The Use of E-cigarettes and the Cessation of Smoking

 

The electronic cigarette is an electronic device that delivers nicotine to steam, and it allows the individual to take in nicotine without experiencing some of the negative effects of smoking. This is especially considering that the steam produced does not contain tar or carbon monoxide. Studies have shown that electronic cigarettes can help smokers stop smoking, so they can be tried instead of other remedies that are often recommended by practitioners (Adriaens et al., 2014). As with other approaches, they are most effective when using support smoking services such as the NHS Smoking Support Service, among others. Currently there are no available electronic cigarettes by prescription, but it is likely that as soon as the medicinal products with electronic cigarettes become available, general practitioners, who wish their patients to stop smoking, will be able to prescribe them. The report examines several scientific studies that analyze the harm and benefits of electronic cigarettes, and argues that devices that evaporate liquid nicotine can successfully help smokers end their dependence on nicotine. Although the report acknowledges that electronic cigarettes are probably more harmful when compared to other nicotine replacement treatments because they are not manufactured under the same safety standards, it is likely to be the best method because it has a less harmful effect than smoking conventional tobacco cigarettes (Malas et al., 2016). Therefore, the utilization of e-cigarettes may be instrumental within the accomplishment of smoking cessation as a result of its being solely less harmful than typical tobacco cigarettes; it conjointly ensures that there's the advancement of suggests that through that people square measure ready to cut back their dependence on nicotine.

The increasing use of electronic cigarettes as a substitute for tobacco smoking has been the topic of abundant dialogue, with a lot of speculation regarding their potential risks and profit. A study that was conducted on the matter stated that to meet almost all the problems associated with these products, it is essential to increase studies concerning their long term effects (Brown et al., 2014). It concludes that with cheap regulation, electronic cigarettes will build a big contribution to the interference of premature death, sickness and social inequity in health, that smoking is presently one amongst the most important causes. It additional suggests that smokers within the United Kingdom ought to be confident that these product will facilitate them quit all tobacco use for good. this is often in distinction to the U.S., wherever the Centers for Disease Control and interference focus in the main on the potential dangers of electronic cigarettes, particularly with relation to smoking among adolescents (Camenga et al., 2014). These harmful effects that are focused on come about because since electronic cigarettes are still not regulated in the US, they come in a diversity of flavors such as chocolate and cherries, which are liked by teenagers. The use of these flavors is often banned in normal tobacco cigarettes, which ensures that the safety of individuals is catered for. One of the most significant developments that have taken place in recent years is that electronic cigarettes have ended up overtaking conventional cigarettes in middle and high schools in the US, and this has been cause for concern. In the study, the researchers suggest that in the United Kingdom there is no proof that electronic cigarettes encourage the smoking tobacco.  They further suggest that these products are instead a better means of ensuring that there is a reduction in the use of conventional cigarettes. Moreover, the study focuses more on how electronic cigarettes can be used to effectively remove smokers from conventional cigarettes containing tar and other chemicals that cause cancer.

Electronic cigarettes are relatively new to the market, and it is obvious that much remains to be learned about the personal and broad impact of these products on the health of individuals. However, there is no doubt that electronic cigarettes are very popular, and they give rise to serious disagreements among health professionals (Yong et al., 2014). In particular, the researchers have sought to examine whether the use of electronic cigarettes can reduce or eliminate the use of conventional cigarettes among current smokers. In two randomized controlled trials, electronic cigarettes were compared with non-nicotine control therapy with the outcome being that both tests showed a low or very low quality of evidence. Nevertheless, participants receiving electronic cigarettes more than twice as often experienced a 6-month abstention from cigarettes when compared with the participants in the control group. Another cohort study comparing electronic cigarettes with a nicotine patch showed that 2 products contributed to similar 6-month abstinence rates from conventional cigarettes. Other studies have shown that smoking electronic cigarettes is associated with a significant reduction in the smoking of conventional cigarettes. These data are useful for electronic cigarettes, but are limited and far from final. A recent report from Public Health England (PHE) has sparked controversy over electronic cigarettes, and the analysis of this product visibly calls into question the origins and conclusions of the report; showing the considerable controversy that is still involved concerning electronic cigarettes (McNeil et al., 2016). This study, however, shows positive outcomes when it comes to the use of electronic cigarettes as a cessation method, and it is likely that they will be proven true.

Electronic cigarettes, that are called electronic nicotine delivery systems (ENDS) were originally developed in China in 2003 and have since become wide on the market throughout the world, particularly being oversubscribed on-line. ENDS is heated and vaporized with an outcome containing nicotine, and which has lesser effects than regular tobacco cigarettes (Kalkhoran and Glantz, 2016). Some proponents of nicotine reduction from tobacco smoke indicate that these products are considered viable substitutes for cigarettes, since they turn out fewer toxins within the vapor delivered to the user. However, there certain issues regarding unknown long term safety, inadequate data on content and emissions, particularly with long use associated with nicotine that involve unsupported claims to this product as an aid to quitting smoking. There may additionally be causeless consequences related to the utilization of ENDS, together with the power to cause nicotine dependence in non-smokers or to take care of dependence in smokers. Additionally, some issues of concern were expressed that ENDS may undermine the advanced restrictions on smoking within the premises and therefore the policy relating to the absence of tobacco smoke. This study is so pertinent as a result because it seeks to indicate that there are still several unreciprocated queries regarding the utilization of electronic cigarettes as a cessation tool once it involves encouraging people to quit smoking typical cigarettes. It presents the hope that future studies will be able to finally determine, without a doubt, that electronic cigarettes are the best means through which to discourage cigarette use in the UK. It seeks to show that despite the considerable issues and controversies involved in the use of electronic cigarettes, it is still a viable option to replace regular cigarettes.

Samples of current and former smokers interviewed within the four largest English-speaking countries showed important awareness of electronic cigarettes: from seventy three within the U.S. to twenty in Australia. Among those that grasp, Sixteen Personality Factor Questionnaire tested electronic cigarettes (7.6% of the full sample), and among those that tried electronic cigarettes, 39% (2.9% of the sample) were current users (Adkison et al., 2013). In numerous countries, awareness of those relatively new products within the market was higher among younger, non-minority teams with higher incomes. The testing and use of electronic cigarettes were related to smoking standing and smoking frequency, with smokers World Health Organization don't seem to be the foremost frequent users on a commonplace, most frequently making an attempt to use electronic cigarettes, though there have been few smokers within the sample. Current use was related to an oversized reduction in cigarettes per day over time, compared to non-electronic cigarette users, and this was proven among those participants wherever knowledge was on the market. Despite this being the case, users are not inclined to quit smoking than non-users. The latter finding can be considered to have come about because quitting smoking can be an extremely lengthy process that requires that the individual has time to handle the various effects. The achievement of this goal can be furthered by the use of electronic cigarettes because the latter ensures that the individual maintains a level of nicotine consumption while at the same time helping these individuals avoid the adverse effects of smoking.

The comparatively higher prevalence of use of electronic cigarettes among non-smokers might have many explanations (Wills et al., 2015). First, smokers do not take cigarettes on a daily basis will supplement nicotine intake from alternative sources, since smoking is restricted publicly places, and cigarettes are getting costlier. As a lot of knowledge becomes available, it will be necessary to assess whether or not the utilization of electronic cigarettes is related to the addition of smokeless behavior policies because of smoking restrictions reception, within the geographical point or in alternative public places. The on the market knowledge for this sample failed to show a distinction within the electronic cigarette take a look at between respondents did this compared to those that failed to have a whole ban on smoking reception, though additional use was a lot of doubtless among respondents within the U.S. failed to have prohibitions on smoking reception.  Secondly, the use of electronic cigarettes can encourage smokers to reduce the overall smoking of cigarettes to a non-standard pattern. The achievement of the goal of reducing smoking among smokers can therefore be aided by the use of electronic cigarettes. This study shows that individuals are more likely to reduce smoking, with the latter essentially becoming less frequent. The possibility of ceasing to smoke is actually quite high and it is possible that it might end up bringing about a situation where electronic cigarettes become the norm.

To date, one study has assessed electronic cigarettes as a means of reducing harm and quitting smoking with encouraging results. However, a considerable number of individuals that participated in the study reported that they used electronic cigarettes as a method of obtaining nicotine in smokeless places (Hummel et al., 2015). This is an extremely significant observation because it indicates that electronic cigarettes are also used to satisfy nicotine dependence during periods of temporary abstinence. With the addition of future waves of review of the International Tobacco Control, it will be possible to track whether those who choose to use electronic cigarettes independently from those who do not use electronic cigarettes are more or less successful in their attempts to refrain from smoking. This study shows that one of the most significant achievements of electronic cigarettes is that it has led to a situation where individuals are more likely to quit smoking because they have the means to obtain the nicotine that they need from time to time (Gravely et al., 2014). It is also a fundamental study because it advances the idea that individuals are more than capable to ensuring the advancement of means through which to bring their smoking under control because they have an alternative to actually using conventional cigarettes. Therefore, electronic cigarettes have become a method through which to bring about an end to considerably higher harmful effects brought about by conventional cigarettes.

Levels of awareness, testing and use have been found to be surprisingly high in a number of countries where electronic cigarettes are nominally illegal. This situation is instrumental in showing that there is a diverse number of ways through which individuals are able to obtain a ready supply of electronic cigarettes (Adkison et al., 2013). Among the foremost necessary information that can be found online, that is very necessary in promoting the merchandise, especially, considering the convenience within which product may be sold illegally and used privately. Indeed, those that responded with a computer survey that will indicate a bigger use and familiarity with the web sources a lot of doubtless to report data of electronic cigarettes. This knowledge show however straightforward it is to limit product limitations within the age of the web, and this could be necessary for regulators. Future research should explore how electronic cigarette users get their devices; determine the market share of various electronic cigarette products used, and how products and marketing influence the patterns of use (Buonocore et al., 2017). Such a study will ensure that there is a greater understanding of the status of electronic cigarettes in society while at the same time enabling regulators to bring about a situation where they are able to establish methods for the regulation and legalization of the use of these devices.

Discussion

Assessing the likely impact of cigarette smoking on public health, it is essential to take into account the astonishing number of deaths and illnesses caused by smoking all over the world. In this context, attempts should not be made to prevent new promising approaches that can change this image. Like any new approach that might presumably result in cessation of smoking, there ought to be an overall analysis of electronic cigarettes on the idea of accessible data, recognizing that an overall analysis of all potential long effects would require a multiannual study. The data within the literature review shows that electronic cigarettes will safely facilitate folks quit smoking. a substantial range of studies have return to the conclusion that link the overwhelming majority of smoking-related diseases to smoking product, rather than nicotine to tobacco product and electronic cigarettes. Nicotine may be a substance that's extremely addictive; however it is not the reason for cancer, respiratory organ sickness or lung sickness seen in smokers. Though the rejection of all nicotine-containing products is also a perfect target, smokers who try and stop alone have less of an opportunity of long success and solely slightly a lot of people that these have the chance to receive the mandatory health care. It is therefore essential to make sure that there is the advancement of initiatives aimed at bringing about a reduction of conventional cigarette smoking through the use of electronic cigarettes. The latter can be used as a long-term solution towards cessation because it will ensure that individuals cut down on the number of cigarettes that they smoke.

In this context, the possibility of switching from cigarettes to tobacco in electronic cigarettes containing nicotine but not burning offers great prospects as a way of saving lives. Researchers from authoritative organizations, including the Tobacco and Alcohol Center in the United Kingdom, and the Institute of Social and Preventive Medicine of the University of Geneva have come to the conclusion that electronic cigarettes contribute to reducing or eliminating tobacco use. Recently, the UK government in a bid to regulate conventional cigarette smoking has approved electronic cigarettes as a cure for this problem (Zhu et al., 2017). This position also supports common sense, since any other form of nicotine replacement that has been studied so far has shown that it helps people stop smoking; including studies conducted concerning nicotine gum, nasal spray, inhalers and inhalers. In addition, compared to these therapies, electronic cigarettes can more effectively satisfy the smoker's desire with the rapid injection of nicotine as a cigarette and also satisfy the usual aspects of smoking. As electronic cigarette technology improves, these devices will certainly become more effective tools to help smokers break their dependence on fuel cigarettes. It is possible that the use of these devices will ensure that individuals are better able to gain control over their smoking habit to such an extent that it brings about complete cessation. The achievement of this objective through the use of electronic cigarettes has the potential of making conventional cigarettes a thing of the past and will enable society to significantly reduce the healthcare expenditure that involves cigarette smoking.

The available knowledge confirms by an awesome majority the study that electronic cigarettes are fairly safe and by far very necessary; meaning that it is much less dangerous than cigarettes. Despite the agreement of specialists, some researchers have centered their attention on alternative health issues. Studies involving the negative aspects of electronic cigarettes square measure of dramatic quality and infrequently receive in depth coverage by the press. parenthetically, some initial reports recommended that electronic cigarettes turn out methanol, a venomous substance found in cigarette smoke (Ghosh and Drummond, 2017). However, recent studies have shown that below traditional in operation conditions, electronic cigarettes turn out abundant less methanol than tobacco cigarettes. Moreover, the negative study mentioned shows that electronic cigarettes might not be effective for smokers who need to prevent smoking. The report received extensive but incorrect coverage in the press, as smokers who go to electronic cigarettes may be an independent group with particular difficulties to stop smoking. The gold standard for efficacy assessment is a randomized clinical trial and two experiments so far have shown that electronic cigarettes can help smokers stop smoking. One of the most fundamental issues that are not addressed in this study is that there is little consideration that most of the recommended remedies for cessation of smoking do not often work. Emergency approaches are desperately required particularly considering that the WHO predicts that one billion deaths are going to be related to smoking within the twenty first century (Nemati et al., 2017). Electronic cigarettes have an incomparable ability to scale back the result of smoking on smokers and non-smokers by permitting smokers to exchange smoking habits and nicotine from smoking while not becoming victims of the venomous effects of combustion.

Patients use the electronic cigarette for a variety of reasons, but the most common are many who stop smoking to reduce the number of cigarettes smoking per day and use a product that is considered "healthier" than cigarettes smoking. The use of electronic cigarettes is therefore a safer means of smokers obtaining a dose of nicotine when compared to other forms of nicotine administration. Thus, electronic cigarettes may have an advantage over other smoking cessation treatment as it approaches optic and behavioral smoking. Many of the aesthetic and behavioral aspects of smoking, which smokers are trying to stop usually - for example, non-nicotine rewards and the aesthetic kinetic effects of hand-mouth, visual or throat emotions are shaped using electronic cigarettes. The use of these devices end up leading to the advancement of treatment for smokers in such a way that they end up being discouraged from continuing to make use of conventional cigarettes. It also ensures that there is a viable option that can be adopted in a bid to achieve cessation because there are instances where individuals are not willing to cease smoking immediately, and the process has to be conducted at a slower pace. A consequence is that the use of electronic cigarettes allows for the advancement of smoking cessation over a long term; ensuring that there are lesser occurrences of individuals returning to conventional cigarettes.

One of the most important findings made by the studies above is that electronic cigarettes could help smokers reduce the number of smoked cigarettes compared to other methods of bringing about cessation. Although it is not known whether "dual use" - using electronic cigarettes, and the continued smoking, albeit less, cigarettes - is only one step in the process of smoking cessation with the help of electronic cigarette or if it can prolong the duration of smoking. It is well known that reducing the number of conventional cigarettes is a useful strategy for smoking cessation and ultimately leads to less exposure to harmful toxins than continued smoking. The studies in the literature review have shown that reducing the number of smoked cigarettes before the scheduled use of electronic cigarettes led to a reduction in smoking, abrupt smoking, without reducing the number of smoked cigarettes. In a small study in the UK, smokers who were given electronic cigarettes as part of a specialized treatment to "stop smoking" and who failed in an attempt to stop but continued to use electronic cigarettes to reduce the amount of toxins, ended up being positively affected when compared to those who continued smoking only smoke cigarettes, offering short-term "dual use" associated with reducing damage. Therefore, the use of electronic cigarettes can be considered an essential method, if not the most effective, in helping smokers reduce smoking conventional cigarettes and eventual cessation.

Conclusion

Uncertainty about hypothetical damage that might be caused by electronic cigarettes does not always justify the imposition of sanctions. This is especially where the costs and dangers of such a restriction are likely to be much higher than the costs and to prejudice the "light touch" regulation based on what we know about the toxicology of electronic cigarettes. Currently there are data on the chemical properties of aerosols in the electronic cigarettes, so it is difficult to think that the scope of any adverse health effects, even decades’ accumulation will rival what is derived from decades of toxic smoke inhalation. Even if there were an adverse health effect unknown, the authorities could probably wait several decades before there was any sign. One of the most significant suggestions that can be made is that those who offer to wait have an ethical obligation to specify what kind of evidence would convince them to lift the sales ban in the electronic cigarettes. Appropriate approach would be to enable product availability, while ensuring a stable regulatory requirement for product ingredients and to use surveillance and compliance at all levels of tobacco control and point of sale. In this way, it will be possible to ensure that there are adequate controls aimed at reassuring users as well as the public concerning the effectiveness of electronic cigarettes in bringing about cessation of smoking.

Many people will ask about electronic cigarettes, may have tried them, perhaps use them on a daily basis, or intend to use them. They should be informed that the electronic cigarettes are the safest options to continue to smoke tobacco and are probably equally effective in quitting smoking, such as nicotine replacement therapies. Those who do not want to quit smoking or who have tried the range of evidence-based but non-smoking yet repeated approaches should actively discontinue trying or continue using electronic cigarettes if they are using them already. Rather than being discouraged, these individuals should be supported and should be warned that if they use electronic cigarettes, it is used more safely without further smoking, even a cigarette. If they find it difficult to cut out smoking altogether, then "dual use" should provide for a limited period of time, with the intention of reducing and eventually ceasing to smoke cigarettes.

In addition to the wide range of products within the electronic cigarette group, several of the new inhaled nicotine devices that appear to be promising are in development. These include products developed by tobacco companies such as "unheated cigarettes", aerosol systems with metered dose inhaler and a nicotine-pyruvate. Such products, especially those developed by the tobacco industry and its subsidiaries, pose a challenge to community tobacco control, although they have potential as new opportunities for many smokers seeking help to quit smoking and improve their health. It also raises the issue of reducing the harmful effects of smoking as a valid smoking strategy and raises questions about industry commitment. As there is the development of new products with reduced levels of harm, it is vital that healthcare professionals adhere to the innovation and evidence in this area in order to guide people who smoke in public and politicians to advance the use of electronic cigarettes.

Electronic cigarettes are thought of by its critics as a cause for long harm. The chance of harm from the long use of electronic cigarettes can't be rejected because of the inhalation of ingredients other than nicotine, however most likely abundant smaller and significantly below the results of smoking with acceptable product standards. To minimize exposure to alternative elements ought to be attainable to additional reduce physical health hazards. Though it is unimaginable to accurately assess the long health risks related to electronic cigarettes, studies indicate that it is unlikely to exceed five percent of those in regard to smoking tobacco product and should be considerably less than that figure. The studies and discussions above show the necessity for proportional regulation, however recommended that regulation should not be able to considerably impede the adoption and use of the electronic cigarettes which might end up hurting smokers. The restrictive strategy ought to be a balanced approach to making sure product safety, to change and encourage smokers to use the merchandise rather than tobacco and to notice and stop the results that are contrary to the objectives of the tobacco management policy.

 

 

 

 

 

References

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Healthcare Coverage

      Health insurance includes a range of methods for guaranteeing healthcare services at no or reduced costs and these include government provided programs and individually purchased programs or products. The original health insurance concept was designed to spread the risk of incurring large claims across a broad population (some of which will actually have no claims at all in a given calendar year). In the United States, a complex system of contracts, specialized terms, selection of risk (selecting individuals who have fewer claims) and regulations at both the state and federal levels have sprouted from the original concept.

         Healthcare coverage is a very controversial topic especially in the United States. Many attempts have been made beginning in the twentieth century to provide a universal healthcare coverage to all those Americans who were not insured but most of them ended up in failure due to the influence of some groups, like doctors, who saw it as a way of curtailing their freedom to practice in the service of their patients. Many of the early efforts to provide discounted healthcare were pressured out of existence by physician groups but the rising cost of healthcare has made it a mandatory issue to be considered and discussed within the political circles. Healthcare coverage has become a very important matter within the United States because of the increasing costs which prevents many of those Americans in great need of the said medical care from getting it. This is mostly due to the fact that they can barely afford to pay the premiums demanded by insurance companies, or if they are able to, they can only afford insurance with little coverage. Attempts have been made by the federal government to ensure that healthcare coverage is available for all Americans by requiring all employers to provide health insurance for their workers while the government covers those who are not employed.

         This proposition has however been opposed by some sectors of the economy, most notably, small businesses. These small businesses balk at the cost of providing insurance for more employees because, they argue, the government does not provide enough resources to enable them to bear these costs. The proposition that businesses expand coverage for their employees would force these businesses to cut wages, lay off workers, and perhaps even cease operations because of the high cost of insurance. The government could choose to bear the cost of all health care, as is done in Canada, because it can control the cost of health care to a greater degree than it does in the current system. This proposition has been opposed by many organizations which argue that this move would make access to health care more unequal because the rich and influential in society would just be able to skip the line and get preferential treatment as opposed to those who were there first. Moreover, this system would discourage further research into the development of new pharmaceuticals and medical devices which are an essential part of the improvement of medical services.

        In conclusion, I propose that the best way to deal with this issue is to first implement the universal healthcare coverage and then deal with the problems that arise from it as they come because there is no perfect system in the world.

Implications of the Patient Protection and Affordable Care Act on the Healthcare Environment

The Patient Protection and Affordable Care Act is one of the most important policy initiatives of the American government in the contemporary world. The first of its aims to ensure that there is collaboration between government, individuals, and employers in order to achieve near-universal healthcare coverage. The second aim is to ensure that al of those individuals who receive health insurance coverage are able to achieve a high level of fairness, affordability, and quality. Another aim is to ensure that individuals who have coverage are able to receive a high quality of care without wasteful spending through the improvement of efficiency and accountability to patients. This policy also aims at promoting the development of a situation where there is a strengthening of primary care with the objective of easier access to preventative healthcare; essentially encouraging the reduction of healthcare costs. The final objective of this policy is to ensure that there is investment in needed healthcare facilities in so that it can be possible to bring about the expansion of clinical preventative care that is useful in the creation of a stable healthcare system. Patient Protection and Affordable Care is essential in the fixing the healthcare system so that a majority of the population can have access to quality care.

One of the most fundamental aspects of the American healthcare system is that it is one of the most expensive in the world. Unlike in European countries, where there are strong social welfare systems that ensure universal healthcare, in the United States, prior to Affordable Care, it was quite difficult for individuals to access quality healthcare. Furthermore, there was a situation where very few individuals had health insurance; meaning that some treatable health conditions ended up becoming a burden on patients. Therefore, the move by government to ensure that there was the expansion of healthcare insurance as well as an increase in investment in medical facilities to cater for the needs of individuals in need of them. This legislation had considerable support from the Obama administration, which promoted it by proposing that it was not only a matter of government policy, but also a moral issue that could not be ignored. In addition, while there was an attempt by the Democratic majority in Congress to take on a bipartisan approach, this ended up not being the case because the policy faced considerable opposition from conservative elements in the Republican Party such as the Tea Party. Moreover, some lobby groups associated with the healthcare complex were also involved in pushing their agendas in the development of the policy.

Among the considerations that were made during the development of Patient Protection and Affordable Care Act was the establishment of a single-payer Medicare for All Act. However, this option was discarded because of the belief that it would not be able to acquire support within the Senate that was filibuster-proof. The Medicare for All Act would have been one of the most progressive accomplishments of the policy because it would have ensured that all individuals were able to have health insurance. However, this alternative was not considered because it would have met with considerable opposition, especially from the conservative elements in the Republican Party. Furthermore, there was the fear that if such an act was passed by Congress, it would encourage freeloading among those individuals who were not willing to pay their fair share of insurance premiums. Therefore, the most progressive aspects of the Affordable Care Act were discarded because of the potential of considerable opposition to it. Furthermore, the need to ensure that the bipartisan concerns were addressed so that the act could be passed meant that compromises had to be made in order to create a situation where it was possible for majority support to be comfortably obtained.

The implementation of the Affordable Care Act was conducted at the state level. However, it was not implemented according to its original design because of considerable resistance that the legislation received from its opponents. A consequence was that states were given the option of making the decision of whether or not to expand their Medicaid programs. Since the objective of promoting the full adoption of Affordable Care in the whole of the United States was not achieved, it has remained a considerable point of contention on both sides of the political divide. However, a number of states ended up expanding their Medicaid to such an extent that a large number of individuals who previously did not have the means to have quality healthcare currently have access to it. This situation shows that if there had been proper bipartisan support for the policy, it would have led to universal healthcare coverage in the country to such an extent that it would have promoted the health of all Americans while reducing costs. Those states that opted not to expand their Medicaid created a situation where the federal government had to revise its estimates concerning how Affordable Care would work. This meant that it was essential to reduce the expectations concerning the savings that would have been made following implementation in all states.

While the policy started with good intentions for the healthcare system, it ended up not being able to achieve its intended goals because of resistance towards it both at the political and state levels. However, it was able to solve a considerable part of the original problem because it allowed individuals who could not previously afford it to have healthcare coverage. The progress of this policy was interrupted because some states opted not to adopt it because of the belief that it would increase their Medicaid costs. The lack of bipartisan support for this policy, especially considering Republican resistance, meant that its chances of success were limited to those states that adopted it. A consequence was that because some states opted not to adopt Affordable Care, the cost savings ended up being much less than was originally projected. Thus, this policy can be considered to have been neither a success nor a failure because while it was able to achieve its objectives in some states, in others, it had a hard time gaining acceptance.

Teenagers and Plastic Surgery

Over the past few years, statistics have shown that there has been an increase in the number of teenagers opting to go for cosmetic surgery. The most popular of the non-surgical cosmetic procedures among teenagers include laser hair removal and chemical peels, which have grown in popularity especially over the last two years. It has been stated that the most popular cosmetic surgery among teenagers has been cosmetic ear surgery, also known as otoplasty. Some experts in cosmetic surgery state that for some teenage patients, plastic surgery could have a very positive effect in their lives not only physically, but also in their emotional development. Moreover, cosmetic surgery has become so popular among teenagers that their parents are now bestowing them to their children as gifts for their birthdays or even graduations. Many surgeons state that they are seeing more teenagers than ever coming to their practices for the various cosmetic surgery procedures available to them. Despite the fact that many parents and their teenage children have been advised against turning to major surgical procedures as a fix for the teenagers’ self-confidence, the number of teenagers who have undergone these procedures has continued to rise. For example, the number of teenage girls under the age of 18 years who undergo breast augmentation procedures has nearly tripled from one year to the next. Teenagers undergoing cosmetic surgery have become a common phenomenon and it is no longer a procedure reserved for the rich as it has previously been.

In the initial stages before a surgeon can put a teenage patient in the cosmetic surgery procedure, he must assess whether this patient is suited for the procedure, otherwise, the entire procedure would be unethical because the surgeon will only be interested in the patient’s money and not their well-being. The most important thing that a surgeon must consider is whether the patient is physically mature this is because performing an operation on a physical feature, which has not fully developed could interfere with its growth and lead to or could have a negative impact on the surgery in the future. Secondly, the surgeon has to consider the emotional maturity of his patient and not only should he inform the teenager of the benefits of the procedure, but also its limitations and he should make sure that the patient is ready to live with the consequences of the procedure whether it meets their expectations or not. Lastly, teenagers and their parents should be made to understand the risks of undergoing the cosmetic surgery as well as the time it takes to recover from the procedure.

In addition, there has been a growing trend among teenagers towards undergoing cosmetic surgery to improve their appearance. From a handful of these procedures that were done some two decades ago on teenagers, today, a large number of teenagers in their hundreds of thousands, undergo cosmetic surgery. This number has kept on growing over the last ten years and it is actually becoming quite common. For example, the number of lipoplasty procedures for teenagers under the age of 18 years has continued to increase over the years and this has continued to be so despite the very careful selection by surgeons of the patients in this group. Furthermore, of the women who underwent breast augmentation procedures in the year 2010, about two percent of them were under the age of eighteen and this is quite a significant number. The reasons why teenagers go for cosmetic surgery to reduce or increase the size of their breasts, correct the balance between a pair of body parts and in this case mostly breasts and ears, correct the severe underdevelopment of some body parts and finally the need to increase their self-confidence in an environment where they feel insecure.

Many teenagers who wish to undergo plastic surgery are motivated by factors, which are very different from those that influence adults to do the same. Most of them want to improve the physical characteristics, which make them feel and look awkward; moreover, they believe that this awkwardness may pursue them for the rest of their lives. In fact, teenagers are always motivated by the current trends of the time and many undergo surgery just so that they can look similar to their friends or their favorite celebrities. This motivation is quite different from that of adults because they tend to undergo the cosmetic procedure not only to look different from their peers, but also to stand out. The most common physical characteristics, which teenagers often want to change for the better through cosmetic surgery include misshapen noses, protruding ears and either small or overly large breasts. After a successful procedure, many teenagers often regain their confidence because their perceived physical deformities have been corrected. In fact, this procedure if successful tends to make teenagers more confident in their social skills and this ensures that the social withdrawal, which had haunted them before is gone.

There are very strict procedures, which have been put in place to ensure that all teenagers who undergo cosmetic are well suited for it. The most common procedure that is supposed to be undertaken is to establish whether the teenager is mature enough emotionally and that this teenager understands the limitations of the surgical procedure which he is to undergo. Teenagers, and their parents, whose consent they need in order to have cosmetic surgery, have to understand that the effects of the surgical procedure on their bodies will be permanent and cannot be reversed and that they should therefore be very realistic in their expectations about what it will do for them. Moreover, the body of a teenager is more often than not fully developed and those perceived deformities that a teenager may have could be outgrown in time without the need for any surgery.

Many people believe that the increase in the number of teenagers undergoing plastic surgery is not a trend but an evolution, which has led to a new way of life. It is stated that one of the main reasons for this growth is the visibility of the procedure considering the fact that most teenagers are today growing up with parents who have undergone cosmetic surgery and they therefore have more knowledge about it. Media of all types has also made teenagers more aware of the procedures that one has to go through in a plastic surgery procedure and this awareness has ensured that their interest in it is whetted and it has become an acceptable thing among them (Janet, 2004). Teenagers have come to realize that plastic surgery does not only repair their physical appearance but it also boosts their self-confidence, something that they tend to require in the very competitive environment in which they live today. Plastic surgeons are also aware of the problems that teenagers’ face, which leads them to come to the decision to undergo the procedure and the surgeons, therefore, assess their psychological condition before putting them under the knife. Surgeons also recognize the fact that the surgical procedure may not do anything to help a teenager make an advance in their self-confidence and this is as a result of their prior experiences with celebrities who have remained very insecure despite undergoing so many cosmetic surgery procedures. Teenagers should be made to understand that although it is their right to have cosmetic surgery, they should be very careful in their consideration of whether to have it or not. They should realize that their wish to have the surgery should not be expressed lightly because the effects of this procedure will stay with them for the rest of their lives. Whether it is a trend or not, it has to be recognized that teenagers undergoing plastic surgery is something that is here to stay and that it should no longer be a surprising thing.

Responsibilities of Nonprofit Health Care Organizations

The existence of nonprofit healthcare organizations is essential in the provision of affordable healthcare to many Americans who would otherwise find it hard to get treatment elsewhere. These organizations are therefore very important and according to Dewar (2009) they are divided in to three main categories. The first are organizations which are populated by a general membership in a specific industry and a very good example of this is the American Medical Association. The second category comprises of those organizations which are mandated to provide services towards a specific therapeutic problem such as cancer, diabetes, among others and an example of this is the American Cancer Society. The third and final category are nonprofit organizations which are founded and operated by private citizens whose main aim is to help anyone they choose to help and one of the most prominent of these organization is the World Vision Foundation.

The GAO Report on nonprofit hospitals states that the Federal tax exemption for charitable organizations has been in existence since the beginning of the federal income tax law and it is based on the assumption that the loss of government tax revenue is offset by the ability of these charitable organizations to provide for the population’s welfare. One of the greatest beneficiaries of this tax exemption system has been the nonprofit hospitals due to the belief that the promotion of medical healthcare especially to the poor is a charitable function and should be exempted from taxation. The IRS et al (1993) states that one of the main conditions for this exemption is that these hospitals should be organized and operated exclusively for the purpose of the provision of health and that all the income it generates should not go to the benefit of individuals within this organization but should be put back into pursuing the main objectives of such an organization. Furthermore, nonprofit hospitals do not have to provide free medical services in order to qualify for tax exemption so long as they provide services to the community which will reduce the government’s financial burden. In relation to this, the clinics operated by the Memorial Medical Center help it to maintain its tax exemption status due to the fact that these clinics were opened for the purpose of providing better healthcare services to the communities within which they are situated. The operation of these clinics provides it with the means for it to ask for exemptions because they provide the services which the government should be providing and it has also been seen that the provision of these services comes at great expense to the Medical Center considering the losses that are incurred in one of the clinics.

The article An Organizational Ethics Decision-Making Process by William Nelson looks at the steps that can be undertaken by the Memorial Medical Center when making decisions that are related to ethics in order to satisfy all the stakeholders in making the decision of whether to close a loss making clinic or not. The first which is to be considered is the clarification of the ethical issue in question and the parties involved should be able to declare the specific areas where they are in disagreement. The second step is the identification of all the affected stakeholders and giving them the opportunity to express their views concerning the ethical issue involved. A third step is understanding the issues surrounding this ethical conflict and this requires fact finding missions to find out exactly what its root cause is, be it medical, financial, or the community. The fourth step is the identification of the ethical perspectives that are relevant to this conflict from the different views from which it can be seen. The fifth step is the identification of the different options that are open to respond to this issue such as adopting new strategies to stop the financial drain that it has been experiencing. The sixth step is the analyzing the different options identified in the previous step to look for their merits and demerits and to determine whether the opinion of one stakeholder appears to be stronger that those of all the others. The seventh step is to share and implement the decision with all the people concerned. The eighth step is the reviewing of the decision to see whether its implementation managed to achieve the desired goals that it was intended to achieve. There are several options open to the Medical Center including the following: keeping the loss making clinic open and continue running it at a loss, appealing to the government for more tax exemptions in order to get more funds to run this clinic, and finally, it can decide to close the clinic. I believe that the Medical Center should choose the second option because it will enable it to be able to continue operating the clinic with minimal or no losses at all due to the fact that it is getting more tax exemptions. It would not be ethical for the Center to close up its clinic because many people living in that area rely heavily on it due to its affordability.

Nicholson et al (2000) states that it is the ethical obligation of non-profit hospitals to provide medical healthcare to all the people who come to it not only to maintain their tax-exempt statuses but also as a way of contributing to the society.  It is therefore not acceptable for such a hospital to only do the barest minimum to maintain its exemption status because that can only be considered to be illegal. Instead, it should do its utmost to provide the necessary services to justify why it should have any tax-exemptions.

Cited Works

Dewar, D.M. (2009). Essentials of Health Economics. Burlington, MA: Jones and Bartlett Learning.

Government Accountability Office. (2008). Report to the Ranking Member, Committee on Finance, U.S. Senate. Retrieved from http://www.gao.gov/new.items/d08880.pdf

Nelson, W.A (2005). An organizational ethics decision-making process. Healthcare Executive, 20(4), 8-14.

Nicholson, S., Pauly, M. V., Burns, L. R., Baumritter, A., & Asch, D. A. (2000). Measuring community benefits provided by for-profit and nonprofit hospitals. Health Affairs, 19(6), 168-77. Retrieved from http://0search.proquest.com.alice.dvc.edu/docview/204632733?accountid=38376

Tax exemption granted to nonprofit charitable hospitals that accept payment for services rendered.(1997). The Appraisal Journal, 65(4), 420-420. Retrieved from http://0search.proquest.com.alice.dvc.edu/docview/199949607?accountid=38376

United States Internal Revenue Service. Statistics of Income Division, American Statistical Association. (1993). Statistics of Income: Turning Administrative Systems into Information Systems. Washington D.C: Government Press.