Perspective of Carl Jung Essay Example for Free

Perspective of Carl Jung Essay The most obvious thing Carl Jung had an opinion was the psychology of the times, and how the mind worked. His main interaction of the ideas of the time was through his, what one could call, feud with Freud. Freud believed that there were two parts that affected human thought and action: the conscious, and the subconscious. The conscious was what we thought, believed, and other things that we were able to easily access in our minds, such as strong memories. The subconscious however, was everything that affected our behavior and though, but wasnt easily reachable, such as recessed memories and thoughts and instinct. Jungs system was a slightly more complex system made up of three parts: the conscious, the subconscious, and the general subconscious. The conscious was basically the same, but the subconscious lacked Freuds instinct, and the general subconscious was totally new. Jung believed that every human being tapped into a general subconscious, which allowed instinct, similar reactions to things, and another key subject in Jungs psychology: Archetype and symbols. In Jungs psychology, he believed that there were many symbols and ideas that were immediately recognizable to people of any education, race or class. The thing was that since this was a part of the general subconscious, we were likely not even able to recognize that we recognized these symbols! This recognition may stem out of an emotional response, or a simple nagging feeling at the back of the mind, if anything at all. Another important pillar of the Jungian psychological ideas was the interpretation of dreams. Again, he ran against Freud in his ideas about interpreting dreams. The Freudian method of ‘free association allowed for any detail of the dream to be focused upon, and continually broadened upon until the ‘problem was found. The Jungian method believed that the dream as a whole had a specific purpose. The overall feeling, topic and main details of the dream were focused upon in this method rather then any individual one.

Smoking and Coronary Heart Disease Impact

Smoking and Coronary Heart Disease Impact Introduction Medical innovations and rapidly evolving technology has led to a decrease in the rate of mortality from diseases. However, the fast and constantly changing hectic lifestyle of today has led to the introduction of new diseases, unhealthy lifestyle and early, premature deaths. Todays technology has provided us with the benefits of early detection and preventive treatments and answers to some of the previously incurable diseases. But it has brought in increased stress and unhealthy eating and other habits that have in some ways caused more harm than benefit. This report titled Smoking: The Heart Breaker is a look at the current situation of coronary heart diseases caused by smoking, relevant legislations, policies and practices, strategies to deal with the situation and future of the disease at local, national and global levels. The report will start by discussing the smoking and coronary heart disease as a public health issue and the reasons for concern. It will provide a background to help better understand the present situation along with an epidemiology of the disease and its causes, with special reference to smoking. It will then go on to report about the legislative policies and strategies that are being currently undertaken in the region of Burnley, East Lancashire to counter this particular health issue. The report will also discuss the policies and initiatives and the status of the health issue at national and global level, so as to provide a complete and holistic picture of the seriousness of the health issue. Finally the report will discuss the current strategies being employed by the government as well as non-government agencies to tackle the health issue. Recommendations will also be made to help make an improvement in the current situation. Public Health Issue: Coronary Heart Disease due to Smoking The term Coronary heart disease is used to describe a condition of blockage or interruption of blood supply to the heart due to build-up of fatty substances in the coronary arteries (NHS, 2009). This build-up (called atheroma) can lead to insufficient supply of blood to the heart causing pain in the chest known as angina. A completely blocked artery can lead to a heart attack (called myocardial infarction) (NHS, 2009). There are various mild to critical impacts of this condition that even result in death. According to the British Heart Foundation Statistics (2009), diseases related to the heart and circulatory issues are the biggest cause of deaths in the UK, resulting in over 90,000 deaths in the UK in a year. This has resulted in not only raised concerns about the disease but also growing efforts to increase the awareness about the disease, its causes, and preventive as well as precautionary measures that can help to avoid the disease. The situation isn t any brighter in other par ts of the world. According to the World Health Organisation (WHO), the majority of countries around the world are affected by coronary heart disease and the disease is a major killer, especially in developing and transitional countries of the world. In a WHO report, cardiovascular diseases including coronary heart disease is considered to be the leading cause of death and is projected to increase from 17.1 million in 2004 to 23.4 million in 2030 (WHO, 2004). Among the various causes of coronary heart disease, smoking is regarded to be one of the primary causes. According to the WHO report, tobacco-related deaths are expected to rise from 5.4 million in 2004 to 8.3 million in 2030, representing 10% of all global deaths; and smoking has been associated to cardiovascular diseases and subsequent deaths (WHO, 2004). According to a study conducted in 2008, smoking is the leading cause of cardiovascular diseases including coronary heart disease (Bullen, 2008). Though increasing age has been thought as a cau se of coronary heart disease, two studies have found that improper lifestyle, stress, etc are increasing the mortality rates due to coronary heart disease among the young population in the UK, USA and Australia (Nemetz, Roger Ransom, 2008) (Ford Capewell, 2007). Therefore, the growing concern for this disease and its preventable yet common cause is the choice of topic for this report. Background and Epidemiology Cardiovascular diseases including coronary heart disease have been found to be an unbiased killer that can create havoc in any society irrespective of its economic, political, cultural, religious, regional or racial identity. Similarly, tobacco smoking (either active or passive) is known to be a major cause of many diseases including the coronary heart disease. Given the stressful lifestyle in today s world, many people take up smoking to tackle the stress levels and in the process get addicted. They not only harm themselves but also people around them. The region of Burnley in East Lancashire, is no exception to this trend. Being witness to many friends and family members taking up smoking in the name of relieving stress and then getting addicted and finally ending up suffering from diseases, especially coronary heart disease inspired the choice of topic for this report. There are several causes that can result in coronary heart disease. The NHS lists smoking as the major cause of the disease (NHS, 2009). The various other causes of coronary heart disease have been listed as high blood pressure, high level of cholesterol in blood, presence of thrombosis and / or diabetes unhealthy lifestyle with no regular exercise, obesity and a family history of angina and / or heart attack (which are hereditary) (Nemetz et al, 2008). The risk factors associated with coronary heart diseases which cannot be treated, modified or changed include age, gender and heredity (or race). Increasing age increases the risks of coronary heart disease and fatality from it. Men are found to be at a greater risk of suffering from coronary heart disease in comparison to women (Wells, 1999). Heredity of coronary disease or its causes such as diabetes, high blood pressure, and cholesterol are also known to create risks of coronary heart conditions. The causes such as smoking, high le vel of cholesterol in blood, high blood pressure, physical inactivity, being overweight and / or obesity and diabetes (diabetes mellitus) are some of the risk factors of coronary heart disease that can be modified, changed and controlled by taking medication and / or by adopting a healthy lifestyle. Other risk factors and causes of the disease include stress and alcohol addiction and can in certain circumstances prove to be fatal causes of the coronary heart disease (Ewles Simnet, 2003). Comparative data of the effects of coronary heart disease in different countries do not provide a very positive picture (see appendix 1). According to a World Health Organisation survey report, the mortality from cardiovascular diseases in 2002 for the developed nations like the United Kingdom and the United States was higher than many other developing nations like China, India, even Nigeria (WHO, 2002). It is clear from the data, that developing countries have a much higher mortality rate from cardiovascular and consequently coronary heart diseases in the developed countries like UK, USA, Germany; and an important fact to notice is that the death rate is higher in the European region in comparison to other regions of the world. This most probably can be attributed to the excessive use of tobacco, alcohol, improper lifestyle that increases stress levels, improper eating habits that leads to blood sugar and cholesterol in the blood. The tobacco usage in different countries around the world also points towards the grimness and enormity of the situation, through which one can appreciate the risk of tobacco causing further deaths due to coronary heart disease (WHO, 2008). The WHO report on tobacco consumption in different countries show that despite government initiatives and regulations, the tobacco consumption has mostly increased and has led to increased mortality especially in the age groups between 25-45 years. Though coronary heart disease is of global nature without any kind of boundary, various specific groups of people are in greater risk of having the disease in comparison to others. The affinity to having coronary heart disease is dependent on factors such as geography, heredity, age and gender. Men are at an increased risk of suffering from coronary heart conditions as compared to women (Wells, 1999). Increase in age increases the chances of suffering from coronary heart disease (DoH, 2004). Coronary heart conditions are also known to be prevalent among Mexican Americans, some Asian Americans, American Indians, and Native Hawaiians (American Heart Association, 2010). England is one of the most vulnerable nations in Europe when it comes to coronary heart diseases (NHS, 2009). Populations in developing and underdeveloped nations of the world too are at a higher risk of suffering from coronary heart disease and related fatalities (American Heart Association, 2010). Smokers, obese people and people with high blood cholesterol are also included in the high risk group for coronary heart disease. Female smokers are more susceptible to the disease especially with increased age since females are more susceptible to the dangers of smoking in comparison to men (WHO, 2002). With increased impact of aggressive and unhealthy lifestyle and stress, the young population across the developed nations of the world too are increasingly coming under the risk of coronary heart disease (NHS, 2008). Therefore, these risk factors result in the coronary heart disease taking on a pandemic nature if certain precautionary and preventive measures are not taken to control the risk factors that can be influenced. Strategies, Policies and Initiatives Given the growing concern about coronary heart diseases, deaths due to the disease and the impact on the younger population, government agencies around the world are taking steps to combat the growing menace. Non-governmental and private agencies too are joining the efforts to promote a healthy lifestyle and awareness about preventive techniques that can help to bring down the risks associated with the disease and the rising cases of fatalities. This section of the report looks at the strategies, agenda, policies, that are being undertaken at the local (NHS East Lancashire, 2010), national and global levels to combat coronary heart disease. Local Public Health In East Lancashire, several workshops and other programmes have been undertaken to increase awareness, educate and help the residents of the area give up smoking and adopt a healthy lifestyle that will help prevent and fight coronary heart disease. The MPs in the region are encouraging antismoking legislations and policies being adopted by the authorities. The NHS has introduced the concept of smoke free zones. The SMYL programme is promoting healthy lifestyle and eating habits (NHS East Lancashire, 2010). Another campaign called Could it be you was also started in 2008 to help people fight coronary heart disease and adopt healthy and preventive lifestyle (Chime Communications Plc, 2008). The authorities in East Lancashire have also collaborated with different agencies to start networks that can promote anti tobacco campaign and raise awareness on coronary heart disease (NHS Networks, 2010). This involvement of the government as well as non-government agencies in the area, one can b e hopeful that headway will be made into the matter. However, it is important that the public realise the criticality of the situation and take advantages of the programmes being undertaken to have a long, healthy and disease free life. Implications at the National Level The National Heart Forum (2006) indicated that heart diseases cost the UK around  £29 billion per year and was termed as economic burden . There are several programmes that have been taken up by the health care authorities and the government in collaboration with non-government agencies to promote anti smoking habits in the country. Several regional programmes such as Bolsover Teenage Smoking Programme, Corby Smoking Cessation Programme, Halton Smoke-Free Programme, London Borough of Tower Hamlets Tobacco Control Alliance, Pendle Smoke-free Council, Heartbeat Awards, the GO Smokefree Campaign, etc have been launched in an earnest to curb the growing effect of smoking in the country (IDeA, 2009). Several governmental legislations have also been put into place (IDeA, 2007). The Department of Health has also started programmes such as Start4Life, 5 A Day, National Support Teams and Let s Get Moving to promote healthy lifestyle that can help to prevent coronary heart disease (DoH, 201 0). Therefore the various government and nongovernment agencies in UK are making effort to control smoking habit and improve lifestyle of the citizens of the country thereby ensuring a brighter future free from smoking and coronary heart disease. Global Health The fight against smoking and coronary heart disease has taken enormous proportions with the growing realisation that these are two of the most important killers in the world today. Especially, the understanding that smoking causes diseases such as the coronary heart disease not only in the smoker but also in non-smokers who have been in the presence of smokers, has led major organisations and developed nations of the world to taking a stand against smoking. The Work with Heart project by WHO is helping to spread the message of preventive actions that can help in prohibiting coronary heart disease and other cardiovascular diseases (WHO, 2010a). WHO has also taken up research and global partnership initiatives to help the developing countries of the world fight cardiovascular diseases (WHO, 2010b). Furthermore, WHO has aligned with several countries in the world to promote regional activities under the global strategy to counter cardiovascular diseases which includes America, Eastern Mediterranean, Africa, South-East Asia, European region and Western Pacific (WHO, 2010c). To help fight the smoking addiction growing among countries, WHO has set up the Global Tobacco Surveillance System (GTSS) (WHO, 2010d) and is also collaborating with different international organisations such as the United Nations and the governments of various countries to help campaign against sale and use of tobacco among different nations (WHO, 2010e). Recommendations and Conclusion Upon analysing the current situation on a local, national and global basis, the following recommendations can be made: Initiatives to prevent coronary heart disease and promote anti smoking habits need to be undertaken at the grass root level, i.e. at local level. This will make the initiatives and campaigns more effective. The developing nations such as India, Brazil and China need to be targeted with confidence. Further researches into preventive and curative medicines and technologies for coronary heart diseases need to be promoted. Healthy lifestyle needs to be promoted at every level since preventive practices are more beneficial than curative ones. It is important to realise that despite several initiatives being taken by local, national and global agencies and governments, smoking trends are increasing around the world and has started to affect the young population. Coronary heart disease too has started to take its toll on the population around the world due to the hectic and unhealthy lifestyles that have come to permeate people s lives. It is highly essential that for the success of the initiatives and programmes, people must be involved in them and everyone across the globe has to realise that simple changes to their lifestyle, eating habits and anti smoking measures will help to fight and prevent coronary heart disease. The changes in lifestyle will also bring down coronary heart disease caused due to other factors such as stress, alcohol, blood sugar and cholesterol. To conclude, it can be stated that prevention is better than cure and quitting smoking and leading a healthy lifestyle can protect everyone from the silent killer, the coronary heart disease (Ewles Simnet, 2003). References American Heart Association (2010) Risk Factors and Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.americanheart.org/presenter.jhtml?identifier=4726 ASH (2009) Ash facts at a glance: Implementation of the Smoke-free Law in England, Wales and Northern Ireland [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_594.pdf Ash (2007) Ash facts at a glance: Smoking and Diseases [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_94.pdf Ash (2010) Ash facts at a glance: Smoking Statistics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_93.pdf Ash (2010) Ash facts at a glance: Tobacco Economics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_95.pdf Ash (2009) Ash facts at a glance: Tobacco Regulations [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_96.pdf British Heart Foundation Statistics Website (2009) Mortality [Online] last accessed 2nd December 2009 at http://www.heartstats.org/topic.asp?id=17 Bullen, C. (July, 2008). Impact of Tobacco Smoking and Smoking Cessation on Cardiovascular Risk and Disease. Expert Review of Cardiovascular Therapy, Vol. 6, No. 6, pp. 883-895. Chime Communications Plc (2008) East Lancashire PCT Enlists BMT to Develop a Campaign to Tackle the Region s Biggest Killer [Online] last accessed 2nd December 2009 at http://www.chime.plc.uk/press-releases/bmt-launches-east-lancashire-pct-campaign-could-it-be-you Department of Health (DoH) (2010) Public Health [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publichealth/index.htm Department of Health (DoH) (2004) The National Service Framework for Coronary Heart Disease: Wining the War on Heart Disease [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4077154 Ewles L, Simnett I. (2003). Promoting Health: A Practical Guide. London: Balliere Tindall. Ford, E. S. Capewell, S. (2007) Coronary Heart Disease Mortality Among Young Adults in the U.S. from 1980 Through 2002. Concealed Levelling of Mortality Rates Journal of the American College of Cardiology Vol. 50, pp. 2128-2132. Improvement and Development Agency (IDeA) (2009) Smoking [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=5889940 Improvement and Development Agency (IDeA) (2007) Smoke-free Legislation [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=6166044 National Health Service (NHS) (2009) Health A-Z: Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.nhs.uk/conditions/Coronary-heart-disease/Pages/Introduction.aspx National Health Service (NHS) (2008) Rates of Heart Disease in the Young [Online] last accessed 2nd December 2009 at http://www.nhs.uk/news/2007/January08/Pages/Ratesofheartdiseaseintheyoung.asp National Heart Forum (2006) Economic Cost of Heart Disease [Online] last accessed 2nd December 2009 at http://www.heartforum.org.uk/AboutCHD_Economicburden.aspx Nemetz, P. N., Roger, V. L., Ransom, J. E., Bailer, K. R., Edwards, W. D., Leibson, C. L. (2008) Recent Trends in the Prevalence of Coronary Disease: A Population-Based Autopsy Study of Non-natural Deaths Archival of Internal Medicine Vol. 168, No. 3, pp. 264-270. NHS East Lancashire (2010) SMYL If you want to live longer [Online] last accessed 2nd December 2009 at http://www.smyl.eastlancspct.nhs.uk/welcome/ NHS Networks (2010) East Lancashire Public Health Network [Online] last accessed 2nd December 2009 at http://www.networks.nhs.uk/networks.php?pid=727 Smoke Free (2007) Smoke-free Legislation Compliance Data [Online] last accessed 2nd December 2009 at http://www.smokefreeengland.co.uk/files/dhs01_03-smokefree_report_final.pdf Wells, A. J. (1999) Passive Smoking and Coronary Heart Disease New England Journal of Medicine Vol. 341, No. 9, pp.697-698. World Health Organisation (WHO) (2004) Causes of Death (part 2). The Global Burden of Disease: 2004 Update [Online] last accessed 2nd December 2009 at http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf World Health Organisation (WHO) (2010a) Cardiovascular Diseases: Key messages to protect heart health [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/en/ World Health Organisation (WHO) (2002) Global Burden of Disease in 2002: Data Sources, Methods and Results [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/compare.aspx?dm=10countries=818%2c250%2c414%2c484%2c554%2c566%2c643%2c710%2c826%2c840year=2002sf1=mo.cg.059sex=all World Health Organisation (WHO) (2010d) Global Information System on Tobacco Control [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_data/en/index.html World Health Organisation (WHO) (2010e) Global Network [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_interaction/en/ World Health Organisation (WHO) (2010c) Regional Activities to the Global CVD Strategy [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/region/en/ World Health Organisation (WHO) (2010b) Research and Global Partnership Initiatives [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/research/en/ World Health Organisation (WHO) (2008) Tobacco Use: Infobase [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/report.aspx?rid=116dm=8 Bibliography American Heart Association (2010) Risk Factors and Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.americanheart.org/presenter.jhtml?identifier=4726 Ash (2007) Ash facts at a glance: Smoking and Diseases [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_94.pdf ASH (2009) Ash facts at a glance: Implementation of the Smoke-free Law in England, Wales and Northern Ireland [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_594.pdf Ash (2009) Ash facts at a glance: Tobacco Regulations [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_96.pdf Ash (2010) Ash facts at a glance: Smoking Statistics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_93.pdf Ash (2010) Ash facts at a glance: Tobacco Economics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_95.pdf British Heart Foundation Statistics Website (2009) Mortality [Online] last accessed 2nd December 2009 at http://www.heartstats.org/topic.asp?id=17 Bullen, C. (July, 2008). Impact of Tobacco Smoking and Smoking Cessation on Cardiovascular Risk and Disease. Expert Review of Cardiovascular Therapy, Vol. 6, No. 6, pp. 883-895. Chime Communications Plc (2008) East Lancashire PCT Enlists BMT to Develop a Campaign to Tackle the Region s Biggest Killer [Online] last accessed 2nd December 2009 at http://www.chime.plc.uk/press-releases/bmt-launches-east-lancashire-pct-campaign-could-it-be-you Department of Health (DoH) (2004) The National Service Framework for Coronary Heart Disease: Wining the War on Heart Disease [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4077154 Department of Health (DoH) (2010) Public Health [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publichealth/index.htm Ewles L, Simnett I. (2003). Promoting Health: A Practical Guide. London: Balliere Tindall. Ford, E. S. Capewell, S. (2007) Coronary Heart Disease Mortality Among Young Adults in the U.S. from 1980 Through 2002. Concealed Levelling of Mortality Rates Journal of the American College of Cardiology Vol. 50, pp. 2128-2132. Hill, S. Blakely, T., Kawachi, I., Woodward, A. (2004) Mortality Among Never Smokers Living with Smokers: Two Cohort Studies British Medical Journal Vol. 328, No. 7446, pp. 988-989. Improvement and Development Agency (IDeA) (2007) Smoke-free Legislation [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=6166044 Improvement and Development Agency (IDeA) (2009) Smoking [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=5889940 Jiang, H.E., Vupputuri, S., Allen, K., Prerost, M. R., Hughes, J., Whelton, P. K. (1999) Passive Smoking and the Risk of Coronary Heart Disease A Meta Analysis of Epidemiological Studies New England Journal of Medicine Vol. 340, No. 12, pp. 920-926. Kaur, S., Cohen, A., Dolor, R., Coffman, C.J., Bastian, L.A. (2004) The Impact of Environmental Tobacco Smoke on Women s Risk of Dying from Heart Disease: A Meta Analysis Journal of Women s Health Vol. 13, No. 8, pp. 888-897. National Health Service (NHS) (2008) Rates of Heart Disease in the Young [Online] last accessed 2nd December 2009 at http://www.nhs.uk/news/2007/January08/Pages/Ratesofheartdiseaseintheyoung.asp National Health Service (NHS) (2009) Health A-Z: Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.nhs.uk/conditions/Coronary-heart-disease/Pages/Introduction.aspx National Heart Forum (2006) Economic Cost of Heart Disease [Online] last accessed 2nd December 2009 at http://www.heartforum.org.uk/AboutCHD_Economicburden.aspx Nemetz, P. N., Roger, V. L., Ransom, J. E., Bailer, K. R., Edwards, W. D., Leibson, C. L. (2008) Recent Trends in the Prevalence of Coronary Disease: A Population-Based Autopsy Study of Non-natural Deaths Archival of Internal Medicine Vol. 168, No. 3, pp. 264-270. NHS East Lancashire (2010) SMYL If you want to live longer [Online] last accessed 2nd December 2009 at http://www.smyl.eastlancspct.nhs.uk/welcome/ NHS Networks (2010) East Lancashire Public Health Network [Online] last accessed 2nd December 2009 at http://www.networks.nhs.uk/networks.php?pid=727 Smoke Free (2007) Smoke-free Legislation Compliance Data [Online] last accessed 2nd December 2009 at http://www.smokefreeengland.co.uk/files/dhs01_03-smokefree_report_final.pdf Wells, A. J. (1999) Passive Smoking and Coronary Heart Disease New England Journal of Medicine Vol. 341, No. 9, pp.697-698. Whincup, P. H., Gilg, J. A., Emberson, J. R., Jarvis, M. J., Feyerabend, C., Bryant, A., Wakler, M., Cook, D. G. ( 2004) Passive Smoking and Risk of Coronary Disease and Stroke: Prospective Study with Cotinine Measurement British Medical Journal Vol. 329, No. 7459, pp. 200-205. World Health Organisation (WHO) (2002) Global Burden of Disease in 2002: Data Sources, Methods and Results [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/compare.aspx?dm=10countries=818%2c250%2c414%2c484%2c554%2c566%2c643%2c710%2c826%2c840year=2002sf1=mo.cg.059sex=all World Health Organisation (WHO) (2004) Causes of Death (part 2). The Global Burden of Disease: 2004 Update [Online] last accessed 2nd December 2009 at http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf World Health Organisation (WHO) (2008)Tobacco Use: Infobase [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/report.aspx?rid=116dm=8 World Health Organisation (WHO) (2010a) Cardiovascular Diseases: Key messages to protect heart health [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/en/ World Health Organisation (WHO) (2010b) Research and Global Partnership Initiatives [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/research/en/ World Health Organisation (WHO) (2010c) Regional Activities to the Global CVD Strategy [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/region/en/ World Health Organisation (WHO) (2010d) Global Information System on Tobacco Control [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_data/en/index.html World Health Organisation (WHO) (2010e) Global Network [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_interaction/en/ Smoking and Coronary Heart Disease Impact Smoking and Coronary Heart Disease Impact Introduction Medical innovations and rapidly evolving technology has led to a decrease in the rate of mortality from diseases. However, the fast and constantly changing hectic lifestyle of today has led to the introduction of new diseases, unhealthy lifestyle and early, premature deaths. Todays technology has provided us with the benefits of early detection and preventive treatments and answers to some of the previously incurable diseases. But it has brought in increased stress and unhealthy eating and other habits that have in some ways caused more harm than benefit. This report titled Smoking: The Heart Breaker is a look at the current situation of coronary heart diseases caused by smoking, relevant legislations, policies and practices, strategies to deal with the situation and future of the disease at local, national and global levels. The report will start by discussing the smoking and coronary heart disease as a public health issue and the reasons for concern. It will provide a background to help better understand the present situation along with an epidemiology of the disease and its causes, with special reference to smoking. It will then go on to report about the legislative policies and strategies that are being currently undertaken in the region of Burnley, East Lancashire to counter this particular health issue. The report will also discuss the policies and initiatives and the status of the health issue at national and global level, so as to provide a complete and holistic picture of the seriousness of the health issue. Finally the report will discuss the current strategies being employed by the government as well as non-government agencies to tackle the health issue. Recommendations will also be made to help make an improvement in the current situation. Public Health Issue: Coronary Heart Disease due to Smoking The term Coronary heart disease is used to describe a condition of blockage or interruption of blood supply to the heart due to build-up of fatty substances in the coronary arteries (NHS, 2009). This build-up (called atheroma) can lead to insufficient supply of blood to the heart causing pain in the chest known as angina. A completely blocked artery can lead to a heart attack (called myocardial infarction) (NHS, 2009). There are various mild to critical impacts of this condition that even result in death. According to the British Heart Foundation Statistics (2009), diseases related to the heart and circulatory issues are the biggest cause of deaths in the UK, resulting in over 90,000 deaths in the UK in a year. This has resulted in not only raised concerns about the disease but also growing efforts to increase the awareness about the disease, its causes, and preventive as well as precautionary measures that can help to avoid the disease. The situation isn t any brighter in other par ts of the world. According to the World Health Organisation (WHO), the majority of countries around the world are affected by coronary heart disease and the disease is a major killer, especially in developing and transitional countries of the world. In a WHO report, cardiovascular diseases including coronary heart disease is considered to be the leading cause of death and is projected to increase from 17.1 million in 2004 to 23.4 million in 2030 (WHO, 2004). Among the various causes of coronary heart disease, smoking is regarded to be one of the primary causes. According to the WHO report, tobacco-related deaths are expected to rise from 5.4 million in 2004 to 8.3 million in 2030, representing 10% of all global deaths; and smoking has been associated to cardiovascular diseases and subsequent deaths (WHO, 2004). According to a study conducted in 2008, smoking is the leading cause of cardiovascular diseases including coronary heart disease (Bullen, 2008). Though increasing age has been thought as a cau se of coronary heart disease, two studies have found that improper lifestyle, stress, etc are increasing the mortality rates due to coronary heart disease among the young population in the UK, USA and Australia (Nemetz, Roger Ransom, 2008) (Ford Capewell, 2007). Therefore, the growing concern for this disease and its preventable yet common cause is the choice of topic for this report. Background and Epidemiology Cardiovascular diseases including coronary heart disease have been found to be an unbiased killer that can create havoc in any society irrespective of its economic, political, cultural, religious, regional or racial identity. Similarly, tobacco smoking (either active or passive) is known to be a major cause of many diseases including the coronary heart disease. Given the stressful lifestyle in today s world, many people take up smoking to tackle the stress levels and in the process get addicted. They not only harm themselves but also people around them. The region of Burnley in East Lancashire, is no exception to this trend. Being witness to many friends and family members taking up smoking in the name of relieving stress and then getting addicted and finally ending up suffering from diseases, especially coronary heart disease inspired the choice of topic for this report. There are several causes that can result in coronary heart disease. The NHS lists smoking as the major cause of the disease (NHS, 2009). The various other causes of coronary heart disease have been listed as high blood pressure, high level of cholesterol in blood, presence of thrombosis and / or diabetes unhealthy lifestyle with no regular exercise, obesity and a family history of angina and / or heart attack (which are hereditary) (Nemetz et al, 2008). The risk factors associated with coronary heart diseases which cannot be treated, modified or changed include age, gender and heredity (or race). Increasing age increases the risks of coronary heart disease and fatality from it. Men are found to be at a greater risk of suffering from coronary heart disease in comparison to women (Wells, 1999). Heredity of coronary disease or its causes such as diabetes, high blood pressure, and cholesterol are also known to create risks of coronary heart conditions. The causes such as smoking, high le vel of cholesterol in blood, high blood pressure, physical inactivity, being overweight and / or obesity and diabetes (diabetes mellitus) are some of the risk factors of coronary heart disease that can be modified, changed and controlled by taking medication and / or by adopting a healthy lifestyle. Other risk factors and causes of the disease include stress and alcohol addiction and can in certain circumstances prove to be fatal causes of the coronary heart disease (Ewles Simnet, 2003). Comparative data of the effects of coronary heart disease in different countries do not provide a very positive picture (see appendix 1). According to a World Health Organisation survey report, the mortality from cardiovascular diseases in 2002 for the developed nations like the United Kingdom and the United States was higher than many other developing nations like China, India, even Nigeria (WHO, 2002). It is clear from the data, that developing countries have a much higher mortality rate from cardiovascular and consequently coronary heart diseases in the developed countries like UK, USA, Germany; and an important fact to notice is that the death rate is higher in the European region in comparison to other regions of the world. This most probably can be attributed to the excessive use of tobacco, alcohol, improper lifestyle that increases stress levels, improper eating habits that leads to blood sugar and cholesterol in the blood. The tobacco usage in different countries around the world also points towards the grimness and enormity of the situation, through which one can appreciate the risk of tobacco causing further deaths due to coronary heart disease (WHO, 2008). The WHO report on tobacco consumption in different countries show that despite government initiatives and regulations, the tobacco consumption has mostly increased and has led to increased mortality especially in the age groups between 25-45 years. Though coronary heart disease is of global nature without any kind of boundary, various specific groups of people are in greater risk of having the disease in comparison to others. The affinity to having coronary heart disease is dependent on factors such as geography, heredity, age and gender. Men are at an increased risk of suffering from coronary heart conditions as compared to women (Wells, 1999). Increase in age increases the chances of suffering from coronary heart disease (DoH, 2004). Coronary heart conditions are also known to be prevalent among Mexican Americans, some Asian Americans, American Indians, and Native Hawaiians (American Heart Association, 2010). England is one of the most vulnerable nations in Europe when it comes to coronary heart diseases (NHS, 2009). Populations in developing and underdeveloped nations of the world too are at a higher risk of suffering from coronary heart disease and related fatalities (American Heart Association, 2010). Smokers, obese people and people with high blood cholesterol are also included in the high risk group for coronary heart disease. Female smokers are more susceptible to the disease especially with increased age since females are more susceptible to the dangers of smoking in comparison to men (WHO, 2002). With increased impact of aggressive and unhealthy lifestyle and stress, the young population across the developed nations of the world too are increasingly coming under the risk of coronary heart disease (NHS, 2008). Therefore, these risk factors result in the coronary heart disease taking on a pandemic nature if certain precautionary and preventive measures are not taken to control the risk factors that can be influenced. Strategies, Policies and Initiatives Given the growing concern about coronary heart diseases, deaths due to the disease and the impact on the younger population, government agencies around the world are taking steps to combat the growing menace. Non-governmental and private agencies too are joining the efforts to promote a healthy lifestyle and awareness about preventive techniques that can help to bring down the risks associated with the disease and the rising cases of fatalities. This section of the report looks at the strategies, agenda, policies, that are being undertaken at the local (NHS East Lancashire, 2010), national and global levels to combat coronary heart disease. Local Public Health In East Lancashire, several workshops and other programmes have been undertaken to increase awareness, educate and help the residents of the area give up smoking and adopt a healthy lifestyle that will help prevent and fight coronary heart disease. The MPs in the region are encouraging antismoking legislations and policies being adopted by the authorities. The NHS has introduced the concept of smoke free zones. The SMYL programme is promoting healthy lifestyle and eating habits (NHS East Lancashire, 2010). Another campaign called Could it be you was also started in 2008 to help people fight coronary heart disease and adopt healthy and preventive lifestyle (Chime Communications Plc, 2008). The authorities in East Lancashire have also collaborated with different agencies to start networks that can promote anti tobacco campaign and raise awareness on coronary heart disease (NHS Networks, 2010). This involvement of the government as well as non-government agencies in the area, one can b e hopeful that headway will be made into the matter. However, it is important that the public realise the criticality of the situation and take advantages of the programmes being undertaken to have a long, healthy and disease free life. Implications at the National Level The National Heart Forum (2006) indicated that heart diseases cost the UK around  £29 billion per year and was termed as economic burden . There are several programmes that have been taken up by the health care authorities and the government in collaboration with non-government agencies to promote anti smoking habits in the country. Several regional programmes such as Bolsover Teenage Smoking Programme, Corby Smoking Cessation Programme, Halton Smoke-Free Programme, London Borough of Tower Hamlets Tobacco Control Alliance, Pendle Smoke-free Council, Heartbeat Awards, the GO Smokefree Campaign, etc have been launched in an earnest to curb the growing effect of smoking in the country (IDeA, 2009). Several governmental legislations have also been put into place (IDeA, 2007). The Department of Health has also started programmes such as Start4Life, 5 A Day, National Support Teams and Let s Get Moving to promote healthy lifestyle that can help to prevent coronary heart disease (DoH, 201 0). Therefore the various government and nongovernment agencies in UK are making effort to control smoking habit and improve lifestyle of the citizens of the country thereby ensuring a brighter future free from smoking and coronary heart disease. Global Health The fight against smoking and coronary heart disease has taken enormous proportions with the growing realisation that these are two of the most important killers in the world today. Especially, the understanding that smoking causes diseases such as the coronary heart disease not only in the smoker but also in non-smokers who have been in the presence of smokers, has led major organisations and developed nations of the world to taking a stand against smoking. The Work with Heart project by WHO is helping to spread the message of preventive actions that can help in prohibiting coronary heart disease and other cardiovascular diseases (WHO, 2010a). WHO has also taken up research and global partnership initiatives to help the developing countries of the world fight cardiovascular diseases (WHO, 2010b). Furthermore, WHO has aligned with several countries in the world to promote regional activities under the global strategy to counter cardiovascular diseases which includes America, Eastern Mediterranean, Africa, South-East Asia, European region and Western Pacific (WHO, 2010c). To help fight the smoking addiction growing among countries, WHO has set up the Global Tobacco Surveillance System (GTSS) (WHO, 2010d) and is also collaborating with different international organisations such as the United Nations and the governments of various countries to help campaign against sale and use of tobacco among different nations (WHO, 2010e). Recommendations and Conclusion Upon analysing the current situation on a local, national and global basis, the following recommendations can be made: Initiatives to prevent coronary heart disease and promote anti smoking habits need to be undertaken at the grass root level, i.e. at local level. This will make the initiatives and campaigns more effective. The developing nations such as India, Brazil and China need to be targeted with confidence. Further researches into preventive and curative medicines and technologies for coronary heart diseases need to be promoted. Healthy lifestyle needs to be promoted at every level since preventive practices are more beneficial than curative ones. It is important to realise that despite several initiatives being taken by local, national and global agencies and governments, smoking trends are increasing around the world and has started to affect the young population. Coronary heart disease too has started to take its toll on the population around the world due to the hectic and unhealthy lifestyles that have come to permeate people s lives. It is highly essential that for the success of the initiatives and programmes, people must be involved in them and everyone across the globe has to realise that simple changes to their lifestyle, eating habits and anti smoking measures will help to fight and prevent coronary heart disease. The changes in lifestyle will also bring down coronary heart disease caused due to other factors such as stress, alcohol, blood sugar and cholesterol. To conclude, it can be stated that prevention is better than cure and quitting smoking and leading a healthy lifestyle can protect everyone from the silent killer, the coronary heart disease (Ewles Simnet, 2003). References American Heart Association (2010) Risk Factors and Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.americanheart.org/presenter.jhtml?identifier=4726 ASH (2009) Ash facts at a glance: Implementation of the Smoke-free Law in England, Wales and Northern Ireland [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_594.pdf Ash (2007) Ash facts at a glance: Smoking and Diseases [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_94.pdf Ash (2010) Ash facts at a glance: Smoking Statistics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_93.pdf Ash (2010) Ash facts at a glance: Tobacco Economics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_95.pdf Ash (2009) Ash facts at a glance: Tobacco Regulations [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_96.pdf British Heart Foundation Statistics Website (2009) Mortality [Online] last accessed 2nd December 2009 at http://www.heartstats.org/topic.asp?id=17 Bullen, C. (July, 2008). Impact of Tobacco Smoking and Smoking Cessation on Cardiovascular Risk and Disease. Expert Review of Cardiovascular Therapy, Vol. 6, No. 6, pp. 883-895. Chime Communications Plc (2008) East Lancashire PCT Enlists BMT to Develop a Campaign to Tackle the Region s Biggest Killer [Online] last accessed 2nd December 2009 at http://www.chime.plc.uk/press-releases/bmt-launches-east-lancashire-pct-campaign-could-it-be-you Department of Health (DoH) (2010) Public Health [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publichealth/index.htm Department of Health (DoH) (2004) The National Service Framework for Coronary Heart Disease: Wining the War on Heart Disease [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4077154 Ewles L, Simnett I. (2003). Promoting Health: A Practical Guide. London: Balliere Tindall. Ford, E. S. Capewell, S. (2007) Coronary Heart Disease Mortality Among Young Adults in the U.S. from 1980 Through 2002. Concealed Levelling of Mortality Rates Journal of the American College of Cardiology Vol. 50, pp. 2128-2132. Improvement and Development Agency (IDeA) (2009) Smoking [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=5889940 Improvement and Development Agency (IDeA) (2007) Smoke-free Legislation [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=6166044 National Health Service (NHS) (2009) Health A-Z: Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.nhs.uk/conditions/Coronary-heart-disease/Pages/Introduction.aspx National Health Service (NHS) (2008) Rates of Heart Disease in the Young [Online] last accessed 2nd December 2009 at http://www.nhs.uk/news/2007/January08/Pages/Ratesofheartdiseaseintheyoung.asp National Heart Forum (2006) Economic Cost of Heart Disease [Online] last accessed 2nd December 2009 at http://www.heartforum.org.uk/AboutCHD_Economicburden.aspx Nemetz, P. N., Roger, V. L., Ransom, J. E., Bailer, K. R., Edwards, W. D., Leibson, C. L. (2008) Recent Trends in the Prevalence of Coronary Disease: A Population-Based Autopsy Study of Non-natural Deaths Archival of Internal Medicine Vol. 168, No. 3, pp. 264-270. NHS East Lancashire (2010) SMYL If you want to live longer [Online] last accessed 2nd December 2009 at http://www.smyl.eastlancspct.nhs.uk/welcome/ NHS Networks (2010) East Lancashire Public Health Network [Online] last accessed 2nd December 2009 at http://www.networks.nhs.uk/networks.php?pid=727 Smoke Free (2007) Smoke-free Legislation Compliance Data [Online] last accessed 2nd December 2009 at http://www.smokefreeengland.co.uk/files/dhs01_03-smokefree_report_final.pdf Wells, A. J. (1999) Passive Smoking and Coronary Heart Disease New England Journal of Medicine Vol. 341, No. 9, pp.697-698. World Health Organisation (WHO) (2004) Causes of Death (part 2). The Global Burden of Disease: 2004 Update [Online] last accessed 2nd December 2009 at http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf World Health Organisation (WHO) (2010a) Cardiovascular Diseases: Key messages to protect heart health [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/en/ World Health Organisation (WHO) (2002) Global Burden of Disease in 2002: Data Sources, Methods and Results [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/compare.aspx?dm=10countries=818%2c250%2c414%2c484%2c554%2c566%2c643%2c710%2c826%2c840year=2002sf1=mo.cg.059sex=all World Health Organisation (WHO) (2010d) Global Information System on Tobacco Control [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_data/en/index.html World Health Organisation (WHO) (2010e) Global Network [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_interaction/en/ World Health Organisation (WHO) (2010c) Regional Activities to the Global CVD Strategy [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/region/en/ World Health Organisation (WHO) (2010b) Research and Global Partnership Initiatives [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/research/en/ World Health Organisation (WHO) (2008) Tobacco Use: Infobase [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/report.aspx?rid=116dm=8 Bibliography American Heart Association (2010) Risk Factors and Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.americanheart.org/presenter.jhtml?identifier=4726 Ash (2007) Ash facts at a glance: Smoking and Diseases [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_94.pdf ASH (2009) Ash facts at a glance: Implementation of the Smoke-free Law in England, Wales and Northern Ireland [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_594.pdf Ash (2009) Ash facts at a glance: Tobacco Regulations [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_96.pdf Ash (2010) Ash facts at a glance: Smoking Statistics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_93.pdf Ash (2010) Ash facts at a glance: Tobacco Economics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_95.pdf British Heart Foundation Statistics Website (2009) Mortality [Online] last accessed 2nd December 2009 at http://www.heartstats.org/topic.asp?id=17 Bullen, C. (July, 2008). Impact of Tobacco Smoking and Smoking Cessation on Cardiovascular Risk and Disease. Expert Review of Cardiovascular Therapy, Vol. 6, No. 6, pp. 883-895. Chime Communications Plc (2008) East Lancashire PCT Enlists BMT to Develop a Campaign to Tackle the Region s Biggest Killer [Online] last accessed 2nd December 2009 at http://www.chime.plc.uk/press-releases/bmt-launches-east-lancashire-pct-campaign-could-it-be-you Department of Health (DoH) (2004) The National Service Framework for Coronary Heart Disease: Wining the War on Heart Disease [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4077154 Department of Health (DoH) (2010) Public Health [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publichealth/index.htm Ewles L, Simnett I. (2003). Promoting Health: A Practical Guide. London: Balliere Tindall. Ford, E. S. Capewell, S. (2007) Coronary Heart Disease Mortality Among Young Adults in the U.S. from 1980 Through 2002. Concealed Levelling of Mortality Rates Journal of the American College of Cardiology Vol. 50, pp. 2128-2132. Hill, S. Blakely, T., Kawachi, I., Woodward, A. (2004) Mortality Among Never Smokers Living with Smokers: Two Cohort Studies British Medical Journal Vol. 328, No. 7446, pp. 988-989. Improvement and Development Agency (IDeA) (2007) Smoke-free Legislation [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=6166044 Improvement and Development Agency (IDeA) (2009) Smoking [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=5889940 Jiang, H.E., Vupputuri, S., Allen, K., Prerost, M. R., Hughes, J., Whelton, P. K. (1999) Passive Smoking and the Risk of Coronary Heart Disease A Meta Analysis of Epidemiological Studies New England Journal of Medicine Vol. 340, No. 12, pp. 920-926. Kaur, S., Cohen, A., Dolor, R., Coffman, C.J., Bastian, L.A. (2004) The Impact of Environmental Tobacco Smoke on Women s Risk of Dying from Heart Disease: A Meta Analysis Journal of Women s Health Vol. 13, No. 8, pp. 888-897. National Health Service (NHS) (2008) Rates of Heart Disease in the Young [Online] last accessed 2nd December 2009 at http://www.nhs.uk/news/2007/January08/Pages/Ratesofheartdiseaseintheyoung.asp National Health Service (NHS) (2009) Health A-Z: Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.nhs.uk/conditions/Coronary-heart-disease/Pages/Introduction.aspx National Heart Forum (2006) Economic Cost of Heart Disease [Online] last accessed 2nd December 2009 at http://www.heartforum.org.uk/AboutCHD_Economicburden.aspx Nemetz, P. N., Roger, V. L., Ransom, J. E., Bailer, K. R., Edwards, W. D., Leibson, C. L. (2008) Recent Trends in the Prevalence of Coronary Disease: A Population-Based Autopsy Study of Non-natural Deaths Archival of Internal Medicine Vol. 168, No. 3, pp. 264-270. NHS East Lancashire (2010) SMYL If you want to live longer [Online] last accessed 2nd December 2009 at http://www.smyl.eastlancspct.nhs.uk/welcome/ NHS Networks (2010) East Lancashire Public Health Network [Online] last accessed 2nd December 2009 at http://www.networks.nhs.uk/networks.php?pid=727 Smoke Free (2007) Smoke-free Legislation Compliance Data [Online] last accessed 2nd December 2009 at http://www.smokefreeengland.co.uk/files/dhs01_03-smokefree_report_final.pdf Wells, A. J. (1999) Passive Smoking and Coronary Heart Disease New England Journal of Medicine Vol. 341, No. 9, pp.697-698. Whincup, P. H., Gilg, J. A., Emberson, J. R., Jarvis, M. J., Feyerabend, C., Bryant, A., Wakler, M., Cook, D. G. ( 2004) Passive Smoking and Risk of Coronary Disease and Stroke: Prospective Study with Cotinine Measurement British Medical Journal Vol. 329, No. 7459, pp. 200-205. World Health Organisation (WHO) (2002) Global Burden of Disease in 2002: Data Sources, Methods and Results [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/compare.aspx?dm=10countries=818%2c250%2c414%2c484%2c554%2c566%2c643%2c710%2c826%2c840year=2002sf1=mo.cg.059sex=all World Health Organisation (WHO) (2004) Causes of Death (part 2). The Global Burden of Disease: 2004 Update [Online] last accessed 2nd December 2009 at http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf World Health Organisation (WHO) (2008)Tobacco Use: Infobase [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/report.aspx?rid=116dm=8 World Health Organisation (WHO) (2010a) Cardiovascular Diseases: Key messages to protect heart health [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/en/ World Health Organisation (WHO) (2010b) Research and Global Partnership Initiatives [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/research/en/ World Health Organisation (WHO) (2010c) Regional Activities to the Global CVD Strategy [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/region/en/ World Health Organisation (WHO) (2010d) Global Information System on Tobacco Control [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_data/en/index.html World Health Organisation (WHO) (2010e) Global Network [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_interaction/en/

The Importance of Ending Consumerism :: Environment Capitalism Essays Papers

The Importance of Ending Consumerism America is the world’s biggest and most earnest consumer. Within the national culture, there is a tremendous emphasis placed on the acquisition of goods, and subsequently, the cultivation of luxury. The American dream itself implies material gain, the pot of gold at the end (or top) of the socioeconomic ladder. Collectively and personally, Americans identify themselves through consumerist attitudes and practices. Ironically, the price of such consumerism is far greater than the simple cost of any given product; though not necessarily in terms of currency, but that of planetary expense. The harm done to Mother Earth is substantial both in its scope and rate of growth. Luckily, though, it is also avoidable. Clearly, one of the best ways to aid the environment is to eliminate excess. By excess, I mean the needless proliferation of products, elaborate packaging and the waste that such extravagances necessitate. The overuse of fossil fuels in production, waste products created by industry and the damage rendered to the landscape, all direct outgrowths of consumerist practices, contribute to the destruction of our most valuable resources, such as clean water, and air. Still, American society continues to heedlessly grow more and more materialistic each year. As a wealthy and powerful nation, we Americans seem to give credence to the philosophy that if we have the economic means, we should acquire all that we can. This ideology is merely the reflection of another: might makes right. Yet, our government is often intervening in foreign affairs which do not concern our country in an immediate sense; cases in which a weaker nation or group is being victimized by a stronger party, for example, U.S. intervention in the Bosnian conflict in the late 1990s. Thus the contradiction is established between our military or foreign policy and that of our economic patterns and practices. Truly, should not the environment be defended in the same fashion as the weaker nations to whose defense we rush as a matter of custom? The present state of the environment in America demonstrates an acute lack of foresight and an abundance of greed. Depressing though it may be, it is time that we, as nation, came together to truly evaluate the problem. Additionally, it is time that we eliminated the wheat from the chaff of our lives, the harmful luxury from the necessity.

Sophocles Antigone - Creons Flaws :: Antigone essays

Antigone: Creon's Flaws In the play Antigone, I choose Creon to be the tragic hero because he is the King of Thebes and he looses everything he has. Creon being King makes the audience believe that something like that can happen to the King then what can happen to us. Antigone the niece of Creon, The sister of Polyneices was punished by Creon for burying Polyneces after his death, Creon has forbidden anybody to do so. Once Creon punished Antigone the blind prophet Teiresias told him that the Gods will take revenge for his actions, then Creon tried to change everything but he is too late. Creon's tragic flaws were his stubbornness, the abuse of power and the actions he took to cause the downfall of the Thebes. Creon showed his stubbornness by not wanting to be proved wrong because of pride. When the Choragos tried to tell Creon that he made a mistake by telling that nobody can burry the body of Polyneices. Creon did not want to listen to the people of Thebes who tried to tell him that Antigone did the right thing, but of fear to Creon the could not really say anything. Creon thought by making an example of Antigone's execution, everybody would get scared and won't try to brake his laws. It actually worked for a while. Creon abused his power by thinking that he can change or brake the laws of the Gods and not allowing other people to brake his laws. He did not want to burry Polyneices' body, but one of the God's law is that every human deserves to be buried after death not depending what that certain person did in his lifetime. Creon caused fear among his people by making a public announcement that nobody is allowed to burry Polyneices. He said that the state of Thebes consists of only him, and that there are no other laws then his. According to the play the major actions that Creon took to cause the downfall of Thebes are that he did not want to burry Polyneices nor did allow any body to do it. Creon broke the burial law of the Gods and punished Antigone for following their laws. The people of Thebes knew that Creon made a mistake but still were too afraid to speak up. Antigone thought that she should get honored for that what she did, but Creon did not think that way.

The Influence of Sigmund Freud on Society Essay -- Essays Papers Sigmu

The Influence of Sigmund Freud on Society The late nineteenth century marked a number of radical developments on science, art, and philosophy. Although the lives of humans used to be constantly at the mercy of nature, during this time, humans began harnessing its power and eventually started controlling it. A sudden urge to look beyond the surface of things became widespread. Sigmund Freud looked beyond the effects of behavior and explored the unconscious. He significantly changed the way the world viewed behavior by explaining certain levels of consciousness, the components of the unconscious mind, and different developmental phases. Sigmund, son of Amalia and Jacob Freud, was born on May 6, 1856 in Freiburg, a rural town which was then a part of the Austro-Hungarian Empire. A confused child, he experienced extreme love, desire, and hate which ultimately inspired him to study human development. School consumed virtually all of Freud's time until he graduated from the University of Vienna in 1881, with a degree in medicine (Stevenson). Freud began experimenting with hypnosis and asking his patients to freely speak while being hypnotized. In this he discovered the existence of an unconscious. Freud referred to this as "free association" and soon began using it with patients who were not hypnotized but merely in a relaxed state. While his patients spoke he found their unconscious minds were releasing memories, sometimes painful ones, that had been trapped within their minds since childhood. He called this uncovering of memories psychoanalysis (Myers 420). In his experimentation with the unconscious mind, Freud discovered three levels of consciousness. The first is consciousness. This i... ...sible to find clear solutions to problems without blaming people. These and other discoveries of Freud's changed the world in many ways. It was then possible to understand the origin of behavior and how to change it. Psychoanalysis opened doors to the unconscious mind and gave reasons for certain behavior. The work of Sigmund Freud was only a small portion of the gradual control over nature that humans began possessing at the turn of the century, yet in the world of psychology this was quite a large step. Works Cited - Myers, David G. Psychology. Holland: Worth Publishers, 1998. "Sigmund Freud" <http://oldsci.eiu.edu/psychology/Spensor/Freud.html> (31 March 1998). - Stevenson, David B. "Sigmund Freud: The Father of Psychoanalysis." http://www.stg.brown.edu/projects/...dow/HTatBrown/freud/Biography.html> (31 March 1998).

Focus Bpr from Dell Inc.

Focus BPR from Dell Inc. In recent centuries, market conditions are changing all the time. Tens of thousands of enterprises are faced with severe challenges due to the increasingly fierce competition. The competition makes customers have more choices for commodities as well as higher requests to services. What should companies do for the sake of gaining a foothold and developing their own advantages? Most of them had already found the answer – business process reengineering. Business process reengineering, which also called BPR, is â€Å"the analysis and redesign of workflow within and between enterprises† (Baltzan and Phillips 30).Companies will think over the existing process, redesign the process and then establish new process structures according to customers demand by using advanced manufacturing technology, information technology and modern management means, so as to realize great improvements. One of the BPR cases occurs at Dell Incorporated, one of the largest P C vendors in the world. Unlike the rival Compaq Computer Corporation, which uses a vast network of resellers, Dell sells all its systems directly to its customers (Zuckerman 18).It recently redesigned its computers so that each computer consisting many of the same component parts. The company is able to minimize the inventories it hold in order to reduce the inventory cost. Stocking a few parts instead of large work makes Dell be able to respond quickly to the market condition, for example, emergence of new technology, change of customer demand and overall prices standard. Dell even wants to go further. The company had experienced a new factory in Austin, where the new plant would have nowhere to storage. We believe that if you don’t have any place for inventory, then you won’t have any inventory. † Mr. Dell said (Zuckerman 22). Dell will not begin to produce a machine until it has received an order from customer. They do not have to bother to ponder what clients really need, because customers will tell them directly. When a customer places an order, the custom parts requested by the customer are automatically sent to the manufacturer for shipment (Business Process Reengineering). It can reduce the maintenance cost for inventory.However, BPR could be a double-edged sword. If Dell only builds a machine when customers tell them to, it will take some time. While other computer manufacturers might have already sold several finished products during Dell’s producing period. It needs to weigh between the time value and the inventory cost. The success that Dell achieves owes to the understanding of business process reengineering. Corporations should monitor the existing system and break the traditional organization structure to reengineer so as to make great improvements in cost, quality and service.Works Cited Baltzan, Paige and Amy Phillips. Business Driven Technology. Ed. Carrie Braun. 4th. Springfield: Missouri State University, 2010. Bu siness Process Reengineering. 2008. . Zuckerman, Laurence. Do Computers Lift Productivity? It's Unclear, But Business Is Sold. 2 January 1997. 2 January 1997 ;http://www. nytimes. com/1997/01/02/business/do-computers-lift-productivity-it-s-unclear-but-business-is-sold. html? pagewanted=all;src=pm;.

Creative Writing – The Bliss Of Acceptance

The plane's contact with the ground woke me from my semi-conscious state and I looked around anxiously, to see where I was. We had finally landed, and I felt life flow back into my limbs as I stretched in my seat. A gentle murmur rose as the plane slowed down, and the reassuring sound of the pilot echoed through the plane. â€Å"Ladies and gentlemen, we have now arrived in Delhi, the temperature is a pleasant forty three degrees with cloudless skies, and local time is four fifteen PM†. Stewardesses strutted up and down isles collecting litter, and passengers began to abscond from the plane. As I lifted myself to my feet, still in a half alert state from jetlag-induced fatigue, I stumbled into the sunshine outside. The blue sky dazzled my agitated eyes, and I grumbled to myself in irritation. The scorching hot sun was already upon me, burning my unconditioned skin in a similar way to a magnifying glass burning an ant. Hours followed as we collected bags; showed passports and performed countless other tasks that made me want to curl up on the floor and lapse into hibernation. Whether I was in Delhi or London, I was still exhausted and cantankerous. Finally we managed to obtain our car, and, as I had suspected, a long trip hundreds of miles upwards to Northern India followed. On our journey, my irritation began to crumble. The first village we stopped at, where I could appreciate the scenery, was near the Punjab, in a rural area. The village itself looked primitive and simplistic, with buildings partially finished, abandoned with no roofs or waterproofing, like an unwanted animal abandoned on the street. Poverty reigned rampant, and incoherent languages flood towards me. We drew nearer to the village market, passing by unsavoury looking beggars and lone children. An old man peered at me through a half developed cataract, before falling into a coughing fit. The world around me seemed dismal. In a split moment, my impression changed. Just as the flood washes dirt from its path, so my notions about India changed. We turned the corner into the market square, and were met with a blissful scene; a crowded square full of laughing, shouting and commotion; stall owners bellowing at the top of their voices to advertise their goods, and amidst the joyful chaos young children scuttled around like playful insects. A rich variety of vivid colours met my eye in the form of scarlet apples, striking yellow bananas and earthy brown yams. Countless fruits held my gaze, which I had never known before. The poor no longer seemed menacing; a half smile on their face was noticeable, as if they were simply satisfied by the atmosphere. Everyone around me seemed happy; and the first question that I asked myself was, why? Back in London for a moment, the answer arrived. A grey sky enveloped the city, and people trudged in their various directions, minding their own businesses and keeping themselves to themselves. After living in my home for ten years, there were still people on my street I didn't know. However, the main question I was posed, which was how could people with little money, health care, and a low standard of living be happier than those living in a modernised world with excessive amounts of money and a high standard of living? The sad answer was, that we appear to have forgotten how to obtain happiness. Epicurus, a Greek philosopher living around 300 BC, spent much of his life finding out what was required to obtain true happiness. A well-known phrase of his is: The human soul is as material and mortal as the human body. To live a good life, is to exercise prudence and to enjoy life through stimulating the senses, subjecting oneself to tranquillity and scientific study. † Later, however, he concluded that to obtain true happiness one must have a number of things. Friends, a frugal lifestyle, time and thought were all considered prerequisites for happiness. Visualising the crowded metropolis of London in my mind, trying to ignore the shouting of the stall keepers intent on making me buy their spinach, I felt that we had all these. What was it that these people had that we did not? This question remained on my mind throughout my trip in India; through the bustle of the city in Jalundar; the peaceful tranquillity in the village; the faint sounds of gunshots near Kashmir; even during the humorous incident of seeing a man squat in the middle of a field only feet away from a road. Sitting back at home in London listening to the gentle drumming of the rain, I contemplated why it was so hard for the Western man to gain happiness. Like the correct document finally being found in a stack of papers, I finally produced the answer. A Ch'an (Zen) Buddhist once said: â€Å"Humans are afflicted with all external forms of life: we are subject to life and death, pleasure and pain, love and fear, good and evil, beautiful and ugly. We tend to sway, or strive towards one side, and reject its opposite. There is no real escape of one or the other, yet we somehow believe that sooner or later, we will be able to conquer the other side if we stay focused long enough. † The reason the average man in the West could not find happiness lies in acceptance. Driven relentlessly by the Capitalist machine, we are constantly told we must improve, do better, get promoted, find a better job, or save for the latest electronic gadget. The real obstacle in the way of happiness was an excess of opportunity in the West, which in turn sows the seeds in men's mind that they can achieve better all the time, leaving only a handful of people who achieve their goal, and reject the rest of the spoiled harvest of the population who are scarred with depression and left with an 'empty feeling' in life: that they have achieved nothing. It could be said that pain is essential for pleasure, if pleasure is to be known as pleasure. If we did not know of evil in the world, then how would we be able to distinguish good? Denial of one of these extremes is similar to denying the existence of both. If we believe that evil cannot exist, or that we can block it from our lives, then good cannot exist, because then there is nothing to measure it against. However, if we accept that both good and evil exist in our lives, it can allow us to feel more at home in the world, perhaps obtaining happiness. Looking back to India as evidence for this, I remembered an encounter with a family of peasants. The husband of the family was a peasant, working for the richer men as a farmer, constantly toiling at the fields every day with no hope of extra pay or advancement in his job. The wife of the family took care of their four children, all destined for the same lifestyle, in what many would call an endless, and pointless cycle. However, far from pitying them, I envied them. They were contented with their lives; they earned enough money to live under a roof with adequate food and drink. The end result of this was that they were happy; they had no ambitions to gain wealth, and were satisfied with their lot. To be truly happy we must not linger in the past, or hypothesise about the future, but live life for the moment, and enjoy its small pleasures. By losing the foresight of the future, or hindsight in the past, we open up that world of acceptance. Some people will steal because they see that they have something more in their future. Some people will perform good deeds because they desire to feel better about themselves. In this society, we can never truly be completely happy. From our first few years of life we have ambitions: to decide what we will be when we grow up, and how we will choose to live our lives. Without these ambitions society would, unfortunately, not function correctly; no one would have any motivation to do well at their jobs and get promoted, as the idea of a Marxist/Communist society shows. It seems to me the human population has dug itself into a pit where the light of true happiness is growing more and more remote as we dig further and further down. There will always be, even in the mind of a Buddhist monk or Christian nun, a growing desire to gain something else, no matter what it may be. This, I conclude, makes it impossible for anyone in the modern 21st Century to gain the status of ‘Buddha', or ‘The Enlightened, or Blissful One'.