Smoking

Harmonizing to Fink ( 1998, pp.3 ) the literature reappraisal procedure can be termed as “a systematic method for placing, measuring and construing the work produced by research workers, bookmans and practicians ” .

Government Policy on smoke in gestation and after childbearing:

There are three of import policies made by the British authorities in related to smoking in gestation foremost is kids ‘s wellness and good being, than malignant neoplastic disease bar and the decrease of wellness inequalities. To back up this policies there are assorted different policy paperss like Every Child Matter ( HM Government, 2004 ) , Maternity Matters: Choice, entree and continuity of attention in a safe service ( DH, 2007a ) , the Cancer Reform Strategy ( DH, 2007b ) , Health Inequalities: advancement and following stairss ( DH, 2008 ) , Smoking Kills ( DH, 1998 ) and the Implementation Plan for cut downing wellness inequalities in infant mortality: a good pattern usher ( DH, 2007c ) .

In add-on to damaging the wellness of the female parent, antenatal smoke is associated systematically with a figure of complications during gestation ( Castles et al, 1999 ) and several possible conditions impacting the baby ( Cnattingius, 2004 ) . Smoking rate among pregnant adult females in the UK was 23 % in the twelvemonth of 1995, it declined to 19 % in 2000 and farther declined to 17 % in 2005 ( Baxter et al, 2005 ) . But RCM has noted an addition in gestation smoke rates since 2005 ( Baxter et al, 2009 ) . It is estimated that around 17 % and 23 % of pregnant adult females are estimated to smoke throughout gestation in the United Kingdome ( Owen et al, 1998) . It is of import that cost effectual intercessions are developed and disseminated so that smoking-related wellness complications can be avoided.

While face to confront smoking surcease behavioral support is by and large available for pregnant tobacco users, attending rates are really low ( Taylor et al, 2001 ) . In instance when the pregnant adult females are non able to go to face to confront smoking surcease behavioral support the option is self aid intercessions ( Ussher et al, 2005 ) . Self aid intercessions are peculiarly of import due to their low cost and they can make wider group of population. Giving pregnant adult females brochures incorporating information of jeopardies of smoke is one of the common signifier, but they can besides include picture, telephone and computing machine based systems.

A recent Cochrane reappraisal concluded that, compared with having no stuffs, self help stuffs on their ain addition surcease rates merely marginally among non pregnant tobacco users ( Lancaster and Stead, 2005 ) . Tailored ego aid stuffs were found to be increasing the quitting rates compared to standard stuffs used for intercession ( Lumley et al, 2004 ) . Tailoring is the usage of participant features to individualize intercession stuffs and is believed to be effectual because it increases the relevancy of the information to the person and heed to the message ( Dijkstra and De Vries, 1999 ) .

Self aid stuffs are common constituents in behaviour intercessions for pregnant tobacco users and are considered to be of import to cessation reding aid to pregnant adult females tobacco users to discontinue smoke ( Ussher et al, 2004 ) . However it is ill-defined whether ego aid intercessions on their ain can increase discontinuing among pregnant tobacco users.

Several reappraisals have confirmed that intercessions promotion smoking surcease during gestation can cut down smoking rates significantly ( Kelley et al, 2001 ; Lumley et Al, 2004 ; Mullen et Al, 1999 ) . Lumbley et Al ‘s ( 2005 ) reappraisal largest in this country to day of the month included tests supplying a assortment of surcease intercessions, including self aid stuffs, reding techniques, fiscal inducements and nicotine replacing therapy. Lumbley et Al ‘s ( 2004 ) indicated that hazard of smoking in late gestation was lower among intercession groups than usual attention groups. They besides found that intercessions of greater denseness determined by personal contact, added small benefit. Kelley et Al ( 2001 ) reported that the degree of reding provided within an intercession was non associated with efficaciousness.

Sing the possible benefits of ego aid intercessions it is of import to find whether they can be effectual on their ain in mark group.

Inclusion/Exclusion

As an ethical bookman my inclusion and exclusion standards explains my attack towards choosing a proper literature for my attack. As a pupil of Northumbria University my first attack was to travel through the diaries available on NORA. There was plenty data available on NORA for research articles related to my subject. I besides tried to get quality resources from other hunt engines every bit good. I searched through Cochrane library to acquire good reappraisal articles on my research subject.

Search engine

I used Nora, Wiley Inter scientific discipline, The Cochrane library, British diary of Psychology, Official site of Elsevier publication which enabled me to entree articles through scientific discipline direct, PubMed, CINAHL etc. I used my university login wherever required for the entree of articles. This hunt engines are choice assured and supply entree to high quality of international resources.

Search footings

PICO method was used to seek cardinal words to govern out the articles in each database. PICO is a method of hunt scheme that allows taking a more grounds based attack to literature seeking in database like CINAHL, ScienceDirect, etc ( Schardt et al. , 2007 ) .

Electronic seeking yielded 1010 relevant articles of which 725 were extras and after testing of the commendation or mention 285 articles were published one. Based on the survey criteria 11 articles were related to self aid intercessions. 3 articles were eliminated due to type of qualitative or prospective survey. 4 articles were good, they were run intoing my inclusion exclusion standards but I was non able to entree them as they were paid articles. Finally, 8 to the full published articles were included in this assessment.

PICO Method

Population: Pregnant adult females smoking during gestation

Intervention: Tests were considered if at least one of the experimental weaponries met the ego aid definition. The definition used based on Lancaster & A ; Stead ‘s ( 2005 ) defines self aid as the proviso of structured stuffs that assist the person in doing quit effort and prolonging abstention without important aid from a wellness professional or group support.

Comparison: Comparison was done between different intercessions. Usual attention given to pregnant tobacco users during their ante natal attention was compared with ego aid intercessions. Besides usual attention was compared with picture based and brochures intercession.

Result: Smoke results were accessed either in 2nd or during the 3rd trimester. The tests besides determined the smoke position either during late gestation or postpartum ( Moore et Al, 2002 ) .

Arm 1: Standard obstetrics advice to halt smoke and a self-help cusp appropriate for adult females in the readying phase. Midwifes received no extra preparation except in survey protocol.

Arm Two: TTM based arm. Woman were been seen by accoucheuses with 2.5 yearss specialist preparation, 2 of these yearss on TTM. Women received a TTM based self-help brochure and received four Sessionss of behavioral reding from the accoucheuses ( three during gestation and one 10 years post partum )

Arm Three: TTM based arm. Woman were been seen by accoucheuses with 2.5 yearss developing as in arm 1. Intervention was the same as arm two, with the add-on of a computing machine based surcease intercession used on the four juncture ‘s of the accoucheuses visit.

Pregnant adult females in weaponries two and three ( TTM- based ) were significantly more likely to travel frontward in phase of alteration than adult females in the control arm.

Overall, the TTM-based intercession produced some motion in adult females ‘s preparedness to discontinue but it was hard to construe this determination as the TTM intercessions were besides more intensive. The writers concluded that TTM had small cogency in explicating smoking surcease behavior during gestation.

Participant, Recruitment and Sampling Methodology

A sum of 146 adult females were screened for the survey. Sixty four adult females failed to run into the inclusion standards for the test ( & gt ; 18 old ages of age, smoke & gt ; 3 coffin nails per twenty-four hours, less than 30 hebdomads pregnant, have a on the job VCR, be willing to put a quit day of the month within two hebdomads of showing, and non involved in any other formal smoke surcease plan ) .

82 adult females participants were indiscriminately assigned.

Usual attention ( UC ) ( N= 40 ) and UC plus picture ( UCV ) ( N= 42 ) groups. All participants continued to have the usual prenatal attention provided by their primary doctor, plus survey stuffs as described below. All intercession stuffs were provided through the mail, after participants had undergone a telephone testing for inclusion. All follow ups were besides conducted by telephone.

Abstinence was observed between the two groups. Abstinence studies were measured by salivary cotinine values.

Seven twenty-four hours point prevalence abstention informations did non demo any significance consequences. At the terminal of quit day of the month the abstention rate was 10 % in control group and 3 % in experimental group. At the terminal of intervention the abstention rate was 12 % in control group and 7.5 % in experimental group.

The present sample size may be unequal to pull any i¬?rm decisions sing the differential effectivity of the picture intercession.

The effectivity of low-priced smoke intercessions targeted to pregnant adult females has been demonstrated, although few additions in absolute surcease rates have been reported in the past decennary. Under conditions of typical clinical pattern, this survey examined whether results achieved with brief reding from antenatal attention suppliers and a self-help brochure could be improved by adding more resource-intensive cognitive-behavioural plans.

Study Design

• Randomised Controlled Trial
• Participant, Recruitment and Sampling Methodology
• Womans 18 old ages of age or older who self-reported to be active tobacco users at their initial antenatal assignment. 131 adult females were randomised.
• Control group: 111 participants.
• Experimental Group: 120 participants.

Intervention

Participants were randomized to one of three groups:

• ( a self-help brochure tailored smoke forms, phase of alteration, and life style of pregnant tobacco users ;
• the brochure plus entree to a computerized telephone surcease plan based on synergistic voice response engineering ;
• or  the brochure plus proactive telephone reding from nurse pedagogues utilizing motivational interviewing techniques and schemes.

Biochemically conirmed abstention measured by degree of cotinine in urine samples obtained during a everyday antenatal visit at about the 34th hebdomad of gestation.

Twenty per centum of participants were conirmed as abstainer with no signiicant differences found between intercession groups. Cessation rates in heavy tobacco users were less in all intercession groups.

Neither a computerized telephone surcease plan nor systematic proviso of motivational guidance improved surcease rates over a trim self-help brochure delivered within the context of brief advice from antenatal suppliers.

Experimental group received usual information with a prenatal and station partum information. Control group received merely usual information. The intercession consisted of single accomplishments direction and guidance by a equal wellness counselor on the usage of a self-help surcease usher and everyday clinic support.

It was measured by smoking surcease confirmed by cotinine measuring. Significant decrease in smoke was besides considered as an result step. Smoking forms were besides considered

Among the Experimental group ( n = 193 ) , 6.2 % were cotinine confirmed quitters at 3rd trimester and among the C group ( n = 198 ) the quit rate was 5.6 % .

No important differences were found in the two groups.

To measure the effectivity in assisting pregnant adult females stop smoke of two intercessions ( Pro-Change for a healthy gestation ) based on the Trans theoretical theoretical account of behaviour alteration ( TTM ) compared to current criterion attention

Study Design

• Cluster randomised survey.
• Participant, Recruitment and Sampling Methodology
• 494 pregnant tobacco users participated.
• Control group: 243 participants.
• Experimental group: 251 participants.
• Arm 1 for standard attention.
• Second arm for TTM based ego aid manuals.
• Third arm for TTM based ego aid manuals plus session with an synergistic computing machine plan giving individualized smoke surcease advice.

Biochemically confirmed smoke surcease for 10 hebdomads and point prevalence abstention, both measured at 30 hebdomads of gestation and 10 years after bringing.

There were little differences between the TTM weaponries. Uniting the two weaponries, the odds ratios at 30 hebdomads were 2.09 ( 95 % assurance interval ( CI ) 0.90 to 4.85 ) for 10 hebdomad sustained abstention and 2.92 ( 95 % CI 1.42 to 6.03 ) for point prevalence abstention relation to controls. At 10 yearss after bringing, the odds ratios were 2.81 ( 95 % CI 1.11 to 7.13 ) and 1.85 ( 95 % CI 1.00 to 3.41 ) for 10 hebdomad and point prevalence abstention severally.

Borderline important addition in discontinuing in the combined intercession weaponries.

Smoking surcease rates were low when cotinine measuring was done. The rates were 18.8 % in intercession group and 20.7 % in normal attention group.

Self reported smoking surcease rates were high. The rates were 29.1 % in intercession group and 25.6 % in Normal attention group.

Self Help Intervention was utile but non so effectual during prenatal attention. There needs to a more intensive and tailored made intercession be made for good consequences.

88 topics were enrolled as experimental topics, they received trim smoke surcease messages through mail, one after each antenatal visit. 85 topics in control group received a quit smoke brochure and no other stuffs.

The experimental group was given trim messages after each antenatal visit. They were given manus held computing machine and were advised to make full up abruptly follow up interview. Urine samples were collected at the pre natal visits. The control group were merely given merely discontinue smoking brochures.

It was measured by the interview signifiers filled by the pregnant adult females.

Rate of surcease in control group was 14 % as compared to experimental group was 15 % . There was no important difference in smoking surcease rates.

Tailored message produced no alterations in the smoke behavior of the topics.

Mr. L. , a 55-year-old bartender in a large metropolitan area, has been a heavy smoker for 40 years. He was diagnosed as having COPD 7 years ago. Mr. L. lives in the city and takes the city bus to work, although he still has to walk about three blocks to the bar where he works. He has found it increasingly difficult to walk the three blocks without stopping to rest at frequent intervals. At work, his manager has also expressed concern about the effect Mr.

L. ’s continuous coughing has on customers. (p. 440). According to the National Center for Biotechnology Information (NCBI), smoking is the leading cause of Chronic Obstructive Pulmonary Disease (COPD), and it is considered one of the most common lung diseases known. “COPD is a diagnostic term used to describe a group of conditions that are characterized by respiratory symptoms such as dyspnea (shortness of breath), cough, sputum production, limitation of air flow, and chronic inflammation of the lungs. ” (Falvo, 2008, p. 420). Often, people have both.

On the flip side, there are also the rare cases of nonsmokers who lack a protein called alpha-1 antitrypsin that can develop into emphysema. The longer a person smokes, the likelihood of developing COPD is high but there are some who are exceptionally fortunate who do not contract this disease as a result of routine, long term smoking. This paper will examine the causes, the symptoms and complications and what the social implications of having COPD that can affect an individual in an adverse way using the above case study as the example. It is known that Mr. L. began smoking at fifteen years of age.

At age 48, he was diagnosed with COPD yet still continues to smoke. Let us assume that Mr. L. has had a nice physique given to him from good genetics rather than regular visits to the gym. Let us also assume that he is a New Yorker and has lived there all of his life. Because the city is so large, there is also automobile traffic that never ceases at any hour – day or night which produces high amounts of carcinogens into the air. There are still manufacturing buildings that also produce pollutants such as exposure to gases or fumes as well as tens of thousands of smokers who release second hand smoke into the environment.

Add barbeques and smoke pits or poor ventilation in a smoky bar into the mix and one is exposed to heavy amounts of carcinogenic pollutants every single day. This kind of long term exposure can attribute to some of the causes that may be factored in as to why he was diagnosed with COPD. Mr. L. has been told by his physician that he needs to quit smoking and start a regular exercise routine along with the prescribed medicine to make his conditions manageable and bearable. Because Mr. L. as smoked for 40 years and lived in an urban environment with long term exposure to pollutants along with his own habit, he began to notice a “smoker’s cough” or excessive mucus that is lingering much longer than a common cold. He notices that he begins to wheeze and gets fatigued when simply walking a few blocks from his bus stop to work or home. Once at work or home, he may realize that he has a hard time catching his breath (dyspnea) with any mild activity such as changing out a keg, moving a case of beer or carrying out the garbage.

He’s given up going to the gym as it wears him out to easily and is embarrassing to him because he wheezes and coughs too often and doesn’t want to be the subject of ridicule from younger, healthy people. He has noticed more lines on his face from not only age, but the smoking has aged him even faster. His teeth are yellowed from nicotine as well as his index and middle fingers from where he holds his cigarettes. New York has passed a non-smoking law for all public places as of the year 2000 and where there were once many smokers, it seems that more have quit than smoke.

His patrons have been verbal about his coughing near their beverages or how they have to wait on him as he runs out back to catch a quick smoke, and he does this quite often because he is a 2 pack a day smoker. They complain that his breath and clothing smell of stale cigarettes even though he tries to cover it with breath fresheners and cologne. The patron’s regularly harass him on his choice to smoke and taunt him to quit which annoys him and makes him irritable. Smoking which at one time made him look cool, has now made him a pariah in most social circles as well as the stigma attached to his habit and symptoms.

They tease him and say that he will become one of “those” people who will have to carry an oxygen tank around with him. Johnson, Campbell, Bowers and Nichol assert that “Stigma is a social construction that defines people in terms of a distinguishing characteristic or mark, and devalues them as a consequence”. Their article further reports that, “a study involving 27 women and men living with COPD reported that respondents repeatedly described a sense of stigmatization that was a direct result of using supplemental oxygen around other people and which led to feelings of embarrassment and social isolation. (2007). Since there is no cure for COPD, clearly the fastest way to retard lung damage for Mr. L. before he absolutely needs the oxygen tank is to stop smoking. Taking his prescribed medications can treat many of the symptoms such as the wheezing, coughing and shortness of breath. He can increase the amount of time walking to build up strength. The stigma of smoking will then change to encouragement from his patrons to see success in his effort to quit. His breath will not be so offensive nor will his clothes smell of cigarettes.

His nails will begin to lose the yellow discoloration and he can whiten his teeth so that he can feel better about his physical looks along with his self pride can be restored by committing to quit. No longer will he feel dismay, embarrassment or be annoyed because of the stigma attached to a smoker that displays the outward symptoms of his disease. Mr. L. ’s whole outlook and attitude will change by simply giving up a horrible habit that can destroy not only his health, but other’s as well. References Falvo, D. R. (2008). Medical and Psychosocial Aspects of Chronic Illness and Disability. 4th ed. ). Sudbury: Jones and Bartlett Publishers. Johnson, J. L. , Campbell, A. C. , Bowers, M. & Nichol, A. (2007). Understanding the Social Consequences of Chronic Obstructive Pulminary Disease: The Effects of Stigma and Gender. The Proceedings of the American Thoracic Society. Retrieved August 1, 2011 from: http://pats. atsjournals. org/cgi/content/full/4/8/680#otherarticles The National Center for Biotechnology Information Web site provides information on COPD http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0001153/

The United States is the world”s second largest tobacco grower. Thus, tobacco is an important cash crop and the cigarette manufacturers play a very important role in the U. S economy.(7:2)

Approximately 500,000 Americans die every year as a direct result of smoking (1:66). As the U. S. population becomes more health conscious, the number of smokers is decreasing every year. However, the tobacco industry has remained prosperous due to the continuing demand of millions of smokers still present in the U.S.A and other places like Asia, Russia and Eastern Europe.(7:2)

The tobacco industry has never before publicly admitted to a direct connection between smoking and lung or heart diseases (7:2). Since 1954, 825 cases have been filed against cigarette companies demanding compensatim. Out of this only 22 have gone for trial, three of which resulted in partial victory.(1:66)

Marketing can be defined as the process by which goods and services are sold and purchased. It also includes functions like, advertising, mail-order business, public relations and the like. The main goal of marketing is to acquire, retain and satisfy customers.(2:1)

Cigarette companies seem to understand the above mentioned definition perfectly. They carefully follow management’s wishes about promotion of cigarettes. Like any other firm, cigarette manufacturers try to supply, design and produce products that will satisfy consumer needs.(4:4)

However, critics complain of the effects of marketing tobacco on society. Advertisement of brand names like Marlboro, Lucky Strike etc. are harmful for children since they generally glorifies smoking. Cigarette firms have been criticized for designing and promoting brands that target the special tastes of working persons, African -Americans etc. (4:4). Thus, critics feel that for tobacco no marketing tool that increases profit or marketing share should be used.(4:11)

No matter how unhealthy cigarettes are, they still are legal. Therefore, tobacco companies have a right to market their products. After all, we could categorize tobacco marketing as “Misplaced Marketing”.(4:4)

The major tobacco companies of U.S.A were headed for trouble this year. In early 1997, the smallest tobacco company. Liggett Group agreed to a wide-ranging settlement of health-related lawsuit and admitted publicly that tobacco causes cancer, is addictive and is “marketed” to teens. This admission ended up being a big problem for other’s tobacco companies.(6:3)

On 27 June 1997, the companies: Philip Morris RJR Nabisco Holdings, B.A.T Industries, Brown & Williamson and Loews Corp. reached an agreement with the attorneys -general of nearly 40 American states. This settlement resulted in the tobacco industry changing its own marketing rules.(5:23)

1.Financial implications of the settlement

The above mentioned settlement calls for the tobacco industry to start an annual payment of $10 billion (eventually rising to $15 billion) to compensate states for smoking-related health costs and to pay people who successfully file for damages. The five tobacco companies must also finance anti-smoking medical and educational research, in order to prevent youths from smoking.(5:23)

The cigarette companies also have to pay $60 billion in damages as a form of punishment. Besides all this, the industry will face additional penalties if the number of teenage smokers does not decrease by 50% in seven years.(5:25)

This settlement, is set to drastically change the marketing program of the tobacco companies.

From now on, human or cartoon figures will not appear in cigarette advertisements. That is, the advertisements will have to consist of words only (5:23). Tobacco advertisements are also banned from billboards, stadiums and the Internet. They are also prohibited from advertising in films or in theaters. The settlement also ends the use of all cigarette vending machines (5:24). Tobacco companies cannot use their brand marks on T-shirts, caps and other promotional free gifts (5:25). The agreement would give the Food and Drug Administration (FDA) authority to regulate tobacco products. In addition, cigarettes would come with tough new warnings such as ‘smoking causes cancer” and ‘smoking can kill you”.(5:24)

The above mentioned changes will alter the marketing techniques of tobacco as never before and thus, the tobacco companies have to adapt to a new way of doing business.

The tobacco industry has been hit hard by the settlement it signed. But it does not mean the end of this multi-billion dollar business. Let us have a look at some new and upcoming ways in which tobacco is sold.

Even if the tobacco industry faces a gloomy business future in U.S.A it can earn a lot by selling more cigarettes in developing countries from the Middle East to South East Asia INTERFERENCE With practically no government interference and millions of smokers, tobacco companies could even earn profits from brands that are dead in USA. They can also expect bigger profits by trying to change local customs. For example: In Japan, the number of women’s smokers is on the rise, after tobacco promotions persuaded society not to prohibit women smoking.(3:34)

As the numbers of public outlets for cigarettes decrease in the future a mail-order tobacco business could be created and this could be even more profitable. Being good database marketers, the databases of the tobacco industry will act as a communication and distribution channel. RJ Reynolds has already taken a lead in this type of marketing.(3:34)

From now on, tobacco companies will have to do most of their advertising in adult magazines. They might even end up opening cigarette only retail stores, as another way to supply smokers. As marketing of tobacco has become more challenging than ever before, it will remain a powerful part of management for the tobacco companies.(5:27)

Tobacco firms have always shown enthusiasm in marketing their products. However, they have to face constant criticism of their marketing techniques. Critics feel that tobacco marketing is an example of misplaced marketing. The recently signed agreement between leading cigarette companies and nearly forty American states, will lead to radical change in the marketing field.

Besides financial penalties, cigarette companies have also agreed to restrict and reshape their promotional strategies. In the future, tobacco firms will have to come up with new ideas to market cigarettes and probably will have to increase their foreign sales. Basically, cigarette manufacturers have to right to promote and advertise their products so long as they are legal. Thus, clearly tobacco will be marketed, in some form or the other, for years to come.

A cigarette is a product consumed through smoking and manufactured out of cured and finely cut tobacco leaves, which are combined with other additives including nicotine, the rolled or stuffed into a paper-wrapped cylinder.

Cigarettes are proven to be addictive. Apart from this, cigarette also is one of leading causes of lung cancer as well as birth defects.  Nowadays, more people all around the world are becoming addicted in cigarette smoking.  Governments around the world are alarmed in the increasing number of people using cigarettes.

As a result, the government imposed cigarette taxes in order to regulate its use.  Cigarette tax is a tax measure levied to cigarette manufacturers. It is paid by a distributor and eventually passed on the consumers as value-added tax.  Cigarette taxes usually emerged as a form of “sin tax”. The terminology was coined for taxes imposed on products that serve as vices or usually forms part of a connotative “sin”.  Sin taxes are deemed to be imposed not only to cigarettes but to alcohols as well.  The religious sector considered smoking and drinking as evil and – in effect – they are pushing the government to impose a higher tax so that people would no longer avail it.

There are many reasons why the government opted to impose taxes in cigarettes. One of the most important reasons is to promote an effective antismoking policy.  Higher taxes would discourage consumers, especially the youth, to purchase it. There has also been suggestions that cigarette taxes be used to address the financial costs since it is believed to inflict harm to the rest of society, caused by environmental tobacco smoke.

Moreover, there are two forms how a cigarette is tax is levied. First, though tax imposition based on unit sales and second as ad valorem taxes.  As clearly defined, a tax imposed based on unit sales is a tax charged as a fixed amount on the sale of each unit of a product, usually on a tax per pack basis.[2]

Generic brands will consequently pay the same tax.  An ad valorem tax, on the other hand, is typically imposed at the time of a transaction, usually sales tax or value added tax.[3]  In this case premium brands consequently pay a higher tax amount than lower priced brands.  In addition, ad valorem taxation of cigarettes may have adverse effects to the extent that cheaper brands pose greater risks.

Meanwhile, the sale of cigarettes in the United States is regulated by federal, the states and the local laws and is strictly enforced by the different states.  Each state has a different tax rate for the sale in cigarette and tax exemption.  Like in New York, the sale of cigarettes is governed by their local laws.

It imposes certain rates and certain exemptions in different circumstances.  The consideration in the imposition of taxes is whether it is bought for resale or consumption.  Cigarette tax is paid once on each pack of cigarettes, generally by the wholesale vendor, who passes the cost on to the retail buyer through the price of the cigarettes.  The tax is imposed at a rate of 75 cents for each ten cigarettes or fraction of a group of ten or $1.50 for a standard pack of 20 cigarettes.  However, if a package of cigarettes contains more than 20 cigarettes, the rate of tax on the cigarettes over twenty is 38 cents for each five cigarettes or any fraction of a group of five.[4]

However, taxes are not allocated on cigarettes in the following circumstances: these are the use of cigarettes packed in two cartons or less in New York City; or if the user brings the cigarettes into the city for use, not for sale.

In addition, taxes are not allocated as well if: cigarettes are sold to the United States Government; if cigarettes are sold to or by a voluntary unincorporated organization of the armed forces operating a place for the sale of goods pursuant to federal regulations; if cigarettes sold to the State of New York, or any public corporation, or political subdivision of the state, not for resale; cigarettes possessed by an agent or wholesale dealer for sale to an out-of-city dealer, or for sale and shipment to a person in another state for use there; and cigarettes sold to the United Nations, its personnel and certain qualified diplomatic personnel.[5]

Each state in the United States imposes different taxes, which in effect tends consumers to travel to a nearby state in order to obtain cigarettes with a much lower tax. By purchasing cigarettes in a nearby state, taxes are being avoided to be paid in their home town state.  Hence, this makes the consumers stirred toward illegal trading like smuggling.

In member-states of the European Union, it is almost a comparable condition in the United States, where different members of the Union has a different tax rate. The reason for giving a high tax for cigarette in the European Union is to prevent lung cancer and to encourage smokers to quit, especially the minors. To make their policies effective, the European countries made some campaign. Like in France, they put a picture of a gruesome diseased lung plastered all over cigarette packets.  Meanwhile, smoking in Ireland will be forbidden in all workplaces, including pubs, bars, and restaurants. And in Britain, the authorities persuade the bar and restaurant owners to improve their ventilation and expand non-smoking areas.[6]

The European policies with regards to cigarette are not to ban cigarettes as well as cigarette smoking but aimed to reduce cigarette sales.  However, these policies tend to increase the sale of smuggled or counterfeit cigarettes within the European Union.

Today many countries are concerned in conducting policies with regards to youth smoking.  Many people have picked up the habit of smoking when they are young. In fact, it has been said that about 90% of all adult smokers started when they were young.  Furthermore, there are more than 4,400 kids which have become regular smokers everyday.[7]  There are influential factors behind the increase in teen smoking cases. One of the most important factors is whether the parents smoke in the home and allow their children to do the same.  This factor is more influential than imposing taxing on the product.  If parents allow their children to smoke and making themselves as an example, the imposition of tax measures on the product would not be effective.

One way of preventing youth smoking is to enforce higher taxes the cigarettes.  Through taxes the young ones are discouraged to buy cigarette. As a result, this can prevent them from smoking.  However, the effectiveness of the tax measure would not solely depend on high tax imposition but also on educating the youth with the dangers brought about by cigarette smoking.  Should the youth be smoking, it is not yet too late to give counseling in order to help him eventually quit the vice.

As we all know smoking is a very dangerous consumer habit.  Although this has been the case, more and more people indulge with the vice due to lack of awareness of the risks involved with it. If only the people are aware of the risks, they can poise the apparent benefits and expected costs of the activity and choose to smoke if doing so enhances their welfare.[8]  In this case, the government or the authorities should conduct information campaign in the dangers of smoking to the consumers.

In cigarette tax, the lower income group in such country is more likely the affected.  With the imposition of taxes, it is not the framers of the law who will be affected in the burden of the tax but rather the poor consumers who are using the product.

All countries in general have the same reason and principles for cigarette taxation; however, its enforcement is varied.  Each country has its own policies to make their goal effective.  They main goal is to eliminate smoking but our existing system cannot ban cigarette. What needs to be done or rather can be done by the government is to simply regulate it.  Imposing taxes on cigarette is a means to lessen the cigarette smokers rather than to generate revenue.

As emphasized in this paper, higher taxes could discourage smoking and eliminate the market.  However, taxing the cigarette will not be effective if there is no strong campaign in attaining their goal.  Now, different countries come up with campaigns discouraging the use of cigarette by making a zonal area where they can only smoke and by placing an image of gruesome diseased lung in every pack of cigarettes.  The effect of such levying of taxes as well as enforcement of policies will depend on the absurd decision-making of consumers.

This is primarily because even though the government plans to increase the price of the cigarettes or make a strong campaign against it, there are still possibilities that smokers will overlook it and as a result, consumers will still continue buying cigarettes.   In addition, such policies will attract smugglers to smuggle cheaper products and will create a counterfeiting products.  These illegal acts can be prevented depending on the insurance structure in a country.  If the country has a strong structure and great political will, it can prevent such illegal acts and in effect it can lead to effective policies.

In terms of youth smoking, taxing the cigarette is not the only reason why it the campaign for it become effective.  There were regulatory mechanisms is developed, such as minor restriction in purchasing cigarettes.  But, such policy is would be effective if their also education to the youth the danger of smoking to their health.  Some countries, lack this kind of policy to educate the youth.  In educating the youth from the start will prevent them not to smoke in the future.

However, the imposition of ad valorem taxes on cigarettes does not promote good objectives as well. In conclusion, what needs to be enforced is an effective and aggressive policy on cigarette.

WORKS CITED

1. (2007). Cigarette Tax Enforcement. Retrieved 17 April 2007, from New York City Department of Finance Website:http://www.nyc.gov/html/dof/html/services/services_fraud_cigarettes.shtml.
2. (2007). Cigarette Tax. Retrieved 17 April 2007, from New York Government Website:http://www.nyc.gov/html/dof/html/business/business_tax_cigarette.shtml.
3. (2007). Cigarette. Retrieved 17 April 2007, from Wikipedia: The Free Encyclopedia Website:http://en.wikipedia.org/wiki/Cigarette.
4. (2007). per-unit tax definition. Retrieved 17 May 2007, from MSN Encarta Website:http://encarta.msn.com/dictionary_561547810/per-unit_tax.html.
5. Homeier, Barbara P. MD,. (2005). Kids and Smoking. Retrieved 17 April 2007, from Nemours Foundation Website:http://kidshealth.org/parent/positive/talk/smoking.html.
6. Ford, Peter, . (2003). Europe’s smokers feel heat. Retrieved 17 April 2007, from The Christian Science Monitor Website:http://www.csmonitor.com/2003/1024/p01s04-woeu.html.
7. Viscusi, W.Kip, . Principles for Cigarette Taxation. Dissertation Harvard Law School, 2003. 17 April 2007 ;http://www.iticnet.org/030530-Principles%20for%20Cigarette%20Taxation%20-%20Draft%203.kpt.pdf;.
8. [1] “Cigarette”. Wikipedia: The Free Encyclopedia. 2007:1
   [2] “Per-Unit Tax”. MSN: Encarta. 2007:1
   [3] Ibid.
   [4] “Cigarette Tax Enforcement”. New York Government website. 2007:1
9. [5] Ibid.
   [6] Ford, Peter, “Europe’s smokers feel heat” 2003:1
   [7] Homeier, Barbara P. MD. “Kids and Smoking” 2005:1
   [8] Viscusi, W.Kip, . “Principles for Cigarette Taxation” 2003:1

PERCEPTIONS OF PAULINIAN STUDENTS IN THE IMPROVEMENT OF CIGARETTE WARNING LABELS IN THE PHILIPPINES A Thesis Presented to the Faculty of Nursing St. Paul University Quezon City In Partial Fulfillment of the Requirements for the Degree of Bachelor of Science in Nursing FILART, THERESA MARIE D. A. BRINGUELO, RIO LAINE J. ASUNCION, MICHELLE ANN A. September 2011 Table of Contents I. The Problem and Review of Related Literature A. Introduction……………………………………………………………………………………… 1 B.

Review of Related Literature……………………………………………………………… 3 C. Conceptual Framework……………………………………………………………………. 31 D. Statement of the Problem…………………………………………………………………. 33 E. Significance of the Study…………………………………………………………………. 33 F. Scope and Limitations……………………………………………………………………… 34 G.

Definition of Terms…………………………………………………………………………. 35 II. Methodology A. Research Design…………………………………………………………….. ………………. 36 B. Participants…………………………………………………………………………………….. 36 C. Instrument………………………………………………………………………………………. 39 D. Data Gathering Procedures………………………………………………………………. 9 E. Data Analysis…………………………………………………………………………………. 40 III. Results and Discussion A. Results…………………………………………………………………………………………… 43 B. Discussion……………………………………………………………………………………… 55 IV. Summary, Conclusions, and Recommendations A. Summary……………………………………………………………………………………….. 1 B. Conclusions……………………………………………………………………………………. 62 C. Recommendations…………………………………………………………………………… 63 References Appendices A. Letter to the Registrar………………………………………………………………………. 73 B. Validation Letters……………………………………………………………………………. 74 C.

Letter to the Deans………………………………………………………………………….. 78 D. Questionnaire…………………………………………………………………………………. 81 E. Curriculum Vitae…………………………………………………………………………….. 87 Acknowledgements This study would not have been possible without the help and guidance of several individuals who, in one way or another, contributed and extended their valuable assistance in the completion of this thesis.

We would like to extend our deepest gratitude to our thesis adviser, Dr. Adrian Lawrence Carvajal, for his unfailing guidance in directing our study. To Mrs. Cristina Price, our statistician, for her expertise. She has guided us in computing and analyzing our gathered data. To Mrs. Maricar Tan, Mrs. Jennifer Lualhati, and Mr. Marlon Lofredo who gave their time in validating our questionnaire. They shared valuable insights for the improvement of this study. To the deans of the three college departments of St. Paul University Quezon City, Sr.

Sahlee Palijo, SPC, Dr. Clarissa Deliarte, and Dr. Helen Rigor, for allowing us to distribute our questionnaires and conduct our survey. To Ms. Rosemarie Bautista, head of Registrar’s Office, who provided us with information that are pivotal for the completion of this study. To Mr. Robin Robert Nunez for giving his generous time and support, and for his assistance on how to use the software needed for the study. To our families and friends who have been supportive, understanding, and patient throughout our thesis making.

And most importantly, to our Almighty God who blessed us with his wisdom and knowledge in order for us to accomplish this study. Abstract The purpose of this study was to provide recommendations to improve cigarette warning labels here in the Philippines. The respondents’ perceived susceptibility to smoke-related illnesses, the severity of the effects of smoking, and their perceived ways in improving cigarette warning labels were examined. A quantitative study approach was done by the researchers, and a self-constructed survey questionnaire was used to obtain the data needed for the study.

Frequency and percentage, as well as weighted mean, were used to analyze the gathered data. The results revealed that most of the respondents are 18 years old and below, are female, and are non-smokers. They believe that smoking makes one highly susceptible to lung cancer, respiratory infections, and chronic obstructive pulmonary disease. Respondents who are smokers also believe that smoking could harm their health, while non-smokers believe that second hand smoking has negative effects on their wellbeing.

The greater part of the respondents wants to improve cigarette warning labels in the Philippines. When asked how, they prefer to put pictures on both front and back cover, and occupy 50% of the cigarette package. If these suggested improvements are to be implemented, most of them would then be more aware of the dangers posed by smoking; smokers would be motivated to quit, while non-smokers would be discouraged to engage in smoking. Lastly, majority of the respondents would have a change in perception regarding smoking. Chapter 1

THE PROBLEM AND REVIEW OF RELATED LITERATURE INTRODUCTION Smoking is one of the biggest threats to the public health, contributing largely to the morbidity and mortality rate among individuals. Among all the types of tobacco, cigarettes are one of the most popular and commonly consumed products nationwide. In today’s time, tobacco consumption and exposure greatly influence the perception of the public towards smoking, especially when cigarettes are widely advertised, cheap, and easily accessible (Mackay & Eriksen, 2002).

Contrary to popular belief that smoking relieves stress, it actually does nothing good in one’s physiological, emotional, and mental health; in fact, it only causes our body harm. Smoking poses a great risk on one’s health. It predisposes numerous illnesses such as lung cancer, emphysema, tuberculosis, and cardio vascular diseases to both smokers and non-smokers. “Global data show that 1 out of 5 people use tobacco. WHO estimates about 5 million tobacco-related deaths annually.

This means that in the 20th century, more than 100 million deaths can be attributed to tobacco use,” stated Tetch Torres (2011) on her article “Ex-health secretaries want graphic warnings on cigarette packs” last January 17, 2011 in the Philippine Daily Inquirer. The public is being informed of the harmful effects that smoking cause. Some anti-smoking campaigns include posters depicting an image of an altered body caused by the destructive habit, conducting seminars, and putting ads on cigarette packaging labels saying, “Government Warning: Cigarette smoking is dangerous to your health. But despite these, it seems that there are still a lot of people who indulge in smoking. They say a picture speaks a thousand words, but could it save lives? Neighboring countries like Singapore, Malaysia, and Thailand have already put graphic health warnings on their cigarette packages so as to motivate consumers to quit smoking. The article of Torres (2011) reveals that based on international studies of the WHO, picture warnings are more easily seen and effective than those of only texts. Also, when it was implemented in Brazil, 7 out of 10 (67 percent) smokers were motivated to quit.

Like how restaurants improve their quality of service and food based from the consumers’ suggestions, the opinion of the people also hold an importance in the improvement of cigarette packaging labels in the Philippines. The voice of the people is an excellent tool in assessing what is missing or lacking so as to make a better product, or in this study, an advocacy. The purpose of this study is to provide recommendations to improve cigarette warning labels here in the Philippines based from the perceptions of the respondents. REVIEW OF RELATED LITERATURE A. Local Sources The first order under Section 13 of Republic Act No. 211, An Act Regulating the Packaging, Use, Sale Distribution, and Advertisements of Tobacco Products and for Other Purposes, is “all packages in which tobacco products are provided to consumers withdrawn from the manufacturing facility of all manufacturers or imported into the Philippines intended for sale to the market starting January 1, 2004 shall be printed in either English or Filipino, on a rotating basis or separately and simultaneously, the following health warnings: “GOVERNMENT WARNING: Cigarette Smoking is Dangerous to Your Health”; “GOVERNMENT WARNING: Cigarettes are Addictive”; GOVERNMENT WARNING: Tobacco Can Harm Your Children”; or “GOVERNMENT WARNING: Smoking Kills. ”” (Republic Act No. 9211, 2003) Second, “upon effectivity of this Act until June 30, 2006, the health warning shall be located on one side panel of every tobacco product package and occupy not less than fifty percent (50%) of such panel including any border of frame. ” (Republic Act No. 9211, 2003) Third, “beginning July 1, 2006, the health warning shall be on the bottom portion of one (1) front panel or every tobacco product package and occupy not less than thirty percent (30%) of such panel including any border frame.

The text of the warning shall appear in clearly legible type in black text on a white background with a black border and in contrast by typography, layout, or color to the other printer materials on the package. The health warning shall occupy a total area of not less than fifty percent (50%) of the total warning frame. ” (Republic Act No. 9211, 2003) Fourth, “the warning shall be rotated periodically or separately and simultaneously printed so that within any twenty four (24) month period, the four (4) variations of the warnings shall appear with proportionate frequency. (Republic Act No. 9211, 2003) Fifth, “the warning shall not be hidden or obscured by other printed information or images, or printed in a location where tax or fiscal stamps are likely to be applied to the package or placed in a location where it will be damaged when the package is open. If the warning to be printed on the package is likely to be obscured or obliterated by a wrapper on the package, the warning must be printed on both the wrapper and the package. ” (Republic Act No. 211, 2003) Sixth, “in addition to the health warning, all packages of tobacco products that are provided to the consumers shall contain, on one (1) side panel, the following statement in a clear, legible, and conspicuous manner; “NO SALE TO MINORS,” or “NOT FOR SALE TO MINORS. ” The statement shall occupy an area of not less than ten percent 10% of such side panel and in appear in contrast by color, typography, or layout with other printed material on the side panel. ” (Republic Act No. 9211, 2003) Lastly, “no other printed warnings except the health warning and the message required in the 6th paragraph shall be placed on cigarette packages. (Republic Act No. 9211, 2003) Unfortunately, despite these warnings, there has been an increase in cigarette consumption, especially by students who are mostly teenagers. Health experts should warn students never to try smoking and all efforts should be made to prevent teenagers from trying smoking. They must be informed about the harmful effects of smoking. (Students advised not to try smoking at all, 2010) Valmero (2010) reveals that “about 17. 3 million Filipinos aged 15 years old and above are tobacco smokers with at least 13. 8 million smoking daily, the Philippine Global Adult Tobacco Survey (GATS) showed”.

Almost 94 percent of the surveyed smokers admitted that serious illnesses such as lung cancer, heart attack, and stroke could happen to them. Smoking is a hard habit to break because tobacco contains nicotine, which is highly addictive. Like addictive drugs, the body and mind quickly become used to the nicotine in cigarettes that a smoker needs to have it just to feel normal. President Benigno S. Aquino III, who is himself a confessed smoker, advised the students in impromptu speech at a recent launching of a book entitled “12 Little Things Our Filipino Youth Can Do For Your Country” not to smoke, especially if one is not into it yet. Students advised not to try smoking at all, 2010). According to the announcement of Department of Health, Over 240 Filipinos, or 10 every hour, die every day due to these smoking-related illnesses (Gorospe,2011). Smoking increases the risk of developing heart diseases, lung ailments, and various types of cancer. It also has a damaging effect on the skin, nails, hair, taste, and appetite. In the United States, about one out of five deaths are caused by smoking. One-third of the people who start smoking when they are teenagers will die prematurely from the effects of smoking.

Recent statistics show that about nine out of ten smokers start before they are 18 years old. Most adults who started smoking in their teens never expected to become addicted. Therefore, it is best for people to not try smoking at all (Students advised not to try smoking at all, 2010). On May 12, 2010, the Department of Health (DoH) issued Administrative Order (AO) No. 2010-0013. The AO requires putting graphic health information on all tobacco packages that are “noticeable, relevant and memorable in order to be effective,” and adopting ways to make certain that tobacco product packaging and labeling do not promote tobacco use by any means.

This AO is one of the government’s attempts to curb tobacco use (DoH Issues Administrative Order Requiring Graphic Health Information on Tobacco Packaging, 2010). Apart from the above-mentioned reason why AO No. 2010-0013 was issued, it was also done to reduce smoking’s enormous socio-economic costs. The country tolls an estimated P200 billion due to the health costs and productivity losses caused by smoking, a highly substantial amount in comparison to the P30 billion profit gain from the taxes paid by the tobacco industry.

If tobacco consumption is to be reduced, most gains are estimated to come from the youth sector who will be likely discouraged from smoking because of the graphic health warnings. According to the Philippines’ 2007 Global Youth Tobacco Survey, the smoking prevalence among young Filipinos aged 13-15 has increased by approximately 30% over the past two years, and thus making this order very relevant (DOH Issues Administrative Order Requiring Graphic Health Information on Tobacco Packaging, 2010). At least 38 countries and territories are already implementing picture-based warnings on tobacco packaging. These include Canada, Brazil, Singapore, Thailand, Venezuela, Jordan, Australia, Uruguay, Panama, Belgium, Chile, Hong Kong, New Zealand, Romania, United Kingdom, Egypt, Brunei, India, Taiwan, Malaysia, Peru, Djibouti, Switzerland, Cook Islands, Niue, Papua New Guinea, Samoa, Mongolia and Iran. ” (DoH Issues Administrative Order Requiring Graphic Health Information on Tobacco Packaging, 2010).

The DOH had already filed a bill to both the Senate (SB 2377) and the House of Representatives (HB3364). It wished to consent the use of “picture-based warnings instead of mere text warnings on no less than 50% of both the front and back sides of the tobacco packages. ” These legislative initials, however, were met by strong opposition from the tobacco industry (DoH Issues Administrative Order Requiring Graphic Health Information on Tobacco Packaging, 2010). The Philippine Tobacco Industry (PTI), an association of leading tobacco companies, used R. A. 9211 against the DoH’s order. R. A. 211 is a law which only asks to place text warnings on cigarette packaging labels and PTI said that the AP violates this regulation. With this, the petition of the DoH to put graphic warning in cigarette packages went back to square one (Balane, 2010). B. Foreign Studies Biraghi and Tortorano (2009) reveal that tobacco smoking is a serious public health threat worldwide and they are said to be addictive and lethal. For years, numerous scientific researches have been conducted regarding the effects of tobacco smoke, proving time and time again that its consumption poses a great risk in one’s health.

Despite this, the number of people worldwide who are smoking are increasing, and smokers are smoking more cigarette (Mackay & Eriksen, 2002). Anderson (2006) explains that when a cigarette is lit, the tobacco breaks down into ash and smoke, and then this smoke is inhaled by the smoker through the filter and into the lungs. “Tobacco smoke contains over 4000 chemicals, some of which have marked irritant properties and some 60 are known or suspected carcinogens.

Tobacco smoke includes acetone, ammonia, arsenic, butane, cadmium, carbon monoxide, hydrogen cyanide, methanol, naphthalene, toluene, vinyl chloride, as found in paint stripper, floor cleaner, ant poison, lighter fuel, car batteries, car exhaust, fume, insecticide, gas chambers, rocket fuel, moth balls, and industrial solvent plastics. ” (Mackay & Eriksen, 2002). 250 of these contents were known to be harmful and more than 50 of the toxic chemicals in secondhand tobacco smoke cause cancer. There is absolutely no safe level of exposure to secondhand smoke (Woods, 2010).

So what happens when we smoke? According to Anderson (2006), when we inhale or breathe in lighted cigarette, the burning tobacco reaches the temperature of up to 1290°F (700°C) at the tip. This causes a number of chemical reactions to take place, including the formation of gases such as carbon monoxide and of tiny droplets of sticky solids, known as tar. When we draw tobacco smoke into our lungs, it irritates the delicate lining of the air passages, which may make us cough or experience a burning sensation. The brown, syrupy tar condenses and sticks to the wall of our bronchioles and alveoli.

This interferes with the lungs’ ability to fight infection and makes us more prone to colds, flu, bronchitis, and pneumonia. It also makes it more difficult for oxygen to pass from the lungs and into the bloodstream. Also, Anderson (2006) stated that once the chemicals from the tobacco smoke gets into our bloodstream, they are rapidly transported through the body. Carbon monoxide reduces the amount of oxygen in the blood because it binds with hemoglobin in red blood cells more easily than oxygen does. This makes our heart and lungs work harder. It can also reduce our ability to think quickly.

Nicotine takes between 8 to 15 seconds to reach the brain. It stimulates the receptors in the brain which increases our heart rate and blood pressure and generates feelings of pleasure. This is the dizzy sensation of smoking “high” that new smokers experience. “Nicotine is a stimulant, and just like cocaine, amphetamines, and methamphetamines, it works by speeding up the processing rate of the central nervous system (CNS). Nicotine is highly addictive, and smokers can quickly become dependent on cigarettes and suffer serious symptoms of withdrawal when they try to quit.

Nicotine travels through the body and the brain quickly, affecting the CNS, hypothalamus, and pituitary glands, and then accumulates in the brain. But just as rapidly as it came, its effects also disappear quickly–only a few minutes–meaning that you need to smoke more and more often to maintain the feeling that you get from smoking. ” (Wagner, 2003). Mackay and Eriksen (2002) stated that cigarette smoking affects most of the organ in the body. Smoking-related disorders include lung, esophageal, stomach, colon, pancreatic, cervical, kidney, bladder, liver, oral, pharyngeal, and laryngeal cancer.

It also causes chronic obstructive pulmonary disease (COPD), emphysema, bronchitis, pneumonia, asthma, strokes (CVA), anxiety, poor circulation, discolored and loose teeth, gingivitis, reduced sense of taste, deformity, loss of motility, reduced number of sperm, infertility and impotence, longer time of wound healing, non-insulin dependent diabetes mellitus (Type 2, adult-onset), increased leg pain, gangrene, peripheral vascular disease, cataracts, premature aging of skin, stomach and duodenal ulcers, aortic aneurysm, osteoporosis, earlier menopause for females, infertility and delayed conception, leukemia, and weakened immune system.

Smokers have increased risks of multiple cancers. In addition to that, they are also at greater risk of having heart disease, stroke, emphysema, and other diseases (Mackay & Eriksen, 2002). Research reveals that smoking reduces life expectancy by seven to eight years. Each cigarette, on an average, shortens a smoker’s life by around 11 minutes. The National Cancer Institute reports that mere exposure to secondhand smoke causes roughly 38,000 deaths annually (Does smoking increase the risk of early death). We are all influenced by what other people think and do.

There is nothing wrong with this, but it can become a problem if we are under too much pressure to behave in a certain way. The tobacco industry argues that smoking among young people is a societal problem. It insists that most smokers take up the habit as a result of family or peer pressure. Anderson (2006) learned that children are more likely to smoke if their parents smoke, and numerous studies have shown that most young smokers are influenced by their friends’ and older siblings’ smoking habits (Anderson, 2006).

Also, Anderson (2006) believes that media plays a big part in influencing smoking in teenagers. Films, television, music, and magazines are good in creating the image of a lifestyle we would like to have. When a film star or a famous model lights a cigarette, it looks glamorous. A recent World Health Organization survey has examined the Indian film industry and found that young people who watch their favorite actors smoke are three times more likely to do so themselves. The survey also found that these young people are sixteen times more likely to think positively about smoking.

People start smoking for many different reasons, but most continue to smoke for one reason only – they are addicted to nicotine. Addiction occurs when we take a drug that changes the way we feel and we become increasingly dependent, both in order to continue to experience its effects and to avoid the discomforts of its absence. For many, the desire comes from an addiction that is both mental and physical. Physical addiction occurs when our bodies are used to having a certain amount of nicotine in the blood.

Without further doses of nicotine, smokers start to experience discomfort in the form of withdrawal symptoms such as irritability, restlessness, anxiety, and even depression (Anderson, 2006). In the article “What are the Effects of Smoking on Productivity at Work? ”, Fornis (2007) wrote that due to the temporary stimulating effects of nicotine, smokers often think they are performing well on their job. Smoking however, is a dilemma that is related with decreased job performance, reduced productivity, increased absenteeism, and taking long work breaks too often.

Studies, which were done in Sweden and United States, showed that workers who smoked continued to have poor performance, demotion, and other non-honorable discharges. Nordqvist (2009) stated that according to WHO (World Health Organization), mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. WHO stresses that mental health “is not just the absence of mental disorder”. Moreover, Anderson (2006) declared that many smokers believe that smoking helps them concentrate, but research suggests that the only thing cigarettes do is temporarily suppress the symptoms of withdrawal caused by not smoking. Researchers said that smoking can also affect one’s mental health as nicotine causes the immune cells of the brain to attack not only the unhealthy cells, but the healthy ones as well. This event could induce depression, social isolation, insomnia, and lowered IQ. Furthermore, not only is this effect common in smokers, but also those who are victims of assive smoking. (Smoking degrades the status of your life – physically and mentally, n. d. ). Cassan (2007), a British woman who studies at University for Political Science and Environment, said, “As an ex-smoker I was curious about the environmental impact of smoking so I decided to investigate. These days everyone knows what smoking cigarettes does to our bodies, but the knowledge of what smoking does to the Earth is not as common. There are some things that every smoker who has any concern for environmental issues should know. She mentioned that it is not only the nonsmokers who are affected by smokers, but the environment as well. Cassan alao atated that, “It is obvious that smoking pollutes the air. It makes it unsafe for the present citizen and future children of the next generation. ” She knows for sure that quitting is hard especially when one is addicted to it, but she advised that for smokers to help lessen the negative effects of smoking, they should always think twice before engaging themselves to it. WHO Director-General Dr.

Margaret Chan stated that, “the cure for this devastating epidemic is dependent not on medicines or vaccines, but on the concerted actions of government and civil society”. She mentions that in order to cease smoking, the government should apply measures within their reach, regardless of income level. She mentions of banning tobacco advertising, which was already done, protecting people from second-hand smoke, warning people about the hazards of tobacco, helping those who want to quit, and monitoring the use to understand and reverse the said epidemic (UN: ‘Tobacco epidemic’ could kill 1 billion in 21st century, 2008).

Szabo (2010) reported that due to the increase in numbers of active smokers every day, the number of their victims also rises. Second-hand smoking kills the rights of people to live in a safe environment. Moreover, an estimated 21% of all american adults (45 million people) who smoke cigarette everyday affects millions of people through passive smoking (Tobacco Use Among Adults—United States, 2005). Over 126 million non-smoking Americans continue to be exposed and most of the time, they are prevalent in homes, vehicles, workplaces, and public places (US Department of Health and Human Services, 2006).

The Food & Drug Administration and the Department of Health and Human Services propose a new aid to reduce tobacco use. They have reported 443,000 deaths per yer due to cigarette smoking. FDA Commissioner Margaret Hamburg said in an interview that this is a very serious problem with a very serious medical consequences. The FDA now uses their authority to regulate tobacco which includes selling guidelines for marketing and labelling, banning certain products, and limiting nicotine. However, nicotine or tobacco are not totally banned. They proposed 36 label comments like “Smoking can kill you. and “Cigarettes cause cancer. ” with added graphic image such as a cartoon of a mother blowing smoke to her baby’s face, rotting teeth and diseased gums, as well as cigarettes being flushed down the toilet to sgnify quitting. These convey the dangers of tobacco and remind smokers about diseases they are exposed to everytime they smoke (Felberbaun, 2009). Based on research, about 46 million adults are hooked with this health concern and though the average cost per pack has gone from 38 cents to $5. 33, the increase in usage still cannot be prevented (Felberbaun, 2009).

The amount one is paying to buy cigarette could almost help one in expenses in extra medical cost, lost pay, food expense, etc. The tobacco companies derive income at the expense of health, wealth, happiness, efficency, and resources of the addicted smoker. (Smoking Facts: The Facts About Smoking – How And Why To Quit n. d). Felberbaum (2009) also stated that though these may not totally cease smoking, it could at least lessen it. On the other hand, Stanton Glanz, a tobacco researcher at the University of California in San Francisco, sees these graphic labels “tremendously effective. Craige (2009) identified that Article 11 of the Framework Convention on Tobacco Control (FCTC) is the world’s first health treaty, which focuses on health warnings. This report was created to provide policymakers with evidence from world’s most wide-ranging research devoted to assessing the impact of policies of the FCTC, the International Tobacco Control (ITC) Policy Evaluation Project. Cigarette packages in most countries include health warning labels but the size, number, and the way the health information is presented vary among countries.

The use of standardized methods and measures across all ITC surveys ensures that the effectiveness of health warning labels can be compared among countries in order to provide guidance in the designing warning labels. The findings of the said research provide an evidence base that outlines the components of effective warning labels and strongly supports the implementation of graphic warnings. In short, it offers evidence-based answers to the question: “What is effective and what is not effective for policies on health warnings? Health warnings on cigarette packages are one of the most noticeable sources of information about the dangers of smoking and tobacco use. Aside from television, a lot of smokers state that they learn about the risks of smoking from the packages of cigarettes and tobaccos. Compared to other smoking prevention efforts, health warnings are farthermost cost-effective. For example, smokers who smoke 20 cigarettes a day are potentially exposed to the warnings at least 7300 times a year. Non-smokers, including youth, also stated the same thing.

Research conducted by the ITC Project has proven that warning labels are an effective tool for educating/informing smokers and non-smokers about the many negative health consequences of smoking, motivating and encouraging smokers to quit and non-smokers not to start smoking, and providing information to enhance efficacy for quitting (Craige, 2009). Craige (2009) stated that another significant reason for implementing strong health warning in smoking packages is that it can counteract misleading messages and convey the health risks of smoking and exposure to second hand smoke.

Herman (2010) explained that according to the American Cancer Society, secondhand smoke causes breathing problems in nonsmokers, including coughing, mucus, chest discomfort and reduced lung function. FCTC Article 11 guidelines for health warnings states that health warnings on cigarette packages should cover at least 50% of the principal display areas (both the front and back), but at a minimum must cover at least 30% of the principal display areas.

It also requires that warnings be rotated; large, clear, visible, and legible; and approved by the competent national authority. Strong international guidelines for Article 11 adopted in November 2008 during the Third Conference of the Parties recognize the evidence that effectiveness of health warnings increases with their size and that graphic warnings have a greater impact than text-only warnings. The guidelines recommend pictorial warnings on at least 50% of the package and call for key requirements for the content, position, and size of warnings.

Furthermore, labels should be at the top of the package, include full color pictures, rotate multiple messages, include a range of warnings and messages, include information on harms of tobacco smoke, provide advice about cessation, and list constituents without numbers (Craige, 2009). Canada was the first country (2001) to implement pictorial warning labels that are compliant with the FCTC Article 11 Guidelines. As of May 2009, more than 24 countries have passed legislation requiring large pictorial health warnings on cigarette packages.

Other countries are currently preparing strong warning label policies in response to the new FCTC guidelines (Craige, 2009). Craige (2009) also mentioned that the International Tobacco Control (ITC) Four Country Survey (ITC-4), a cohort survey of approximately 9000 adult smokers in Canada, Australia, the United Kingdom, and the United States was conducted and provided major evidence to support policymakers in implementing larger warning labels, including images.

Conducted between 2002 and 2006 (ongoing to 2014), the ITC Project has examined labeling policies of over 4 countries and has studied what happens when countries implement changes in text and size only, compared to when graphic warnings were introduced. The following findings provide convincing evidence of the effectiveness of graphic warnings in Canada and Australia and improved UK text warnings, establishing the case for strong implementation of the Article 11 Guidelines. In 2001, Canadian graphic warning labels were most effective in informing smokers about the risks of smoking.

Australia’s text warnings, which were slightly below the FCTC minimum requirement, were more effective in providing the range of health risks than the United States’ side-of-pack text warning and the UK warning, both of which were well below the minimum FCTC standard (Craige, 2009). On the other hand, in 2003, when the UK implemented larger text warnings in compliance to the FCTC guideline, more smokers reported that they read and notice these warnings and were more likely to report that the health warnings had discouraged them from having a cigarette.

Furthermore, Canadian smokers continued to report higher levels of impact than smokers in the other three countries (Craige, 2009). Figure 1. Front of Cigarette box Figure 2. Back of a Cigarette Box Craige (2009) also revealed that in 2006, the introduction of graphic warnings in Australia (as shown in figure 1 and 2) resulted in an increase in noticing and reading of warning labels, thinking about the health risks and quitting, reporting that the labels had made them withhold a cigarette they were about to smoke, and avoiding warning labels among Australian mokers. These are all positive outcomes because they are associated with increases in quitting. An enormous body of health communication research has shown that the use of pictures results in messages that are easily noticed and remembered. Understanding both the health risks and severity of smoking are important factors in motivating smokers to quit. ITC Four Country Survey showed that larger graphic warnings are likely the most effective means of conveying the severity of health risks to smokers.

After Canada introduced large graphic warning labels in 2001, 91% of smokers in Canada said they had read the warnings and 84% of smokers saw health warning labels as a source of health information, compared with 47% of US smokers, where only text-only labels are required. Graphic warning labels increased awareness of the connection between smoking and specific health hazards (Craige, 2009). An ITC study regarding the knowledge and warning labels in Canada, Australia, the US, and the UK in 2002 showed that a large proportion of smokers have insufficient knowledge about the dangers of smoking.

Smokers in Canada, the only country that had pictorial warnings on 50% of the front and 50% of the back of the pack, are most knowledgeable of the effects of smoking. US smokers, where text warnings appear only on the side of the pack, are less knowledgeable of the effects of smoking. From this, it can be concluded that enhanced health warnings increase knowledge of the risks of smoking (Craige, 2009). Furthermore, Craige (2009) reported that in early 2003, the size of text warning in the UK increased from 6% of the front and back to 30% of the front and 40% of the back and is surrounded by a border of 3-4mm.

The number of warnings increased from 6 to 16. These changes made the smokers state that their awareness regarding health risks greatly improved. Also, unlike Mexican smokers, Canadian smokers are aware that smoking causes stroke, impotence, and mouth cancer, as these illnesses are included in warning labels in Canada but not in warning labels in Mexico. As stated by Craige (2009), the size, as well as the location of the warning labels, matter.

This was one of the aspects that Australia considered in their graphic warnings when it was introduced in 2006. The warning was put on 30% of the front and 90% of the back. It seemed like the better choice because it is likely that people look at the front far more than the back of a package. In an observational study by Borland and Lal (2004), observers recorded which side was facing up of packs lying on restaurant tables in Melbourne. More than 90% of 160 observed that packs were facing front-side up.

This implies that the proper way to evaluate different size options is to take into consideration how often people are exposed to the front or the back of cigarette packs. If the average is weighted for exposure, then the 50-50 option render a higher average exposure to the warnings when the person is exposed to the front of the pack at least twice as often as to the back. In addition, many countries require warnings in multiple languages and allocate each side to a different language. This makes it even more important that the size on both sides of the pack be as large as possible.

According to Craige (2009), “graphic, fear arousing images do not have negative effects. ” Although people have a general knowledge on the harms caused by smoking, picture warning labels, however, present these effects in a more vivid manner that would be more easily noticed and better remembered by the mass. Fear, after decades of research studies, has been shown to be effective in motivating behaviour change (i. e. quitting), especially if coupled with information on how to avoid these fearful consequences.

ITC research had also found out that fear of or negative emotional reactions to these picture warning labels elicit avoidant behaviors (e. g. covering the pack, keeping it out of view, or avoiding specific labels) that can motivate quitting. Craige (2009) argued that larger and more comprehensive health warnings are more effective. In the analyses of the first wave of the ITC Four Country Survey done in 2002, FCTC found out that larger (50%) and more comprehensive warning labels were more likely to be effective. 0% of Canadian smokers agreed that they have noticed the warnings “often” and “very often” since they use larger and more comprehensive warning labels compared to those of Australia, UK and US smokers, who have only rated 52%, 44 %, and 30% respectively. In 2003, UK enhanced their health warning labels in order to meet the minimum FCTC standard, and a significant increase in warning label salience and self-reported impact were noticed following the improvement of the cigarette package.

From 44% of UK smokers who noticed health warnings “often” and “very often,” it increased to 82% — the highest rank among the four countries. Compared to the US and Australian smokers who had yet to enhance their warning labels, UK smokers were more likely to report that these new health warnings have dissuaded them from having a cigarette (Craige, 2009). Craige (2009) unraveled there is a common phenomenon termed “message wear-out” in health communication. Over time, warnings may lose their impact with repeated exposure on health warnings.

The results showed after the ITC-4 Country Survey suggests that “pictorial warnings sustain their effects longer than text warning. ” While a decrease in salience and impact has been reported in the UK two and a half years following the introduction of new warning labels, wear-outs were more prominent in Australia, where the warning has been in place for almost eight years and only a little bit smaller than that of UK’s, and in the US, where labels are printed small and only on the side of the pack.

Canada, on the other hand, kept a high level of salience and impact even after four years of following the implementation of large, picture warning labels. Evidence from the ITC surveys also suggest that larger pictorial warning labels are more effective in promoting smoking cessation. Large pictorial warnings stimulate more cognitive responses by means of increasing the knowledge of the harms posed by smoking, thoughts about the health risks, and behaviours like avoiding the warnings.

These responses can then lead to motivate intentions to quit and then finally, quitting attempts (Craige, 2009). Figure 3. Countries that implement warning labels Craige (2009) showed “smokers in low and middle income countries such as Thailand, China, and Malaysia, are more likely to notice warning labels “often” or “very often” compared to smoker in high income countries such as Canada, US, Australia and UK. These may be due to the lack of information sources available to convey the harms of smoking. Since warning labels are so prominent in these low and middle-income countries, they have the potential to influence smokers’ behaviours more than in high-income countries. ” See figure 3. Figure 4. Effectivity of Warning labels ITC research conducted in the three Asian countries found that noticing level is high, thus suggesting that they have a strong impact on smokers.

Compared to the extent that the warning labels in Thailand make the smokers think about the health risks of smoking, the potential for effective warning labels is not fulfilled in Malaysia and China, where warning labels are small and less comprehensive. Health warnings are more likely to assume greater importance in low and middle-income countries as they have fewer other sources of information about the harms of smoking, given that the labels are adequately prominent so as to fulfill their potential (Craige, 2009) See figure 4.

Figure 4. Effect of Warning labels in Thailand and Malaysia Evidence from the ITC Thailand survey shows that enhancing warning labels beyond FCTC minimum standard increases effectiveness. This was evaluated by comparing the change in Thailand from when they used 30% text-only warning labels to the enhanced 50% pictorial, to the change in Malaysia at the same time where the label warnings did not change. The survey found that the bigger the label size and putting graphic images to warning labels also increase its effectiveness.

After the implementation of these new warnings in Thailand, “the percentage of smokers stating that the labels made them think about the health risks “a lot” increased from 34% to 53% and those stating that the labels made them “a lot” more likely to quit increased from 31% to 44%. Meanwhile, the survey conducted in Malaysia showed no such increase in effectiveness, as their labels did not change during that time. (Craige, 2009) Figure 5. Warning labels in China Figure 6. Actual Warning labels in China Figure 7. Effectiveness Rating Table

China, on the other hand, also enhanced their cigarette warning labels on 2008 by replacing the text warnings on the side of the pack to text warning on 30% of the front and 30% of the back – meeting only the minimum label size of the FCTC standard. The actual Chinese warnings – text-only and 30% of front and back – had the lowest rating among the 10 warnings in terms of motivating smokers to quit. See figures 5 and 6. Also, consistent with the ITC-4 findings, graphic warnings had a higher rating compared to their corresponding text warnings in terms of label effectiveness (Craige, 2009).

See Figure 7. Craige (2009) observed that the warning labels that were created on Chinese cigarette packages using graphic and text warnings from Canada, Singapore, Hong Kong, and The European Union, were ranked and rated in terms of perceived effectiveness in motivating smokers to quit and convincing youth not to start smoking. The results are as follows: graphic and text warnings were ranked highest; text-only warnings were ranked middle; and 30% of front and back, the newly enhanced Chinese text warnings, were rated the lowest. “There is a strong public support for large picture warnings. In the research done by the ITC, it shows that smokers desire to see more health information on cigarette packages, even in countries where graphic warning labels are already implemented (Craige, 2009). Figure 9. Warning Cigarette Label in Brazil In FCTC Article 11 Tobacco Warning Labels of Craig (2009), some of the most vivid and emotionally stirring pictorial warning label graphics can be found in Brazil. Their approach is based on research in the neurobiology of emotions stating that avoidant responses are motivated by very negative and highly arousing stimuli.

Figure 9 shows some of Brazil’s pictorial warning labels CONCEPTUAL FRAMEWORK Administration of survey questionnaire Data Analysis Profile of the respondents a. Age b. Gender c. Category of respondents as to smoking Perceived susceptibility to smoking-related illnesses Perceived severity of the effects of smoking Perceived ways on how to improve selected cigarette warning labels Recommendations to improve cigarette warning labels in the Philippines based on the respondents’ perceptions InputProcess Output

Figure 1: Paradigm of the Study Figure 1: Paradigm of the Study shows the four components of the input of the study which are as follows: the profile of the respondents in terms of age, gender, and category as to smoking, the respondents’ perceptions on their susceptibility to smoke-related illnesses, the respondents’ perceptions on the severity of the effects smoking, the respondents’ perceived ways in improving cigarette warning labels. The process was through the administration of survey questionnaire and data analysis.

The output of the study was the recommended ways on how to improve selected cigarette warning labels in the Philippines. STATEMENT OF THE PROBLEM The main purpose of the study is to recommend ways to improve cigarette warning labels in the Philippines based on the perception of the respondents. Specifically, it sought to answer the following: 1. What was the profile of the respondents in terms of: a. Age b. Gender c. Category as to smoking? 2. What were the respondents’ perceptions on their susceptibility to smoke-related illnesses? 3.

What were the respondents’ perceptions on the severity of the effects of smoking? 4. What were the respondents’ perceived ways in improving cigarette warning labels in the Philippines? SIGNIFICANCE OF THE STUDY This study aims to recommend ways on how to improve cigarette warning labels in the Philippines. The researchers analyzed the perceptions of the respondents and from this, created new designs for cigarette boxes. For the students, this study will aid create awareness about the dangers posed by smoking. It aims to help motivate the smokers to quit, and for nonsmokers to not engage in smoking at all.

For the school, this study will help in its advocacy of health promotion and its attempt to curb smoking amongst its students. The school could use this study as basis for identifying the perceptions and knowledge of Paulinian students regarding smoking and its effects. For the future researchers, this study can be used as a reference material and basis for prospective studies about cigarette warning labels. Lastly, this is another contribution to literature as the researchers provided added information regarding the possible improvement of cigarette warning labels.

Lastly, this study wishes to strongly encourage the government and its legislators to pass the Department of Health’s Administrative Order (AO) No. 2010-0013 in lieu of improving cigarette warning labels in the Philippines. SCOPE AND LIMITATIONS The study was delimited to the respondents’ perception regarding their perceived ways on how to improve cigarette warning labels in the Philippines. The respondents’ susceptibility to smoke-related illnesses, and the severity of the effects of smoking were also studied.

The respondents of the study were the 334 enrolled college students of SPUQC under SY 2010-2011, 2nd semester. DEFINITION OF TERMS The following words were defined operationally and arranged by significance: Cigarette warning labels. In this study, it referred to the information found in cigarette packages. Perceived susceptibility. In this study, it referred to the respondents’ beliefs about the chances of contracting a health condition. Perceived severity. In this study, it referred to the respondents’ beliefs about the seriousness of the effects brought about by smoking.

Smoking-related illnesses. In this study, it referred to the illnesses that can be acquired through smoking such as lung cancer, ischemic heart disease, chronic obstructive pulmonary disease (COPD ), stroke, asthma, respiratory infections, emphysema, bronchitis, coronary artery disease, peripheral artery disease, colorectal cancer, liver cancer, prostate cancer, erectile dysfunction in men, stomach cancer, bladder cancer, abdominal aortic aneurysm, leukemia, cataract, cervical cancer, kidney cancer, pancreatic cancer, periodontitis, and pneumonia. Chapter 2 METHODOLOGY RESEARCH DESIGN

The tool that helped define the respondents’ perceived susceptibility to the health-hazards posed by smoking, the severity of the effects of smoking, and their perceived ways on how to improve selected cigarette warning labels in the Philippines was a survey questionnaire. The study made use of the descriptive research design where it described the data and characteristics about the population or phenomenon that was being studied. It answered the questions who, what, where, when, and how. PARTICIPANTS The respondents of this study were the random 334 students which are sample representatives for the three Colleges of St.

Paul University Quezon City, 2nd semester, SY 2010-2011. The total number of enrollees in the college department as of February 2011 was 2009, 1313 of which were from the College of Business and Technology (CBT), 167 from the College of Health and Sciences (CHS), and 529 from the College of Arts, Sciences, and Education (CASE). 218 students from the CBT, 28 from the CHS, and 88 from the CASE were taken. Slovin’s Formula and stratified random sampling were used to determine the researchers’ sample size. The computations were as follows: Where: n = sample size N = population e = margin of error; 5% or . 05 ^2 = 0. 0025 n = 2009 1 + 2009 (0. 0025) = 2009 1 + 5. 0225 = 334 334 = 0. 166 2009 CBT1313*0. 166=218 CHS167*0. 166=28 CASE529*0. 166=88 | Total Population| Respondents| College of Business and Technology| 1313| 218| College of Health and Sciences| 167| 28| College of Arts, Sciences and Education| 529| 88| TOTAL| 2009| 334| INSTRUMENT The primary instrument for this study was the self-constructed questionnaire of the researchers, printed in English. The survey was divided into four parts, and first of which determined the profile of the respondents in terms of age, gender, and category as to smoking.

The second and third parts made use of the Likert scale to assess the respondents’ perception regarding their susceptibility to smoke-related illnesses and the severity of the effects of smoking. The last part of the questionnaire assessed the perceived ways of the respondents on how to improve selected cigarette warning labels in the Philippines. DATA GATHERING PROCEDURES In order for the researchers to get an accurate sample size, they went to the Registrar’s office to request and asked for a permission to get the population of the students enrolled in the college department as of the 2nd semester, SY 2010-2011.

Prior to distribution, the questionnaires were handed to three professors for validation. After it was checked, consent letters for distribution were given to the College Deans of St. Paul University Quezon City; namely, College of Business and Technology, College of Arts, Sciences and Education and College of Health and Education. Upon approval, the survey was conducted to the students of St. Paul University Quezon City before the summer class of SY 2010-2011. Each respondent was given a questionnaire wherein instructions and content were briefly explained and discussed.

With regards to medical terms, the researchers attached a piece of paper where information and definitions of the latter can be found. Also, in areas where the respondents felt like they needed more explanation, they were encouraged to raise questions or queries for clarifications. These, according to the respondents, helped comprehend the material better — making it possible to answer the questions as honest as possible. As for researchers, this made the questionnaires more accurate and valid since respondents were well informed.

After all the survey questionnaires were submitted, the papers were tallied and studied. Based on their answers, researchers formulated ways on how to improve selected cigarette warning labels in the Philippines based on the Paulinian’s point of view. DATA ANALYSIS The profile of the respondents and their perceived ways on how to improve selected cigarette packaging labels in the Philippines were measured by means of frequency and percentage. The formula, Percentage = f x 100 % n shall be used, where: f = frequency/number of responses n = sample size/number of respondents

The perceived severity of the effects of smoking was measured by means of weighted mean. The weighted mean has a verbal interpretation of: WeightMean valueVerbal Interpretation 43. 25-4. 0Strongly Agree 32. 50-3. 24Agree 21. 75-2. 49Disagree 11. 0-1. 74Strongly Disagree The perceived susceptibility of the effects of smoking was measured by means of weighted mean. The weighted mean has a verbal interpretation of: WeightMean valueVerbal Interpretation 43. 25-4. 0Highly susceptible 32. 50-3. 24Susceptible 21. 75-2. 49Less susceptible 11. 0-1. 74Not susceptible at all and make use of the formula:

Weighted Mean = ? fw n Where: ? = summation f = frequency w = weight per scalen = sample size CHAPTER III RESULTS AND DISCUSSION RESULTS I. Profile of the respondents Table 1 Respondents’ Age Age| CBT| CHS| CASE| Total| %| Rank| 18 years old below| 123| 0| 59| 182| 54| 1| 19-21 years old| 93| 27| 26| 146| 44| 2| 22-24 years old| 2| 1| 2| 5| 1| 3| 25 years old and above| 0| 0| 1| 1| 0| 4| Total| 218| 28| 88| 334| 100| | Table 1 shows that out of 334 respondents in the college department, 182 belong to the age bracket of 18 years old and below, thus comprising 54 % of the total population.

There are 146 out of 334 respondents who belong to the age bracket of 19-21 years old, and comprising 44% of the population. 5 respondents belong to the age bracket of 22-24 years old, comprising 1% of the total population. One respondent belongs to the age group of 25 years old and above. Table 2 Respondents’ Gender Gender| CBT| CHS| CASE| Total| %| Rank| Femaile| 164| 9| 79| 252| 75| 1| Male| 54| 19| 9| 82| 25| 2| Total| 218| 28| 88| 334| 100| | Table 2 shows that 252 out of 334 respondents are female and comprising 75 percent of the total population.

Meanwhile, the remaining 82 respondents are male, involving the 25 percent of the population. Table 3 Respondents’ Category as to Smoking Category of respondents as to Smoking| CBT| CHS| CASE| Total| %| Rank| Smokers| 67| 11| 30| 108| 32| 2| Non-Smokers| 151| 17| 58| 226| 68| 1| Total| 218| 28| 88| 334| 100| | Table 3 shows that 108 out of 334 respondents, or 32% of the population, are smokers. On the other hand, 226 respondents are non-smokers, thus making up 68% percent of the total population. Table 4

Respondents’ Perceived Susceptibility to Smoking Related Illnesses | CBT| CHS| CASE| Grand Weighted Mean| Verbal Interpretation| Lung Cancer| 3. 56| 3. 86| 3. 49| 3. 63| Highly Susceptible| Ischemic Heart Disease| 3. 28| 3. 57| 3. 20| 3. 35| Highly Susceptible| Chronic Obstructive Pulmonary Disease| 3. 32| 3. 71| 3. 16| 3. 40| Highly Susceptible| Stroke| 3. 04| 3. 64| 2. 94| 3. 21| Susceptible| Asthma| 3. 41| 3. 39| 3. 24| 3. 35| Highly Susceptible| Respiratory Infections| 3. 44| 3. 82| 3. 26| 3. 51| Highly Susceptible| Emphysema| 3. 16| 3. 79| 2. 86| 3. 27| Highly Susceptible| Bronchitis| 3. 9| 3. 71| 3. 08| 3. 36| Highly Susceptible| Coronary artery disease| 3. 11| 3. 71| 2. 91| 3. 25| Susceptible| Peripheral artery disease| 3. 12| 3. 43| 2. 88| 3. 14| Susceptible| Colorectal cancer| 3. 09| 3. 25| 3. 00| 3. 11| Susceptible| Liver cancer| 3. 17| 3. 39| 2. 90| 3. 15| Susceptible| Prostate cancer| 0. 00| 3. 29| 2. 75| 2. 01| Susceptible| Erectile dysfunction in men| 3. 01| 3. 25| 2. 74| 3. 00| Susceptible| Stomach cancer| 2. 92| 2. 96| 2. 67| 2. 85| Susceptible| Bladder cancer| 2. 94| 2. 93| 2. 58| 2. 82| Susceptible| Abdominal aortic aneurysm| 2. 96| 3. 25| 2. 69| 2. 7| Susceptible| Leukemia| 2. 89| 2. 86| 2. 48| 2. 74| Susceptible| Cataract| 2. 82| 2. 71| 2. 51| 2. 68| Susceptible| Cervical cancer| 2. 85| 2. 93| 2. 52| 2. 77| Susceptible| Kidney cancer| 2. 98| 3. 04| 2. 59| 2. 87| Susceptible| Pancreatic cancer| 2. 96| 2. 96| 2. 60| 2. 84| Susceptible| Periodontitis| 2. 92| 2. 96| 2. 50| 2. 80| Susceptible| Pneumonia| 3. 08| 3. 57| 2. 73| 3. 13| Susceptible| OTHERS: none| –| –| –| –| –| ————————————————- GRAND MEAN3. 05 Susceptible WeightMean valueVerbal Interpretation 43. 25-4. 0Highly susceptible 2. 50-3. 24Susceptible 21. 75-2. 49less susceptible 11. 0-1. 74Not susceptible at all Table 4 shows that the respondents perceive that they are highly susceptible to: lung cancer, ischemic heart disease, COPD, stroke, asthma, and respiratory infections, emphysema, and bronchitis; susceptible to: stroke, coronary artery disease, peripheral artery disease, colorectal cancer, liver cancer, erectile dysfunction in men, stomach cancer, bladder cancer, abdominal aortic aneurysm, leukemia, cataract, cervical cancer, kidney cancer, pancreatic cancer, and pneumonia, and prostate cancer.

Table 5 Respondents’ Perceived Severity of the Smoking Related Illnesses Table 5. 1: Smokers | CBT| CHS| CASE| Grand Weighted Mean| Verbal Interpretation| 1. Smoking could harm my health. | 3. 43| 3. 45| 3. 30| 3. 40| Strongly Agree| 2. Smoking can be addictive and I might have a hard time quitting. | 3. 13| 3. 18| 3. 03| 3. 12| Agree| 3. I will get diseases from smoking. | 3. 28| 3. 36| 3. 17| 3. 27| Strongly Agree| 4. These diseases that I might encounter could affect my job in the future. | 3. 06| 2. 82| 2. 83| 2. 0| Agree| 5. Smoking could affect my income/savings in the future. | 2. 87| 2. 73| 2. 53| 2. 71| Agree| 6. Smoking could affect my mental health. | 2. 60| 2. 82| 2. 47| 2. 63| Agree| 7. I will die at an early age because of smoking. | 3. 06| 2. 73| 2. 67| 2. 82| Agree| 8. OTHERS: none | –| –| –| –| –| GRAND MEAN2. 98Agree | Table 5. 2: Non smokers | CBT| CHS| CASE| Grand Weighted Mean| Verbal Interpretation| 1. Second hand smoking has negative effects on the health of individuals. | 3. 71| 3. 94| 3. 74| 3. 0| Strongly Agree| 2. I am also susceptible to diseases that active smokers could get. | 3. 61| 3. 82| 3. 62| 3. 68| Strongly Agree| 3. I am most likely to smoke if the people around me smoke. | 2. 11| 2. 59| 2. 05| 2. 25| Disagree| 4. Smoking causes an unsafe environment. | 3. 72| 3. 82| 3. 62| 3. 72| Strongly Agree| 5. OTHERS: none| –| –| –| –| –| GRAND MEAN3. 39Strongly agree | Table 5 shows that the smokers strongly agree that smoking could harm their health and that they will get diseases from smoking.

Furthermore, they agree that a) smoking can be addictive, b) the diseases they might encounter could affect their job in the future, c) smoking could affect their income and/or savings in the future, d) smoking could affect their mental health, and e) that they will die at an early age because of smoking. On the other hand, non-smokers strongly agree that second hand smoking has negative effects on the health of individuals, that they are also susceptible to diseases that active smokers could get, and that smoking causes an unsafe environment. Nonsmokers disagree that they are most likely to smoke if the people around them smoke.

Table 6 Respondents’ Perceived Ways in Improving Selected Cigarette Warning Labels Do you want to improve cigarette warning labels in the Philippines? | CBT| CHS| CASE| Total| %| Rank| Yes| 194| 21| 76| 291| 87| 1| No| 24| 7| 12| 43| 13| 2| Total| 218| 28| 88| 334| 100| | Table 6 shows that 291 out of 334 respondents, or 87% of the population, said that they want to improve cigarette warning labels in the Philippines. The remaining 43 respondents that encompass 13% of the population said that they do not want to improve cigarette warning labels in the Philippines. Table 6. 1

Respondents’ Preferred Details to be Included in Cigarette Packaging If I were to improve cigarette packaging label, I would include:| CBT| CHS| CASE| Total| %| Rank| Pictures of smoking-related illnesses| 137| 16| 53| 206| 71| 1| Details about the smoke-related diseases| 129| 14| 36| 179| 62| 4| Slogans about the negative effects of smoking| 123| 13| 48| 184| 63| 3| Statistics on deaths or sicknesses caused by smoking| 11

ADD 1102- PUBLIC SPEAKING (ASSIGNMENT 1) ASSIGNMENT ONE PROPSAL –FOR INFORMATIVE SPEECH ID-I07006815 Proposal For Speech on the Effects OF Holly Wood Movies On The Youths. I am going to give a speech on the Effects of Holly Wood Movies on the Youths. My purpose of this speech is to alert youths around the world to know the negativity of watching Holly Wood movies. My age bracket I call the youth in this presentation is from the age of 15 to the age of 25, 26 years old youths These are some of the negativity of watching Holly Wood Movies- * Violence

This is one of the really important negativity of Holly Wood movies, Violence scenes are shown in Holly Wood movies, teaching the general public of violence and the youths are mostly the affected ones in this case, since they are still growing up, they can be easily influenced by these movies example of movies with violent contents are a. Scarface, Terminator series, etc Most of these movies contain scenes of killing, gangster way of living, using weapons, guns, knives, usually when young adults, youths see these movies they will follow and imitate their behavior, because they just think its cool. Eroticism Most Holly Wood movies have Erotic scenes, such as bareness and sex, many problems such as porno, coprology, canal’s and One-night love has emerged and became prevalent. Everybody knows that it is a moral backwardness of the society. It also leads to the growth of divorce rate. This makes the smallest cell of the society family insecure, displaced and transitory. This affects the youth they watch these erotic scenes and they see sexual scenes and as youths they want to try new things so they watch this movies and try to do or act what they see on the movies.

This can lead to bad morals, and can lead to unwanted pregnancies, abortion etc. * Unrealistic contents Holly wood movies contain unrealistic contents, Hollywood is never going to show the public a real life situation from scene one to the final scene; this would not be creative, it would not sell, so they manipulate the story line and characters to make things more interesting to their way of thinking. So to make profit This affects the youths because they think life is that easy and fun fill and they follow what they see in these movies * Shows bad habits (Smoking)

In a 1999 survey of more than 4,900 school children aged nine to fifteen in Vermont and New Hampshire, those who had been exposed to more incidents of smoking in the films they recalled seeing were much more likely to have tried smoking (even after adjusting for other factors associated with smoking and smoking initiation or experimentation). The kids were asked which of 50 movies from a randomly chosen list of recent movies they had seen,and only 4. 9 percent of kids who had seen zero to 50 incidences of smoking in the movies they had seen from that sample had tried smoking, compared to 13. percent who had seen 51 to 100 incidences of smoking, 22. 1 percent who had seen 101 to 150, and 31. 3 percent who had seen more than 150. In other words, those with the heaviest exposure to smoking through the movies they attended were more than two and a half times more likely to have tried smoking than those with the least exposure to smoking in movies. Conclusion I think Holly Wood movies are bad influences on the youths, thou it has good aspects too, like help people to know a little more about History and also can gain knowledge too in some aspects.

I suggest the directors and producers of these Holly Wood Movies should try to change the theme of there movies and try to stop sending out the wrong message to the general public or try to make strict restrictions of some movies to some certain age of people cinemas should be more strict. Mostly reduce the sexual scenes, try to be more realistic and try not to send the wrong message across. Try restrictions of some movies to some certain age of people. I think this would help to reduce or help the youth and reduce all this wrong messages sent. Thank you.

Smoking is a major income to the government; it brings in about �10 billion pounds annually. The government has proceeded to raise the tax rate of tobacco above the inflation rate from 1993 to the present day, this was implemented to help reduce consumption further.

This policy has resulted that tax on tobacco in the UK is amongst the highest in the world and far ahead of any of those in other EU member states. For example the price of a typical pack of cigarettes in the UK is currently �5.54, whilst in Belgium the price is about �2.70 and in Latvia they retail at a mere 42p.

The cost to the NHS of smoking related illnesses is generally not believed to outweigh the income the government makes out of tobacco sales.

The government is being very hypocritical of themselves because a large amount of public money comes from the tax of cigarettes but at the same time the government is trying to stop people form smoking by banning people to smoke in public places and also with adverts on television urging people to stop smoking.

There has been a lot of opposition to the smoking ban of which the arguments have been that the ban will be disastrous to small pubs that rely on smokers to keep their business afloat. Small pub landlords have said that they will loose vital trade from people who normally go out to the pub to have a smoke and a pint who now will stay at home instead and smoke and drink there. A knock on effect of the economic down turn is perceived to be a loss of jobs across the industry and rising pub prices as landlords would have no choice but to subsidise their loss of business by increasing prices. The closure of pubs would ultimately result in a lack of choice for the customer.

People who are still against the ban argue alternative methods of how to reduce the health impact of passive smoking.

The introduction of the use of ventilation is regarded by some as an adequate solution on its own. Some respondents are strongly of the opinion that ventilation removes all the harmful effects of smoking from the air.

Designated smoking areas in public places are have previously been used before the smoking ban came into effect in various shopping malls, restaurants and clubs. People did not complain about these smoking areas, of which people who wanted to smoke could do so inside out of the way of other people who did not want to smoke.

People against the smoking ban argue that separate designated smoking areas with good ventilation is a better alternative then banning smoking in public places altogether.

The government doesn’t want to stop there with banning smoking. They have almost banned the rights of people to smoke in their own car. The law now states that if the driver is smoking and does not have full control of the vehicle the driver can be prosecuted for smoking while driving. This is an extension of the current law which is that the driver must have full control of the vehicle at all times. What I do not understand is that why the government feels that they now have to have a separate law to cover smoking while driving, does that not also come under the law that states that the driver must have full control of the vehicle at all times?

There have now also been talks that a law is trying to be passed to stop adults smoking in their own vehicle while a child is present, is this just saying to the nation that they cannot look after their own children?

Ibi from Birmingham thinks that banning smoking is a way for the government to take all of our fun away. “This seems ok but doesnt anybody else worry about this being a slippery slope. First, no smoking in public places, then no smoking at all, then no drinking, no shouting, no laughing, no talking and no fun. And once this is all done they will find something else to ban. And im a non smoker.”

Howard John Dell from Chelmsford agrees that the money made by the government from smokers is too high to ignore the rights of one of its biggest money makers. “I do not agree with a total ban on smoking. It is my right to smoke and the government make a considerable amount of money from my smoking through taxes which easily pays for any health cost tot he NHS.”

Colin McEwan from Edinburgh agrees that the smoking ban could have bigger economic consequences than we think. “The Scottish government is drafting its own regulations regarding smoking and seems to be bent on a total ban. This, in my view is a step too far at this time. I work in Ireland where such a ban has, I believe, reduced pub sales substantially in some areas and has cost many jobs. I have no issue with the argument that people must not be subjected to passive smoking. But the alternatives, such as designated smoking areas with proper ventilation have not been properly considered. Sure it will be difficult to implement properly but the ‘Ban it everywhere’ brigade does not seem to be interested in the logic … only the principle.”

The smoking ban seams to be supported by many more non-smokers than smokers. I think that because smokers are a minority here, the majority have won their case outright. There seams to be more suitable alternative methods than the banning of smoking in public places completely.

I think that the banning of smoking in public places was a policy set up by the government to try and win the votes of the majority of people because people had lost faith in the current government because of the currently unsuccessful invasion of Iraq.