high-risk sexual behaviors, and occupational
hazards. (WHO, 2014)
Cigarette
smoking is the number one risk factor for lung cancer. In the United States
alone, cigarette smoking is linked to about 90% percent of lung cancers.
Cigarettes are definitely not the only cause of lung cancer, pipes and cigars
are also major risk factors. There are about 7,000 chemicals that make up
tobacco smoke, making it extremely toxic. Most of the chemicals are poisonous
and at least 70 are known to cause cancer (CDC, 2014). Tobacco use is the single
largest preventable cause of death and chronic disease in the world today,
causing 5.4 million deaths in 2005. It is a risk factor for six of the eight
leading causes of death, including heart disease and several cancers and lung
diseases. Tobacco use disproportionately affects males and lower socioeconomic
groups in developed and developing countries, and is increasingly prevalent in
poorer parts of the world. In developed countries, multiple social
disadvantages contribute independently to smoking status. Poor households in low-income countries
carry a particularly heavy burden from tobacco use, with significant health,
educational, housing and economic opportunity costs (CDC, 2014).
There
are two stages of life where inequities in vulnerability and exposure to
tobacco use are most evident: sadly, during adolescence, with those from lower
socioeconomic backgrounds most at risk of taking up tobacco; and during
adulthood, especially young adulthood, where tobacco use cessation is more
difficult for those from disadvantaged backgrounds. At both stages,
vulnerabilities such as social, psychological and physical health issues and
disproportionate levels of exposure due to family and peer tobacco use,
targeted advertising, social norms permissive to tobacco use and less access to
affordable cessation services often tip the balance towards tobacco use take-up
and continuation. Tobacco use is supported by a vast network of business and
commercial interests (CDC, 2014).
Tobacco use is
a choice. Tobacco use is a public health problem because it has been
intentionally built into the social structure and environment of most societies
by an industry that profits from continued trade in tobacco products. Not only
is smoking detrimental to your own health, but it is also hazardous to those
around you (CDC, 2014). Second hand smoke is almost unavoidable. Most exposure to secondhand smoke occurs in homes and
workplaces. Secondhand smoke exposure also continues to occur in public places
such as restaurants, bars, and casinos, as well as multi-unit housing and
vehicles. Eliminating smoking in indoor spaces is the only way to fully protect
nonsmokers from secondhand smoke exposure. Separating smokers from nonsmokers,
although it sounds like a good plan, when people share the same air space,
cleaning the air, opening windows, and ventilating buildings does not eliminate
secondhand smoke exposure. Nonsmokers who are exposed to secondhand smoke at home
or work increase their lung cancer risk by 20–30%.Secondhand smoke exposure
causes an estimated more than 7,300 lung cancer deaths annually (for 2005–2009)
among adult nonsmokers in the United States. African-American male workers,
construction workers, blue collar workers and service workers are some of
the groups who continue to experience particularly high levels of secondhand
smoke exposure relative to other workers (CDC, 2014).
Health starts in our homes,
schools, workplaces, neighborhoods, and communities. We know that taking care
of ourselves by eating well and staying active, not smoking, getting the
recommended immunizations and screening tests, and seeing a doctor when we are
sick all influence our health. Our health is also determined in part by access
to social and economic opportunities; the resources and support available in
our homes, neighborhoods, and communities; the quality of our schooling; the
safety of our workplaces; the cleanliness of our water, food, and air; and the
nature of our social interactions and relationships. The conditions in which we
live explain in part why some Americans are healthier than others and why
Americans, generally, are not as healthy as they could be (Healthy People, 2014).
Evidence
Based Programs and Policy Interventions and Effectiveness
CDC
–
The Division of Cancer Prevention and Control (DCPC) is working to prevent and
control lung cancer by—
- · Gathering critical information about diagnoses and deaths from lung cancers in the United States.
- · Supporting programs in states, tribes/tribal groups, and U.S. areas that struggle to prevent and regulate tobacco use and endorse a healthy diet.
- · Applying public health interventions and counter marketing tactics to reduce smoking.
- · Upholding a lung cancer Web site (Cancer Prevention and Control, 2013).
NationalCancer Institute - Population-level
interventions
In
addition to independently focused cessation efforts, a number of tobacco control
approaches at the community, state, and national level have been recognized
with reducing the commonness of smoking. Strategies include the following:
- · Reducing minors’ access to tobacco products.
- · Distributing effective school-based prevention programs together with media strategies.
- · Raising the price of tobacco products by raising taxes.
- · Using tobacco excise taxes to supply and fund community-level interventions including mass media.
- · Providing verified quitting strategies through health care organizations.
- · Adopting smoke-free regulations and policies (Lung Cancer Prevention, 2014).
Educating
individuals on what smoking can do to your body is the first step in having a
successful intervention. The Surgeon General’s report on smoking and health, which
summarized more than a decades worth of research on the adverse health effects
of tobacco use, helped the use of tobacco decline considerably. The effect of
subsequent education and tobacco control efforts has been considerable with an
estimated 200,000 premature deaths avoided in the period from 1964 to 1978.
Anti-smoking
Ads are proven to be extremely effective. The first year of the federal
government’s “Tips from Former Smokers” national advertising campaign exceeded
all expectations, driving 1.6 million smokers to try to quit and helping more
than 100,000 to succeed, according to a study published today in the medical
journal The Lancet. The 2012 campaign, conducted by the U.S. Centers for
Disease Control and Prevention (CDC), also inspired millions of nonsmokers to
encourage friends and family members to quit smoking. Researchers estimated
that, by quitting, former smokers added more than a third of a million years of
life to the U.S. population.
Raising
the cost of cigarettes has proven to be effective in reducing smoking in age
groups 13-18, and 18-24. Eight different studies were done and the conclusion
was that a negative price elasticity of demand estimate reflects a decrease in
tobacco use in response to an increase in tobacco product price. There have been
many studies on the effectiveness on no smoking bans. In 2009, a report by the
International Agency for Research on Cancer concluded that there is strong
evidence (the second highest level of evidence under the report’s rating scale)
that implementation of smoke free legislation causes a decline in heart disease
morbidity. Also "in 2010, a Cochrane review of 12 studies found consistent
evidence of a reduction in hospital admissions for cardiac events following
implementation of smoke free laws" (CDC, 2014)
Conclusion
Finally,
we would like to address the two following questions: what is a winnable
battle, and what makes lung cancer a winnable battle? Winnable battles are
defined by the CDC as “public health priorities with large scale impact on
health and with known, effective strategies to address them” (2014). The aim of Winnable Battles is to address the health concerns of the public in effective ways which will “improve their outcomes” (CDC, 2014). Though
lung cancer has not been specifically targeted by the CDC as a winnable battle
one of the largest contributors to lung cancer has been identified, and that is tobacco
use. In our discussion of lung cancer we have focused mainly on the use of
tobacco products and programs and policies which are being implemented to help
with tobacco cessation efforts. Unless there are major advances made in cancer
research there is no way to prevent genetically induced cancers, but we do
know that tobacco use is a major risk factor for developing cancer. Lung
cancers could be significantly reduced if the use of tobacco products ceased.
As shown in the Policy section, there are many interventions currently in place
which are helping to decrease the number of lung cancer incidence and death
including “Tips from Former Smokers” campaign and increasing the price of, and
taxing, tobacco products. We need to challenge the dialogue around smoking and
target people at high risk for smoking to ensure that everyone is afforded safe and
clean places to live and work as well as information on the harmful effects of
tobacco use. Cancer treatments are not cheap, and they are not easy on the
body. Lung
cancer due to tobacco use is preventable! Lung cancer due to poor living and
working conditions and environmental factors such as pollution could be
preventable as well. It is our responsibility to address these issues and
concerns for a healthier population, and for a future where no one dies from a
preventable cause such as tobacco use.
Reference
List
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