In a hospital without HDU facilities, patients who are receiving HDU levels of care on discharge from the ICU have a high in-hospital mortality.
ObjectivesTo explore (1) the social function of shisha cafes for young people living in the UK and (2) other alternative activities (existing or potential) that do not involve tobacco smoking.MethodsWe conducted qualitative interviews with young adults (age 18–30) in Leeds, UK. Snowballing sampling was used in selecting the participants. Interviews were audio-recorded and explored the perspectives and experiences of young people in as well as potential alternative activities. Data were transcribed and analysed thematically.ResultsShisha use plays a central role in social interactions. Youth described using shisha because of emotional and sensory pleasure. Shisha use was implicitly endorsed by respected professionals, such as doctors and university lecturers, who were seen smoking it. Most, but not all, shisha smokers acknowledged that shisha use is harmful. Suggestions for reducing shisha use included use of non- tobacco alternatives, legislation to reduce access and alternative means for socialising, such as sports.ConclusionFor young people in the UK, the known health dangers of shisha are outweighed by its social benefits and shisha is perceived as acceptable. Interventions to reverse the increase in shisha cafes should focus on both individual smoker as well as the community, without sacrificing the importance of social interactions.
This chapter has provided a foundation upon which to base further study; it has presented the key values and principles of health promotion; emphasized the need to tackle the social determinants of health; presented a history of health promotion's development through the WHO-led conferences; introduced some threshold concepts; outlined professional and lay concepts of health; and suggested that empowerment approaches are the essence of health promotion. The next three chapters provide detail on three central aspects of health promotion, which follow logically from what we have outlined thus far: working with communities, developing healthy public policy and communicating about health. These three areas also, logically, form modules of study on many postgraduate courses.
This book chapter seeks to: (i) consider models of communication and assess their relevance to health communication; (ii) suggest that health promotion must adopt participatory means of communication; (iii) critique top-down 'banking' approaches to communication and education; (iv) discuss the implications of digital technology development on health communication; (v) assert the importance of health education and consider the idea of health literacy; (vi) explore and critique social marketing; and (vii) explore and critique psychological models of behaviour change.
This chapter has attempted to discuss some challenges in the practice of health promotion, ending on the challenges in terms of the skills required to do health promotion work. Some of these challenges reoccur in the next chapter, particularly when discussing capacity building for health promotion at a societal level rather than the individual level, as we have done here. Working ethically, developing evaluation skills and evidence-based practice are contentious areas and we do not pretend to have produced all the answers here. It remains to be seen whether settings approaches will really 'deliver'. Many factors run counter to organizations wishing to become healthier settings, not least the imperative in some sectors to be profitable or show 'value for money'. However, as we suggest in the next chapter, health promotion is an optimistic profession, and the future development of health promotion will be explored next.
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