Applied Sciences

Running Head: COVID-19 1

COVID-19 7

The Role of Tobacco Cessation and Prevention to Combat COVID 19

Outline:

I. Abstract

II. Table of contents

III. Background

i. General background of Rural tobacco use

IV. Theoretical background

i. Rural tobacco use and COVID 19 background from behavioral science perception.

V. Literature review

i. Summarize related supportive literature revies on this topic.

VI. The Importance of Tobacco Cessation

i. Education factor

ii. Economic factor

iii. Disease factor e.g. cancer, COPD etc.

VII. COVID-19 and respiratory factors

i. Smoking behavior association with adverse progression of COVID-19

ii. Media perception of rural tobacco use

VIII. Recommendations

IX. Conclusion

X. References

Background

Undoubtedly, this research focuses on investigating the effects of smoking against the novel of corona virus in the United States. From the start of the outbreak, many pieces of research reveal that smoking is among the risk factors that can lead to the spreading of corona virus. (Gonzalez-Rubio, J 2020). Later, it was examined that, the prevalence of people who smoke and are hospitalized with the corona virus was significantly lower compared to the smoking rate in the whole sample.

However, the symptoms and signs of COVID-19 can appear from two to fourteen days after one has conducted the Virus. The period between exposure and having symptoms is referred to as the period of incubation. Common symptoms and signs may include fever, cough, and tiredness. Early symptoms of this disease are loss of smell or taste, and other symptoms may be sore throat, breath shortness, chills, muscle aches, pink eye, and chest pain. However, other symptoms have been reported like diarrhea, vomiting, nausea, and rash. The symptoms found on children for this disease are similar to those found on adults. (Garufi, G., 2020) The severity of corona virus symptoms ranges from mild to severe. Some individuals may experience symptoms that are worse, like severe breath shortness and pneumonia, about seven days after the symptoms start to show. Some people may experience a lot of symptoms while others will not experience any symptoms at all. Also, aged people are at higher risk of conducting COVID 19 compared to young people.

General background

Tobacco smoking has been known to be a risk factor for various respiratory infections. Tobacco smoking affects both smokers and non-smokers. Tobacco smoke is harmful to the lungs of smokers and non-smokers, and it is harmful to non-smokers who have exposure to second-hand smoke. The people in rural areas form the most part of smokers and those working in physical industries like construction.

One of the most significant public health problems globally is the use of tobacco. The smoking of cigarettes provides a health hazard to the public that has called for various interceptions to be made to reduce these hazards created by cigarette smoking. The COVID-19 pandemic has made the interventions to help reduce the tobacco concentration in the air that affect the people’s health in this period that the infections of the disease sour. The tobacco affects the lungs, and many people who suffer from incapacitated lungs do not have the needed capacity to protect them against infections to the lungs. This means that the individuals are at a higher risk of suffering severe conditions when they inhale the tobacco smoke than this protected from the exposure. The studies below explore the role of Tobacco Cessation and Prevention to Combat COVID-19 Morbidity and Mortality in Rural Areas. It also sheds light on the smoking behaviors and severe symptoms of Covid-19 and the need for intensive care facilities in rural areas.

Theoretical background

It I argued that people learn from modelling, observation, or instruction of other people that is related to the social cognitive theory in behavioral learning. The theory tries to enact smoking cessation by breaking the situational and emotional connections that smoking has established. The strategies of behavioral scheme put focus on the associations considered as pleasure oriented and that have situational cues that have the potential to reinforce and maintain smoking (Greenhalgh et al., 2016). It differs from the strategies in cognitive scheme which target cognitions and emotions that have a potential effect on a person’s tobacco use.

This project aims at examining how tobacco leads to an increase of spread of corona virus in rural areas, the impacts of tobacco cessation in reducing the spread of corona virus cases in rural areas, how the cessation of tobacco consumption can be gained among the people, and the risk of tobacco smoking in the community concerning the spread of corona virus. This research will focus on COVID-19 morbidity and mortality cases of individuals who were using tobacco before conducting the virus. Secondary data will be gathered from individuals who know victims of the corona virus who were smokers.

Survey research will be carried out to identify several cases of COVID-19 morbidity and mortality that are associated with tobacco use (Gonzalez-Rubio, J 2020). Information for the survey will be gathered from government journals, newspapers, and through observation. As well, self-administered questionnaires will be utilized to gather information from citizens, officials of the government and other stakeholders to establish what their views are on the effectiveness of tobacco prevention and cessation in combating COVID-19 morbidity and mortality. This research design will be utilized because it guarantees flexibility, and it will assist in reaching respondents who will assist in providing useful information.

Literature review: Role of Tobacco Cessation and Prevention to Combat COVID-19

Tobacco smoking has been known to be a risk factor for various respiratory infections, and it has been argued that it has the impact of increasing their severity. This means that tobacco smokers are at a high risk of contracting COVID-19 and that their immune system is not strong enough to protect them from the severity of the disease. The WHO has published reports that tobacco smokers consist of the population that is most likely to progress severe ailment with COVID-19 when paralleled to non-smokers. It has been proven that severe diseases like cancer, diabetes, and heart diseases affect smokers most (Zhang and Schwartz, 2020). These diseases increase the risk of the patients succumbing to the disease as their health condition worsens when they get infections to their lungs. With the available research about tobacco smoking and COVID-19 disease, it is quite clear that smokers are at a greater risk of mounting severe virus and demise.

Gawin & Grace, 2020. Researchers explored that people living in US rural areas are more addicted to tobacco and are at high risk of Covid-19 morbidity and mortality. The intake of Tobacco effect a lot on the lungs of human beings which incraeses the danger of Covid- 19 as the effect of Coronavirus is highest at lungs There are several factors determined such as lack of healthcare facilities, lack of education, low income, and lack of tobacco control policies due to which the individuals living in rural areas have a high rate of tobacco use as compared to individuals staying in urban areas. It has been observed that rural people possess a higher rate of diseases such as cancer, obesity, and diabetes, and risk health behaviour like smoking and physical inactivity. They are more habituated to use smokeless tobacco that impacts their health heavily. Additionally, they lack to have access to programs that may help them quit tobacco. Therefore, the harmful effects of tobacco directly relate to the symptoms of Covid-19 such as breathing difficulty, shortness of breath, and chest pain because of which the people addicted to tobacco consumption have high rates of Covid-19 morbidity and mortality.

Few immediate and long-term health benefits of tobacco cessation that can help to combat Covid-19 morbidity and mortality in rural areas are discussed below:

● The heart rate and blood pressure will drop within duration of 20 minutes.

● The amount of carbon monoxide in the blood will come to its normal level within 12 hours.

● It starts improving circulation and lung function in 2 to 12 weeks.

● Breathing problem and coughing decreasing in a span of 1 to 9 months

● The risks associated with coronary heart disease gets reduced within a year

● Stroke risks also get reduced within a span of 5 years

● Risks of lung cancer and other risks related to cancer of the pancreas, mouth, throat, bladder, cervix, and esophagus also fall to half within 10 years.

● Within 15 years, risks related to heart diseases are that of a non-smoker (WHO, 2020).

● Quitting tobacco also helps to combat the risks of many diseases that are related to second-hand smoke in children of rural areas such as infections, asthma, and other respiratory problems.

The COVID-19 disease has proven to be more severe to the people who have respiratory diseases, and statistics have proven that there are many individuals in the rural areas who have succumbed to the infections. For example, the rural areas in New York have witnessed massive deaths and a rise in infection rates. Tobacco smoking has effects on the lungs as it reduces the capacity of the lungs to function appropriately. Smoking tobacco impairs the lung function that leads the body to have an inability to fight off the virus. This means that a high morbidity and mortality rates for tobacco smokers are expected for COVID-19 disease.

Tobacco cessation and prevention will reduce the chances of the impairment of the lungs. The lungs will function in their full capacity when smokers quit the behavior, and it would lead to getting further immune for the lungs to fight the infection. When the lungs are not impaired by tobacco, it is easier for the body to fight infections and reduce their severity. The COVID-19 is likely not going to develop to a severe state when the lungs are not incapacitated as they are likely to put up a fight against the infection and ensure that people recover faster.

Tobacco cessation and prevention are likely to reduce the impacts of the disease on the health of the people in rural areas. Tobacco smoking affects both smokers and non-smokers. It has been proven that tobacco smoke is harmful to the lungs of smokers and non-smokers, and it is harmful to non-smokers who have exposure to second-hand smoke. The effect of tobacco smoking could be reduced by tobacco cessation and prevention as the number of people affected by this smoke would reduce significantly (Mahabee-Gittens et al., 2020). This would mean that the immunity of the body to fight infections would have a boost by reducing the effects of tobacco on our lungs.

Kelvin, 2019. Researchers found that taking initiatives for tobacco cessation would help tobacco users to quit smoking. Stopping tobacco consumption is very necessary as the study reveals that smokers have a high rate of severe outcomes from Covid-19. It is very important to spread awareness among people to stop using of tobac The government can take initiatives that can be helpful to provide people with free access to nicotine replacement therapy. Moreover, digital health workers can use AI to spread awareness related to Covid-19 and tobacco consumption to people staying in rural areas that may allow them to develop a thought related to quitting tobacco. WHO has also said that there’s existed a strong link between Covid-19 and tobacco consumption. Therefore, it is necessary for the government to pass tobacco control laws, especially in rural areas in order to protect the health of people during the Covid-19 pandemic and beyond. Taking initiatives for rural would help to deliver tobacco cessation services that may help them to combat mental and physical addiction to tobacco.

Researchers also noted that rural hospitals lack time, experiences, clinical agencies and don’t know the proper ways to spread awareness related to tobacco cessation, so they can adapt online.

education and tobacco educational programs that will help the nurses and doctors to perceive more knowledge. These means will help them to speard awareness for stopping the use of tobacco. This will build up confidence and help them to educate rural people regarding tobacco cessation through organizing campaigns and anti-smoking programs (WHO, 2013).

Jean, 2019. The research also concluded few barriers to tobacco cessation in rural hospitals such as lack of mental and primary healthcare resources, lack of staff training, community distress, low morals of healthcare staff, and limited health services. The researchers also found a few possibilities that would help rural clinics to overcome the above-discussed challenges. Boosting up staff morale, appointing tobacco-dedicated staff, providing quick access and flexibility to healthcare services, and improving health service would be beneficial. These measures will also help to improve the attitudes of rural healthcare staff. The finding of the research also states that quit lines to tobacco are very low in rural areas due to lack of desire to quit, lack of knowledge related to the impact of tobacco, lack of tobacco cessation programs, and lack of telephone access. Few barriers related to tobacco programs that can be faced by poor people involve a shortage of money to access the telephone, transportation, accommodation, and insurance coverage. If the educational programs will provide tobacco addicted patients with integrated treatment plans, proper education then it would help providers to conduct webcam facilities to give home assistance as well. If the insurance will cover the program fees, it would play a huge role in tobacco cessation in rural areas. Online programs can even help people to reduce cessation costs, and barriers related to transportation.

The article related to Improving healthcare in rural communities talks about the people who reside in rural communities of America who have very little access to healthcare services. The rural facilities are not enough to provide transitional care or follow-up care to COVID patients and tobacco addicted patients. US Department of Health & Human Services states that almost one-quarter of America’s population belongs to rural areas and lack proper access to health care. Therefore, it has been observed that rural hospitals are slowly shifting to outpatient services because of a lack of staff and funds. Still, Mayo Clinic and Select Medical are the two organizations that are trying to strengthen care options in rural areas of the US. they have developed Allevant solutions to provide people with intensive care programs and ventilator weaning. Through this initiative, Allevant can guide the doctors and nurses with updated information and new healthcare techniques. It will also provide cost-saving advice and developing management strategies that would be essential for local hospitals to offer quality care to patients. Therefore, these initiatives would help to educate and support tobacco addicted people in rural areas and take prevention to combat Covid-19 morbidity and mortality.

The cessation and prevention play the role of elimination of the harmful smoke in the lungs and in the air to improve the lung capacity to fight infections. The structure of the rural areas is one vested with an aging population, which indicates the prevalence of existing comorbid diseases. The structure indicates that the people are at higher risks of contracting the disease and succumb to it (Propper, 2020). The elimination of tobacco smoke in the air is going to protect them from getting severe illnesses.

The people in the rural areas are disadvantaged compared to those in the urban areas on the grounds of receiving the relevant and needed information on the pandemic. Most rural areas do not have the power to connect them to the inventions made on ways to protect and prevent the spread of the disease. This means that people have no knowledge to practice safe practices that are emerging daily. The smokers in rural areas often smoke in the chain in that a cigarette could be smoked by two to three people. This means that the particles of COVID-19 can be transferred faster among smokers.

The cessation of tobacco could help reduce the risk of smokers to COVID-19 infections and severity in rural areas. The smokers would not have to share cigarettes or come together to smoke, which could consequently lead to the reduction of the spread of the disease in rural areas (Upton & Thompson, nd). The prevention of tobacco use would ensure that there are no individuals flouting the rule of the World Health Organization (WHO) of keeping social distance to combat the disease. The keeping of social distance rule is quite effective in making sure that contact with infected people is reduced. This will indeed reduce community transmission and reduce the fatalities due to COVID-19 infections.

Undoubtedly, this research focuses on investigating the effects of smoking against the novel of corona virus in the United States. From the start of the outbreak, many pieces of research reveal that smoking is among the risk factors that can lead to the spreading of corona virus. (Nájera, A. (2020). Later, it was examined that, the prevalence of people who smoke and are hospitalized with the corona virus was significantly lower compared to the smoking rate in the whole sample.

However, the symptoms and signs of COVID-19 can appear from two to fourteen days after one has conducted the Virus. The period between exposure and having symptoms is referred to as the period of incubation. Common symptoms and signs may include fever, cough, and tiredness. Early symptoms of this disease are loss of smell or taste, and other symptoms may be sore throat, breath shortness, chills, muscle aches, pink eye, and chest pain. However, other symptoms have been reported like diarrhea, vomiting, nausea, and rash. The symptoms found on children for this disease are similar to those found on adults. (Orlandi, A., 2020) The severity of corona virus symptoms ranges from mild to severe. Some individuals may experience symptoms that are worse, like severe breath shortness and pneumonia, about seven days after the symptoms start to show. Some people may experience a lot of symptoms while others will not experience any symptoms at all. Also, aged people are at higher risk of conducting COVID 19 compared to young people.

However, this virus has affected many countries including the United States with high numbers of new cases and new deaths resulting from the virus being reported each day. The United States is among the countries which have been affected by the virus to high levels. A total of 7,118,713 cases have been reported in the United States, which are the highest numbers received by a single country in the world. . (Hefler, M., & Gartner, C. E. (2020). There have been 206,067 death cases in the United States that have resulted in the virus. However, the US has also experienced a good number of recoveries, which amounts to 4,373,627 in number. COVID-19 is believed to have no cure, and researchers are working hard to develop the cure and vaccines.

However, tobacco is one of the plants which are believed to have caused the spread of corona virus mostly in rural areas; its leaves are the main ingredient and are mostly rolled up with a paper and smoked. Tobacco possesses stimulants that are addictive called nicotine. Its leaves are dried are commonly used for smoking in cigarettes. The use of tobacco is a risk factor or cause for many diseases, mostly the ones which affect the lungs, liver, and heart.

Smoking of tobacco is very dangerous such that it can lead to disability and paralyze body parts. Also in the United States, 16 million individuals are living with diseases that are caused by smoking tobacco. For each individual who loses life because of smoking, at least 30 other individuals live with an illness that is related to smoking. Smoking tobacco leads to cancer, diabetes, lung diseases, stroke, and heart diseases. Smoking tobacco may increase the risk of conducting tuberculosis and eye diseases. Researchers have argued that tobacco has contributed to the spread of the corona virus.

The article ‘Systematic review of clinical insights into novel coronavirus (CoVID-19) pandemic’ by Lakhani et al. (2020) focuses on the persisting challenges of COVID-19 in the U.S. rural population. There is cumulative evidence of epidemiology inconsistency in disease burden between the rural regions and the urban centers. It accesses the prevailing challenges of COVID-19 in rural regions based on the prior pandemic cases and weights it has on rural inhabitants. Rural areas have minimal resources, preparedness, and other health challenges to handle the challenges brought by the pandemic effectively. COVID-19 is a respiratory disease, and persons with smoking antiquity have greater odds of adverse virus infection. These cases could be severe and may require ventilators. The rural areas tend to have a higher proportion of the smoking population. Besides preventing the transmission dynamics and spread of the virus in rural areas has received limited attention, which poses a significant challenge. Lack of preparedness in rural areas may negatively impact the rural population to greater heights.

Brake et al. (2020), through the article ‘Smoking up-regulates angiotensin-converting enzyme-2 receptor’ dwells on how the smokers are more prone to respiratory ailments. They are more prone to COVID -19 as they show dual influenza frequency and amplified bacterial illnesses rates. Smoking damages the user’s lungs making them more vulnerable to pulmonary infections. It places the rural smoking population at a higher risk as they are less protected and prepared to handle the virus’s spread and containment from spreading. If the illness spreads, the population would be exposed to danger as they have minimal resources and facilities to help them handle the cases. Complications may arise as the patients have infected lungs, which may create a high demand for ventilators, which are scarce even in the modern-urban hospitals. As a result, smokers in rural areas can be a vulnerable group, especially smokers with pre-existing respiratory health issues.

World Health Organization (2020), ‘the impact of the COVID-19 pandemic on noncommunicable disease resources and services, ‘ discusses the impact of COVID-19 on noncommunicable illnesses. Tobacco use is a risk factor common among NCDs-cardiovascular illnesses, cancer, chronic lung disease, and diabetes. Tobacco already poses a significant risk to the world’s population, especially the rural areas. Tobacco use is a major risk factor among other illnesses, and the pandemic worsens the situation as the smokers are more prone to the illness. COVID-19 affects the patient’s respiratory systems and significantly damages the lungs in extreme scenarios. On the other hand, tobacco consumption is known for causing chronic lung diseases that are severely fatal as they increase the patient’s death risk. The rural hospitals and healthcare facilities are not equipped to handle chronic lung diseases without help from urban centers. The spread of COVID-19 can cause a significant challenge in the rural areas as smoked tobacco and COVID-19 can cause fatal challenges on the patients and the healthcare facilities.

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