Essay: Critically evaluate the role of the social cognitive models on our understanding of smoking as a health behaviour

A critical review of understanding that smoking is a health risk behaviour from the social cognitive models’ view. Social cognitive models attempt to explain the factors which could result in poor health behaviours. They also explain that through psychological physical and social interventions these can condense the engagement with such behaviours (Armitage & Conner, 2007). There are numerous social models, such as the Theory of Planned Behaviour, the Theory of Reasoned Action, the Protection Motivation Theory, the Health Belief model and the Transtheoretical Model of Behaviour Change. The point of this assessment is to analyse explicitly the Transtheoretical Model of behaviour change (Prochaska & DiClemente, 1983) and the Health Belief Model – HBM (Becker & Rosenstock, 1978) in our perception of smoking being a health behaviour.
Health behaviour theories are vital, as they intend to comprehend the origin of human behaviour, how you alleviate threat to your health and what causes the change. To encourage wellbeing/health, cultivate approaches and propose intercessions to decrease risk.
Smoking can have acute consequences to health, for example, infatuation, dependency in nicotine as it increases the levels of neurotransmitter dopamine, this transports straight to the brain through the blood from the lungs causing a short period of ecstasy thus the pharmacokinetic assets make a need for the drug. Activating withdrawal side effects when smoking is constrained, which can cause depression, impatience, attention deficits, cravings, Sleep disruption and anxiety (NIDA, 2018), thus effecting all properties of the cardiovascular system in one way or another, therefore this heightens the likelihood of cardiovascular diseases and associated cancers (Parkin, Boyd & Walker, 2011). The organs which receive the worst impact are the heart and lungs. There are many illnesses that arise due to smoking such as, pneumonia, heart attacks, chronic bronchitis, coronary heart disease, lung cancer etc.
Furthermore, smoking can cause cervical cancer as well as be linked to infertility for both genders. Many reports by the NHS (2018), state that approximately 10,000 people die every year due to smoking. Doll & Peto (1981) anticipated that 75% of the deaths due to cancer were related with behaviour, of which 35% was due to poor diet, 30% because of smoking, 3% due to liquor intake and 7% due to sexual conduct. Moreover, Mokdad et al (2004) conducted a much recent study in USA where the primary cause of death is smoking at a maximum rate of 18.1% than physical inactivity and poor diet at 16.5% and lastly at 3.5% was alcohol consumption. These figures establish a substantial percentage of the population’s death rate due to behavioural attributes, more exclusively, smoking.
Excessive Smoking can have a negative impact on an individual’s health, exclusively those who are younger i.e. babies and young children as they are more vulnerable. Environmental tobacco smoke can encourage the possibility of acquiring chest infections such as bronchitis and asthma. Regardless of all the severe health disorders related with smoking, individuals still enthusiastically engage in this health behaviour. This generates many enquiries as to why individuals are keen on participating in this health behaviour and how it can be prohibited. Generally speaking, smoking can have inconvenient impacts to our wellbeing, and it causes addiction, in this manner it could be progressively hard for somebody to free themselves from it.
To test the efficiency of the social cognition models – TPB, HBM, TRA & PMT, a study was performed by Ogden (2008), the analysis from this study showed that these models can be believed as rational tools for researchers and health psychologists, as they deliver an important structure. However, there are some flaws in this study, as the models cannot be verified as they focus on systematic facts rather than artificial facts, which can alter and produce both behaviours and cognitions rather than define them from their theoretical basis.
A further study was conducted by DiClemente & Prochaska (1982), where individuals who smoked were given a demographic smoking history questionnaire, along with a change-process questionnaire following the successful deficiency they were then seen 5 months later and interviewed again. Spoken procedures impacted the decision-making procedure to change while activity procedures were crucial in breaking the smoking habit.
The first model developed for health-related behaviours was the Health Belief Model in 1950s. From that point forward, this model has been favoured and extensively utilised within the health and education field. Benefits, perceived susceptibility, barriers and severity are four key concepts within the HM model. Emphasis on ‘perceived’ as it is alleged to be the individuals’ views of the barriers and the benefits which are linked with specific activities that regulate behaviour.
Perceived barriers allude to a person’s evaluation of the complications to behaviour change. Regardless of whether an individual sees a health condition as undermining and accepts that a specific activity will viably diminish the risk, barriers may avoid commitment in the wellbeing advancing conduct. At the end of the day, the perceived advantages must exceed the perceived barriers all together for conduct change to happen, for example, the withdrawal signs and conflicts in light of the nicotine dependency.
Perceived susceptibility is the belief that an individual has obtained a condition or prone to have a condition in light of taking an interest in a behaviour, for instance, getting malignancy due to taking part in smoking. Individuals’ who think they may have a serious health problem may participate in behaviours in order to avoid the risk from occurring.
Perceived benefits is the individual’s valuation of the effectiveness of engaging in a health-promoting behaviour to diminish the possibility of illnesses. For instance, if an individual believes that a specific action will diminish susceptibility or decrease the severity of the illness, then that individual will be most likely to engage in that behaviour for example, wearing sunscreen to eliminate the risk of getting cancer.
Perceived severity is when an individual realises the severity of the health problem and the consequences that can result from the illness due to the health behaviour. Therefore, individuals again are most likely to engage in behaviours that will avoid the health problem from arising.
The grouping of perceived severity and susceptibility see the pleasure of this approved health behaviour, if the risk is huge the likelihood of taking part in a health defensive behaviour is higher than it would be if the risk was seen as low. Equally, the person’s assessment of perceived barriers and benefits merged decide the reaction to the health behaviour change if advantages exceed the costs.
Self-Efficacy and Cues to Action are also two important components of the Health Behaviour Model. Self-Efficacy alludes to the view that an individual can effectively embrace a specific behaviour and continue with that behaviour despite difficulties, the trust in their very own capability. Cues to Action performs as a trigger to behaviour, this compels the individual to make a move i.e. viewing an advertisement on TV regarding charity and needing to contribute etc. These can be external or internal. Examples of internal cues of action can be symptoms or pain due to an illness. Furthermore, it escalates the individual’s readiness to make a move.
However, there are a few issues with the health belief model as it accepts that individuals are coherent with their practices and have coherent information handling. It has a fairly idealistic desire as it presumes each individual would propose to limit risk, and doesn’t accentuate enough on the social ecological factors that could impact and incriminate the procedure and our behaviour, for example, peer pressure, since every one of these recognitions are influenced by adjusting variables, for example, knowledge, gender, socio-economic group, age, ethnicity, which the model examines yet is concentrating more on the individual and does exclude passionate components related with, for instance anxiety or fear. The theorists Harrison, Mullen & Green (1992) claimed that the Health Behaviour Model anticipated rationality as well as being spontaneous and has a realistic significance in the study of health behaviours.
The theorist Prochaska created The Transtheoretical Behaviour Change Model in the 1970s, the model points on the procedures that lead individuals to change their health practices and keep up the appropriate behaviours, through a system that surveys a person’s availability to progress to another behaviour and gives methodologies to move towards the proposed behaviour through the following five phases: maintenance, contemplation, action, precontemplation and preparation,
Precontemplation stage is the point at which an individual isn’t prepared and there is no motivation to change their health behaviour, as it is not seen as an issue, this could be due to not being advised adequately about the harm which can be caused to an individual’s life. Interference in this stage isn’t relevant as it is too soon, and any support could be viewed as a danger of just perceiving the negative impacts and being increasingly impervious to the possibility of their health behaviour difference. For example, susceptibility to cardiovascular ailments and cancer.
The Contemplation stage, individuals are proposing to begin the healthy behaviour (characterized as within the following half a year). Individuals perceive that their behaviour might be challenging, and a progressively keen and practical consideration of the advantages and disadvantages of changing the behaviour occurs, with equivalent accentuation set on both. Indeed, even with this acknowledgment, individuals may in any case feel indecisive toward changing their behaviour.
The Preparation stage is when individuals are prepared to make a change or small changes. For example, decreasing the number of cigarettes smoked daily. Individuals begin to make steps towards the behaviour change, and they believe changing their behaviour can prompt a more beneficial life. Individuals require a support group or a plan of action in order to progress to the next stage and guarantee success.
The Action stage is when the change has been implemented and the individual is enthusiastically participating in the new behaviour, in this context the change would be to longer smoke.
The last stage of TTB is Maintenance, in this stage individuals have maintained their change of behaviour and they aim to maintain the change of behaviour going forward. Individuals in this stage work hard to avoid reverting back to the earlier stages.
Moreover, there are a few limitations related to the transtheoretical model of behaviour change when utilising this model in public health, for example there are not any instructions provided in how much time is required for each stage or how long a person can stay in each stage, is it days? Weeks? Or months? also it overlooks the social perspective in which change occurs. Prochaska & Velicer (1997), tested this theory for smoking, with an additional stage of termination after the last stage maintenance and revealed that through the execution of the model, health promotion and interference procedures can have a optimistic influence on behaviour change.
Every social cognitive model has given a structure analysis clarifying what characteristics change health behaviours and how this could be accomplished. To conclude, the social psychological models attempting to fathom the human behaviours and behaviour change and give a specific frame to interference. Assessing the transtheoretical model of behaviour change has improved our comprehension by expanding familiarity with the individuals’ capability to act to trigger behavioural change. The health behaviour change model investigated the patient’s inspirations to function. One might say that these speculations are interlinked, as stage two of TTB (contemplation) has a comparable justification to the HBM. HBM was hypothesised in 1950s and the TTB was speculated on the 1970s this shows a movement of comprehension after some time. The TTB has gone onto expand these speculations and outline the procedure a patient would experience in transit of behavioural change.
Subsequently, activities such as restricting indoor smoking in public spots, and advertising the negative health effects of smoking on tobacco. In addition, raising awareness of the craving and its outcomes through advertisement, health training classes provide in schools for children and supporting services for nicotine addicts, for example, activities like Smoke Free zones.