Smoking And Anti Smoking Regulations Health And Social Care Essay

The baccy epidemic is a immense menace to public wellness. Harmonizing to WHO each twelvemonth, about six million people die due to it and out of these more than 5 million are current tobacco users and ex-smokers and about 600, 000 are inactive tobacco users. Approximately one individual dies every six seconds due to tobacco and this histories for one in 10 grownup deceases. Up to half of current users will finally decease of a tobacco-related disease. Lower and in-between income states have the highest load of baccy related diseases and comprise of about 80 % of the tobacco users worldwide. Unchecked, tobacco-related deceases will increase to more than eight million per twelvemonth by 2030. Over the class of the twenty-first century, baccy usage could kill a billion people or more unless pressing action is taken.

Harmonizing to professor J. Khan, Aga Khan Hospital, Karachi, every twelvemonth about 100,000 Pakistanis dice due to smoking [ 1 ] . Smoking coffin nails poses great wellness hazards to its consumers and besides to non-consumers exposed to the contaminated environment. Persons who smoke coffin nails are 12 times more likely to decease from lung malignant neoplastic disease, two to four times more likely to develop coronary bosom disease, twice every bit likely to hold a shot, and 10 times more likely to decease from chronic clogging lung disease. [ 2 ]

Cigarette smoke is the most usual manner of smoke, accounting for 65-85 % of planetary baccy ingestion. It is estimated that one in three people smoke worldwide. Harmonizing to World Health Organization ( WHO ) estimates there are around 1.1 billion tobacco users worldwide. [ 3 ]

In Pakistan, the prevalence of smoking in population-based study varies from 21 % to 30.3 % [ 4 ] . Harmonizing to WHO 2011 study 32.4 % males and 5.7 % females are current baccy tobacco users in Pakistan. [ 5 ] A survey conducted by R. Maher and S. Devji in 2002, showed that the prevalence of smoke in Karachi metropolis is about 33 % , which was similar to antecedently conducted surveies which showed prevalence of about 21-32.3 % .

Although smoke is one of the most of import preventable causes of morbidity and mortality worldwide, merely the last 15 old ages attempts have been made by authorities and private concern policies to restrict smoke in enclosed public countries, including workplace. [ 6 ] The Prohibition of Smoking and Protection of Non-Smokers Health Ordinance of 2002 had come into consequence in Pakistan on June 30, 2003. However harmonizing to a reappraisal article by Sabir Shah in November, 2012, Pakistan still does non hold effectual smoke limitations in force boulder clay day of the month.

Harmonizing to WHO study on planetary baccy epidemic 2011, supplying a smoke-free environment is one of the six evidence-based baccy control measures that are proven to cut down baccy usage and salvage lives. [ 7 ] Hospitals in most states have enforced steps to command baccy use by censoring smoke in infirmary edifices. Hospitals and their staff members are supposed to deter wonts hurt to one ‘s wellness such as smoke, whereas their tolerance to this wont will hold the opposite consequence. . With the world-wide anti-smoking runs, it seems improbable that smoking would take topographic point in infirmaries, nevertheless the pattern continues. Particularly in states like Pakistan, due to weak execution of Torahs, smoke is still prevailing in workplaces including infirmaries.

Health Professionals comprise the most of import staff members of a infirmary. They can play a significant function in commanding tobacco use among the population coming in contact with them. They can increase consciousness on the injuries imposed by baccy ingestion through public instruction, better communicating, and informational runs along with other demand decrease steps refering baccy dependance and surcease as they reach a high per centum of the population. They are considered by most people as a dependable beginning of wellness information hence they can utilize this chance to alter behaviors, give advice and supply counsel sing effects of baccy ingestion. [ 9 ]

World Health Organization asks all wellness professionals to move as function theoretical accounts for their patients. Some states have experienced steep diminutions in smoking prevalence among wellness professionals. However, there is grounds that a significant proportion of physicians continue to smoke in Pakistan. In a 2003 survey carried out in Karachi, 32 % of physicians at a teaching infirmary were tobacco users. The most recent studies have found a smoke prevalence of 19 % to 26 % among male and 1 % to 5 % among female medical pupils in Pakistan [ 10 ]

A survey was conducted in 2010 at Mayo infirmary, Lahore, to detect the frequence of coffin nail smoke in physicians and paramedics. They received informations from 234 physicians and 207 paramedics. The consequences showed that 80 seven ( 37.18 % ) Doctors and 74 ( 35.74 % ) Paramedics were tobacco users with 82 ( 50.31 % ) male physicians and 5 ( 7.04 % ) females. This survey shows that a important figure of physicians and paramedics fume.

If physicians and other staff members continue to smoke, it would be hard to do the infirmary environment smoke-free and physicians who smoke themselves can non efficaciously act upon their patients to avoid or discontinue smoke. Since infirmaries can hold a major impact on public sing smoke, a cardinal measure would be to find the behaviors and attitudes of hospital staff members towards smoking and their conformity with anti-smoking ordinances.

The aim of this survey is to find the attitudes and behaviors of the hospital staff members of the Aga Khan University Hospital ( one of the major third attention infirmaries in Karachi ) towards smoking. This survey besides aims at measuring the positions and conformity of the hospital staff towards anti-smoking ordinances in the infirmary.


Multiple surveies worldwide have been conducted to find attitudes and behaviors sing smoke among physicians and hospital staff members but few such surveies have been conducted in Pakistan.

Establishing the attitudes and concerns sing smoke and the willingness of the hospital staff members towards smoking prohibitions can assist plan future policies to ease in cut downing the load of baccy related diseases.


Study design: Cross-sectional, descriptive.

Study scene: this survey will be conducted at the Aga Khan University Hospital, Karachi, one of the major third attention infirmaries of Pakistan. Patients from all over Pakistan visit this infirmary for both outpatient and inpatient services. The infirmary consists of 577 beds. It provides patients with high quality of attention in a broad scope of secondary and third services providing to over 50,000 hospitalised patients and to about 600,000 outpatients yearly.[ I ]

Study topics: all full-time staff members employed at the Aga Khan University Hospital, Karachi.

Inclusion standards: all full-time staff members employed at the Aga Khan University Hospital, Karachi.

Exclusion standards: staff working part-time will be excluded.

Data aggregation: all staff members working full clip at the Aga Khan University Hospital Karachi will be approached. A self-administered questionnaire will be provided after taking permission from the infirmary ‘s disposal. . All topics will be briefed about confidentiality, namelessness and the pick to decline. During the filling of the questionnaire the research workers will assist the respondents, if needed ; but they will in no manner act upon the replies. The respondents will hold the right to choose out of make fulling the questionnaire, if they feel the demand to make so.

The information will be entered into EpiData 3.1 by two research workers individually and so compared to guarantee cogency of the consequences.

The informations aggregation tool that will be used is a self-administered questionnaire. This will be both in English every bit good as Urdu linguistic communication to ease the survey topics in understanding the inquiries.

The information requested will include sex, age, section at which employed, and whether the respondent is a non-smoker or ex-smoker, and if smoker the measure of coffin nails smoked per twenty-four hours, the measure of coffin nails smoked while at work if any and the old ages she/he fumes. They will besides be asked if they suffer from smoke-related diseases like high blood pressure, coronary bosom disease and respiratory jobs.[ two ]Staff members will be asked about their positions on whether smoke should be permitted in assorted countries of the infirmary ( such as wards, offices, and cafeteria ) , and whether there should be 24 hr entree to smoking remainder suites for patients, staff, and visitants. Smokers will be asked if they would wish to fall in a “ quit smoke ” support group.[ three ]Finally, they will be asked to describe if any member of their household is a current tobacco user.

“ Non-smokers ” will be defined as those who report holding smoked no cigarettes the last 6months. “ Ex-smokers ” will be defined as those who report holding smoked at least one coffin nail per twenty-four hours for a twelvemonth but smoked no cigarettes the last 6months. “ Smokers ” will be defined as anyone who habitually smoked coffin nails, irrespective of sum.

Operational DEFINATIONS:


Smoke is the inspiration of the fume of firing baccy encased in coffin nails, pipes, and cigars. A smoke wont is a physical dependence to baccy merchandises. Many wellness experts now regard accustomed smoke as a psychological dependence, excessively, and one with serious wellness effects.


An attitude can be defined as a positive or negative rating of people, objects, event, activities, thoughts, or merely about anything in the environment. Eagly and Chaiken, for illustration, specify an attitude “ a psychological inclination that is expressed by measuring a peculiar entity with some grade of favor or disfavor.

Sample size:

Entire figure of full-time on the job staff at the Aga Khan University infirmary will be identified to bring forth a sample size.

Sampling methodological analysis:

Non-randomized sampling, since the intent is to acquire information from all staff members.

Ethical consideration:

Ethical blessing of the survey would be taken from the Ethical Review Committee ( ERC ) of Aga Khan University, Karachi. The Questionnaires will be handed out to staff members after a verbal every bit good as a written consent has been obtained.

Respondents may experience free to hold or decline to reply the whole questionnaire. Anonymous self-administered questionnaires will be used. Information collected will be kept confidential and will non be disclosed to any other research participant except the chief research worker. The consequences will be published one time the article gets accepted in an indexed diary.