This essay will demonstrate the government health policies regarding to smoking including with changes in health care field from the development of NHS with current scenario. It is important to know what is policy. Policy is a collection of different ideas and methods which is used for the improvement in any field including health care and on the other hand, health policy is a practical device, or advantageous procedure and political course of action [ Hennessy, D. & Spurgeon, P., 2000]. Health policies may be explained as the strategies & methods adopted as being advantageous, measure to provide within the recourses available from health systems that, at least maintain and preferably improves health.

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As time is changed there is changed in people thinking, behavior and their lifestyle due to this reason the consumption of cigarette smoking in society is increased from last few decades. Smoking has been recognized as one of the most considerable causes of avoidable death and disease. Smoking alone is the supreme cause of preventable illness and premature death in UK and smoking is responsible for 23 Percent in males and 12 Percent in female deaths. There is more than 106,500 deaths are due to cigarette smoking (Wilkinson S. et al, 2004). Smoking is defined as the inhalation and exhalation of smoke from flaming tobacco in cigarettes, cigars and pipes etc. Historically smoking put into practice, was followed by inhabitants of western hemisphere, in spiritual rituals and for therapeutic purposes. Smoking has a history preliminary from the late 1500s.Cigarette smoking is a serious health hazard. Tobacco contains nicotine a toxic substance named alkaloid -and some others dangerous stuff like carbon monoxide, prussic acid, and ammonia etc which are very harmful for the health. The current scenario of smoking in England have fallen from 28 percent in 1998 to 25 percent in 2003-means approximately 1.2 million smaller numbers of smokers (Department of health,2003). Due to smoking , one in five deaths held in UK and smokers lose, Tobacco smoke can causes the 90 percent of lung cancer then non smokers(Peterson and Peto,2004) [Neubeck, L., 2006]. It is anticipated that about 120,000 young men who aged between 30 and 50 years in the United kingdom are impotent as a consequence of smoking [British Medical Association(BMA)] , 2004].
The main aim and purposes for choosing this topic is to study smoking policy in united kingdom and to improve knowledge about current health policies on local level or at national level and to see the statistical data of smoking cessation and what are the government policies regarding the smoking cessation in the society for different age groups and to discuss the need, origination and operation of policies in health care. To develop the understanding about health care system in the United Kingdom and to improve knowledge about NHS as an organization and its role and policies in health care system.
Smoking is considered very dangerous for health not only for an individual but for the nation also because many billion pounds every year spend by NHS for prevention. Smoking is a causing factor of many diseases which is related to our health and environment directly or indirectly such as chronic obstructive pulmonary disease, heart diseases lifestyle related problems and behavioral problems. Due to smoking, people become habitual and then it is hard to come out from this situation or if a person suddenly quit then it gives some harmful effect to our body. Smoking affects the person and it effects others through second hand smoking and passive smoking. if a pregnant women involves in any kind of smoking during pregnancy then, this is not only harmful to her but also to her baby too and the results are baby deliver with some congenital anomalies.
In the UK (Department of health, 1998) illustrates that, approximately 23% in 1995 and 15% in 2009 babies were born with disabilities who were delivered from smoker mothers. So the government introduced new health policy on smoking ,Choosing health (Department of Health, 2007) introduced the smoke free public policy which says that no is allowed to do smoking in public place such as malls, buses and railway station etc.. This policy included with, to regulate the way of smoking is portrayed on television and on advertisement in newspapers and mark health warning notice on tobacco products. There are some causing factors which enhance or encourage youth to involve in smoking such as now a days it shows as a symbol of prestige and personality which effects the youth and children. Specially children are more prone to be affected by smoking directly or indirectly because they learn from elders and they are more curious to learn and try everything and on health effect their lungs are small compare to adults and their immunity is low and they are more prone to get and harmful effect of cigarette smoke. According to human anatomy children breaths faster than the adults and hence they inhale more toxins and harmful chemicals as compare to adults.
Smoking can cause many diseases it affects the respiratory system and can lead to diseases like cancer, bronchitis etc. .It also causes the headache and poor circulation, bad breath and stomach cancer and cancer of the pancreas ( Peterson and Peto,2004).According to Department of health (2005) in the general adult population for 2001 still shows that approximately 28 percent of men and 25 percent of women smoke (Department of health 2005). There are some other effects of smoking cessation like restlessness, waking up at night, increased appetite, Depression, Mouth ulcers and cancers, with poor concentration on work (smoking and health, 2005).
There are some other risk factors associated with the second-hand smoking. In adults it causes coughing, feeling sick and breathing problems and in babies and children much higher rate of cot death as compared to the children of non smokers. Higher chances of ear infection, complaints of coughs, sneezing and cold and flu (Source Jamrozik, 2005). Nowadays due to change in the disease pattern people are thinking about their health .They want to have smoking policies which reduces the rate of smoking. Thinking of people Behavior and life style is changed. The disease rate of lung cancer, cardiovascular system and respiratory problems are increased due to smoking. In UK 12000 people are die in every year due to second-hand smoke (Jamerozik, 2005). In addition to this, smoking affects in a loss of productivity among workers, and ill health. A smoke free policy needs to be practical and impartial. Second-hand smoke is of two types: Main stream and Side stream smoke.
The Residential and Commercial Services (RCS) introduce that all public places including residential areas, offices areas will be smoke free. This policy comes into progress on Sunday 1st July 2007.Smoking Is prohibited in all enclosed premises i.e. university buildings, covered walk ways. This policy applies to all university employees, students, residents and visitors etc. NHS Direct has a duty to promote and maintain the health of the community. It extends to the work environment, and thus help in promotion of general well being of all people. The NHS Direct policies not worried with people who smoke but with where they smoke and to prevent effects of smoking on visitors, and non smoking colleagues. It is also alarmed with the presence of carcinogenic substances in the vicinity of NHS Direct sites.
From 1st July 2007, practically all enclosed places including work places in England will become smoke free, which will make sure a better and healthy environment, so that everyone can relax, travel and work free from second-hand smoke ( NHS Direct,2008 ).According to this policy smoking is prohibited in all working areas, such as centers and offices surroundings at all times, it will also includes after working hours periods and shifts as well as evenings and weekends and will also in the following ordinary areas: meeting Room, kitchen areas, Store Room reception Areas. According to Health and Safety at work etc Act, 1974).
In UK the Department of Health (NHS Direct, 2008) has taken achievement to increase the general awareness of the risks concerned with the second-hand smoke through the following: countries first ever multimedia and education campaign. Funding to facilitate smoke free cities network and to help cities move towards smoke free on a voluntary basis. Almost all 50 percent in UK (there are 60,000 in the UK) and half of the Restaurants Association (10,500 group and individual restaurants).
Benefits of Action and Second-Hand smoke: Environment and Economic benefits for society individual and industries includes: The NHS expenditures is reduced through smoking prevalence. The costs from the sickness absence are reduced. It enhances safety benefits (such as reduced fire risks).The cleanliness and maintenance costs are reduced. The Action on smoking and health report relates to strategy of tobacco control for England and recommendations which reflects the current balance and reserved powers in England. By helping smokers to quit, harm of tobacco can be reduced. All health professionals should have the skills to provide basics to stop smoking advice to the persons who smokes including the provision of treatment and referral to specialist stop smoking services. There are medicinal products on the market to help the smoker to quit and they also provide substitutes of Nicotine products. The tobacco control community looks ahead to working with the government in shaping the new strategy and new era in tobacco control. The Department of Health, 2004 has set a further public sector agreement(PSA) targeted as to reduce the rate of smoking to 21 percent or less by 2010( 26 percent in 2002).
According to a Report of Smoking in public places on 15th December 2005 was published by the House of Commons Health Committee. They command paper sets out the government response in the report. The aim of government to achieve reduction in smoking frequency through along with combination of policies, which will help 70 percent of smokers who they want to quit.
Smoking in pregnant women remains and issue of public health because the women who continued smoking during pregnancy, the infant born were hospitalized for a considerably more number of days (Petrou etal, 2005)[ ]{midwives attitude to smoking and smoking cessation in pregnancy}. The other national services highlights the danger of smoking like National Services Framework for heart diseases, cancer and children, young person and maternity services they highlights of the danger of smoking .
The Health Action Zone in England, April 1999 to March 2000. The White paper Smoking Kills announced the new money for setting up the cessation services over a three year period. The NHS smoking cessation services will provide a new move towards help the people who want to quit smoking. They provide “specialist” and “intermediate” services. In specialist smoking cessation services they provide intensive treatment, usually clinics, run by smoking cessation specialists, usually in form of group over the course period of 5-6 weeks. It also includes Nicotine Replacement Therapy. In “intermediate” services provided by the other health practitioners who have taken some kind of recognized training usually they provided on a one to one basis, their services also include Nicotine Replacement Therapy.
The new evidences has made by committee in 2004 , which has based on the report of Scientific Committee On Tobacco and Health [SCOTH],1998.They pay attention to the new organization between the secondhand smoke and lung disease. They have published their latest report from SCOTH was along with the Choosing Health White Paper.[Department of Health,2009]. The carpool vehicles should need to display the No smoking signs (NHS, smoking in workplace.2009). The cost effectiveness for government like NHS cost in overall smoking is estimated approximately 1.5 billion pounds a year. This cost will be reduced by decreasing the rate of smoking, about 1.7 percentage rate of smoking is reduced from 25 percent, then it means that about 100 million pounds are saved annually( ).
The development of a smoke-free policy needs to be a practical and impartial. These policies are created to give staff guidance, patient and visitor clear guidance on what is acceptable. The government policy for smoking in the work places is that to reduced passive smoking all employers have to provide designated smoking areas outside the organization (Department of Health, 2009).
Nowadays, the lifestyle of people has been changed the smoking rate is increased in both men and women. Parents smoke in front of their children this leads to affects the children because the children are more curious to learn and they want to trial and experiment of smoking in their peer groups. In pubs and discos youth enjoying their parties with wine, alcohol and smoking. They start due to their peer pressure and thereafter they become habitual of smoking. People spend most of times outside from their homes and they live alone so they start drinking alcohol and smoking to reduce their boredom and tensions. Due to this kind of social impact on the people the rate of smoking is increased.
Nurses play an significant role for delivering health policies in the society through the use of education program for on individual and to the community. Encourage people to attend workshop for the cessation of smoking provide them support to come out of this .Use the opportunities to explain the relationship between changes in health status and smoking. They assess the smoking status of patients and to give advice all smokers to stop. They assist the people who interested in doing so. Health care practioners offer follow up and refer them to specialist stop smoking services if they required. For heavily addicted smokers who are currently unable or to quit, there is also the possibility of switching to pure Nicotine products (which like the current medicinal products on the market, contain Nicotine only and other tobacco derivates).Smokers are addicted to Nicotine but they are harmed by the tar and toxins in tobacco. Now there is more than ever a need for increased efforts to promote tobacco education and the intervention amongst nurses in order for them to have the prospective to be credible and successful advisers to patients and the public.
The community healths nurses are in very good position interfere with smokers. Many who want to give up smoking do so as a result of the health problem. So the problems in community in those nurses have a significant role to help them and community and community people to quit from this lethal problem. People who are habitual to smoke of if they want to quit from it then and nurses and government have to prepare policies to available to them substitute of smoking for example Nicotine Replacement therapy such as chewing gums. Asses the smokers to and help them to quit the smoking give them proper advice and suggestions and help them to take classes and join workshops to the smoking in the society. Advice them that take proper substitute of smoking instead of taking tobacco instance they may consume nicotine substances or the cigarettes and they also take some medical subanstances to reduce their smoking habit. the community health nurse should health to stop smoking . And there are faster acting NRT produce Department of Health, 2000ts available and are being developed in the current scenario. There are more and more treatments are becoming available for smoking cessation. It is a rapidly developing field in the society and there are some others methods like Hypnotherapy is suggested and Acupuncture therapy is beneficial. The care which is offered to the pregnant women would impact on society.
In conclusion, many government policies have been implemented in local and national level for the development of people and encourage them to adopt healthy life style and stop smoking although the government gets several incomes from the sale of tobacco products. These policies and recommendations are taken from NHS and the department of health and implemented in the society. The harmful effects of smoking not only affect to the mother but also their baby in the womb and the impact of health care policies in health care system. It starts with the effects on the fetus and carries on throughout childhood.