Introduction
Although there is no risk related to the issue of tobacco use in the United States, it continues to be one of the leading causes of preventable illnesses and death. Centers for Disease Control and Prevention (CDC) (2021) reports that the number of smokers in the country is close to 40 million. Alarming statistics demonstrate that smoking-related diseases and exposure to secondhand fumes need to be taken seriously as “every day, about 1,600 U.S. youth younger than 18 years smoke their first cigarette” (CDC, 2021, para. 1). Social workers may find themselves in a perfect position to help people battle nicotine addiction and quit the habit altogether. Human services involved an array of strategies and interventions tasked with eliminating additional sources of stress in an individual’s life, which may, in turn, affect the smoking addiction. The field of social work implies the development of a trusting relationship between a professional and a person in need of assistance. Thus, human services workers are already in a great position to engage in smoking cessation.
It is undeniable that the field of human services is poised to provide aid to people through a holistic approach to physical health and mental well-being. After all, substance abuse problems often stem from a mix of environmental issues. Therefore, a social worker is perfectly equipped to untangle the knot of family, friends, and community stressors. The purpose of this paper is to examine the issue of nicotine addiction in the context of human services in order to offer a framework for social workers to make ethical decisions regarding smoking cessation.
The Origins of Tobacco Addiction
In order to provide help to addicts, human services professionals must first understand the origins of nicotine dependence themselves. Firstly, it is crucial to determine what addiction is exactly and how it functions. National Institute on Drug Abuse (2020) states that some of its traits include compulsive drug-seeking behavior and use, even when a person acknowledges immediate health implications. According to the latest statistics, only 6 percent of smokers quit annually, most of them succeeding after multiple failed attempts (National Institute on Drug Abuse, 2020). Once a person takes the first drag of a cigarette, they receive a small dosage of nicotine, which leads immediately to a surge of endorphins. This process involves a brief euphoric state, which is similar yet much shorter than the “high” caused by other substances. Apart from the brain releasing endorphins, nicotine leads to an increase in dopamine levels, which are responsible for encouraging the repeated intake of the drug. Hence, long-term exposure to cigarettes results in the development of addiction that implies withdrawal symptoms and perceived stress relief.
In regards to the withdrawal episodes associated with smoking, they are largely defined by nicotine’s pharmacokinetic traits. While the chemicals absorb rather quickly and their influence is immediate (within 10 seconds or less), the effects dissipate quickly as well. This prompts the creation of a vicious rapid cycle, which forces a smoker to keep dosing in order to prevent the symptoms associated with withdrawal. They may include “irritability, craving, depression, anxiety, cognitive and attention deficits, sleep disturbances, and increased appetite” (National Institute on Drug Abuse, 2020, para. 4). The severity of these quitting effects is unique to each individual and their genetic make-up.
A human services professional has a direct obligation to provide people in need of assistance with the relevant information regarding the problem they might experience. Therefore, a social worker must acknowledge that despite perceived pleasure and short-term cognition boosts, smoking addiction is extremely dangerous. National Institute on Drug Abuse (2020) warns that no short-lived stress-relieving or cognitive effects of cigarettes can outweigh long-term nicotine-related cognitive decline and an increased risk of developing Alzheimer’s Disease. The primary task in human services practice is to alleviate most of the withdrawal symptoms and help smokers battle various environmental triggers. In this process, a social worker may face a number of ethical challenges, which are related to the notions of informed consent, confidentiality, and autonomy.
The Latest Research Surrounding Nicotine Dependence
Prior to dealing with the target of intervention directly, human services practitioner has the moral responsibility to refresh their memory on the issue and familiarize themselves with the latest developments in the field. For instance, the biggest genome-wide association study has uncovered that a specific gene influences the predisposition to nicotine addiction and more severe withdrawal symptoms (RTI International, 2017). Lee et al. (2018) have contributed to these findings and concluded that a particular cluster of genes affects the likelihood of nicotine dependence. As for the impact of smoking, certain researchers focused on the effects of secondhand smoke and “showed an association between passive smoking and the development of CD [Crohn’s Disease]” (Kondo et al., 2019, p. 5). Frequently staying in cigarette smoke-contaminated environments for a long time is, thus, a risk factor for various types of cancer, heart disease, cardiovascular conditions, and pregnancy complications (Kondo et al., 2019).
Apart from the impact and origins of nicotine addiction, human services professionals must familiarize themselves with the recent developments in regard to viable solutions. Thus, Yang and Ma (2021) emphasize the importance of acknowledging that tobacco dependence manifests itself in unique patterns for each smoker. Boffo et al. (2019) highlight the efficiency of Cognitive Bias Modification interventions in scenarios related to substance abuse. Lastly, Weiss de Souza et al. (2020) specify the nuances of the smoking cessation process and demonstrate the efficiency of the Mindfulness-Based Relapse Prevention initiative.
Ethical Standards of Human Services Practice
The field of substance abuse implies the existence of a number of ethical dilemmas a human services professional might face. Some of these unique issues are the constant need to prove and re-affirm the value of the assistance provided, the importance of conducting interventions in accordance with moral values and duties, as well as the need to respect a client’s right to self-determination. What makes the field of addiction so complex is the fact that the dangers of ethical misconduct are much more long-lasting and harder to avoid. A human services organization or an individual professional is more vulnerable to mistakes in the realm of ethical decision-making. This is due to the fine line between the client’s desire to get better and their possible rejection of assistance because of particularly severe withdrawal symptoms.
The main ethical considerations in the field of substance abuse are related to the notions of privacy, confidentiality, informed consent, and conflict of interest. Human services professionals are obligated to respect people’s right to privacy and existing standards of confidentiality. They should not solicit any information unless it is absolutely necessary for research or evaluation. When it comes to informed consent, social workers should explain the primary objectives, risks, and limitations of their collaborative efforts to battle tobacco addiction. Furthermore, they should inform the client of their right to refuse to continue or ask for an alternative. Apart from ensuring confidentiality and informing of the extent of the services, human services practitioners are obliged to eliminate any sources of conflicts of interest. They may stem from dual relationships with the client or the disregard for appropriate professional practice boundaries.
The best way to protect the client’s interests and effectively assist them simultaneously is through the utilization of a rational ethical decision-making framework. For example, a social worker might regard the services they provide in four stages: identification of issues, review of options, deliberate action, and evaluation. The first stage involves a human services practitioner determining the primary clinical, cultural, environmental, and legal issues in the context of ethics. The next step is the development of an ethical dilemma and the review of possible options, including the process of examining each alternative’s advantages and disadvantages. After a social worker creates short- and long-term plans comes the stage of action. Lastly, there is a need to evaluate ethical decisions made throughout the process in order to assess the impact of services on the client.
Conclusion
In conclusion, it is evident that tobacco addiction is an alarming issue, which affects millions of Americans. Human services is a field perfectly poised to provide assistance to individuals with substance abuse problems. However, in order to do that, social workers must familiarize themselves with the latest research surrounding the issue. Apart from the knowledge required for developing the most effective smoking cessation solutions, there is an array of ethical considerations associated with addiction treatment and assistance. The paper offers a framework for making morally competent decisions, which any human services practitioner can use while dealing with a nicotine addict. The main stages of such a decision-making model include the identification of primary issues, review of options, action, and, lastly, evaluation.
References
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Lee, S. H., Ahn, W. Y., Seweryn, M., & Sadee, W. (2018). Combined genetic influence of the nicotinic receptor gene cluster CHRNA5/A3/B4 on nicotine dependence. BMC genomics, 19(1), 1–11. Web.
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