Impact of Parental Smoking in the Smoking Patterns Among Selected Students of Far Eastern University School Year 2006-2007

IMPACT OF PARENTAL SMOKING IN THE SMOKING PATTERNS AMONG SELECTED STUDENTS OF FAR EASTERN UNIVERSITY
SCHOOL YEAR 2006-2007

An Undergraduate Thesis Submitted to

Institute of Nursing

In Partial Fulfillment for the Requirements

in Nursing Research

Submitted by:

Apostol, John Benedict A.
Balbin, Marie Venellie B.
Clutario, Neil Yannick V.
Dannug, Percival D.
Lagunero, Ryan B.
Magbitang, Jayson P.
Malgapo, Cristian Carlo D.L.
Pangilinan, Maria Jovita B.
Rafols, Glaiza D.
Rodriguez, Kimmy R.
Santos, Mary Queen C.
Ty, Aizha Joanne N.

CHAPTER I
THE PROBLEM AND ITS BACKGROUND

Introduction

Smoking, according to World Health Organization (WHO) is one of the major preventable causes of premature death and disease in the world. A disproportionate share of the global tobacco use burden falls on developing countries where an estimated 84 percent of the world 's 1.3 billion current smokers live. The Philippines, a third world country share this burden. Yet, smoking in the Philippines remains acceptable. This is why despite the anti-lobby and mounting proof of tobacco 's health risk, the number of young smokers in our country is still rising. Our country ranks number one in terms of youth smokers among other countries in the Western Pacific and Southeast Asian region. It is estimated that more than twice of the Filipinos are smokers compared to other youth overseas. (Figueroa, 1998)

Nicotine, a component of cigarettes acts as stimulant on the heart and nervous system. When tobacco smoke is inhaled, the immediate effects on the body are faster heart beat and elevated blood pressure. These effects, however, are quickly dissipated. A third principal component of cigarette smoke, carbon monoxide causes some of the more serious health effects. Long-term effects of cigarette smoking are emphysema, chronic bronchitis, heart disease, burns and various cancers.

The influence of parental smoking to their children is complex. On one hand, parents act as role models in childhood and adolescence. On the other hand, parents might attempt to impose restrictions on their children wanting to start smoking. However, if parents themselves are smokers, then obvious credibility issues arise. Result of the Philippine Global Youth Tobacco Survey of 2004 revealed that in the family setting, 60.1% of youth smokers live in homes where other smoke in their presence and 56.3% have one or more parents who smoke.

As nursing students who belong to adolescent stage, a clear and established evidence of the detrimental outcomes that arise due to cigarette smoking are already developed because of the teaching emphasis of the health hazards it poses. They are also expected to live a healthy lifestyle because they have enough knowledge about wellness. Also, they should serve as role model so that they would have the credibility in educating people. In that context, the researchers conducted this study to answer the question why some nursing students still smoke today.

Statement of the Problem This study will endeavor to explain the impact of parental smoking in the smoking patterns among selected students of Far Eastern University for school year 2006-2007.

Specifically, the study seeks to clarify the following:

1. What is the demographic profile of the prevailing active smokers among selected students of Far Eastern University for school year 2006-2007 in terms of:

i. gender ii. position in the family iii. place of origin (urban, rural) iv. living with parents, not living with parents

2. How do the respondents rate the impact of their parents’ smoking patterns with their own patterns of smoking in terms of:

i. starting age of smoking ii. extent of smoking iii. beliefs about health hazards of smoking iv. attitudes on smoking cessation

3. Are there significant differences between the respondents responses when grouped according to:

a. gender b. ordinal position c. place of origin i. urban, rural ii. living with parents, not living with parents

Hypothesis

1. There is no significant difference between the respondents’ response when grouped according to gender. 2. There is no significant difference between the respondents’ response when grouped according to ordinal position. 3. There is no significant difference between the respondents’ response when grouped according to place of origin whether urban or rural. 4. There is no significant difference between the respondents’ response when grouped according to place of origin whether living with parents or not living with parents.

Significance of the Study

The study seeks to know the impact of parental smoking in the smoking patterns of selected students of Far Eastern University. The following will benefit from the study:

Nursing Education: The results of study will be used to assess and validate the teaching effectiveness on practical application of students concerning conditions of healthy lifestyle. The result of the study may also be used as a basis to include smoking cessation program in educational curriculum.

Nursing Research: The outcome of the study will be of further use for future nursing researchers by serving as their related study and source to further have a study about the effects of smoking in an individual.

Community: The study will help in effective assessment and prioritization of the target population wherein smoking cessation programs may be implemented. Also, government officials could obtain insights about advocacy programs to be imposed among their constituents through this study.

Family and Parents: The product of the study will be used to evaluate the effectiveness and importance of parenting. It will help them understand deeply their children’s smoking patterns and render family support during the different developmental stages of their children.

Youth and Student: The results of the study will broaden their knowledge about the effects of smoking in their various relationships like with their family, friends and other people in the larger society. It may motivate them to stop smoking by realizing that smoking is dangerous to their health and to the health of other people.

Scope and Limitations

This study focused only in determining whether there is an impact of parental smoking in the smoking patterns among selected students of Far Eastern University for school year 2006-2007. The sample consisted of active smokers whose parents are also active smokers. This was for the determination of vital parental influences in the smoking patterns of their children.

The study population was narrowed down to 70 Level IV Nursing students.

The patterns of smoking were limited only to 4 aspects namely: the starting age of smoking, frequency of smoking, the attitudes on smoking cessation and beliefs on the health hazards smoking poses. Other factors contributing to smoking and other patterns of smoking were not included.

Theoretical Framework

The researchers utilized the Theory of Human Becoming of Rosemary Parse, which holds that man is an open, whole being, co-existing and participating with the environment while continuously co-constituting patterns of relating. Man, as an open being freely chooses situations, attaches meaning to those situations and bears the responsibility for decisions. Man is a composite of more than the sum of parts, a wholeness of biological, social, psychological and spiritual aspects within the context of environment and lived experiences. In this theory, man views health as a process of lived experiences, unfolding, continually changing, including a synthesis of values and way of living. (Christensen, Paula J., Nursing Process Application of Conceptual Models, p. 36-37)

Conceptual Paradigm

Independent Variable

Population Variable

Dependent Variable

Figure 1. shows the relationship between the independent variable, which is parental smoking to the demographic profile of the selected population, Level IV Nursing students of Far Eastern University for school year 2006-2007. This population was grouped according to gender, ordinal position, place of origin and whether living with parents or not. The smoking patterns of student in terms of starting age, extent of smoking, beliefs about health hazards and attitudes on smoking cessation are the dependent variable.

The Level IV Nursing students, considered as an open and whole being co-exists with the environment, choose situations in this environment, and attaches meaning to it.
As adolescents, who most of them are living with parents, they were easily influenced by their parental smoking and attached certain reasons, beliefs and attitudes why they chose to adapt the behavior. These were evidenced by taking responsibility for their actions and smoking patterns in terms of starting age, extent of smoking, beliefs about health hazards and attitudes on smoking cessation.

Definition of Terms

The following terms are defined conceptually and operationally in this study:

Active smoker

an individual who inhales and exhales the burning tobacco product.

an individual who smoke tobacco product at least once a day.

Attitude

is a personal view of something, an opinion or general feeling about something.

Belief is usually defined as a conviction to the truth of a proposition without its verification, therefore it is a subjective mental interpretation of the perception results, own contemplation/reasoning or communication.
Impact

the effect of something on the individual’s social values, disposition and outlook in life towards smoking.

result; effect

Parental

is a father or mother; one who begets or one who gives birth to or nurtures and raises a child or a relative who plays the role of a guardian.

referring to parents, either mother or father.

Passive smoker

second hand smoker, or an individual who inhales smoke from one person 's burning tobacco product.

an individual who regularly inhales burning tobacco product smoked by another person.

Rural

are areas (also referred to as "the country", countryside) are sparsely settled places away from the influence of large cities and towns. Such areas are distinct from more intensively settled urban and suburban areas, and also from unsettled lands such as outback or wilderness. People in rural areas live in towns, villages, on farms and in other isolated houses. referring to provinces
Smoking cessation

the effort to stop smoking tobacco products. quitting the smoking habit.

Smoking pattern

a regular way of doing something.

is the behavior of a person towards smoking.

Starting age

is the beginning age of a person to engage on something.

age when the person starts smoking regularly.

Urban is an area with an increased density of human-created structures in comparison to the areas surrounding it. This term is at one end of the spectrum of suburban and rural areas. An urban area is more frequently called a city or town. Referring to any city outside the province.

CHAPTER II
REVIEW OF RELATED LITERATURE

Foreign Literature

Children as young as 2 years old may be influenced by their parents’ tobacco habits, many years before they even consider using cigarettes themselves. (Archives of Pediatric and Adolescent Medicine vol. 159, p. 854, 2006)

Dalton (2006) stated that although it is not clear whether the children were more likely to ultimately smoke or drink alcohol, “compelling evidence that the process of initiation – which typically involves shifts in attitudes and expectations about behavior – begins as young as three years of age.

Sanford (2006) added that it has been known for a long time that children learn behavior such as smoking from their parents. Children are two to three times more likely to take up smoking if their parents smoke.

Researchers from Dartmouth Medical College in New Hampshire presented that children were nearly four times as likely to buy cigarettes if their parents smoke. (Archives of Pediatric and Adolescent Medicine vol. 159, p. 854, 2006)

Studies that focus on the influence of family relations have identified “parenting” as a key concept for analyzing adolescent substance use. Parenting refers to styles by which parents socialize to their children; it encompasses most, if not all, aspects of parent-child relations, including a substantial part of children’s daily activities. Parenting involves two key concepts. These are support (i.e., nurture, attachment, acceptance, love) and control (i.e. discipline, punishment, supervision, monitoring) (Barnes and Farrell 1992).

Burton (1998) said that the adolescent is more likely than a nonsmoker to have a family member and friends who smoke. Moreover, he or she is more likely to have a history of living in a smoking environment. For instance, in Canada’s Waterloo Project, having parents, siblings and friends who smoked when the student was in 6th grade was strongly predictive of the student smoking when he/she was in 12th grade.

Newman and Ward (1998) found that nonsmoking parent who disproved of smoking had 10.3% of their adolescent children who were smokers. In contrast, the smoking prevalence among the children of smoking parents who were indifferent to their children’s smoking was 32.5%.

Richardson (1998) reported that the patterns of smoking among teen-agers in many industrialized countries are similar. While there are differences among these countries in adolescent smoking rates by gender, there are also notably similar patterns: namely that smoking initially develops among boys and then is followed by an increased smoking rate among girls that eventually levels off at about the same level as that for boys. To add, other factors within the family internal structure affects smoking. In the study about birth order effect in smoking, it was found that a significant birth-order relationship suggested lower ages of smoking onset in later born siblings of a 1979 National Longitudinal Survey of Youth cohort. (Bard, 1979)

Analyses revealed inhabitants of metropolitan areas to be more likely current smokers than inhabitants of rural areas (odds ratio 1.56, 95%-confidence interval 1.51; 1.62). Among current and former smokers those who lived in urban communities had also increased odds for being heavy smokers than those who lived in rural communities.
(Duelberg, 1996)

Burton (1998) cited that smoking as one of the most difficult addictions to overcome in adulthood, is usually an entrenched aspect of personality. Among adult smokers, dependence on the psychoactive properties of nicotine can be evidenced by a cigarette being lit every 30-60 minutes, a period comparable to the half-life of nicotine. The situation exists despite the fact that majority of adult smokers say that they would like to quit smoking and do regularly try to quit, mostly without long-term success.

A study that adolescents reported that 85% of adolescents who expressed a desire to stop smoking specified most often as their reason a concern about general health, followed by 70 % of those who desire to reduce unpleasant taste, smell and feelings associated about smoking. 51% reported that they wanted to quit because they want to increase the quality of their general appearance. Nevertheless, the importance of providing clear relevant information about the effects of smoking on health and fitness should not be underestimated. There is evidence that adolescent smokers are surprisingly unaware of these effects and that they do not feel personally at risk. (Richardson, 1994)

According to a national household survey conducted in 1992 in the United States, about 75% of adolescents between the ages of 12-18 years who were currently smoking had made at least one serious attempt to quit. The issue of motivation was addressed systematically in a project in which 72 focus groups were conducted with high school students in identifying the events that would lead them to want to quit smoking. The 3 most powerful motivators for these teen-agers, according their self-reports were: 1. a message from their personal physician telling them that they should quit, 2. the actual tobacco-caused suffering, illness or death of a loved one and less surprisingly, 3. a message to quit from their boyfriend or girlfriend.

There is also an evidence that family members should be involved in the process of smoking cessation, both by being provided with guidance in assisting the adolescent to quit and the in the case of the parents who smoke, by being assisted to attempt to quit smoking themselves. A subsequent anonymously answered questionnaire which surveyed random samples of students in 24 high schools revealed that among the teen-ager’s top three reasons for quitting, the easiest to address may also be the least likely to addressed; routine physician advice to stop smoking has significant potential as a cessation intervention for adolescents. (Richardson, 1994) The early establishment of psychological dependence on smoking makes it harder to quit smoking. It has been found that as early as grade 9, many smokers claim that smoking helps them to relax and relieve boredom. McNeill et. al (1998) have reported that 82%of the 12-15 year old female smokers in their study described themselves as feeling calmer when smoking, with more daily smoker that occasional smokers experiencing this. (Richardson, 1994)

Local Literature

Raedina (2001) in her study discussed that the family is a very close and intimate group. The most meaningful relationships are found among family members. The family is the setting of the most intense emotional experiences during the lifetime of the individual – birth, puberty, marriage and death. Thus, the family’s influence on personality and character is significant and pervasive. The family affects the individual’s social values, disposition and outlook in life. The family is the source of the individual’s ideal, aspirations and basic motivations. Another unique characteristic of the family is that it is the first social group to which the individual is exposed. Furthermore, family contact and relationships are repetitive and continuous. They extend over a long period of time, often for a lifetime. In no other group does the individual spend more of his waking and sleeping hours than in the family. Thus, the individual’s earliest and longest experience in living takes place in a family setting. Because of this, the experiences in the family make a lasting impression on the individual.

Mendrez and Jocano (1997) stated that as a family oriented society, Filipinos look to the parents for the elementary training of their children in accepted social values. The parent’s responsibility is symbolized in the rhetorical expletives “yan ba ang turo ng magulang mo?”

Emma Tan, in her book Questions and Answers on Bringing Up Children (2004) the idea involved in the effectivity of parental example is what psychologists describe as the concept of the identification. According to this theory, a child develops his beliefs as a result his identification with his parents. A son dreams to become a businessman like his father, or a daughter hopes she will grow up to be a dressmaker, like her mother. Individual children use their parents as models and incorporate the ways of their parents into their own style of life. A boy who relishes his mother’s looking hopes to marry a girl who can cook as well. Because of this, we might expect children to eventually adopt their parents’ moral standards and values.

Parane (2004) stated that parents have a power to influence their children behavior outside the home as well as within it. If one parent is an alcoholic, a smoker, abuses drugs, or is violent toward the other parent, the teenager’s view of life can be warped.

Most teens start smoking because they imitate their parents who are cigarette – chiggers themselves. (Woman Today May 15 2002. Smoking is Uncool for You pg. 32)

Young people are more likely to smoke if they are living in households where a parent or an elder siblings smoke. (Woman Today July 7 to August 25, 1999 Volume 19.1 pg. 26)

Data from the Centers for Disease Control and Prevention showed that over 14 percent of children experiment on the use of cigarettes before the age of 12. In the Philippines, a survey done by the American College of Chest Physicians Philippine Chapter (ACCP) on 2,923 respondents – students from 12 elementary and secondary public and private schools in Metro Manila from 1998 to 2001 noted that 29.6 percent engaged in smoking. 18.8 percent were current smokers with 4.7 percent smoking at least one cigarette per day. Another local survey conducted by the Department of Health (DOH) estimated that 42 percent of grade school and high school students had tried smoking with 15 percent admitting that smoking their first cigarette before the age of 10 years. Tobacco campaign in print and multimedia, peer pressure, smoking parents are some of the factors that rendered smoking as acceptable adult behavior.

Philippine GYTS conducted in 2004 with a total of 11, 630 students who participated in the said study determined the prevalence of cigarette and other tobacco use. It revealed that 21.6 percent of these students currently smoke cigarettes where in 32.6 percent of the male students are currently smokers and 12.9 percent of the female students are currently smokers. 25.8 percent of the students think that boys who smoke have more friends and 13.9 percent think that girls who smoke have more friends. 13.8 percent of the students think that boys who smoke looks more attractive and 8.9 percent think that girls who smoke looks more attractive. 18.5 percent of the students usually smoke at home. 60.1 percent of the students live in homes where others smoke. 56.3 percent of the students have one or more parents who smoke. 84.8 percent of the students want to stop smoking. 84 percent of the students tried to stop smoking during the past year.90.5 percent of the students have received help to stop smoking.58.6 percent of the students had been taught in class, during the past year, about the dangers of smoking.64.1 percent of the students had been taught in class, during the past year, the effects of tobacco use.

The World Health Organization reports that today more people die from smoking than any known disease or accident, effectively facing the global number of people addicted to smoking. The main culprit for the health related effects of smoking is its active ingredient, the nicotine. Tar, which is found in the smoke contains many carcinogens. These compounds, many of which are polluted air but are found in vastly great quantities of cigarette smoke, have been identified as major causes of cancer and respiratory difficulties. Evenly young smokers have shortness of breath, nagging cough or develop cardiovascular and respiratory difficulties. A third principal component of cigarette smoke, carbon monoxide also causes some of the more serious health effects. It can reduce the blood’s ability to carry oxygen to body tissues and cause arteriosclerosis (hardening of arteries). Long-term effects of smoking cigarettes are emphysema, chronic bronchitis, heart disease, burn deaths, lung cancer in other parts of the body. (Figueroa, 1998)

Foreign Studies
Concordance Between Parental and Children’s Reports of Parental Smoking
Rafael Laniado-Labori’n, MD, MPH, FCCP; Jeanette I. Candelaria, MPH, Adriana Villasen, Susan I.Woodruff, PhD, James F. Sallis, PhD

A total of 3, 624 adolescents from 10 middle high schools in San Diego, California completed baseline smokers assessing demographic characteristics, seven parental prompts to smoke, past month smoking, parental smoking, acculturation and familism. A similar questionnaire was developed to collect information by telephone from smoking parents. Results of the study showed significant proportion of smoking parents’ behavior that could inadvertently prompt their children to smoke. The most frequent prompt by either parent, as reported by both parent and child was to ask their children to bring cigarettes to parents.

The Smoking Behaviors of Adolescents and Their Friends: Do Parents Matter?
Avril J. Mewse [pic]‌ J. Richard Eiser [pic]‌ Alan M. Slater [pic]‌ Stephen E. G. Lea [pic]‌

This study examined relations among adolescent smoking, parental authoritativeness, parental disapproval of smoking, parental smoking, friends ' self-reported smoking, and friends ' reports of their parents ' authoritativeness. 317 adolescents (12-15 years of age) gave saliva samples and completed questionnaires concerning their own smoking behavior, aspects of their parents ' parenting behaviors (used to construct a measure of authoritative parenting), their parents ' smoking behaviors, and parental disapproval of smoking. Independent reports obtained from friends were used to calculate measures of friends ' smoking and levels of friends ' parents ' authoritativeness. Results showed higher levels of authoritative parenting and parental disapproval of smoking along with lower levels of parental smoking were associated with a lower likelihood of smoking during adolescence. Friends ' smoking was positively associated with adolescent smoking, and it mediated the association between parental smoking and target adolescents ' smoking. Friends ' parents ' authoritativeness did not mediate the association between friends ' smoking and adolescent smoking. Conclusions made were along with friends ' smoking, parental authoritativeness and parental disapproval of smoking are important influences on adolescent smoking. Consideration of the conjoint influence of the family and the peer group, rather than either in isolation, improves understanding of adolescent smoking behavior

Local Study

A qualitative study entitled “Beliefs, Attitudes, Perceptions Behaviour of Young People about Identity, Sexuality and Health” made by University Center for Women’s Studies Foundation, Inc. of the Philippines deliberated the factors correlating smoking initiation among adolescents of 10-17 years old from Barangay 704, San Andres, Manila. The results of the study revealed that 1-2 of the parents of the subjects are smoking and the profile of Filipino smokers showed that 94 percent of the reasons for initial intake of smoking are familial influence and 85 percent of the reasons for continuing intake are of familial influence.

Synthesis

Most of the foreign literature stated that as early as 2 or 3 years of age, parents’ tobacco habits begin to influence their children. Moreover, children are more likely to take up smoking up to 4 times if their parents smoke. One more factor that the literature cited is that environment has a significant role in the attitudes of children towards smoking. Many of these smokers have tried to stop but failed. The early establishment of psychological dependence on smoking makes it harder to quit smoking but with the involvement of family members on smoking cessation, it can be possible.

Local literature showed that Filipinos, as a society of close family ties were greatly influenced by the family. This is associated to the process of identification with parents and is dictated by culture. Like most of the industrialized countries, the Philippines, a third world country has prevailing large number of adolescent smokers, usually starting in early high school. This was attributed to familial influence, among other influences. Both gender also smoke in almost parallel prevalence. Filipino youth smokers have also tried to quit smoking, but was often unsuccessful.

Foreign and local studies strengthened the literature. This included parental prompting of their children to smoke and the effect of parental authoritativeness.

CHAPTER III RESEARCH METHODOLOGY

Research Design

This study utilized a descriptive design. Descriptive design observes, describe and document aspects of situation as it naturally occurs and sometimes to observe as a starting point for hypothesis generation or theory development. It also describes the frequency of occurrence of a behavior or condition. Therefore, descriptive design is used when the objective is to provide a systematic description that is as factual and accurate as possible. It provides the number of times something occurs, or frequency, lends itself to statistical calculations such as determining the average number of occurrences or central tendencies. (Polit and Beck, 2003)

In this design, the subjects answered a set of questionnaires, wherein the respondents were asked to rate the impact of parental smoking with regards to their starting age of smoking, extent of smoking, beliefs about health hazards of smoking, and attitudes on smoking cessation.

Study Population

The target population, the Level IV Nursing students consisted of more than 2,700 students was narrowed down through an initial assessment to determine who would fit the inclusion and exclusion criteria. Results of the assessment revealed that only 154 students fitted the criteria. Through simple random sampling, wherein a sampling frame of 70 was identified by the researchers, sample elements or the individuals were chosen.

Sampling Technique

Purposive sampling was used to narrow down the Nursing students according to inclusion and exclusion criteria.

Inclusion Criteria:
1. Level IV Nursing Students of Far Eastern University
2. Approximately 18-22 years old
3. Active smoker
4. Parent/s is/are active smoker/s
5. Oriented to time, person and place
6. Able to speak, understand and follow English and Tagalog commands
7. Voluntarily consented to participate

Exclusion Criteria:
1. Passive smokers
2. Occasional smokers

After the total number of active smokers with smoking parents among Level IV Nursing students (154) was identified, simple random sampling was done to obtain the sample size. In simple random sampling, the researchers established a sampling frame, which were 70 students. Elements or individuals were then chosen randomly through fish ball technique.

Research Setting and Locale

The study was conducted in Far Eastern University, Nicanor Reyes St. Morayta, Manila. A letter addressed to the Dean of Institute of Nursing was delivered, explaining the purpose and procedures needed in the conduct of the study in order to have contacts to selected Level IV Nursing students. A written informed consent was presented to students who will participate in the study and their affirmation was obtained.

Implementation Protocol

1. A formal arrangement between the investigators and the respondents who will participate in the study was done. 2. A written informed consent was obtained from all subjects. 3. Rapport was established with each subject prior to obtaining data. 4. The consent was presented to the individual; after explaining the nature and procedure of the study and was done in front or in the company of a friend or classmate. 5. The subject’s safety was at no time threatened during the entire process of data gathering.

Instrumentation

The set of questionnaires was validated by a research adviser that would provide an accurate and reliable outcome. The researchers gave the questionnaires to the respondents and explained the nature and procedure of the study. With it is a written consent for them to sign if they want to participate or not.

Data Gathering Procedure

The 70 potential subjects identified through simple random sampling were identified in the selected locale, the Far Eastern University in Morayta, Manila. The procedure was done from 9 am to 3 pm, during free hours of the respondents for 7 days.

For the data gathering procedure, rapport was first established with the subject through introduction of the researchers. The purpose of the research was explained to each of the subjects, with an explanation of the person’s participation in the procedure. An informed consent was then presented to the subject and then was asked to sign his/her name.

Each subject was then given a set of questionnaires for them to answer. Directions about answering the questionnaire were explained to the respondents by the researchers. After the respondents have answered all of the questions, the researchers obtained the answered questionnaires. In summary, the flow chart of the data gathering procedures was presented below:

Flow Chart for the Data Gathering Procedure
70 potential subjects identified through simple random sampling

Establish rapport with the respondent by introducing name and explaining the purpose of the research

Explain the person’s participation in the study

Obtain an informed consent from the client

Directions about answering the questionnaires were given

Ask the client to answer the questions truthfully

Tell the client to ask the researcher if he/ she did not understand any of the question/s

Obtain the answered questionnaire.
Statistical Treatment

Data obtained was entered to Statistical Software SPSS version 14.0 and consultation to the statistician was made in analyzing and generating statistical tables. The researchers utilized both descriptive and inferential statistics for data interpretation.

For the determination of the profile of the respondents when grouped according to demographic profile, the frequency distribution table was used. A frequency table was constructed by dividing the scores into intervals and counting the number of scores in each interval. The actual numbers of scores as well as the percentage of scores in each interval were displayed. Hence, the formula for computing the percentage was computed using the following equation:
Percentage = f/N x 100 where:

f is the frequency associated with each category or score value N is the total number of observations Percentage can be converted to a percent by multiplying p by 100. For the determination of the extent of the perception of respondents on the impact of their parents’ smoking patterns with their own patterns of smoking in terms of starting age of smoking, extent of smoking, beliefs about health hazards of smoking and attitudes on smoking, the weighted mean was utilized. The weighted mean is a mean where there is some variation in the relative contribution of individual data values to the mean. Each data value (Xi) had a weight assigned to it (Wi). Data values with larger weights contribute more to the weighted mean and data values with smaller weights contribute less to the weighted mean. The formula is:

or: [pic]

[pic] where: Wi is the actual weight assigned Xi is the observed data value

The qualitative interpretation used is shown in the following range of values: 1.50 and below = Strongly Disagree 1.51 – 2.50 = Disagree 2.51 – 3.50 = Agree 3.51 and above = Strongly Agree

To determine the test of significant difference on the perception of respondents on the impact of their parents’ smoking patterns with their own patterns of smoking in terms of starting age of smoking, extent of smoking, beliefs about health hazards of smoking and attitudes on smoking when grouped according to demographic variables, the t-test of significant difference and analysis of variance (ANOVA) were used. Analysis of variance is a test of the hypothesis that the variation is not greater than the normal variation due to individuals ' characteristics and error in their measurement. In statistics, analysis of variance (ANOVA) is a collection of statistical models and their associated procedures which compare means by splitting the overall observed variance into different parts. The formula for Analysis of variance is:
[pic]

On the other hand, the t-test for dependent samples was used. Technically, the t-test for dependent samples helps the researcher to take advantage of one specific type of design in which an important source of within-group variation (or so-called, error) can be easily identified and excluded from the analysis. Hence, the formula for t –test dependent sample is
:
[pic]

All statistical measures was set at p = 0.05 level of significance, is the probability level at which the result of statistical analysis are judge to indicate a statistically significant difference between groups, Burns and Grooves (2001), explain that if the level of significance is found in the statistical analysis is < 0.05 the two groups or in the case of this study, (smoking patterns and demographic profile) were considered to have significant difference.

CHAPTER IV
PRESENTATION, ANALYSIS, INTERPRETATION AND DISCUSSION OF DATA

This chapter presents the results of the study based on the data gathered from Level IV nursing students who fitted the inclusion and exclusion criteria. The first phase of this presentation consists of the descriptive analysis of the respondent’s demographic characteristics to draw a general picture of the participants in the study.
Demographic Profile of the Respondents

Problem # 1.1 What is the demographic profile of the respondents when grouped according to gender?

Table 1.1
|Gender |Frequency |Percentage |
|Female |35 |50.00% |
|Male |35 |50.00% |
|Total |70 |100.00% |

Table 1.1 shows the profile of the respondents when grouped according to gender. Out of 70 respondents, 50.00% were males and 50.00% were females.

The similar patterns of smoking in terms of gender may be attributed to the fast-paced world influencing today influencing an individual. The findings of this study is in line with Richardson (1998) reports that the patterns of smoking among teen-agers in many industrialized countries are similar. While there are differences among these countries in adolescent smoking rates by gender, there are also notably similar patterns: namely that smoking initially develops among boys and then is followed by an increased smoking rate among girls that eventually levels off at about the same level as that for boys.

Problem # 1.2 What is the demographic profile of the respondents when grouped according to ordinal position?

Table 1.2
|Ordinal Position |Frequency |Percentage |
|Eldest |31 |44.29% |
|Middle |14 |20.00% |
|Youngest |18 |25.71% |
|Others |7 |10.00% |
|Total |70 |100.00% |

Table 1.2 shows the profile of the respondents when grouped according to ordinal position. Among 70 respondents 31(44.3%) were the eldest; 14(20.00%) were the middle; 18(25.71%) were the youngest; and 7(10.00%) were either third, fourth, fifth in the family.

This study is in contrast with the study about birth order effect in smoking, which found that a significant birth-order relationship suggested lower ages of smoking onset in later born siblings of a 1979 National Longitudinal Survey of Youth cohort. (Bard, 1979)

Problem # 1.3 What is the demographic profile of the respondents when grouped according to place of origin whether rural or urban?

Table 1.3
|Place of Origin |Frequency |Percentage |
|Urban |54 |77.14% |
|Rural |16 |22.86% |
|Total |70 |100.00% |

Table 1.3 shows the profile of the respondents when grouped according to place of origin whether rural or urban. Among the 70 respondents 54(77.14%) were living in an urban area and 16(22.86%) were living in a rural area.

These results is in line with analyses that revealed inhabitants of metropolitan areas to be more likely current smokers than inhabitants of rural areas (odds ratio 1.56, 95%-confidence interval 1.51; 1.62). Among current and former smokers those who lived in urban communities had also increased odds for being heavy smokers than those who lived in rural communities. (Duelberg SI, 1996)

Problem # 1.4 What is the demographic profile of the respondents when grouped according to place of origin whether living with parents or not living with parents?

Table 1.4
|LW |Frequency |Percentage |
|Parents |44 |62.86% |
|Others |26 |37.14% |
|Total |70 |100.00% |

Table 1.4 shows the profile of the respondents when grouped according to place of origin whether living with parents or not living with parents. Among the 70 respondents, 44(62.86%) were staying with their parents; 26(37.14%) were not staying with relatives.

Problem no. 2
Smoking Patterns of the Respondents

Table 2.1 How do the respondents rate the impact of their parents’ smoking with their own patterns of smoking in terms of starting age of smoking?

|Age |Weighted Mean |Interpretation |Rank |
|13-15 |1.10 |Strongly disagree |3 |
|16-18 |2.81 |Agree |2 |
|19-21 |3.08 |Agree |1 |

Table 2. 1 showed the level of perception of students in terms of the impact of their parent’s smoking with their own patterns of smoking in terms of starting age of smoking. The starting age of 19-21 with a weighted mean of 3.08 (WM=3.08, Agree) which can be verbally described as Agree, ranked first, 16-18 (WM=2.81, Agree) ranked second and 13-15 (WM=1.10, Strongly Disagree) ranked third.

These results were in contrast with the results of the data from the Centers for Disease Control and Prevention which showed that over 14 percent of children experiment on the use of cigarettes before the age of 12. Also, it is in contrast with another local survey conducted by the Department of Health (DOH) estimated that 42 percent of grade school and high school students had tried smoking with 15 percent admitting that smoking their first cigarette before the age of 10 years was supported.

Table 2.2 How do the respondents rate the impact of their parents’ smoking with their own patterns of smoking in terms of extent of smoking?

|F |Weighted Mean |Interpretation |Rank |
|5years |3.55 |Strongly Agree |1 |

Table 2.2 showed the response of the respondents as to the rate of the impact of their parents’ smoking patterns in their own smoking patterns in terms of extent of smoking. Those who smoked for greater than 5 years ranked first with a weighted mean of 3.55 which can be verbally described as Strongly Agree (WM=3.55, Strongly Agree), followed by those who smoked for 1 to 5 years with a weighted mean of 3.00 defined as Agree (WM=3.50, Agree). The third was those who smoke for less than a year with a weighted mean of 2.82 (WM=2.82, Agree) verbally described as Agree.

Table 2.3 How do the respondents rate the impact of their parents’ smoking with their own patterns of smoking in terms of beliefs about health hazards of smoking?

|Beliefs About Health Hazards of Smoking |Weighted Mean |Interpretation |Rank |
|Smoking causes illness and diseases (cancer, |3.30 |Agree |1 |
|hypertension, heart diseases, etc.) | | | |
|Smoking reduces weight |2.36 |Disagree |3 |
|Smoking relieves stress |3.04 |Agree |2 |

Table 2.3 showed that the level of perception of the respondents about the impact of parental smoking to their own smoking patterns in terms of their belief about the health hazards of smoking. The belief that smoking reduces weight ranked third among other beliefs presented with a weighted mean of 2.36 (WM=2.36, Disagree), that smoking relieves stress ranked second with a weighted mean of 3.04 (WM= 3.04, Agree) and that smoking causes illness and diseases ranked first. (WM=3.30, Agree)

This data supports a study which reported that 85% of adolescents who expressed a desire to stop smoking specified most often as their reason a concern about general health, followed by 70 % of those who desire to reduce unpleasant taste, smell and feelings associated about smoking. 51% reported that they wanted to quit because they want to increase the quality of their general appearance. Nevertheless, the importance of providing clear relevant information about the effects of smoking on health and fitness should not be underestimated. There is evidence that adolescent smokers are surprisingly unaware of these effects and that they do not feel personally at risk. (Richardson, 1994)

Table 2.4 How do the respondents rate the impact of their parents’ smoking with their own patterns of smoking in terms of attitudes on smoking cessation?

|Attitudes on Smoking Cessation |Weighted Mean |Interpretation |Rank |
|I enjoy smoking too much |2.53 |Agree |1 |
|I will miss smoking with my friends |2.01 |Disagree |3 |
|I lack the will power to stop |2.50 |Disagree |2 |

Table 2.4 presented how the respondents rate the impact of their parent’s smoking in their own patterns of smoking in terms of the attitudes on toward smoking cessation. The attitude verbally described as “I enjoy smoking too much” ranked first with a weighted mean of 2.53, verbally described as Agree. (WM=2.53, Agree). The third was the attitude “I will miss smoking with friends” (WM=2.01, Disagree) and the second was the attitude “I lack the will power to stop” (WM=2.50, Disagree).

This study may be used to further prove a national household survey conducted in 1992 in the United States, that reported about 75% of adolescents between the ages of 12-18 years who were currently smoking had made at least one serious attempt to quit. The issue of motivation was addressed systematically in a project in which 72 focus groups were conducted with high school students in identifying the events that would lead them to want to quit smoking. The 3 most powerful motivators for these teen-agers, according their self-reports were: 1. a message from their personal physician telling them that they should quit, 2. the actual tobacco-caused suffering, illness or death of a loved one and less surprisingly, 3. a message to quit from their boyfriend or girlfriend.

Testing the Hypothesis

Table 3.1 Are there significant differences between the respondents response when grouped according to gender?

|Variable |df |Critical Value|Level of Significance|t value |Decision |Interpretation |
|Gender | | | | | | |
| |69 |1.67 |0.05 |0.72 |Accept Ho |Not significant |
|Perception of | | | | | | |
|Respondents | | | | | | |

Since the t value of 0.72 is less than the critical value of 1.67, the researchers accept the null hypothesis that there is a no significant difference between the demographic variable specifically gender and the perception of the respondents in terms of smoking.

The findings of this study suggest the report made by Richardson (1998) that the patterns of smoking among teen-agers in many industrialized countries are similar. While there are differences among these countries in adolescent smoking rates by gender, there are also notably similar patterns: namely that smoking initially develops among boys and then is followed by an increased smoking rate among girls that eventually levels off at about the same level as that for boys.

Table 3.2 Are there significant differences between the respondents response when grouped according to ordinal position?

|Variable |df |Critical Value|Level of Significance|t value |Decision |Interpretation |
|Place of Origin | | | | | | |
| | | | | |Accept Ho |Not significant |
| |69 |1.67 |0.05 |1.51 | | |
|Perception of | | | | | | |
|Respondents | | | | | | |

Since the t value of 1.51 is less than the critical value of 1.67, the researchers accept the null hypothesis that there is no significant difference between the demographic variable specifically, place of origin and the perception of the respondents in terms of smoking.

This study is in contrast with the study about birth order effect in smoking, which found that a significant birth-order relationship suggested lower ages of smoking onset in later born siblings of a 1979 National Longitudinal Survey of Youth cohort. (Bard, 1979)

Table 3.3 Are there significant differences between the respondents response when grouped according to place of origin whether urban or rural?

|Variable |df |Critical Value|Level of Significance|t value |Decision |Interpretation |
|Ordinal Position | | | | | | |
| | | | | |Accept Ho |Not significant |
| |66 |4.13 |0.05 |1.12 | | |
|Perception of | | | | | | |
|Respondents | | | | | | |

Since the t value of 1.12 is less than the critical value of 4.13, the researchers accept the null hypothesis that there is no significant difference between the demographic variable specifically, ordinal position and the perception of the respondents in terms of smoking.

These results is in line with analyses that revealed inhabitants of metropolitan areas to be more likely current smokers than inhabitants of rural areas (odds ratio 1.56, 95%-confidence interval 1.51; 1.62). Among current and former smokers those who lived in urban communities had also increased odds for being heavy smokers than those who lived in rural communities. (Duelberg SI, 1996)

Table 3.4 Are there significant difference between the respondents response when grouped according to place of origin whether living with parents or not living with parents?

|Variable |df |Critical Value|Level of Significance|t value |Decision |Interpretation |
|Living with parents | | | | | | |
| | | | | |Accept Ho |Not significant |
| |69 |1.67 |0.05 |1.11 | | |
|Perception of | | | | | | |
|Respondents | | | | | | |

Since the t value of 1.11 is less than the critical value of 1.67, the researchers accept the null hypothesis that there is no significant difference between the demographic variable specifically, living with parents variable and the perception of the respondents in terms of smoking.

CHAPTER V
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

Resume of the Problem

After the interpretation and analysis of data pertaining the impact of parental smoking in the smoking patterns among selected students of Far Eastern University, the following findings were deducted and depicted in the order of questions:

1. 50.00% were males and 50.00% were females among the respondents. 2. 31(44.3%) were the eldest; 14(20.00%) were the middle; 18(25.71%) were the youngest; and 7(10.00%) were either third, fourth, fifth in the family among the respondents when grouped according to ordinal position. 3. 54(77.14%) of the respondents were living in an urban area and 16(22.86%) were living in a rural area when grouped according to place of origin. 4. 44(62.86%) of the respondents were staying with their parents; 26(37.14%) were not staying with parents.

The following answers were also obtained: 1. How do the respondents rate the impact of their parents’ smoking with their own patterns of smoking in terms of starting age of smoking?

The starting age of 19-21 with a weighted mean of 3.08 (WM=3.08, Agree) which can be verbally described as Agree, ranked first, 16-18 (WM=2.81, Agree) ranked second and 13-15 (WM=1.10, Strongly Disagree) ranked third.

2. How do the respondents rate the impact of their parents’ smoking with their own patterns of smoking in terms of extent of smoking?

Those who smoked for greater than 5 years ranked first with a weighted mean of 3.55 which can be verbally described as Strongly Agree (WM=3.55, Strongly Agree), followed by those who smoked for 1 to 5 years with a weighted mean of 3.00 defined as Agree (WM=3.50, Agree). The third was those who smoke for less than a year with a weighted mean of 2.82 (WM=2.82, Agree) verbally described as Agree.

3. How do the respondents rate the impact of their parents’ smoking with their own patterns of smoking in terms of beliefs about health hazards of smoking?

The belief that smoking reduces weight ranked third among other beliefs presented with a weighted mean of 2.36 (WM=2.36, Disagree), that smoking relieves stress ranked second with a weighted mean of 3.04 (WM= 3.04, Agree) and that smoking causes illness and diseases ranked first. (WM=3.30, Agree)

4. How do the respondents rate the impact of their parents’ smoking with their own patterns of smoking in terms of attitudes on smoking cessation?

The attitude verbally described as “I enjoy smoking too much” ranked first with a weighted mean of 2.53, verbally described as Agree. (WM=2.53, Agree). The third was the attitude “I will miss smoking with friends” (WM=2.01, Disagree) and the second was the attitude “I lack the will power to stop” (WM=2.50, Disagree).

Conclusion

Drawing up our conclusion from our hypotheses, we have come up with the following:

1. There is no significant difference between the respondents’ response when grouped according to gender. 2. There is no significant difference between the respondents’ response when grouped according to ordinal position. 3. There is no significant difference between the respondents’ response when grouped according to place of origin whether urban or rural. 4. There is no significant difference between the respondents’ response when grouped according to place of origin whether living with parents or not living with parents.

Recommendations

In the light of the findings and conclusion, the researchers have come up with the following recommendations:

Nursing Education: Include a smoking cessation program in the curriculum.

Nursing Research: The researchers recommend a further study about the effects of smoking in an individual or the effects of parental smoking in the smoking patterns of their children using a larger sample to increase the generalizability of the study.

Community: Government officials should obtain insights from this study about the effects of smoking or parental smoking to the youth. The government may obtain information from this study about the target population for smoking cessation programs and advocacy programs to be imposed among their constituents.

Family and Parents: The researchers recommend that family and parents be involved in smoking cessation programs.

Youth and Student: Youth and students should stop smoking as early as now because the effects of smoking to health outweigh the present individual satisfaction one is gaining from it.

BIBLIOGRAPHY
Foreign Sources

Dee Burton, 1994 On Tobacco Cessation Programs for Adolescents p.98

Mewse,A., Eiser, R., Slater, M., Lea, S. The Smoking Behaviors of Adolescents and Their Friends: Do Parents Matter? Parenting, 2004, Vol. 4, No. 1, p. 51-72

Barnes, G. M. and M. P. Farrell. 1992. Parental Support and Control as Predictors of Adolescent

Dalton, Madelaine, 2006 Two Years Old Influenced by Smoking Archives of Pediatric and Adolescent Medicine vol. 159, p. 854, 2006)

Sanford, Amanda 2006 Brand Awareness Archives of Pediatric and Adolescent Medicine vol. 159, p. 854, 2006)

Bard D.E.; Rodgers J.L. 1979 Sibling Influence on Smoking Behavior: A Within-Family Look at Explanations for a Birth-Order Effect

Duelberg SI, 1996 Preventive health behavior among black and white women in urban and rural areas.

Christensen, Paula J., Nursing Process Application of Conceptual Models, p. 36-37

Local Sources

Raedina, Belen T.G., 2001 The Filipino Family. (2) p. 1-3

Mendrez, Paz Policarpio and Jocano, F. Landa, 1997 The Filipino Family in its Rural and Urban orientation: 2 case studies in Culture and Education. pg. 178

Parane, Ida, Handling a Rebellious Child. Woman’s Home Companion, April 28, 2004

Tan, Emma 2004 Questions and Answers on Bringing Up Children

Yurong, Idelle Marie, Smoking-A Pediatric Disease, December 8, 2005

A Qualitative Study of the Beliefs, Attitudes, Perceptions Behavior of Young People About Identity, Sexuality and Health University Center for Women’s Studies Foundation, Inc. University of the Philippines, Diliman

Woman Today July 7 to August 25, 1999 Volume 19.1 pg. 26
Internet Sources

[e-mail]

Labori’n, R., Candelaria, J., Villasen, A., Woodruff, S., Sallis, J. 2006 Concordance Between Parental and Children’s Reports of Parental Smoking www.cd.gov/communication/tips/shsoke.htm

www.chestjournal.org

APPENDIX A

LETTERS

APPENDIX B

SURVEY QUESTIONNAIRE

-----------------------

SMOKING PATTERNS of STUDENT in terms of:

( Starting age
( Extent of smoking

( Beliefs about health hazards

( Attitudes on smoking cessation

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&!&#&STUDENTS grouped according to gender, ordinal position, place of origin, whether living with parents or not, with the following processes in their system:

(Perception about parental smoking
( Emotional stability

( Knowledge about smoking health hazards

( Belief and value system

PARENTAL SMOKING

Parent/s is/are an active smoker/s.

Parent/s smoke/s at home.

Bibliography: Foreign Sources Dee Burton, 1994 On Tobacco Cessation Programs for Adolescents p.98 Mewse,A., Eiser, R., Slater, M., Lea, S. The Smoking Behaviors of Adolescents and Their Friends: Do Parents Matter? Parenting, 2004, Vol. 4, No. 1, p. 51-72 Barnes, G Dalton, Madelaine, 2006 Two Years Old Influenced by Smoking Archives of Pediatric and Adolescent Medicine vol. 159, p. 854, 2006) Sanford, Amanda 2006 Brand Awareness Archives of Pediatric and Adolescent Medicine vol Bard D.E.; Rodgers J.L. 1979 Sibling Influence on Smoking Behavior: A Within-Family Look at Explanations for a Birth-Order Effect Duelberg SI, 1996 Preventive health behavior among black and white women in urban and rural areas. Raedina, Belen T.G., 2001 The Filipino Family. (2) p. 1-3 Mendrez, Paz Policarpio and Jocano, F Parane, Ida, Handling a Rebellious Child. Woman’s Home Companion, April 28, 2004 Tan, Emma 2004 Questions and Answers on Bringing Up Children Yurong, Idelle Marie, Smoking-A Pediatric Disease, December 8, 2005 A Qualitative Study of the Beliefs, Attitudes, Perceptions Behavior of Young People About Identity, Sexuality and Health University Center for Women’s Studies Foundation, Inc Woman Today July 7 to August 25, 1999 Volume 19.1 pg. 26 Internet Sources