Essay Tobacco Related Disorder

UAS TAKE HOME
KOMPETENSI BAHASA INGGRIS

TOBACCO RELATED DISORDERS
Dosen Pengampu:
Oleh:
Veronika Btari P. / 125120300111032

A. PSI 5
PROGRAM STUDI PSIKOLOGI

FAKULTAS ILMU SOSIAL DAN ILMU POLITIK
UNIVERSITAS BRAWIJAYA
MALANG
2014
Tobacco-Related Disorders
Smoking is a lifestyle that we usually encounter today. Smoking is known to
have started as early as 1439 A.D. Rodrigo de Jerez was the first ever smoker in
Europe, and the development of cigars was originated by the Native American
people. In the twentieth century, cigars were advertised all over the world as a
harmless, anti-stress product with little or no side effects. Smoking was eventually
become widespread all over English-speaking continents and was even popular
among women. As technology became more advanced, the adverse effects of
smoking on human health have increased exponentially. Researchers officially
declared smoking as a harmful habit that in most of the cases is fatal. However,
despite knowing the fact that smoking is harmful, the number of people who smoke
is increasing day by day rapidly. Smoking causes many negative effects more that
people think. It affects not only the smokers health but also the enviroment and
society.
Indonesia has the world's largest cigarette consumption, namely the fourth
after China, USA and Russia. The number of cigarettes consumed in Indonesia is
likely to increase from 182 billion cigarettes in 2001 (Tobacco Atlas 2002) to 260.8
billion cigarettes in 2009 (Tobacco Atlas 2012). Now, public attention to the problem
of smoking cigarettes is high enough; in addition, smoking has undergone radical
controlling measures, such as bans from numerous healthcare and governmental
organizations.
Tobacco is the single cause of death that can be prevented. Tobacco use is
common because the price is relatively affordable, widespread marketing and
aggressive, lack of knowledge about the dangers, and public policy inconsistency
about the use of tobacco. Premature deaths due to tobacco usually occurs on
average 15 years before life expectancy is reached. In 2010, an estimated 6 million
people in the world die (including 190.260 people in Indonesia) due to illness
because of tobacco. Generally, tobacco-related diseases requires years to develop
after smoking behavior begins, so epidemic of tobacco-related illnesses and deaths
in the future will continue to increase. Tobacco can cause various diseases,
particularly lung cancer, stroke, chronic obstructive pulmonary disease, coronary

heart disease, and blood vascular disorders, in addition to causing a decrease in
fertility, increased incidence of pregnancy outside the uterus, fetal growth restriction
(physical and IQ), seizures in pregnancy, infant immune disorders and increased
perinatal mortality.
According to Diagnostic and Statistical Manual Of Mental Disorder 5th Edition
(DSM-5) published by American Psychiatric Association (APA), smoking habits were
included in Tobacco-Related Disorders which is part of Substance-Related and
Addictive Disorders. The diagnostic criteria are:
A. A problematic pattern of tobacco use leading to clinically significant
impairment or distress, as manifested by at least two of the following,
occurring within a 12-month period:
1. Tobacco is often taken in larger amounts or over a longer period than was
intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control
tobacco use.
3. A great deal of time is spent in activities necessary to obtain or use
tobacco.
4. Craving, or a strong desire or urge to use tobacco.
5. Recurrent tobacco use resulting in a failure to fulfill major role obligations
at work, school, or home (e.g., interference with work).
6. Continued tobacco use despite having persistent or recurrent social or
interpersonal problems caused or exacerbated by the effects of tobacco
(e.g., arguments with others about tobacco use).
7. important social, occupational, or recreational activities are given up or
reduced because of tobacco use.
8. Recurrent tobacco use in situations in which it is physically hazardous
(e.g., smoking in bed).
9. Tobacco use is continued despite knowledge of having a persistent or
recurrent physical or psychological problem that is likely to have been
caused or exacerbated by tobacco.
10. Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of tobacco to achieve the
desired effect.
b. A markedly diminished effect with continued use of the same amount
of tobacco.
11. Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for tobacco (refer to Criteria A

and B of the criteria set for tobacco withdrawal).
b. Tobacco (or a closely related substance, such as nicotine) is taken to
relieve or avoid withdrawal symptoms.
Tobacco use disorder is common among individuals who use cigarettes and
tobacco daily. The effects of smoking leads to the deterioration of the brain, causing
a reduction in a persons ability to think. Mental Health (1995) Smoking is one of the
four heart disease risk factors that can effect cognitive skills. Other risks are high
blood pressure, diabetes and obesity. It is said that the more risk factors a person
has, the more likely their mental functions will decline.
Phase of tolerance to tobacco is exemplified by the disappearance of nausea
and dizziness after repeated intake and with a more intense effect of tobacco rather
than the first time it is used. The nicotine in cigarettes makes smoking very addicting.
A person trying to cut down or even quit smoking will begin to go through nicotine
withdrawal. Nicotine causes a chemical dependency, so that the body develops a
need for a certain amount of nicotine at times. Most symptoms of withdrawal will
occur within forty-eight hours from quitting to being gone after about six months.
There are many symptoms of nicotine withdrawal, which are stressful and very
unpleasant. Mental Health (1995) Sweating or rapid pulse, insomnia, nausea or
vomiting, physical agitation, anxiety, headaches, irritability, difficulty concentrating,
depression and increased hunger are some characteristics to nicotine withdrawal.
Many individuals with tobacco use disorder use tobacco to relieve or to avoid
withdrawal symptoms (e.g., after being in a situation where use is restricted). Many
individuals who use tobacco have tobacco-related physical symptoms or diseases
and continue to smoke. The large majority report craving when they do not smoke for
several hours. Spending excessive time using tobacco can be exemplified by chainsmoking (i.e., smoking one cigarette after another with no time between cigarettes).
Giving up important social, occupational, or recreational activities can occur when an
individual do activity because it occurs in tobacco use-restricted areas. Use of
tobacco rarely results in failure to fulfill major role obligations (e.g., interference with
work, interference with home obligations), but persistent social or intepersonal
problems (e.g., having arguments with others about tobacco use, avoiding social
situations because of others disapproval of tobacco use) or use that is physically

hazardous (e.g., smoking in bed, smoking around flammable chemicals) occur at an
intermediate prevalence.
Risk and prognostic factors of Tobacco-Related Disorders are:
Temperamental. Individuals with externalizing personality traits are more likely to
initiate tobacco use; Children with attention-deficit/hyperactivity disorder (ADHD) or
conduct disorder, and adults with depressive, bipolar, anxiety personality, psychotic,
or other substance use disorders, are at higher risk of starting and continuing
tobacco use and tobacco use disorder.
Environmental. Individuals with low incomes and low educational levels are more
likely to initiate tobacco use and are less likely to stop.
Genetic and physiological. Genetic factors contribute to the onset of tobacco use,
the continuation of tobacco use, and the development of tobacco use disorder, with a
degree of heritability equivalent to that observed with other substance use disorders
(i.e., about 50%). Some of this risk is specific to tobacco, and some is common with
the vulnerability to developing any substance use disorder.
To stop smoking, a smoker must learn new coping skills and break old
patterns, an incremental process in which attempts to quit often end in the
resumption of smoking until abstinence is achieved. Smoker can take medication to
counteract the effects of psychoactive (antagonist drug) like naltrecxone and
campral. Smoker can also try to join self-help group (rehabilitation center), or
smokercan try to counseling to psychologist and do Nicotine-Replacement Therapy,
Non- Nicotine Therapy, Cognitive Behavior Therapy (CBT) like coping skills training
and relapse prevention. Smoker, in order to quit must have intention and motivation
from themselves to make an effort, it will have a significant, positive impact for body
health.

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UAS TAKE HOME

KOMPETENSI BAHASA INGGRIS

Veronika Btari P. / 125120300111032

PROGRAM STUDI PSIKOLOGI

particularly lung cancer, stroke, chronic obstructive pulmonary disease, coronary

a. The characteristic withdrawal syndrome for tobacco (refer to Criteria A

situations because of others disapproval of tobacco use) or use that is physically

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