Appraisal Factors Affecting Adoloscents’ Engagement to Cigarette Smoking

APPRAISAL FACTORS AFFECTING ADOLOSCENTS’ ENGAGEMENT TO CIGARETTE SMOKING

CHAPTER 1
PROBLEM AND ITS BACKGROUND
Introduction
Cigarette smoking during childhood and adolescence produces significant health problems among young people, including cough and phlegm production, an increase in the number and severity of respiratory illnesses, decreased physical fitness, an unfavorable lipid profile and potential retardation in the rate of lung growth and the level of maximum Smoking is one lung function. (http://www.lungusa.org). Each time a smoker lights up, that single cigarette takes about 5-20 minutes off the person’ s life.
Adolescence is clearly a sensitive time period in the onset of cigarette smoking. They are easily influenced by their environment and most adolescent are not aware of the long term consequence of cigarette smoking. Adolescent smoking picks no nationality because adolescent smoking thrives in a universal way. Most of the adolescents choose to smoke for the same reason. Adolescents grasp all the accessories of the adulthood and a such smoking is the common adult activity which should be prohibited, but it’s attraction is more intensified. There are no physical reasons to start smoking. The body doesn’t need tobacco the way it needs food, water, sleep, and exercise. In fact, many of the chemicals in cigarettes, like nicotine and cyanide, are actually poisons that can kill in high enough doses. But why some adolescents are engaged in cigarette smoking?
The personal profile of the respondent is seen by the researcher as one factor for the engagement of the adolescent to cigarette smoking. The respondent’s profile, consisting of age, economic status, educational attainment, family structure and classification of the community they are belong to, together with other contributing factor gives a greater impact for the engagement of adolescent to cigarette smoking.
Other contributing factors are cited to the engagement of the adolescents to cigarette smoking such as peer pressure and peer relation, cigarette advertisement, curiosity, depression and family figure.
Peer pressure and peer relationship. During adolescent stage, adolescents are desperately trying to fit in and be cool. Most of the adolescents think they are invisible and cannot become addicted to cigarettes. For this reason, adolescents decide to join in the smoking crowd. It is much easier to give in to peer pressure during adolescent stage in which adolescents are not sure what they want. Adolescent resolve to adopt to principles and various behaviors of the group no matter how unsafe or harmful it be, ultimately, as malfunction to do so could signify rejection, ridicule, expulsion or worse of all, loneliness.
Cigarette advertisements encourage some teens to smoke. Although the government imposed regulations that made it difficult for advertisements to promote smoking to young people, since that show people smoking are still common in movies and television shows usually in positive life. This may influence adolescence regarding their attitude towards smoking.
Curiosity also plays a vital role to adolescents regarding cigarette smoking. Exposure of adolescents to a number of smokers gives rise to curiosity. They tend to ask themselves what it feels like to smoke. They get curious of pleasure it brings that would make so many adults engage in it.
Most smokers believe that cigarettes have the ability to decrease irritability, anxiety and stress. They believe that smoking helps relieve tension and improve their mood. These false beliefs are absorbed by adolescents and during periods of tension, adolescents would smoke in order to alleviate tension and help him cope with stress.
For the family figure, parents who smoke and can also contribute in promoting smoking among young ones especially their children. Adolescent admire the people who smoke. In numerous of home, they simply are modeling themselves to or after parents, grandparents or additional key people in their surroundings. Absence of disapproval of the parents seems to have a significant effect regarding cigarette smoking among children also, adolescent with absentee parents are more likely to be engaged in smoking than those living with their parents who are always present and offers a structured life.
In the Philippines, 40% of adolescent boys smoke, most began in their early teens. Another 6% were former smokers. Most now wish they did not smoke and about two-thirds have tried to give up. Also, many vendors of cigarettes are children. (http://www.wpro.who.int/media_centre/fact_sheets)
Adolescent smoking is not at all regulated in any manner because even in the midst of prohibitory rules, it remains out of control. The deception still lies in the smart marketing strategies of tobacco companies, who have found the adolescents to be a viable target market for smoking. For as long as there are adolescents who will smoke their daily dose of cigarettes, the tobacco industry will continue to thrive until these youngsters reach their old age and maybe even pass on the habit of smoking to their children and the children after them.
Governments of different countries are implementing campaign to lessen if not stop the increasing number of adolescent smoking by increasing the tax of tobacco companies and lessen advertisement for tobacco.
The most effective way to really battle the rampancy of smoking to different strata of society and parts of the world is to understand what causes them to get hooked on the habit to begin with.

Statement of the Problem The general statement of the problem is the Appraisal Factors Affecting Adolescents’ engagement to cigarette smoking. Specifically, this study seeks to answer the following questions:
1. What is the profile of the respondents in terms of: 1.1 Age 1.2 Gender 1.3 Educational Level 1.4 Economic Status 1.5 Family Structure 1.6 Classification of community
2. How does this respondents’ profile affects the adolescents engagement to cigarette smoking?
3. To what extent does the following factors can contribute to the engagement of adolescent to cigarette smoking?
4. Is there any significant relationship between the respondents profile to the factors that contribute to the engagement to cigarette smoking?

Significance of the Study Adolescent. This study aim to provide efficient information regarding the different factors that contributes to adolescent’s engagement to cigarette smoking. Increasing the adolescent’s awareness and knowledge regarding adolescent smoking. Community. This study will help the community to be aware of the condition of the adolescent that are engaged in cigarette smoking. It will give information about the different factors that cause the adolescent to be engaged in cigarette smoking. Nursing Educator. This study will be an effective tool in class deliberation regarding adolescent’s engagement to cigarette smoking. Nursing Researcher. This study will be used as a tool for further or similar studies can be conducted by other researchers to include other factors to which may affect one’s engagement to cigarette smoking in subject in other locality.

Scope and Delimination The study attempt to appraise the factors affecting the adolescence engagement to cigarette smoking in two barangays. For the criteria of the respondents, age was determined according to Erik Erickson’s adolescent stage, from 12 to 18 years of age. Male or female respondents may participate to the study. Respondent must be a residence in any of the two barangays for at least a month and is engaged in cigarette smoking, taking at least one stick per day.

Notes in Chapter I
_http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=39868
_http://ezinearticles.com/?Teen-Smoking&id=255064
_ http://ezinearticles.com/?The-Perils-of-Adolescent-Smoking&id=464013

CHAPTER 2
THEORETICAL FRAMEWORK

This chapter presents the related literature, related studies, the conceptual framewok, the hypothesis of the study and the definition of terms. Related Literature To promote a clear evaluation of the factors that affect adolescent’s engagement to cigarette smoking. The researchers use various studies and literatures to provide them with the background knowledge and insights about engagement to cigarette smoking. Smoking is a practice where a substance most commonly tobacco is burned and the smoke are tasted and inhaled. Addictive effects of tobacco have been documented and it is considered to be a mood and behavior altering substance that is psychoactive and abusable, it is also believe that it is potentially addictive as alcohol, cocaine and morphine. Adolescence is clearly a sensitive time period on the onset of cigarette smoking. More than one-third of high school students smokes at least once a month and 17% smoke a cigarette almost everyday (USDHHS 1998). Studies have identified many predictors of smoking in adolescence, including parental smoking, parenting style, peer influence, knowledge and beliefs about smoking, intentions to smoke, availability of cigarettes, school bonding, social support and personality variables such as independence, sensation seeking, rebelliousness, aggressiveness, and shyness (Greisler, Kandel, & Davies, 2002; Robinson & Klesges, 1997). According to Sorgent JD (2007), advertising was responsible for encouraging some teens to smoke. This may be a major influence on attitude toward smoking in children and adolescents. It is also found in the updated study in the Archives of Pediatrict Adolescent Medicine that adolescent that watches movies which portray smoking are more likely to become established smokers. A similar review is conducted which identified adolescent peer relationship as a primary factor involved in adolescent cigarette smoking. Review of this reveals the contribution that peers in adolescent’s use of tobacco, in some cases promoting use and in other cases deterring it. (Kobus:2003) There is another substantial body of research suggesting that smoking prevalence and initiation may vary by race and sex. Recent reports indicate that smoking prevalence is higher among white middle school students than black middle school students. (Louisiana Office of Public Health, 2002). Another study have explored possible reasons for racial and sex differences in smoking prevalence and initiation. One study reported that boys were more likely than girls to endorse the belief that smoking enhanced their image, and that white adolescent rated cigarette use more positively than black adolescent (Robinson & Klesges, 1997). On the other hand, a study conducted by Maher and Rickwood (1997) showed that attitudes, normative beliefs, and perceived behavioral control predicted intention to smoke in adolescents, and that intentions predicted smoking behavior. In a more recent study, the components of the theory of planned behavior both cross-sectionally and prospectively predicted smoking intentions and smoking behavior in children (Higgins & Connor, 2003). As pointed by Vega and Gil (2005), tobacco and alcohol, often referred to as “gateway drugs” are among the first substances consumed by adolescents. This is likely influenced by their ready availability along with other socio-cultural (e.g., peer influences, acculturation) and biological factors (e.g., family history of substance use disorders). A local study conducted by Diaz R. (2003) stated that nicotine, which is a prime drug in cigarettes, is highly addicting. Cigarette smoke contains, believe it or not, thousands of substances, and one of them is nicotine, which is found only in tobacco leaf. Smokers who crave it find it hard to go without a cigarette. Those who are under stress or feel nervous are the ones at a higher risk of becoming addicted to nicotine. Various theories have been used to explain the process by which social relationship affect tobacco use. Social learning theory (Akers 1998) considers both social processes and cognitive mediation as important in the acquisition and maintenance of behavior such as cigarette smoking. According to this perspective, behaviors are learned through the observations of others engaged in a behavior and subsequent modeling of this behavior, as well as the rewards/punishments and favorable/unfavorable definitions associated with the behavior. Another theory which is the Primary socialization theory (Oetting & Donnermeyer 1998; Oetting et al 1998) assumes that norms and behaviors are learned in social contexts identifies three primary contexts including family, school and peer clusters. The media and local institutions are also consider as sources of influence, but as having indirect impact on norms and behavior through their effect on families, school and peer clusters. The ideas acquired in various readings, journals, studies conducted, and other literature from books and internet which had been cited, had helped in the organization of the study. Similarities of the topics discussed had been taken into consideration for the improvement of this study.

Conceptual Framework The theoretical framework of this study is presented in the conceptual paradigm show in Figure 1.

Input Process Output

Figure 1.1 Conceptual Framework

Hypotheses of the Study In the light of the related literature and studies reviewed that guided this study, the following hypothesis were pursued.
1. There is no significant relationship between the respondent’s profiles to the factors in engagement to cigarette smoking.

Definition of Terms For better understanding of the study, operational definition of key words and important term re given. Appraisal. The act or result of judging the worth or value of something or someone: appraisement, assessment, estimate, estimation, evaluation, judgment, valuation. Smoking. The inhalation of smoke from burned dried or cured leaves of the tobacco plant, most often in the form of a cigarette. Adolescence. Is a transitional stage of physical and mental human development that occurs between childhood and adulthood. This transition involves biological (i. e. pubertal), social, and psychological changes, though the biological or physiological ones are the easiest to measure objectively. Engagement. The act of engaging or the state of being engaged. Being obligation or agreement.

Notes in Chapter 2

_Kimberly Kobus 2003 “Society of the Study of Addiction to Alcohol and other Drugs Addiction 98 (supp 1) 37-55
_(Eiser et al al 1991; Eiser & van der plight 1984; Urberu et al 1991; Ennet et al . 1994 : Michelle 1997 ; akers 1997, 1998 ; Bandura 1997 ; Abrnas and Hogg 1990)
_Miguel Baquilod, MD, MSc 2005 ‘Piloting of the Global Health Proffesionals Tobacco Survey (GHPS) Among Pharmacies School Students in the Philippines Survey Report’
_Mark G. Mayers, Ph.D. 2007 “Cigarette Smoking Among Adolescents with Alcohol and other Drug use problems”

CHAPTER 3
METHODOLOGY

This chapter deals primarily with the method to be used in this study. These are presented in research design, target population, selecting sampling, research instrument, test for validity and reliability of instrument and data gathering technique.

Research Design The researcher uses the Descriptive Research Approach which is survey, specifically Community survey. This design is likewise appropriate for situation analysis and is cheap and easy to conduct. This study attempts to determine the factors that affect adolescence’s engagement to cigarette smoking.

Target Population In this study the primary respondents are the adolescents who are engage with smoking. The subjects of the study are composed of about 100 respondents coming from Brgy. Catmon and Brgy. Mojon of Malolos, Bulacan. It represents 0.7% of the combined population of the 2 barangays.

Selecting the sampling technique Our respondents are selected through random .06% sampling, using fish bowl technique. Wherein everyone will be given a chance to be selected or to be included in the sample. In this method 86,600, everyone has an equal chance to be selected as a sample.

Research Instrument Data were collected to the respondents by using only one valid tool entitled “Appraisal factors affecting Adolescents engagement to cigarette smoking.” The questionnaire comprise of 2 parts. First part consist of background data of the respondent such as name (optional), age, gender. And the second part is the survey proper consisting of the following data:
a. age of the respondent
b. number of sticks usually taken per day
c. appraisal factors that influence them in engaging to smoking

Validation The instrument was pre- tested before its administration on the group of adolescents who were not included as respondents of the study. The researcher recognized difficulties encountered by then for the purpose of improving the tool that was used.

Data Gathering Procedure To facilitate data collection: the researcher secured a written permission from the Bulacan State University, through the College of Nursing Dean then to the Brgy. Captain of Brgy. Catmon and Mojon (City of Malolos) to conduct the research project. Once the request was approved, a survey will be conducted among the adolescent respondents which will be selected randomly. The researchers personally do the survey to achieve a more reliable data.

CHAPTER 4
PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

This chapter shows a thorough analysis and interpretation of the problem investigated and gathered in this research. Problem no. 1. What is the profile of the respondent in terms of age, gender, educational attainment, family income, and family structure.
Table 1. Frequency and Percentage of Respondents according to Age
Age Frequency Percentage
12-13 12 12%
14-15 22 22%
16-17 45 45%
18-19 21 21%

Table 1 shows the frequency and percentage distribution of respondents according to age. The respondents of the study are the main source of information regarding the topic being studied. Age 16-17 got the highest percentage of 45%, followed by age 14-15 having 22% of all the respondents. 21% of the respondents are from age 18-19 and the smallest percentage of the respondent comes from age 12-13. Table 1 shows the combined frequency and percentage of the 2 barangays according to age.

Table 2. Frequency and Percentage Distribution of Respondents According to Gender
Gender Frequency Percentage
Male 93 93%
Female 7 7%

Table 2 shows the frequency and percentage of the respondents according to gender. Males got the highest percentage of 93% while females only got 7% of the total number of respondents according to gender. It only shows that more male adolescents were engaged in cigarette smoking than females according to gender from 2 barangays.

Educational Attainment Frequency Percentage
College Graduate 0 0%
High School Graduate 10 10%
Elementary Graduate 10 10%
College Undergraduate 24 24%
High School Undergraduate 26 26%
Elementary Undergraduate 10 10%
Presently Schooling 75 75%
Stopped Schooling 17 17%
No Formal Education 3 3%
Table 3. Frequency and Percentage Distribution of Respondents According to Educational Attainment

Table 3 shows respondent’s educational attainment and it appears that 75% of the respondents are presently studying, 26% of them are High School undergraduate followed 24% College undergraduate. 10% for Elementary graduate and also for High School graduate, 17% respondents were stopped their schooling and 3% has no formal education which means that most of the respondents are attending formal education and are most probably know the effect of cigarette smoking.

Table 4. Frequency and Percentage Distribution of Respondents According to Family Income
Family Income Frequency Percentage
Below P1,000 12 12%
P1,000-P5,000 40 40%
P5,000 above 48 48%

The distribution of respondents by family income that has been gathered. It shows that 48% of respondents has a family income of more than 5,000 followed by 40% of the respondents who earns 1000-5000 and 12% of the respondents of family income of below 1000. The family income may be considered as a determinant in engagement to cigarette smoking.

Table 5. Frequency and Percentage Distribution of Respondents According to Family Structure
Family Structure Frequency Percentage
Extended 36 36%
Nuclear 64 64%

The distribution of respondents by family structures was shown. It was noted that most of the respondents belongs to nuclear family which is 64%. 36% of them is in extended family. The structure of the family merely affects the adolescent’s engagement to cigarette smoking. The nuclear family was most affected and may show its effect in the perception of the respondents.

Table 6 Frequencies and Weighted Mean of the Factors Affecting Adolescents Engagement to Cigarette Smoking
Factors Frequency 5 4 3 2 1 Mean Interpretation
Curiosity 37 22 20 7 4 3.87 Always Been Affected
Advertisement 13 18 20 22 27 2.68 Never Been Affected
Depression 16 29 13 24 18 3.01 Sometimes Been Affected
Peer pressure 17 27 16 19 21 3.0 Sometimes Been Affected
Family Figure 18 12 23 21 26 2.55 Never Been Affected

Table 6 shows the factors affecting the engagement to cigarette smoking. It appears that curiosity is the main factor that greatly affects adolescents in their engagement to cigarette smoking followed by depression, peer pressure, advertisement and lastly is the family figure.

Problem no 3. To what extent does the following factor can contribute to the engagement of adolescent to cigarette smoking?
Factors 5 4 3 2 1 Weighted Mean Interpretation
Curiosity
1. fun of trying new things 31 28 24 11 6 3.67 A
2.adventurous 28 28 27 10 7 3.6 A
Advertisement
1. believes in advertisement like TV, magazines, posters, etc. 8 18 20 28 26 2.54 N
2. Easily attracted by variety of advertisement regarding cigarettes. 6 16 20 28 30 2.4 N
Depression
1. finds cigarette smoking as a way of escaping to family problems, worries and frustrations 18 23 27 29 13 3.14 ST
2. Finds cigarette smoking as an outlet of releasing depression and stress. 15 28 19 17 21 2.99 ST
Peer pressure
1. easily get attracted to friends who smoke 16 29 15 16 24 2.97 ST
2. find it hard to refuse friends 18 26 19 10 27 3.34 O
3. doesn’t want to be rejected by friends 20 18 10 27 25 2.81 S
4. wants to be “in” 27 9 15 18 31 2.83 S
Family Figure
1. imitating actions of elder family members 8 21 27 15 29 2.64 N
2. shows rebelliousness to the family by means of cigarette smoking 11 14 19 26 30 2.5 N

CHAPTER 5
SUMMARY, CONCLUSION AND RECCOMEDATION This study wants to determine the appraisal factors affecting adolescent’s engagement to cigarette smoking as perceived by adolescents in selected barangay in Malolos, Bulacan. It tried to answer the following questions:
1. Profile of the respondent. 1.1 Age 1.2 Gender 1.3 Educational attainment 1.4 Family income 1.5 Family structure
2. Which of the factors greatly affects the adolescentsengagement to cigarette smoking? a. curiosity b. advertisement c. depression d. peer pressure e. family figure
3. To what extent does the following factors can contribute to the engagement of the adolescents to cigarette smoking?

The study used descriptive method, where in the tool that was used is questionnaire that was made by the researcher with the help of their adviser. It was used to gather the data that were needed to complete the study. With the cooperation of the barangay/respondents, where the study was conducted the instrument was answered completely. The primary respondents were adolescents ages 12-18years old, a total of 100 respondents 50% coming from Mojon and the other 50% came from Catmon. The data that were gathered were reviewed and treated statistically with the use of percentage, weighed mean and standard deviation. Summary findings:
1. Profile of the respondents are as follows: a. ages 12-18 years old but smokers are in ages 16-17 b. Males are the ones who most of the time angage in smoking. c. mostly are presently studying d. most of the family has the income of 5000 a month. e. In terms of family structure most adolescents came from nuclear structure.
2. As to what extent the factors affect the adolescent? The following may be generated: a. most respondent were affected by their curiosity. b. Advertisement is the most least factor that affects most of the adolescents. c. Depression has also great effect with adolescents engagement to cigarette smoking it is their way of releasing their tension. d. Peer pressure also has significant effect the adolescent, they’re afraid of rejection from the group. e. Family figure is the “most Least” in the factors considered that contributes to engagement of cigarette smoking. They consider their role model so they tend to imitate them.

Conclusions From the data that were gathered and analyze conclusions arrived as follows:
1. On the profile of the respondents. Mostly came from nuclear family structure with above 5, 000 monthly income, presently studying ages 16-17 years old.
2. Factors that greatly affect the adolescent was curiosity due to their craving to discover and experience new things and combine with other factors such as depression, advertisement, peer pressure and family figure that caused many adolescent to be engaged in cigarette smoking.

Recommendation Based on the results, findings and conclusions, the researchers recommends the following to enhance the public awareness to adolescents cigarette smoking including its contributing factors.