HEALTH NEEDS ASSESMENT OF PREGNANT WOMEN IN NORFOLK ADDICTED TO TOBACCO SMOKING
BACKGROUND
Smoking is one of the leading causes of avoidable deaths in the United Kingdom. Treatments for smoking related illnesses financially burden the NHS (National Health Service) an estimated £1.5 billion per year (Twigg, 2004). Smoking, in general terms, is the inhalation of smoke from burning tobacco- and may be in the form of cigarettes, pipes and/ or cigars. A smoking habit is a physical addiction to such tobacco products; several health experts support that habitual smoking is a psychological addiction and one with adverse health consequences. Leventhal and Zvolensky (2015) claimed that emotional vulnerabilities link anxiety and depression to smoking; individuals may either be casual or social smokers, but such vulnerabilities have been shown to exist in both such groups. Despite the existence and awareness of targets to reduce smoking during pregnancy in the United Kingdom, the practice remains rather widespread. In a survey done in 2013, 11 percent of pregnant women aged 16 to 49 were identified as smokers and 34 percent as ex-smokers (Statistics on Smoking, 2015). Therefore, active research in terms of understanding the needs of pregnant smokers may be required along with providing them with appropriate support to help them quit the dangerous habit. The current assignment explores the health needs of pregnant women who smoke in Norfolk, United Kingdom. The concept of “need” is one of subjectivity, variability and constant change (Cowley et al., 2000). There are many different theoretical understandings of what needs are, and in ways to solve them. These include; Ponsioen (1962), who asserts that, it is society’s first responsibility to meet the basic survival needs of its members (biological, social, emotional and spiritual); Maslow’s (1943) Hierarchy of Needs defines the needs of life in an order in which needs have to be satisfied (Kendall and Bryar, 2012). Therefore, basic needs must be satisfied before higher needs, to enable individuals to reach their full potential (Thrower, 2002). In order to address the health issues that arise due to smoking during pregnancy for mothers and neonates, health needs assessments needs to be undertaken.
Smoking is the leading preventable cause of morbidity and death among infants and women (Coleman et al., 2012). The known adverse effects during pregnancy and birth outcomes associated with smoking during pregnancy such as placental abruption, miscarriage, congenital abnormalities, low-birth weight, neonatal and sudden infant death as well as increased risks of congenital anomalies, smoking during pregnancy remains prevalent (Hackshaw et al., 2011). Several women continue smoking throughout their pregnancy period, with approximately 17% in England and Wales and 14% in the United States (Tong et al., 2009). Beenstock et al., (2012) reported how around 5000 miscarriages and 300 perinatal deaths per year result from maternal smoking in the UK. The true prevalence of maternal smoking during pregnancy however is likely to be much higher, as under-reporting by mothers who smoke is apparent due to the stigma attached to smoking during pregnancy. The detrimental effects of smoking during pregnancy are not only physiological, but they also include negative consequences on educational and behavioural performance such as issues related to hyperactivity and attention (Lumley et al., 2015). Additional negative consequences encompass increased risk of respiratory infections, asthma, high blood pressure and early onset of diabetes. Pregnant women are also more likely to continue to smoke throughout their pregnancy if they live in a household with presence of other smokers (Owen and Penn, 2002). Research has also shown that having a partner who smokes results in a higher relapse rate amongst pregnant women making it much harder for them to quit (Fang et al., 2004).The cessation of smoking during pregnancy is thus crucial for both maternal and foetal health (Coleman et al., 2012).
HEALTH NEEDS ASSESSMENT
Thus, there is a health need, which needs attention in this particular area. Recognising the health needs of people and communities leads to the availability of flexible health services, with increased accessibility. Carrying out health needs assessment requires careful preparation, the availability of relevant information and clear and effective communication across multidisciplinary teams (Jack and Holt, 2008). A health needs assessment is a systematic method that helps identifying the unmet healthcare needs of a population and then allows the making of changes to address those unmet needs. It is an assessment tha