Smoking among adolescence is an issue that affects countries worldwide. It is now well established that most of the adult users of tobacco start tobacco use in childhood or adolescence. One of the major problems with smoking has to do with the chemical content in cigarettes which is nicotine. Someone can get addicted to nicotine within a few days of first using it. The nicotine content in tobacco can be as addictive as cocaine or heroin. Nicotine can affect the mood as well as the breathing, blood circulation, stomach, and brain.
An Adolescent might be drawn to smoking for any of reasons and some of them are trying to look cool, act older, lose weight, look tough, or even feel independent. The factors that might influence adolescence to smoke are peer pressure, parental and sibling smokers, and the advertisement of tobacco companies.
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It is important to study about this problem, so that we can able to identify those actions that we need to apply to control or encourage adolescence to stop smoking. And we can help other children not to engage smoking. Because of this study we can determine their perceptions about smoking and give information about the possible effects of smoking, and establish clear rules and reasons for them, that can help protect them from these unhealthy habits.
Parents have a big role in guiding their children to stop and avoid smoking. They should not ignore this problem because it can affect children’s health and behavior.
We need to be emphasized the benefits of not smoking to today’s youth who face the daily pressure of whether or not to pick up a cigarette. It is better for your health and the health of everyone around you which is the most important reason to advocate not smoking.
ACKNOWLEDGMENT
Having the opportunity to experience a lot of things whether it make us rise or fall is really worth remembering. Meeting significant people as we walk along is a precious prize to be treasured wherever our journey takes us.
Making this research is not an easy task. It blends our blood and sweats, pour our minds and strength and measures our capabilities and courage. We experienced a lot of things and the preparation was not that easy. Remembering all the things we’ve encountered to the extent of almost giving up because of fears and discouragement but still hope and determination arise and it continues to be a labor of friendship, cooperation and hard work for all of us. With sincere appreciation and gratitude, we wish to acknowledge the significant people we have met along the way whose valuable support, help and insight have contributed in making and conceptualizing this research;
We are really thankful to our respective families especially to our parents for always been in our side to back up financially and emotionally and for the love, patience, and understanding and trust that they have given us throughout the years. To Mrs. Suzette S. Francisco, Mr. Milo and Mrs. Lolita Villa, Mr. Teotimo and Mrs. Angelita Torremocha for the love that they’ve given throughout the years;
We are really thankful to Mr. Rexie G. Bagnol, RM, RN, MAN, our research coordinator for giving us this kind of research that really helped us in enhancing our skills and knowledge. Through this research, it opens our minds as well as our hearts to the things we have to consider and to appreciate.
We really do appreciate the help that was given to us by our
TABLE OF CONTENTS
Title Page
Approval Sheet
Abstract
Acknowledgement
Table of Contents
CHAPTER
The Problem and Literature Review
Background of the Study
Literature Review
Theoretical Framework
Statement of the Problem
Definition of Terms
Scope and Limitations
Methods
Design of the Study
Instrumentation
Participants
Data Gathering Procedures
Data Analysis
CHAPTER 1
THE PROBLEM AND LITERATURE REVIEW
Background of the Study
Children in adolescence stage now a day tends to engage into different experimentation with cigarettes and then progress into regular use or addiction has been a public health concern due to the fact of being young at age. Cigarette smoking is one of the common habit or addiction that is present in many people. They are tempted to smoke for many reasons such as to relieve tension, out of curiosity, to satisfy themselves, but aren’t aware of the consequences that smoking can bring at one’s own health. Some would smoke just to fit in or belong to the popular group. Peer pressure from friends isn’t the only main reason for cigarette smoking among adolescents. Some parents or elders also play a big role and a factor in adolescent who smoke cigarettes. Media influence is also one that enhances the possibility of adolescent to start smoking. Recently, as we observed many of these adolescent are engaged into such activities and doesn’t consider the health threat it brings. Whether it’s in the street, media, our family, it can seem like anywhere we look, someone in their adolescence age is smoking cigarette.
Among young people, the short-term health consequences of smoking include respiratory and non-respiratory effects, addiction to nicotine, and the associated risk of other drug use. Long-term health consequences of youth smoking are reinforced by the fact that most young people who smoke regularly continue to smoke throughout adulthood. Cigarette smokers have a lower level of lung function than those persons who have never smoked. Smoking reduces the rate of lung growth. In adults, cigarette smoking causes heart disease and stroke. Studies have shown that early signs of these diseases can be found in adolescents
who smoke. Smoking hurts young people’s fitness in terms of both performance and endurance – even among young people trained in competitive running (WHO, 2013).
This research is designed to determine and assess the perception of different adolescent in Gravahan Matina, Davao City about cigarette smoking. The result will help serve as a guide to any necessary modifications in the health of an adolescent and minimize their exposure from bad habits. It will also help the researchers to do specific interventions such as health education to have a better understanding about the addictive dangers of cigarette smoking. These also provide literatures of the impact and immediate consequences of smoking which include high risk of illness.
Literature Review
Smoking is considered as a significant health problem in youth around the world, particularly in developing countries. Recent data from the World Health Organization (WHO) revealed the approximately 12% of adolescent boys and 7% of adolescent girls smoke cigarettes. Moreover, more than 6 million children might die at an earlier age due to smoking-related diseases. As a result of smoking at an early age, smokers will have a higher risk for developing many diseases with an earlier onset, including chronic obstructive pulmonary disease (COPD), lung cancer, and heart disease, particularly in developing countries (Al Ghobain et. al, 2011).
The smoking behavior of friends is a major risk factor for adolescent smoking uptake. To explore the social context of smoking experimentation and consolidation with a particular focus on friends, the authors interviewed both members of 14 young adult identical twin pairs who were discordant for smoking. The different smoking status of twins was connected to their different friendship groups and development of different identities. Smoking respondents gravitated to the behaviors and images of the peer and spoke about how the
images conveyed by smoking were inconsistent with their peer group’s image. Adolescents and young adults are aware of the messages that smoking can convey to others and exploit these images to construct a social identity (McLEOD et. al, 2008).
Almost two-thirds of the students reported lifetime smoking and the frequency was higher for boys than for girls (69.3 vs. 60.2%). About one quarter of the total sample (26.4%) was current cigarette smokers. Less than one-tenth of students (8.0%) were frequent smokers. Less than one-fifth (16.8%) of current smokers reported signs of nicotine dependency. Almost one-third of those who have ever smoked initiated smoking before the age of ten (34.8% for boys and 22.3% for girls). About one quarter of those who never smoked reported they were susceptible to initiate smoking in the next year (29.6% for boys and 17.7% for girls). A minority of students considered smoking for boys and girls as attractive. Their attitudes clearly differ according to smoking status. About twice as many current smokers reported a positive attitude compared to respondents who never smoked, more boys than girls (14.4 vs. 6.8%) thought that boys who smoke are more attractive. Parental smoking showed positive association with lifetime smoking, current cigarette smoking and frequent smoking both in boys and girls. In the case of girls, it was strongly associated with signs of nicotine dependency (Warren et. al, 2010).
Despite the overwhelming evidence on the harmful effects of smoking (health Canada, 2008), youth smoking rates in Canada remain high (health Canada, 2007a). Cigarette smoking is often initiated and escalates during the school-year (Clark, 1996). For instance, according to the 2004-2005 Youth Smoking Survey, rates of ever-smoking increased from 5.8% in grade 5 to 34.3% in grade 9 for both males and females (Health Canada, 2007b). Such early initiation of tobacco use is also associated with increased length of time spent
smoking and increased risk of many tobacco-related diseases (Clark, 1996; Chen, 2003). As such, youth tobacco controls programming health care systems (Murnaghan et. al, 2009).
Children often linked smoking to the less educated and less successful social groups but also to the rich. In both investigations, health aspects were the most common reasons for
Choosing not to smoke (69.2% vs. 73.3%), being more frequently presented by girls and non-smokers. A significant shift in the negative aesthetic perception of smoking (14.1% in the 3rd class vs. 40.2% in the 5th class) and economic disadvantages of smoking (3.9% vs. 24.8%) was observed in the given period of time. Restrictive reasons were given only rarely by pupils in the 3rd class (0.7%), unlike pupils in the 5th class who feared the reaction of their parents (24.8%) (Hruba & Zaloudikova, 2010).
Although the risks smoking poses to health are now well known, many young people continue to take up the habit. While numerous cross-sectional studies of adolescents have identified correlates of smoking initiation, much less prospective, longitudinal research has been conducted with young children to gather their accounts of early experiences of smoking, and this study fills that significant gap. Quantitative and qualitative data, collected using questionnaires, interviews and focus groups, are presented from the pre-adolescent phase of the Liverpool Longitudinal Study of Smoking. By age 11, 27% of the cohort had tried smoking, 13% had smoked repeatedly and 3% were smoking regularly. Rates of experimentation increased over time. Qualitative data revealed that curiosity and the role of peers were central to children’s accounts of early smoking. By pre-adolescence, children are at different stages in their smoking careers, therefore interventions must be targeted to their varied experiences. Current prevention strategies often focus on restricting access to cigarettes, but a broad range of intervention measures is required which take account of the
multifactorial nature of smoking onset. To be effective, policies that aim to prevent smoking must be grounded in children’s lived experiences (Milton, 2008).
A survey conducted by the Department of Health showed that Filipino children as young as five years old are already starting to smoke. On the other hand, the National Youth Commission recently reported that two out of every five Filipino teenagers took up smoking in 2011. Filipinos start smoking at a young age. An editor-in-chief of a weekly magazine admitted that he started smoking when he was only 14. Until now, he is still hooked with the habit. “If I don’t quit smoking, I would probably get lung cancer,” he said. Every year, 87,600 Filipinos die of smoking-related ailments that include lung cancer and chronic lung diseases. “(Smoking) is essentially a man-induced disaster that is causing more deaths than all the fatalities due to natural calamities, vehicular accidents, rebellion and all other disasters, either natural or man-caused,” said Dr. Rafael R. Castillo, one of the country’s top cardiologists (Tacio, 2012).
In the Philippines, the number of women who smoke is constantly on the rise. It is a phenomenon that, in recent years, seems to affect the youngest most of all: 30% of girls between the ages of 13 and 15 smoke regularly. According to a recent study conducted by the Southeast Asia Tabacco Control Alliance, 18.7% of Filipino young women between the ages of 13 and 25 smoke cigarettes. The numbers go up if the sample is restricted to teenagers between 13 and 15: 3 out of 10 already have the smoking habit. Among female smokers, 60% say that they smoked their first cigarette at the age of 18, while the remaining 40% say they started when they were still very young. They continue to smoke despite the fact that they are aware of the risks connected to smoking: nine girls out of ten know that smoking can cause lung cancer, infertility, early menopause, osteoporosis, and hysterectomy. For this reason, the country has begun an anti-smoking campaign supported by the local Catholic Church: the first initiatives include that of putting warning labels on packaging (Digal, 2008)
Theoretical Framework
Cigarette Smoking is the single most important preventable cause of illness and early death. But why so people keep on smoking despite from warnings and evidenced-based situations? Unfortunately, as the world evolves to the new era, many adolescent as of now know how to smoke due to influence from environment. Today medical studies have proven that smoking is among the leading causes of diseases such as stenosis, lung cancer, chronic obstructive pulmonary disease, heart problems, and birth defects.
Psychosexual Development Theory of Sigmund Freud who was an Austrian neurologist developed the field of psychoanalysis in the late 19th and 20th century. This theory states that the oral stage of an infant occurs from birth to 18 months of their life. An infant during this time is focused with receiving pleasure and the libido is focused on the mouth. These exist through breast feeding, bottle feed or even sucking on a pacifier. This theory believes during this stage an infant receives too little or too much oral stimulation, a possibility that a child may develop a personality trait that is fixated on oral gratification. The theory states that these people may focus activities that involve the mouth suck as smoking, over eating, biting fingernails or even drinking.
In 1977 Bandura formulated the social learning theory stating that it focuses on learning that takes place within a social environment, meaning that a person learn from observing, copying, or modeling others. This theory also concentrates on being rewarded or reinforcements that we receive bases on our behaviors. This reinforcement could be praise or something to reduce tension or increased self-esteem. Reward or punishments that would result from learned behaviors have a huge effect on the behaviors that a person shows.
In addition, the social learning theory of Bandura in 1977 emphasized that many behaviors, good or bad, can be learned through modeling. Parents and teachers can take
benefit of social learning theory by providing kids with examples of pleasing behaviors, or modeling. Some of the examples of learned behaviors through modeling are demonstrating math problems, bravery or courtesy, and even reading. Moral thinking is also being influenced through observation and modeling. By watching adults make decision, kids tend to learn how to choose between right and wrong.
According to Sutherland’s differential association theory in 1939, an individual’s behavior is based by association and interaction with others. Suggest that through interaction with others, an individual learn the values, attitudes, technique’s, and motivates for a certain behavior. Young people try to create their own identities, they face great amount of pressure.
They imitate clothing, hairstyles, behaviors, and including smoking. They desire to do what their friends are doing. They believe there are fewer rules to follow if they are a grown-up person. It is necessary to raise the self-esteem of young people. Also give them something to handle the wave of pressure and desires that wash over them as they try to make the difficult change from childhood to adulthood.
Another theory of modeling and role modeling by Helen C. Erickson, Evelyn M. Tomlin, and Mary Ann P. Swain in 1983 stated that modeling is captivating an action wherein the nurse uses this in representing the progression of developing a mirror image and in understanding the client’s world from the client’s own perceptive. After modeling has been done, role modeling occurs which involves the facilitation of an individual in promoting, maintaining or attaining good health. Theory represents that if parents play a good role model to their young ones it is expected that their children would perceive and have a good understanding in terms of good health.
The theory of planned behavior according to Icek Ajzen in 1985, understand that one person’s attitude, social norms and perceived control over a behavior influence his intention to carry out such behavior. An individual’s attitudes about the target behavior can be direct or
indirect. A smoker’s as a whole assessment about whether quitting is good or bad is a person’s direct attitude about smoking. And the indirect attitude of a person involves on how strongly they believe a peripheral outcome will take place as a result of performing the behavior. Some smokers believe that they will likely gain unwanted weight if they quit smoking is an example. Social norms are the people around you and a person who smoke might believe that society disapproves of smoking and therefore approves of quitting. Theory assumes that the smoker will assess how likely or unlikely it is that they will comply with others beliefs about quitting. Perceived behavioral control is a person’s self-efficacy as an
individual’s own confidence in successfully executing a behavior. A person might consider factors that may help or hinder quitting. If a smoker quits and determines that there will be withdrawal symptoms but is confident enough that her new daily walking regimen will help.
Statement of the Problem
The reason of this study is to examine adolescent about their perception towards smoking and to explore their understanding of how they use smoking as their way of showing their social life, emotions, and problems. The research question that guided this study is:
What is the perception of adolescence regarding cigarette smoking?
Significance of the Study
This study aims to assess adolescent towards their perception on smoking at Gravahan Matina, Davao City and to identify their way of using Cigarettes in their daily lives. The outcome of the said study will provide systematic information needed.
The Department of Social Welfare and Development (DSWD) is a government institution responsible for the protection of social welfare rights and promotion of social development. Their major priority is to protect and save children from any harms and violence. Smoking is one of the social problems among youth’s today. It is of concerned on the part of DSWD because nowadays, teenagers are known to be pleasure seeking. Smoking among teenagers is usual and just ordinary habit or activity.
Since the study focuses on the perception of smoking in terms of duration, frequency, and usage among adolescence ages 12 to 19 years old, DSWD plays a big part of how to assess and counseled teenagers about the effects of smoking to their social life.
The Department of Health (DOH) is concerned about the health people especially adolescence who engaged on smoking which can cause major health problem such as problems in respiration and circulation. Their task is to help adolescent in avoiding unhealthy habits to maintain normal and healthy life. This problem is seriously dangerous among adolescent smokers which need immediate attention and action to minimize the problem.
The researchers decided to choose this kind of problem to know the importance of knowing their different views towards smoking. The main purpose of this study is to know the perception of an adolescent at Gravahan Matina, Davao City towards smoking. Specifically, this study answers the questions like what are their attitudes when they smoke, what is the difference of children who smoke and who don’t smoke, and what the influence of smoking on children’s life and their performance is at school. For this reason, it prompted the researchers to dig on what’s really the cause and effect of this problem.
This study helps the student recognize about the perception of an adolescent towards smoking for them to be aware what’s going on to their surroundings and to identify smoking as one of the major problems in our society.
Definition of terms
Perception is the act or faculty of perceiving, or apprehending by means of the senses or of the mind. An immediate or intuitive recognition or appreciation, as of moral, psychological, or aesthetic qualities. The result or product or perceiving, as distinguished from the act of perceiving a single unified awareness derived from sensory processes while a stimulus is present.
Smoking is a practice where a substance, most commonly tobacco, is burned and the smoke tasted or inhaled. This is primarily done as a form of recreational drug use, as combustion releases the active substances in drugs as nicotine and makes them available for absorption through the lungs.
Gender is a range of physical, mental and behavioral characteristics distinguishing between masculinity and feminity. Depending on the context, the term may refer to sex (i.e. the state of being male or female), social roles (as in gender roles) or gender identity.
Peer Pressure is the influence exerted by a peer group or an individual encouraging other individuals to change their attitudes, values, or behaviors in order to conform to group norms. A person affected by peer pressure may or may not want to belong to these groups. They may also recognize dissociative groups with which they would not wish to associate, and thus they behave adversely concerning that group’s behaviors.
Family a basic unit consisting of parents and their children, considered as a group, whether dwelling together or not. A social nit consisting of one or more adults together with the children they care for. It is any group of people closely related by blood, as parents, children, uncles, aunts, and cousins.
Parent is a caretaker of the offspring in their own species. Biological parents consist of the make that sired the child and the female who gave birth to the child. In all human societies, the biological mother and father are both responsible for raising their young. However, some parents may not be biologically related to their children. An adoptive parent is one who nurtures and raises the offspring of the biological parents but is not actually biologically related to the child. Children without adoptive parents can be raised by their grandparents or other family members.
Sibling is one of two or more individuals having on or both parents in common. A male sibling is called a brother, and a female sibling is called a sister. In most societies throughout the world, siblings usually grow up together, facilitating the development of strong emotional bonds suck as love, hostility or thoughtfulness. The emotional bond between siblings is often complicated and is influenced by factors such as parental treatment, birth order, personality, and personal experiences outside the family.
Media is the means of communication, as radio and television, newspapers, and magazines, which reach or influence people widely
Adolescence is a period of human growth and development situated between childhood and adolescence. During this remarkable stage of life cycle, adolescences ages 12 to 19 years olds experienced rapid and significant development change.
Age is the time of life at which some particular qualification, power, or capacity arises or rests. It is also the length of an existence extending from the beginning to any given time. It is a period of time dominated by a central figure or prominent feature.
Scope and Limitations
The coverage of this study is exclusively focused on identifying factors that could increase the probability of an adolescent on cigarette smoking. All the contents of this research came from related literature that pertains to different methods of perception of adolescence and the factors that affect it. In view of financial and time constraints on the parts of the researchers, only adolescence is selected. Adolescence ages 12 to 19 years old because it is easy on the part of the researchers for most of them are found everywhere at Gravahan Matina, Davao City. It is also accessible for the researchers because nowadays, smoking is one of the major problems in the society in which innocent children are affected.
CHAPTER 2
METHODS
Presented in this chapter are the methods and procedures in conducting this research work. It includes Research Design, Research Participants, Research Environment, Research Instrumentations, Data Gathering, Procedure and Data Analysis.
Design of the Study
This study will incorporate qualitative using Colaizzi’s Phenomenological Method. It is appropriate for this study since the study focuses on qualitative research; it uses the judgment of the researchers through the use of five senses.
Research Participants
For this study, adolescence at Gravahan Matina, Davao City will be interviewed. Participants of this group are able to verbalize their experiences, as well as their perceptions on smoking and the impact of smoking on their lives. The researcher will be using purposive sampling which also known as judgmental sampling which focuses on sampling techniques where the unit that are based on the judgment of the researchers. The research question for this study will be centered on the perspective and definitions of adolescence who smoke. It is also possible to use judgmental sampling if the researchers know a reliable professional or authority that he thinks is capable of assembling a representative sample.
Research Environment
The research environment is one of the local areas in Davao City which is Gravahan in Matina by which approval of the Barangay Captain and other significant authorities to grant us access to be able to conduct our interview and to utilize our data.
Instrumentation
The guided interview questionnaire is the researcher made instrument will be constructed with the help of the professor, adviser and validators who are expert in research studies. The first part includes the informed consent and the participants profile such as name as optional, age, race/ethnicity, and family members. Second part includes a guided interview questionnaire in which the researchers using open-ended questions and therapeutic communications to explore and express feelings of the respondent.
Data Gathering Procedures
The following are the steps that the researchers have been pursuit in conducting the study.
Seeking permission to conduct the study – the researchers formulate a letter addressed to the Dean of College of Nursing, Ofelia C. Lariego, RN, MAN requesting for authorization to conduct this study.
Seeking permission to conduct the study on the designated area – a letter of permission to conduct the study is send to Gravahan Matina, Davao City for the acquisition of data gathering regarding the perception of adolescence towards smoking in the community and for the distribution of questionnaires.
Administration of research instrument -. After the approval of the research proposal, permission to conduct the study is send to Brgy. Captain of Gravahan Matina, Davao City.
Administration of Interview – the researchers will personally distribute and interview the research participants at Gravahan Matina, Davao City.
Data Analysis
To be able to analyze the data and information to be gathered from the respondents during the interview, we, the researchers will use our own understanding and observation. We will compare the data and information to be gathered from the respondents using guided questionnaire. We will also involve our own experiences, understanding, ideas, thoughts, opinions, and feelings to analyze the date intended to bring overview and general idea of the study.
Questionnaire:
Personal information:
Name (alias): ________________ Age: _____
Gender: _____________________ Occupation: _____________________
Race/Ethnicity: _______________ Religion: _______________________
Educational Attainment: __________________________________________
Contact Number: (optional) ________________
Are you willing to cooperate in a study where you will be interviewed about your experience(s)? All precautions will be taken to ensure privacy and confidentiality.
If yes, it is an honor for us to conduct an interview.
If no, we respect and understand, thank you for your time.
Guided Interview Questions:
Tell me about what cigarette is like for you when you were young like in elementary years? What is it like for you later, in middle school and then high school?
(Masulti ba nimo kung unsa ang sigarilyo para sa imo katong bata pa ka, katong nag elementarya ka, ug hangtud katong nag highschool na ka?)
How old are you when you started smoking?
(Pila imong edad nga nagsugod ka ug panigarilyo?)
What brand of cigarettes you used?
(Unsang klaseha nga sigarilyo imong ginagamit?)
How often do you smoke?
(Kapila ka nagapanigarilyo sa usa ka adlaw?)
How many sticks or packs of cigarettes did you consumed per day?
( Mga pila ka stick o pack sa sigarilyo ang imong mahurot kada adlaw?)
When was the last time you light up a cigarette?
( Kanus-a tong pinaka ulahi nimo nga pagsindi ug sigarilyo?)
Who influence you to smoke?
(Kinsa ang nag ingganyo nimo nga manigarilyo?)
What triggers you to smoke?
(Unsay nakapahatag nimo ug rason kada nimo panigarilyo?)
Can you tell me if there is an existing member of the family who smoke cigarette?
(Masulti ba nimo kung naa bay myembro sa inyong pamilya nga naga panigarilyo?)
Can you describe how your family raised you?
(Masaysay ba nimo kung giunsa ka pagpa daku sa imong mga ginikanan?)
Can you describe what kind of friends do you have?
(Mahulagway ba nimo kung unsa nga klase ang imong mga higala?)
Can you describe what it’s like when you lighted your first cigarette?
(Isulti daw kung unsa imong nabati katong una nimong sindi ug sigarily
