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Chapter 1

THE PROBLEM

Background of the Study

Cigarette smoking and alcoholism are the chief preventable causes of death in the

world.

Tobacco is generally the first drug consumed by children and adolescents.

Smoking usually starts in adolescence and few people start smoking after 18 years of age.

Smoking significantly increases in adolescents who have other risk behaviors such as the

consumption of illegal drugs and alcohol. Having friends that smoke is positively

associated with adolescents’ smoking. The World Health Organization (WHO) attributes

some 4 million deaths a year due to tobacco, a figure expected to rise to 8.4 million

deaths a year by 2020. It is harmful to the body in the long run. With each puff of a

cigarette smoker comes in contact with more than 3,000 chemicals. About 1,200 of them

are poisonous.

Alcohol is the most used psychoactive substance among adolescents. Despite the

fact its consumption is illegal during adolescence, it still is an important problem in the

public health sphere because it is the highest risk factor posed to the health of this group.

Compared to people of other age ranges who also drink alcohol, adolescents present a

higher tendency to engage in binge drinking (consumption of several drinks in a single

occasion: five or more for boys and four or more for girls) and are also more exposed to

traffic accidents and unprotected sex.

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Adolescents generally begin their experiences with drugs that are considered legal

such as alcohol and tobacco, in familiar environments. Peer pressure is highly predictive

of consumption.

A peer group refers to a group of people of roughly the same age and status who

spend time together. Peer pressure is the influence these people have on the life of the

individual. It involves adapting behaviors that the individual would otherwise not adapt.

If members of the group value a particular behavior, there will be a kind of pressure to

conform to this. So if friends drink alcohol, or use drugs, it can be hard to say no. Peer

pressure can be a force for good or bad.

Based on the observation, adolescents in selected barangays of Santa Cruz,

Laguna particularly in barangay Poblacion I and in Sitio Maligaya barangay Pagsawitan

are highly influenced by their peers which lead to cigarette smoking and alcoholism.

Affiliation with friends who engage in risk behaviors has been shown to adapt and imitate

one’s own behavior.

The researchers therefore consummate that peer pressure or disambiguation is

very prevalent to adolescents especially at this time that most are becoming active to the

world trends or social acceptance and susceptible to this hallmark of adolescents. In this

case, adolescents showed a propensity to increase risky and delinquent behavior. To

identify why many adolescents are being influenced of the two vices particularly the

cigarette smoking and alcoholism, the researchers decided to conduct a survey in two

selected Barangays of Santa Cruz, Laguna particularly in barangay Poblacion I and in

Sitio Maligaya barangay Pagsawitan where in the issue is rampant, timely and relevant.
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Statement of the Problem

Adolescence is a transitional period in which adolescents develop their abilities

experimenting with new types of behaviors and face the challenge of adapting healthy

behavior. Healthy behaviors acquired during adolescents tend to prevail in adult life.

Likewise, behaviors that represent a risk to health and that are acquired during childhood

or adolescence are often difficult to eradicate in adult life and can have a serious impact

on health, in the short or long run. Cigarette smoking and alcoholism are among the risk

behaviors.

This research study therefore generally aims to answer the following questions:

I. What is the profile of the respondents in terms of:

a. Age

b. Gender

c. Address

II. What is the extent of influence of peer pressure among adolescents in relation

to cigarette smoking and alcoholism?

III. What are the possible health effects of cigarette smoking and alcoholism

among adolescents?

IV. What are the possible reasons why adolescents still continue on cigarette

smoking and alcoholism?

V. Is there a significant relationship between peer pressure and the possible

reasons why adolescents still continue on cigarette smoking and alcoholism?

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Research Hypothesis

Null Hypothesis

1. There is no significant relationship between peer pressure and the possible reasons

why adolescents still continue on cigarette smoking and alcoholism

Alternative Hypothesis

1. There is a significant relationship between peer pressure and the possible reasons why

adolescents still continue on cigarette smoking and alcoholism

Significance of the Study

The outcome, conclusions, and recommendations of this study will be a great

contribution to the existing theories, researches and knowledge about cigarette smoking

and alcoholism.

Adolescence is a time for exploration, making discoveries and choices. The

options adolescents choose concerning the consumption of substances might have severe

implications on their social and health lives.

The generalization of this present study would be a great contribution to the vast

knowledge in relation to the adolescents’ health. Vital results of this research could be

highly significant and beneficial specifically to the following:

Firstly, study results will provide information to adolescents as they are the ones

subjected to peer pressure which results to cigarette smoking and alcoholism. Moreover,

this study shall make them more aware of the possible health effects that might occur in

the short or long run.

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Secondly, parents of the adolescents would make use of study results in terms of

the appropriate parenting strategies they shall use to better educate their children and not

to engage in cigarette smoking and alcoholism. Their predicaments may be revealed in

this study so that concerned authorities may become aware.

Thirdly, public officials in barangay Poblacion I and in Sitio Maligaya barangay

Pagsawitan Santa Cruz, Laguna would make use of this study results in terms of the

formulation of implementing rules and regulations with regards to the proper use of

cigarettes and alcohols. They are the ones to raise awareness and will be gaining an

insight as to what measures are appropriate to help both adolescents and their parents so

that the number of abusers will decrease.

Finally, on the part of the researchers which refer to the students conducting the

study. They will find self – fulfillment for this research will be used as basis for future

study. This research will serve as reference to help the parents and the community to gain

knowledge about the health effects of cigarette smoking and alcoholism.

Scope and Delimitations of the Study

This study determined the effects of peer pressure, cigarette smoking and

alcoholism among adolescents in selected barangays of Santa Cruz, Laguna. Likewise, it

focused on the male and female adolescents between 13 – 19 years old. The study was

conducted in barangay Poblacion I and in Sitio Maligaya barangay Pagsawitan Santa

Cruz, Laguna. Response of the respondents to the research instrument were taken in their
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face value, that is, answers to questions in the instrument were considered factual and

truthful.

Definition of Terms

To ensure understanding of the terms used in this study, operational and

conceptual definitions are hereby stated.

Adolescents. They are the respondents with ages 13 – 19 years’ old and are the

ones subjected to peer pressure which results to cigarette smoking and alcoholism. They

are the respondents from the selected barangays of Santa Cruz, Laguna particularly in

barangay Poblacion I and in Sitio Maligaya barangay Pagsawitan

Peer Pressure. Major factor that affects the adolescents’ behavior which leads to

cigarette smoking and alcoholism. It is a social pressure by members of one’s peer group

to take a certain action, adopt certain values, or otherwise conform in order to be

accepted.

Cigarette Smoking. The presumed effect of peer pressure among adolescents

which involve the act of inhaling or puffing generated by slowly burning tobacco or

cigarettes.

Alcoholism. The presumed effect of peer pressure among adolescents which

involve the intake of alcohol. It is the chronic disorder characterized by dependence on

alcohol and repeated excessive use of alcoholic beverages.

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Chapter 2

REVIEW OF RELATED LITERATURE AND RELATED STUDIES

This chapter presents a review, examination and analysis of related literature and

studies. This chapter includes the summary of the studies conducted by foreign and local

researchers and readings from professional literature which have significant bearings on

this study and serve as the springboard in conducting this research, as well as guide in

interpretation of its result. As a result of this review, the researchers gained insight and

perspective to develop and formulate the conceptual framework of the study.

RELATED LITERATURE

Foreign Literature

Brief History of Cigarette Smoking and Alcoholism

The use of tobacco for smoking has been practiced for centuries. The tobacco

plant has been grown in America since the 17th century and tobacco has been used in

various forms since. The form of smoking tobacco by rolling the leaves in fine paper was

frequently done by hand for those who practiced it, which limited the habit of smoking.

It was during the 1000 BC where the Mayan civilizations of Central America

begin using the leaves of the Tobacco plant for smoking and chewing. Gradually, the

habit is adopted throughout the America. In the late 1800’s, cigarette making machines

are developed that produce about 200 cigarettes per minute (today’s machines produce

about 9,000 per minute), allowing for cheap mass production.

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In the 19th century, some doctors attempted to attribute amazing powers to

smoking, including claims that it was useful for treating depression and a range of lung

and rheumatic conditions. (Rosado &Florian, 2007).

Cigarette Smoking

According to Neil Caporaso and Andrew W. Bergen J (1999), cigarette smoking,

hereafter referred to as “smoking,” is the largest single risk factor for premature death in

developed countries. Approximately one fifth of the deaths in the United States are

attributable to smoking, and 28% of the smoking-attributable deaths involve lung cancer,

37% involve vascular disease, and 26% involve other respiratory diseases. More than

400,000 deaths per year and 30% of all cancers in the United States are attributable to

smoking. Lung cancer is the largest single cause of cancer-associated mortality and is the

most common cause of smoking-related mortality in the United States. The attributable

risk from smoking for oral, pharyngeal, and esophageal cancers is substantial, although

less than that for lung cancer. The attributable risk from both smoking and alcohol

consumption accounts for the majority of both oral and pharyngeal cancers and of

esophageal cancer.

Morbidity and mortality attributable to smoking would decline in the future if

reductions in smoking prevalence were to be observed. However, despite dramatic

declines in adult male smoking prevalence in the United States observed from the 1960s

through the 1990s, the decline in current adult smoking prevalence slowed by about

1990, and recent surveys of current smoking in youth, defined as cigarette use on at least

one of the last 30 days preceding the survey, show a statistically significant increase

(from 27.5% in 1991 to 36.4% in 1997). The prevalence of current smoking among adults
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in the United States, defined as smoking daily or smoking on some days, is now about

23% in women and 27% in men and is statistically significantly higher in those less than

65 years of age; in those with 9-11 years of education; in those below the poverty

threshold; in whites, blacks, and American Indians/Alaskan Natives; and in military

veterans. Projected demographic and smoking prevalence trends suggest that the absolute

number of current smokers in the United States, about 47 million individuals in 1995,

will continue to increase, especially in those below the poverty threshold, in those with

less than 13 years of education, and in those greater than or equal to 65 years of age.

Smoking prevalence in men worldwide is higher than it is in the United States,

while smoking prevalence among women worldwide is usually less than the prevalence

in men, although it has equaled or exceeded that in men in some northern European

countries. While annual per capita cigarette consumption has dropped in developed

countries from a high of more than 3000 in the 1970s to about 2600 in 1990, it is

increasing in developing countries (260% increase in China between 1970 and 1990), so

that worldwide annual per capita cigarette consumption has not changed substantially

over the last 25 years. Because of the delayed health effects of smoking, morbidity and

mortality in developing countries attributable to smoking have not yet surpassed those in

developed countries but are likely to do so in the next century.

According to the 2007 Global Youth Tobacco Survey, 39.5% of adolescents aged

13 – 16 had ever smoked cigarettes and 17.5% currently smoked.

According to the Journal of International Society of Preventive & Community

Dentistry (2013), tobacco use is one of the leading preventable causes of morbidity and

mortality in the world. Worldwide, tragically the tobacco epidemic kills 5.4 million
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people a year from various tobacco-related diseases. Tobacco use usually starts in

adolescence and continues into adult life, meaning that many future victims tobacco use

are today's children. Adolescents and young adults of colleges are often targeted by the

tobacco industry for marketing. Research has shown that teen tobacco users are more

likely to use alcohol and illegal drugs than are non-users. The risks of tobacco use are

highest among those who start early and continue its use for a long period. The early age

of initiation underscores the urgent need to intervene and protect this vulnerable group

from falling prey to this addiction. The most common reasons cited for children to start

using tobacco are peer pressure, parental tobacco habits, and pocket money given to

them. Presently, adolescents are increasingly exposed to changing lifestyles that have a

negative impact on health. In developed countries, public awareness of the health hazards

of tobacco use has led to increased regulation of the tobacco industry, resulting in

restrictions on the advertising and availability of cigarettes and higher prices for them. As

a result, tobacco companies are aggressively seeking new markets in the developing

world. These markets are quite attractive because in most developing countries, there is

little legislation against the marketing and distribution of tobacco products and smoking

is still socially acceptable. The magnitude of risk that adolescent cigarette smoking

carries for adult smoking using a longitudinal, prospective design, results indicates that

even in frequent experimentation in adolescence significantly raises the risk for adult

smoking by a factor of 16 compared to non-smoking adolescents. Relative risk was also

increased by an early onset of smoking and by a stable, uninterrupted course from

experimentation to regular smoking. Relative risk did not significantly vary by age or

sex. The continuity of smoking behavior between adolescence and adulthood supports the
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importance of primary prevention programs directed as adolescent populations. (Chassin

L, Presson C.C., and Sherman S.J., Edwards D.A., 1990).

Alcoholism

According to Vic Fabe (2006), alcoholism is also known as alcohol dependence

and is considered a disease with symptoms such as craving or feeling a strong urge to

drink; loss of control or not being able to stop once drinking has begun; physical

dependence such as nausea, sweating, shakiness, and anxiety; and tolerance or drinking

greater amounts of alcohol to "get high”. Many people believe that drinking alcohol will

and may ease their problems regarding their family, work and the society, but in fact, it

would not. Acquiring alcoholism may lead to more serious complications and fatal

illnesses that would cause the person's life. (National Institute on Alcohol Abuse and

Alcoholism, 2006).

Several think that alcoholism is a disease, and in fact, the National Institute on

Alcohol Abuse and Alcoholism (2006) is supporting this statement. The Institute explains

that the craving that an alcoholic feel for alcohol can be as strong as the need for food or

water, and an alcoholic will continue to drink despite serious family, health, or legal

problems. Moreover, like many other diseases, alcoholism is chronic, which means that it

lasts a person's lifetime, usually follows a predictable course, and has symptoms. The risk

for developing alcoholism is influenced by both the person's genes and by his or her

lifestyle.

It has been reported that alcoholism was first recognized as a disease in the 1930s

by a group called "Alcoholics Anonymous", and since then, the American Medical

Association has recognized alcoholism as a serious and chronic disease. Alcoholism takes
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time to develop, but once it develops, it does not go away. Cure is not available for

alcoholism, but is treatable, and with proper treatment, an alcoholic will be able to

reclaim his or her normal, satisfying lifestyle ('What is Chemical Dependency?', 2005).

Humans have been drinking alcohol, and presumably experiencing hangovers,

since the first mead was brewed from fermented honey around 8000 BC (Meyer and

Quenzer, 2005). Nevertheless, although a number of studies have been carried out

addressing hangover effects on cognition and performance, we argue in the following

sections that their interpretation is severely limited due to a variety of methodological

considerations.

According to Skala K1, Walter H (2013), up to two thirds of adolescents consume

alcohol and about a quarter engage in abusive behavior at some point. Many users begin

alcohol use at young ages, and binge drinking is a dominant pattern for a proportion of

youth. Because neurogenesis is inhibited by ethanol, consequences of adolescent alcohol

abuse include changes in brain development and impairment of neurocognitive

performance. A variety of mental and psychosocial problems are also often witnessed in

alcohol abusing youth. Apart from the influence exerted by genetic and psychosocial

factors, the chance of developing problematic alcohol consumption is increased by

consumption in a binge drinking manner and by first contact with alcohol at a young age.

Discrimination of alcohol consumption within the frames of normal adolescent behavior

from problematic use is still a challenging issue. Different prevention programs provide

treatment either directly to the adolescent, in the context of the school, or within the

frame of the adolescent's family. Although some of these efforts have been shown to be

effective in reducing alcohol misuse in youth, hardly any intervention reveals satisfactory
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outcomes in a long-term prospect. Successful prevention strategies would need to

comprise treatment of current neuropsychological impairment as well as of comorbid

mental health problems and concurrent other substance misuse.

It has been estimated that over three million teenagers are alcoholics, and several

million more have a serious drinking problem that they cannot manage on their own. This

is why early treatment of alcoholism in adolescents must be done to prevent further

damage on their lives. It has been mentioned earlier that alcoholism presents grave threats

on the lives of many individuals, especially on the lives of many teenagers. These threats

include accidents associated with drunk driving, and crimes. It has been reported that the

three leading causes of death for 15 to 24 year olds are automobile crashes, homicides

and suicides, and alcohol is a leading factor in all three. While drinking may be a singular

problem behavior for some, research suggests that for others if may be an expression of

general adolescent turmoil that includes other problem behaviors and that these behaviors

are linked to unconventionality, impulsiveness, and sensation seeking (Califano, 2000).

Furthermore, the influence of peers can also be attributed to adolescent drinking.

More often than not, adolescents become exposed to alcohol drinking through their peers.

With this, the role of the parents becomes crucial in the discipline of their children.

Proper guidance must be given to adolescents regarding drinking alcohol. Education also

is important, for information regarding alcoholism and drug abuse must be given to

adolescents for early prevention.

Cigarette Smoking and Alcoholism

Bien TH1, Burge R. (1990) believes that smoking and drinking share many

detrimental effects, some of which operate synergistically. Over 90% for alcoholic
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inpatients are smokers, with similar findings regarding outpatients. In the general

population, the relationship between smoking and drinking appears positive but modest.

Nicotine appears to facilitate ethanol consumption and vice versa. While sample

theoretical viewpoints exist to explain the covariance of alcohol and cigarette

consumption, conclusive data supporting one or another of these views are lacking

assumption that alcoholics should be discouraged from quitting smoking as well as

drinking is without empirical basis. Research should ascertain whether problem drinkers

with greater positive association between alcohol and smoking benefit differentially from

quitting both.

According to Zacny JP. (1990), alcohol and tobacco consumption are correlated

consume more alcohol than do non-smokers and alcohol consumers smoke more than do

teetotalers. In addition, heavy drinking tends to be associated with heavy smoking. A

large majority of alcoholics, who by definition are heavy drinkers, smoke. A number of

studies examining the effects of ethanol pretreatment or availability on tobacco

consumption have demonstrated that ethanol potentiates tobacco consumption. Whether

smoking potentiates alcohol consumption is not known. Possible mechanisms underlying

the alcohol and tobacco association, including cross-tolerance between the two drugs, are

discussed. Tobacco appears to counteract the deleterious effects of alcohol on some

measures of performance. The association between alcohol and tobacco consumption

may have some relevance regarding the issue of relapse to either one of the drugs.

Finally, combined use of alcohol and tobacco presents greater risk of certain diseases

than the sum of the excess risks of alcohol and tobacco considered individually.
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According to Fluharty, M. & Taylor, E. et al. (2016), the self – medication

hypothesis postulates that individuals turn to smoking and alcoholism to alleviate their

symptoms and therefore suggests that symptoms of depression and anxiety may lead to

smoking. Users may also report that that cigarette and alcohol alleviate their symptoms

due to the misattribution of withdrawal relief. Given the short half – life of nicotine that

results in withdrawal symptoms (including mood symptoms) after a short period of

abstinence, users may misattribute the relief of short – term withdrawal as reflecting a

genuine anxiolytic effect of smoking and drinking. That is, withdrawal symptoms of

increased anxiety and negative affect may be misattributed as reflecting genuine mood

symptoms, which would lead to the impression that smoking improves mood.

According to the Oral Health Foundation, the majority of mouth cancer cases

continue to be a result of smoking and tobacco use. There are thousands of chemicals

contained in a single cigarette, and their point of entry is the mouth while drinking

alcohol to excess is another major risk factor linked with mouth cancer – associated with

around a third of all cases.

Local Literature

Smoking Behavior between Men and Women

From its conception, tobacco has been predominantly used by men. In early times,

women smoked less compared to men because of the norm that smoking in early men

connotes power, making it a symbol of masculinity, whereas smoking in women signals

promiscuity. (Gender, Tobacco, Taxation, 2016).

In the Philippine Context, there is a general notion that cigarette smoking and

alcoholism are originally the vices of the male population and has long been viewed as an
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activity associated with men. This result also supports the report of the World Health

Organization (WHO) that males tend to smoke and drink early than females. Recently,

however, female smoking and alcoholism caught the interest of health advocates due to the

escalation in smoking and drinking incidences.

Based on the 8th National Nutrition Survey conducted by the Food and Nutrition

Research Institute (FNRI), smoking prevalence in the Philippines has gone down from

31% in 2008 to 25.4% in 2013; or specifically, from 53.2% in 2008 to 44.7% in 2013 in

males, and from 12.9% to 7.8% in females.

Compared to global average, however, male smoking incidence in the Philippines

exceeded the global average of 36% with smoking prevalence of 44.7% in 2013. The

same is also depicted for female smoking incidence at a higher rate of 7.8% against the

global average of 7%. Nonetheless, in spite of these larger than normal figures, smoking

incidence in the Philippines declined in the five-year period.

Women and men have different psychological patterns that influence their

behavior. The same is evident in their motivation to smoke cigarettes. Men are found to

smoke when they are experiencing positive emotions while women smoke to contradict

any negative feelings they harbor. Men are also more prone to smoke in public places

with their peer, whereas women, smoke in hidden places.

Women are known to smoke to control weight, and to relieve stress, which may

come from different pressing factors such as the given related causes: strained family

relationships, peer pressure, poor religious background etc.

Men too, start smoking with similar reasons in lesser frequencies. However, men

tend to be more independent on nicotine compared to women, which is most likely the
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primary influencing factor on cigarette addiction for men. In addition, men use cigarettes

as social tool. Todd, et. at. (1996), have concluded that role socialization and smoking

have a complex relationship where there are cases that socialization is used a means to

get rid of stress.

RELATED STUDIES

Foreign Studies

According to Tarshis (2010), peer pressure can have a positive or negative effect

on students’ motivation and performance in school. Attitudes and aspiration of peers as

well as peers’ expectations and standards affect individual’s efforts and achievement in

school. For many secondary school students, achieving in school is in a direct conflict

with peer acceptance. If adolescents are friends to secondary school dropouts, they have

tendency to be absent from school, have lower grades and less positive attitudes towards

schools, they are less popular and less likely to plan to attend higher institutions. On the

other hand, high achieving peers have positive effects on adolescents’ satisfaction with

school, educational expectations, report-card grades and standardized achievement test

scores. Students who choose friends who have characteristics or talents that they admire,

motivates them to achieve and act as their friends’ act. Such kind of peers encourages

students to study hard at school and can also help them think more creatively.

A lot remains to be done to better understand the relative importance of peers in

adolescent’s cigarette smoking and alcohol use. Having the friends that smoke cigarettes

and drink alcohol or use other drugs influences such behaviors among adolescent. In

contrast, very few adolescents who report having nearly no friends who use such
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substances have tried themselves. For example, Hoffman (2006) stated that the smoking

of friends is one the strongest of several predictors to adolescents smoking while

controlling for family factors and demographics.

According to the study of Dr. Donald F. Wolle (2004) entitled “Smoking and

Alcoholism to Mortality Risk”, smoking and consuming alcohol are both related to

increase mortality risk. Their combined effects on cause-specific mortality were

investigated in a prospective cohort study.

Numerous studies have shown the serious adverse effects of lifelong tobacco

smoking, with increased mortality rates from chronic heavy drinking. Regular light

drinking appears to have little effect on overall mortality and may be protective against

coronary heart disease. In reality, many people both drink and smoke. The neurochemical

mechanisms of action of nicotine and alcohol appear to be mutually reinforcing. Drinking

and smoking together is strongly socially patterned, being normative behavior in pubs,

bars and clubs, worldwide until the recent introduction in some countries of smoking

restrictions in public places. Despite this, few studies have examined the combined

effects of smoking and drinking on mortality.

As with alcohol, adolescent cigarette smoking is strongly associated with illicit

drug use (Eckhardt et al. 1994). In addition to more frequent use of illicit drugs, youth

who consistently smoke throughout adolescence are at significantly greater risk for

marijuana and other drug abuse or dependence (Vega and Gil 2005). Much of the

research in this area has focused on concurrent use of cigarettes and alcohol, which

predicts a variety of problems, both during adolescence and beyond. For example, it has
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been found that youth who smoke and drink have an increased risk of having difficulties

at school, delinquency, and use of other drugs (Hoffman et al. 2001).

Adolescents who report consistent smoking and drinking have higher rates of

deviant behavior and violence and are more likely to have legal and substance use

problems in their 20s than those who consistently drink but do not regularly smoke

(Orlando et al. 2005). The authors of the latter study noted, “...while it is common during

adolescence to drink but not smoke, it is very unusual to smoke and not drink” (Orlando

et al. 2005), suggesting that smoking is a reliable marker of adolescent alcohol use.

Alcohol and tobacco use both have important effects on cardiovascular risk

factors. Overall, the two generally do not affect the same risk factors in the same way,

although levels of blood pressure and triglycerides (i.e., fats in the blood) may be

important exceptions. The relationship between smoking and blood pressure is less clear,

in part because smokers ten to be learner than non-smokers. However, in some laboratory

studies and well-controlled population studies, smoking appeared to raise blood pressure

or risk of hypertension to a modest degree (Niskanen et al. 2004).

An extraordinary body of research has sought to understand the links between

smoking cigarettes and drinking alcohol and an equally substantial body of evidence has

demonstrated their synergy in causing cancer, birth defects, and other medical problems.

In contrast, there generally has been little evidence that they interact to influence

cardiovascular disease. Indeed, one recent review found only a single article that

identified a probable interaction between alcohol and tobacco on risk of heart disease

resulting from narrowing of the arteries that supply blood and oxygen to the heart (i.e.,

coronary heart disease) (Taylor and Rehm, 2006).

 P a g e | 20

Several factors complicate the interaction between tobacco and alcohol on

cardiovascular disease. First, dose matters. The relationship between smoking and risk of

cardiovascular disease is dose dependent ─ more tobacco leads to more disease. For

alcohol consumption, however, the issue is more complex. Most evidence suggest that

consumption in the range of 3 to 14 drinks per week is associated with lower risk of heart

attack (i.e., myocardial infarction) and possibly of other forms of cardiovascular disease,

such as blockage in an artery that supplies blood to the brain, resulting in a deficiency in

blood flow (i.e., ischemic stroke) or failure of the heart to pump blood sufficiently

throughout the body.

Second, cardiovascular disease encompasses a variety of conditions with a diverse

set of causes or origins. Smoking is clearly linked to a higher risk of nearly all forms of

cardiovascular disease, including myocardial infarction, ischemic stroke and bleeding

into the brain (i.e., hemorrhagic stroke), congestive heart failure, and narrowing of the

arteries in the extremities (i.e., peripheral arterial disease) (Burns, 2003).

Third, even those type of cardiovascular disease directly linked to the gradual

build-up of fatty deposits (i.e., plaques) in the arteries, such as myocardial infarction and

stroke, represent acute events superimposed on the background process of the gradual

narrowing and hardening of the arteries (i.e., atherosclerosis). Atherosclerosis itself is a

dynamic and involves cholesterol transport into and out of cells in the blood vessel wall,

the entry of inflammatory cells, and abnormal function of the cells lining the vessel

surface (i.e., endothelial cells). The final trigger in this pathway id often a blood clot that

forms at the site of plaque whose cap has raptured, exposing the blood to irritants within

the plaque. Tobacco and alcohol use may have chronic effects on several steps in the
 P a g e | 21

gradual atherosclerosis process and more acute effects on the formation of blood clots

that often trigger actual clinical events.

Fourth, and perhaps most difficult to address, is the nature of the relationship

between alcohol consumption and cigarette smoking and how it bears on our

understanding of each. In both experimental and observational studies of alcohol

consumption and cardiovascular disease, cigarette smoking is treated as a cofounder or

nuisance parameter. That is, researchers recognize that smoking is common among

drinkers and that it is a strong risk factor for heart disease that could cloud the true effect

of alcohol consumption. Investigators typically study the effect of alcohol independent of

smoking, either by mathematical adjustment or by examining smokers and non-smokers

separately.

In summary, alcohol consumption and tobacco use have been associated with a

wide variety of cardiovascular disease, although these associations include both

detrimental and (at least for moderate drinking) some potentially beneficial effects.

Alcohol intake of three or more drinks per day and cigarette smoking share similar, and

probably additive, adverse effects on some forms of cardiovascular disease. Examples of

these adverse effects include increase in blood pressure and levels of triglycerides in the

blood and higher risks of stroke and congestive heart failure. On the other hand, there is

relatively little evidence that the two act synergistically or that the effects are worse when

smoking and drinking occur together than would be expected from their independent

effects. In most cases, more moderate drinking does not share these risks and even her

effects opposite those of cigarette smoking on HDL-C and blood clotting. Nonetheless,

because alcohol and tobacco are used together and in excess so commonly, their joint
 P a g e | 22

effects are encountered widely throughout the U.S population. Ongoing public health

efforts to minimize tobacco use and harmful drinking should result in clear and important

gains to the nation’s cardiovascular well-being.

According to the study of Oscar Bukstein (1994) entitled “Treatment of

Adolescent Alcoholism Abuse and Dependence”, most adolescents under the legal

drinking age consume alcohol. For many of them, their drinking patterns evolve into

alcohol abuse and dependence. Treatment of these adolescents must take into

considerations their physical, psychological, and social development. Therefore, different

treatment approaches may be needed for adolescents than for adults. Alcohol abuse and

alcohol dependence are not only adult problems. They also affect a significant portion of

adolescents between the ages of 12 to 18, even though the purchase and public use of

alcohol are illegal for them. Diagnosis and treatment of these disorders are important

because alcohol-related problems can have an enormous impact on the adolescents’

future. Early alcohol abuse can lead to social, family, and developmental problems. Other

potential negative consequences include accidents (e.g., motor vehicle crashes, falls, and

drowning), aggressive behavior, and suicide (National Institute on Alcohol Abuse and

Alcoholism [NIAAA] 1990).

Alcohol use also is associated with other risk-taking behaviors, such as smoking,

delinquency, use of illicit drugs, and precarious sexual behavior (Donovan and Jessor,

1978; Braucht, 1982). Furthermore, many alcohol-abusing adolescent become alcohol-

abusing adults (Temple and Fillmore, 1986).

According to the study of Zeena Harakeh & Wilma A.M Vollebergh (2012)

entitled “The Impact of Active and Passive Peer Pressure On Young Adult Smoking: An
 P a g e | 23

Experimental Study”, peers influence adolescent and young adult smoking, but little is

known about the underlying mechanisms. It is necessary to understand whether the

current assumption of peer pressure is valid, or whether an alternative explanation as

imitation is more appropriate. We examined whether passive (imitation) and/or active

(pressure) peer influence affects young adult smoking. A widely held assumption is that

young people engage in smoking and other risk behaviors (e.g., alcohol or cannabis use)

because their peers pressure them to do so. This assumption taps into one of the

frequently applied theoretical models of peer influence, implying an active, explicit form

of peer influence. As a result, most mass-media campaigns and school smoking-

prevention program focus on countering peer pressure by teaching young people refusal

and resistance skills. Nevertheless, susceptibility to peer pressure in young people is not

limited to adolescents but also includes young adults (see also review of Borasi and

Carey, 2001). So far, the findings of survey studies, focusing on this active peer

influence, show inconsistent findings (Perrine and Aloise-young, 2004, Slater, 2003,

Urberg et al., 1990) and experimental studies are reliable (Arnett, 2007, Michell and

West, 1996). Thus, we still know little about the effects of peer pressure on adolescent

and young adult smoking. An important question that needs to be addressed is whether

this assumption and theory of active peer influence is valid.

Synthesis of Related Studies

This study is the first to show the importance of passive (imitation) peer influence

over and above the impact of active (pressure) peer influence on young adult smoking in

an experimental design. In our study, peer smoking increased significantly young adults’
 P a g e | 24

likelihood to smoke more cigarettes while peer pressure did not. In the literature, peer

smoking is suggested to tap into the passive peer influence, and the underlying

mechanism in experimental studies and survey studies on smoking is often contributed to

imitation. Students confronted with smoking peers are more likely to smoke regardless of

being offered a cigarette or not: seeing is doing. Several theoretical models may explain

the underlying mechanisms leading to imitation of behavior of others.

Conceptual Framework of the Study

The Conceptual Framework contains the Dependent and Independent Variables

and Paradigm of the Study.

Its Effects among

Peer Pressure, adolscents in selected
Cigarette Smoking barangays of Santa
and Alcoholism Cruz, Laguna

Independent Variable Dependent Variable

Figure 1.The Independent and Dependent Variables show the presumed cause of another

variable and the presumed outcome or effect respectively.

 P a g e | 25

INPUT PROCESS OUTPUT

Peer Pressure, Questionnaire Significant relationship

Cigarette Smoking and Face-to-face of peer pressure,
and Alcoholism Interview cigarette smoking and
alcoholism and their
impact to adolescents.

Figure 2.The Paradigm of the study shows the relationship of the input, process and

output of the study.

The above paradigm shows the effects of Peer Pressure, Cigarette Smoking and

Alcoholism among adolescents through the methods of questionnaire and face-to-face

interview. Peer Pressure, Cigarette smoking and alcoholism serve as the input and the

significant relationship of peer pressure, cigarette smoking and alcoholism and their

impact to adolescents serve as the output of the study. This can be determined by the

questionnaire that the respondents may answer.

 P a g e | 26

Chapter 3

RESEARCH METHODOLOGY

This chapter presents the research design, sample and locale of the study, data

gathering instruments, data gathering procedures and statistical treatment of data.

Research Design

This study uses Descriptive Statistics and Spearman Rank – Order Coefficient of

Correlation (𝑟𝑠) method to analyze the effects of peer pressure among adolescents in

relation to cigarette smoking and alcoholism.

Descriptive Statistics are brief descriptive coefficients that summarize a given set

of data, which can be either a representation of the entire population or a sample of it.

According to Gay (1971) as cited by Bansolay (2013), descriptive method is the

collection, presentation and description of data in order to test hypothesis or to answer

questions concerning the current status of the subject of the study.

Also, this method will be used to find out the extent of influence of peer pressure

among adolescents in relation to cigarette smoking and alcoholism through quantitative

information that can be tabulated along a continuum in numerical form. Descriptive

studies report summary data such as percentage that will be a big factor in getting the

needed information for this study. Quantitative method “emphasizes objective

measurements and the statistical, mathematical, or numerical analysis of data collected

through polls, questionnaires, and surveys, or by manipulating pre-existing statistical data

using computational techniques. Quantitative research focuses on gathering numerical

data and generalizing it across groups of people or to explain a particular phenomenon.”

 P a g e | 27

Spearman Rank – Order Coefficient of Correlation is a non – parametric method

appropriate for dealing with data that are measured on an ordinal scale, that is, the

subjects under study may be ranked in a two-ordered series. It is also a method of

determining the strength of relationship between two variables because it is not necessary

to assume that the observations are normally distributed.

Also this method will be used to find out the significant relationship between peer

pressure and the possible reasons why adolescents still continue on cigarette smoking and

alcoholism.

With this being said, this makes Descriptive Statistics and Spearman Rank –

Order Coefficient of Correlation method appropriate for obtaining the percentage and

average weighted mean of the peer pressure, its extent of influence to cigarette smoking

and alcoholism and the significant relationship between peer pressure and the possible

reasons why adolescents still continue on cigarette smoking and alcoholism.

The researchers decided to use this method for it is seemingly fitted for the study

to achieve the needed results. The results collected and the information gathered will be

the bases of this study to interpret data.

Sample and Locale of the Study

This study was conducted in selected barangays of Santa Cruz, Laguna

particularly in barangay Poblacion I and in Sitio Maligaya barangay Pagsawitan. The

respondents of this study were the adolescents ages 13 – 19 who are into cigarette

smoking and alcoholism where there would be a total of 100 respondents.

 P a g e | 28

Data Gathering Instruments

The researchers of this study used questionnaire and face-to-face interview to

gather the data needed from the respondents of the study.

The questionnaires used by the researchers are divided into five parts. The

first part of the questionnaire was designed to elicit data on the profile of the respondents

in terms of a) age b) gender and c) address. The second part of the questionnaire was

designed to determine the extent of influence of peer pressure among adolescents in

relation to cigarette smoking and alcoholism. The third part of the questionnaire was

designed to determine the list of possible health effects that might occur as the

respondents continue on cigarette smoking and alcoholism. This part will be used to

determine the highest or most common health effects they observe physically and

emotionally. The fourth part of the questionnaire was designed to determine the possible

reasons why teenagers still continue on cigarette smoking and alcoholism. The fifth part

of the questionnaire was designed to find out the significant relationship between peer

pressure and the possible reasons why adolescents still continue on cigarette smoking and

alcoholism.

The general instruction of the questionnaire was, “Please put a check mark (/) on

the column that corresponds to your answer. Note that there are no right or wrong

responses to any of the items in this survey. Please answer truthfully and rest assured that

the information will be kept confidential. Each statement is followed by the

corresponding points of 5, 4, 3, 2, 1 respectively and each number corresponds to the

following ratings. 5) – I always or almost always do this. 4) – I usually do this. 3) – I

sometimes do this. 2) – I do this occasionally. 1) – I never or almost never do this.”

 P a g e | 29

Data Gathering Procedures

To gather the data that will be recorded in this study with the guidance of the

researchers’ instructor, Mrs. Milith Miano, the researchers designed a project proposal

and they will then construct a letter addressing the respondents and barangay captain of

the selected barangays to allow the researchers to conduct a survey and face-to-face

interview. The process of gathering data or information will be done by listing of

respondents and the 100% retrieval of survey-questionnaires.

Statistical Treatment of Data

To systematically interpret the collected information, the following statistical

analysis tools will be utilized in the study.

The problem number 1 of the study which states the demographic profile of the

respondents in terms of a) age b) gender and c) address will be answered by determining

the Frequency and Percentage Formula.

To calculate response frequencies, count the number of respondents who selected

each response choice for a question and percentages for each question, the percentage

formula will be used:

𝒇
𝑷= × 𝟏𝟎𝟎
𝒏

Whereas:

P = Percentage

f = frequency

N = total number of responses to the question

100 = constant value

 P a g e | 30

The problem number 2 of this study seeks the extent of influence of peer pressure

among adolescents in relation to cigarette smoking and alcoholism, the problem number

3 which seeks to determine the possible health effects of cigarette smoking and

alcoholism among adolescents and the problem number 4 which seeks to determine the

possible reasons why teenagers still continue on cigarette smoking and alcoholism will all

be answered by the Average Weighted Mean (AWM):

∑𝒏𝒊=𝟏(𝑿𝒊𝑾𝒊)
𝑨𝑾𝑴 =
∑𝒏𝒊=𝟏 𝑾𝒊

Whereas:

AWM = average weighted mean

 = the sum of

W= the weights

X= the value

In problem 2, the following scale will be used to interpret the obtained Weighted

Mean:

Scale Descriptive Equivalent

4.21 – 5.0 I always or almost always do this
3.41 – 4.20 I usually do this
2.61 – 3.40 I sometimes do this
1.81 – 2.60 I do this occasionally
1.0 – 1.80 I never or almost never do this
 P a g e | 31

In problem 3, the following scale will be used to interpret the obtained Weighted

Mean:

Scale Descriptive Equivalent

4.21 – 5.0 Highly Aware
3.41 – 4.20 Aware
2.61 – 3.40 Fair
1.81 – 2.60 Somewhat Aware
1.0 – 1.80 Not at all aware

In problem 4, the following scale will be used to interpret the obtained Weighted

Mean:

Scale Descriptive Equivalent

4.21 – 5.0 Highly Agree
3.41 – 4.20 Agree
2.61 – 3.40 Fair
1.81 – 2.60 Disagree
1.0 – 1.80 Highly Disagree

The problem number 5 which seeks the significant relationship between peer

pressure and the possible reasons why adolescents still continue on cigarette smoking and

alcoholism will be answered by the Spearman Rank – Order Coefficient of Correlation

(𝒓𝒔 ) method:

𝟔 ∑ 𝑫𝟐
𝒓𝒔 = 𝟏 −
𝒏𝟑 −𝒏
Whereas:

(𝒓𝒔 ) = Spearman Rank – Order  = the sum of

Correlation Coefficient
𝑫𝟐 = Squared Differences
1 = Constant Value
between paired ranks
6 = Constant Value
N = total number of pair
 P a g e | 32

Chapter 4

DATA PRESENTATION, ANALYSIS AND INTERPRETATION

This chapter presents the data gathered that answered the problems of the study.

The data were predominantly presented in tabular forms and analyzed and interpreted

using appropriate descriptive statistics like frequency counts, percentages and average

weighted mean and the Spearman Rank – Order Coefficient of Correlation (𝒓𝒔 ) method.

One of the specific concerns of the study is to determine the profile of the

adolescents who are into cigarette smoking and alcoholism in Urdaneta City particularly in

barangays Dilan – Paurido, Bayaoas and San Jose. The data gathered are presented in

Table 1.

Table 1
Profile of the Respondents
Profile Frequency Percent
Age
13 4 4%
14 7 7%
15 13 13%
16 25 25%
17 17 17%
18 16 16%
19 18 18%
Gender
Male 76 76%
Female 24 24%
Address
Barangay Poblacion I 50 50%
Sitio Maligaya Barangay 50 50%
Pagsawitan
Age. A total of 100 respondents were chosen randomly in selected barangays of

Urdaneta City particularly in barangays Bayaoas, Dilan – Paurido and San Jose. As could

be seen from the data in Table 1, 4 or 4% of the 100 respondents are 13 years old. It

could be seen from the table that this age has the least respondents from the two
 P a g e | 33

barangays, 7 or 7 % are 14 years old, 13 or 13% are 15 years old, 25 or 25% are 16 years

old. It could be seen from the table that majority of the respondents are 16 years old, 17

or 17% are 17 years old, 16 or 16% are 18 years old and 18 or 18% are 19 years old.

The results above also support the 2007 Global Youth Tobacco Survey which states

that 39.5% of adolescents aged 13 – 16 had ever smoked cigarettes and 17.5% currently

smoked.

Gender. 76 or 76% of the 100 respondents from barangay Poblacion I and Sitio

Maligaya barangay Pagsawitan Santa Cruz, Laguna are male. It could be seen from the

table that the majority of the adolescents who are cigarette smokers and alcohol users are

males while 24 or 24% of the 100 respondents from barangay Pobalcion I and Sitio

Maligaya barangay Pagsawitan Santa Cruz, Laguna are females.

Results show the general notion that cigarette smoking and alcoholism are

originally the vices of the male population and has long been viewed as an activity

associated with men, at least in the Philippine context. This result also supports the report

of the World Health Organization (WHO) that males tend to smoke and drink early than

females. Recently, however, female smoking and alcoholism caught the interest of health

advocates due to the escalation in smoking and drinking incidences.

Address. 50 or 50% of our respondents are from barangay Poblacion I Santa Cruz,

Laguna and 50 or 50% are from Sitio Maligaya barangay Pagsawitan Santa Cruz, Laguna.

In total, 100 or 100% respondents are randomly chosen by the researchers to be surveyed

in selected barangays of Santa Cruz, Laguna.

 P a g e | 34

Another concern of this study is to determine the extent of influence of peer

pressure among adolescents in relation to cigarette smoking and alcoholism. The data are

presented in table 2.

Table 2

Extent of Influence of Peer Pressure among Adolescents in Relation to Cigarette

Smoking and Alcoholism

Categories AWM Descriptive Rating

1. In attempting to develop new friendships, I associate 2.60 I do this occasionally
myself with alcoholism and cigarette smoking to fit in.
2. I listen to whatever my friends are telling me to do like 2.60 I do this occasionally
drinking alcohol and cigarette smoking.
3. I think it is socially acceptable for me to engage in 3.02 I sometimes do this
alcoholism and cigarette smoking since majority of my
friends are into alcoholism and cigarette smoking.
4. I easily fall from simple gestures from my friends like 3.67 I usually do this
being offered a drink, being bought a drink, or having my
drink refilled without asking.
5. I receive punishment/s from my peers if I don’t engage 2.15 I do this occasionally
myself in alcoholism and cigarette smoking.
6. I tend to imitate my friends’ behavior towards cigarette 2.46 I do this occasionally
smoking and alcoholism because of curiosity.
7. I don’t want to cause disappointment to my friends for 2.52 I do this occasionally
not engaging myself in cigarette smoking and alcoholism.
8. I always join our jamming or get together with the use 2.75 I sometimes do this
of cigarette smoking and alcoholism.
9. I feel isolated from my family and I find acceptance 2.60 I do this occasionally
from my alcohol and cigarette smoker peers that’s why I
copy their behavior.
10. I feel like engaging in cigarette smoking and 2.39 I do this occasionally
alcoholism will make me cool and all grown up that’s why
I attempt to copy my friends’ behavior.
OVERALL WEIGHTED MEAN 2.676 I sometimes do this

It could be seen from the table with 3.67 average weighted mean that adolescents

easily fall from simple gestures from their friends like being offered a drink, being bought
 P a g e | 35

a drink, or having their drink refilled without asking. Results show that adolescents

‘usually do this’ or do this 75% of the time.

Apparently, the above findings indicate that adolescents in selected barangays of

Santa Cruz, Laguna particularly in barangay Poblacion I and in Sitio Maligaya barangay

Pagsawitan are ‘sometimes’ influenced by their peers to engage in cigarette smoking and

alcoholism with an overall average weighted mean of 2.676.

The results above support the study of Zeena Harakeh & Wilma A.M Vollebergh

(2012) entitled “The Impact of Active and Passive Peer Pressure On Young Adult

Smoking”, they examined whether passive (imitation) and/or active (pressure) peer

influence affects young adult smoking. A widely held assumption is that young people

engage in smoking and other risk behaviors (e.g., alcohol or cannabis use) because their

peers pressure them to do so.

 P a g e | 36

Another concern of this study is to determine the possible health effects of

cigarette smoking and alcoholism among adolescents. The data are presented in table 3.

Table 3

Possible Health Effects of Cigarette Smoking and Alcoholism among Adolescents

Questions Mean Descriptive Rating

1. I suffer from frequent coughing and often produce phlegm. 2.54 Somewhat Aware
2. I notice the growth of premature wrinkles on my body including my 2.21 Somewhat Aware
face and arms.
3. I suffer from anxiety disorders, panic attacks and engage in high 2.21 Somewhat Aware
risk sexual behavior.
4. I suffer from excessive loss of weight and enlargement of stomach. 2.30 Somewhat Aware
5. I suffer from asthma or the shortness of breath. 1.95 Somewhat Aware
6. I can feel the early signs of heart disease and stroke. 1.80 Not at all Aware
7. I’m getting a higher risk of lung cancer and alcoholic liver disease. 1.82 Somewhat Aware
8. I’m getting a higher risk of certain types of cancer particularly 1.79 Not at all Aware
those of the mouth and throat.
9. I’m aware that cigarette smoking and alcoholism include the 2.28 Somewhat Aware
development of acute and chronic bronchitis.
10. I’m aware that cigarette smoking and alcoholism increase blood 2.60 Somewhat Aware
pressure and heart rate.
OVERALL WEIGHTED MEAN 2.150 Somewhat Aware
It could be seen from the table that the awareness of the possible health effects of

cigarette smoking and alcoholism among adolescents are rated ‘somewhat aware’ with

an overall weighted mean of 2.150. This means that the adolescents are not informed as

to what disease or health effects they might encounter in the short or long run. The item

number 8 which states“I’m getting a higher risk of certain types of cancer particularly

those of the mouth and throat”was the lowest among all the items in terms of the average

weighted mean with 1.79 which revealed that adolescents are not at all aware that they

are getting a higher risk of certain types of cancer particularly those of the mouth and

throat.

According to the Oral Health Foundation (2014), the majority of mouth cancer

cases continue to be a result of smoking and tobacco use. There are thousands of
 P a g e | 37

chemicals contained in a single cigarette, and their point of entry is the mouth while

drinking alcohol to excess is another major risk factor linked with mouth cancer –

associated with around a third of all cases.

The item number 10 which states “I’m aware that cigarette smoking and

alcoholism increase blood pressure and heart rate”was the highest among all the items

in terms of the average weighted mean with 2.60 which revealed that among the

possible health effects listed above, increase blood pressure and heart rate are the health

effects adolescents are somewhat aware of.

According to Burns (2003), the relationship between smoking and risk of

cardiovascular disease is dose dependent ─ more tobacco leads to more disease. For

alcohol consumption, however, the issue is more complex. Most evidence suggest that

consumption in the range of 3 to 14 drinks per week is associated with lower risk of heart

attack such that myocardial infarction and possibly of other forms of cardiovascular

disease, such as blockage in an artery that supplies blood to the brain, resulting in a

deficiency in blood flow such that ischemic stroke or failure of the heart to pump blood

sufficiently throughout the body.

Second, cardiovascular disease encompasses a variety of conditions with a diverse

set of causes or origins. Smoking is clearly linked to a higher risk of nearly all forms of

cardiovascular disease, including myocardial infarction, ischemic stroke and bleeding

into the brain such that hemorrhagic stroke, congestive heart failure, and narrowing of the

arteries in the extremities.

 P a g e | 38

Another concern of this study is to determine the possible reasons why

adolescents still continue on cigarette smoking and alcoholism. The data are presented in

table 4.

Table 4

Possible Reasons Why Adolescents Still Continue

on Cigarette Smoking and Alcoholism

Questions Mean Descriptive Rating

1. I see alcoholism and cigarette smoking as part of the normal 2.91 Fair
teenage experience.
2. I want to belong in my group of friends who are into cigarette 2.39 Disagree
smoking and alcoholism.
3. It relieves my stress and I tend to forget about my problems. 2.94 Fair
4. It relieves my boredom and gives personal excitement. 2.75 Fair
5. It alleviates my feeling of depression. 2.96 Fair
6. Through cigarette smoking and alcoholism, I feel energized 2.64 Fair
and confident
7. It gives me the feeling of rebellion and get violent without fear 2.40 Disagree
8. My body depends so much on cigarette smoking and 2.40 Disagree
alcoholism
9. Alcoholism and cigarette smoking dependence runs in our 2.57 Disagree
family that’s why my parents are not making a move to stop my
vices
10. The availability and presence of alcohol and cigarette in our 2.63 Fair
community are inexpensive and low cost that’s why it’s very
accessible for me to use
OVERALL WEIGHTED MEAN 2.659 Fair

It is indicated that the items listed above were perceived as fair. It was justified

by the computed overall weighted mean of 2.659. Apparently, adolescents are in between

the decision to agree or to disagree on the items listed above in terms of the possible

reasons why adolescents still continue on cigarette smoking and alcoholism.

Specifically, it could be seen from the table that the item number 5 which states

that “It alleviates my feeling of depression” was the highest among all the items in terms
 P a g e | 39

of the average weighted mean with 2.96 which revealed that they engage in cigarette

smoking and alcoholism to alleviate their feeling of depression.

According to Fluharty, M. & Taylor, E. et al. (2016), the self – medication

hypothesis postulates that individuals turn to smoking and alcoholism to alleviate their

symptoms and therefore suggests that symptoms of depression and anxiety may lead to

smoking. Users may also report that that cigarette and alcohol alleviate their symptoms

due to the misattribution of withdrawal relief. Given the short half – life of nicotine that

results in withdrawal symptoms (including mood symptoms) after a short period of

abstinence, users may misattribute the relief of short – term withdrawal as reflecting a

genuine anxiolytic effect of smoking and drinking. That is, withdrawal symptoms of

increased anxiety and negative affect may be misattributed as reflecting genuine mood

symptoms, which would lead to the impression that smoking improves mood.
 P a g e | 40

Another concern of this study is to determine the significant relationship between

pressure and the possible reasons why adolescents still continue on cigarette smoking and

alcoholism. The data are presented in table 5.

Table 5

The Significant Relationship Between Pressure and the Possible Reasons Why

Adolescents Still Continue on Cigarette Smoking and Alcoholism

Respondents Peer Possible rx ry d 𝐝𝟐

Pressure Reasons
1 0.24 0.2 98 97.5 0.5 0.25
2 0.26 0.24 96 92.5 3.5 12.25
3 0.66 0.6 25.5 34 -8.5 72.25
4 0.8 1 6 2 4 16
5 0.26 0.26 96 89.5 6.5 42.25
6 0.46 0.46 60 59.5 0.5 0.25
7 0.44 0.42 67.5 69 -1.5 2.25
8 0.32 0.2 87 97.5 -10.5 110.25
9 0.4 0.46 75 59.5 15.5 240.25
10 0.58 0.8 37 11.5 25.5 650.25
11 0.28 0.78 93.5 14 79.5 6320.25
12 0.74 0.78 13 14 -1 1
13 0.62 0.58 29.5 39 -9.5 90.25
14 0.66 0.76 25.5 16.5 9 81
15 0.76 0.62 11 30.5 -19.5 380.25
16 0.78 1 8.5 2 6.5 42.25
17 0.78 1 8.5 2 6.5 42.25
18 0.56 0.54 41.5 47.5 -6 36
19 0.4 0.4 75 75 0 0
20 0.32 0.24 87 92.5 -5.5 30.25
21 0.52 0.64 51 28.5 22.5 506.25
22 0.56 0.56 41.5 42 -0.5 0.25
23 0.46 0.54 60 47.5 12.5 156.25
24 0.66 0.7 25.5 20.5 5 25
25 0.82 0.7 4 20.5 -16.5 272.25
26 0.4 0.52 75 52.5 22.5 506.25
27 0.68 0.82 20.5 10 10.5 110.25
28 0.36 0.54 81 47.5 33.5 1122.25
29 0.46 0.8 60 11.5 48.5 2352.25
 P a g e | 41

30 0.62 0.76 29.5 16.5 13 169

31 0.58 0.6 37 34 3 9
32 0.54 0.26 47 89.5 -42.5 1806.25
33 0.68 0.86 20.5 8 12.5 156.25
34 0.38 0.36 78.5 78 0.5 0.25
35 0.38 0.34 78.5 80.5 -2 4
36 0.3 0.32 91 85.5 5.5 30.25
37 0.44 0.48 67.5 56.5 11 121
38 0.78 0.66 8.5 25.5 -17 289
39 0.2 0.2 100 97.5 2.5 6.25
40 0.56 0.52 41.5 52.5 -11 121
41 0.66 0.6 25.5 34 8.5 72.25
42 0.48 0.92 56 5 51 2601
43 0.44 0.66 67.5 25.5 42 1764
44 0.6 0.48 33 56.5 -23.5 552.25
45 0.52 0.52 51 52.5 -1.5 2.25
46 0.56 0.56 41.5 42 -0.5 0.25
47 0.82 0.58 4 39 -35 1225
48 0.58 0.58 37 39 -2 4
49 0.44 0.58 67.5 39 28.5 812.25
50 0.52 0.6 51 34 17 289
51 0.32 0.32 87 85.5 1.5 2.25
52 0.7 0.66 18 25.5 -7.5 56.25
53 0.5 0.58 54 39 15 225
54 0.34 0.24 83.5 92.5 -9 81
55 0.32 0.24 87 92.5 -5.5 30.25
56 0.74 0.98 13 4 9 81
57 0.4 0.4 75 75 0 0
58 0.34 0.28 83.5 87.5 -4 16
59 0.28 0.56 93.5 42 51.5 2652.25
60 0.44 0.2 67.5 97.5 -30 900
61 0.46 0.4 60 75 -15 225
62 0.46 0.42 60 69 -9 81
63 0.36 0.34 81 83.5 -2.5 6.25
64 0.46 0.4 60 75 -15 225
65 0.66 0.2 25.5 97.5 -72 5184
66 0.5 0.68 54 22.5 31.5 992.25
67 0.32 0.36 87 80.5 6.5 42.25
68 0.6 0.62 33 30.5 2.5 6.25
69 0.56 0.54 41.5 47.5 -6 36
70 0.6 0.4 33 75 -42 1764
71 0.3 0.36 91 80.5 10.5 110.25
72 0.54 0.42 47 69 -22 484
73 0.36 0.36 81 80.5 0.5 0.25
74 0.68 0.42 20.5 69 -48.5 2352.25
 P a g e | 42

75 0.44 0.46 67.5 59.5 8 64

76 0.54 0.54 47 47.5 -0.5 0.25
77 0.72 0.74 16 18 -2 4
78 0.46 0.38 60 78 -18 324
79 0.74 0.78 13 14 -1 1
80 0.5 0.44 54 63.5 -9.5 90.25
81 0.22 0.2 99 97.5 1.5 2.25
82 0.4 0.6 75 34 41 1681
83 0.84 0.9 2 6.5 -4.5 20.25
84 0.72 0.46 16 59.5 -43.5 1892.25
85 0.82 0.42 4 69 -65 4225
86 0.88 0.84 1 9 -8 64
87 0.26 0.28 96 87.5 8.5 72.25
88 0.42 0.44 72 63.5 8.5 72.25
89 0.72 0.5 16 55 -39 1521
90 0.6 0.66 33 25.5 7.5 56.25
91 0.6 0.54 33 47.5 -14.5 210.25
92 0.44 0.44 67.5 63.5 4 16
93 0.44 0.42 67.5 69 -1.5 2.25
94 0.78 0.9 8.5 6.5 2 4
95 0.54 0.52 47 52.5 -5.5 30.25
96 0.3 0.42 91 69 22 484
97 0.56 0.72 41.5 19 22.5 506.25
98 0.68 0.44 20.5 63.5 -43 1849
99 0.66 0.68 25.5 22.5 3 9
100 0.54 0.64 47 28.5 18.5 342.25
∑ 𝑫𝟐
= 𝟓𝟐𝟑𝟓𝟏. 𝟐𝟓
 P a g e | 43

6 ∑ 𝐷2
𝑟𝑠 = 1 −
𝑛3 −𝑛
𝒕𝒕𝒂𝒃=𝟏.𝟗𝟖𝟒

6(52351.25) 𝑛−2
𝑟𝑠 = 1 − 𝑡𝑐𝑜𝑚𝑝 = 𝑟𝑠√1−𝑟𝑠2
(100)3 −100

314107.5 100−2
𝑟𝑠 = 1 − 𝑡𝑐𝑜𝑚𝑝 = 0.69√1−(0.69)2
1000000−100

98
𝑟𝑠 = 1 − 0.314138913191 𝑡𝑐𝑜𝑚𝑝 = 0.69√0.5239

𝒓𝒔 = 𝟎. 𝟔𝟗 𝑡𝑐𝑜𝑚𝑝 = 0.69√187.058599

df = n – 2 𝑡𝑐𝑜𝑚𝑝 0.69(13.67693675)

df =98; 𝛼 = 0.05

Table 5 presents the summary of the significant relationship between pressure and

the possible reasons why adolescents still continue on cigarette smoking and alcoholism.

It could be seen from the table that the computed 𝒕𝒄𝒐𝒎𝒑 of 9.440 is greater than the 𝒕𝒕𝒂𝒃

of 1.984 at 0.05 level of significance with 98 degrees of freedom. Thus, the alternative

hypothesis is accepted which states that there is a significant relationship between peer

pressure and possible reasons why adolescents still continue on cigarette smoking and

alcoholism.
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Chapter 5

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

This chapter discusses the summary, findings, conclusions and recommendations

SUMMARY

The Problem

This research study determines the effects of peer pressure among adolescents in

relation to cigarette smoking and alcoholism in selected barangays of Santa Cruz, Laguna

Specifically, the study answered the following questions:

I. What is the profile of the respondents in terms of:

a. Age

b. Gender

c. Address

II. What is the extent of influence of peer pressure among adolescents in

relation to cigarette smoking and alcoholism?

III. What are the possible health effects of cigarette smoking and alcoholism

among adolescents?

IV. What are the possible reasons why adolescents still continue on cigarette

smoking and alcoholism?

V. Is there a significant relationship between peer pressure and the possible

reasons why adolescents still continue on cigarette smoking and

alcoholism?
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Research Hypothesis

Null Hypothesis

1. There is no significant relationship between peer pressure and the possible reasons

why adolescents still continue on cigarette smoking and alcoholism

Alternative Hypothesis

1. There is a significant relationship between peer pressure and the two vices which are

the cigarette smoking and alcoholism

Methodology

This study used Descriptive Statistics and Spearman Rank – Order Coefficient of

Correlation (𝑟𝑠) method to analyze the effects of peer pressure among adolescents in

relation to cigarette smoking and alcoholism.

Descriptive Statistics are brief descriptive coefficients that summarize a given set

of data, which can be either a representation of the entire population or a sample of it.

According to Gay (1971) as cited by Bansolay (2013), descriptive method is the

collection, presentation and description of data in order to test hypothesis or to answer

questions concerning the current status of the subject of the study.

Also, this method was used to find out the extent of influence of peer pressure

among adolescents in relation to cigarette smoking and alcoholism through quantitative

information that can be tabulated along a continuum in numerical form. Descriptive

studies report summary data such as percentage that will be a big factor in getting the

needed information for this study. Quantitative method “emphasizes objective

measurements and the statistical, mathematical, or numerical analysis of data collected

 P a g e | 46

through polls, questionnaires, and surveys, or by manipulating pre-existing statistical data

using computational techniques. Quantitative research focuses on gathering numerical

data and generalizing it across groups of people or to explain a particular phenomenon.”

Spearman Rank – Order Coefficient of Correlation is a non – parametric method

appropriate for dealing with data that are measured on an ordinal scale, that is, the

subjects under study may be ranked in a two-ordered series. It is also a method of

determining the strength of relationship between two variables because it is not necessary

to assume that the observations are normally distributed.

Also this method was used to find out the significant relationship between peer

pressure and the possible reasons why adolescents still continue on cigarette smoking and

alcoholism.

Findings

On the profile of the respondents in terms of age, a total of 100 respondents were

chosen randomly in selected barangays of Santa Cruz, Laguna particularly in barangay

Poblacion I and in Sitio Maligaya barangay Pagsawitan. 4 (4%) of the 100 respondents

are 13 years old, this age has the least respondents from the three barangays, 7 (7 %) are

14 years old, 13 (13%) are 15 years old, 25 (25%) are 16 years’ old, this age has the

majority of the respondents from the three barangays, 17 (17%) are 17 years old, 16

(16%) are 18 years old and 18 (18%) are 19 years old.

On the profile of the respondents in terms of gender, 76 (76%) of the 100

respondents from barangay Poblacion I and Sitio Maligaya barangay Pagsawitan are male.

Majority of the adolescents who are cigarette smokers and alcohol users are male while 24
 P a g e | 47

(24%) of the 100 respondents from barangay Pobacion I and Sitio Maligaya barangay

Pagsawitan are female.

On the profile of the respondents in terms of address, 50 (50%) of the respondents

among the two barangays are from barangay Pobalcion I Santa Cruz, Laguna while 50

(50%) of the respondents are from Sitio Maligaya barangay Pagsawitan.

On the extent of influence of peer pressure among adolescents in relation to

cigarette smoking and alcoholism, it was found out that adolescents in selected barangays

of Santa Cruz, Laguna particularly in barangay Poblacion I and in Sitio Maligaya

barangay Pagsawitan are sometimes influenced by their peers to engage in cigarette

smoking and alcoholism with an overall average weighted mean of 2.676.

In terms of the possible health effects of cigarette smoking and alcoholism among

adolescents, it was found out that adolescents in selected barangays of Santa Cruz,

Laguna particularly in barangay Poblacion I and in Sitio Maligaya barangay Pagsawitan

are somewhat aware with an overall weighted mean of 2.150 of the possible health

effects that might occur in the short or long run as they continue on cigarette smoking and

alcoholism.

On the possible reasons why adolescents still continue on cigarette smoking and

alcoholism, the study revealed that among all items listed, “It alleviates my feeling of

depression” was the foremost reason why adolescents are involved in cigarette smoking

and alcoholism. In addition, adolescents are in between the decision to agree or to

disagree on the items listed in terms of the possible reasons why adolescents still continue

on cigarette smoking and alcoholism. The results were perceived as fair It was justified

by the computed overall weighted mean of 2. 659.

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The correlation between pressure and the possible reasons why adolescents still

continue on cigarette smoking and alcoholism were found to be correlated. It means that

peer pressure was successful to correlate with possible reasons why adolescents still

continue on cigarette smoking and alcoholism.

CONCLUSIONS

Based on the findings of the study, the following conclusions are arrived at:

Cigarette smoking and alcoholism typically occur among adolescents age 16 years

old while the minority of the cigarette smokers and alcohol users are 13 years old. In

terms of gender, more than the half of the respondents who engage in cigarette smoking

and alcoholism are males compared to the female respondents. In terms of address, the

respondents are from barangay Poblacion I and from Sitio Maligaya barangay Pagsawitan

Santa Cruz, Laguna

On the extent of influence of peer pressure among adolescents in relation to cigarette

smoking and alcoholism, it was found out that adolescents in selected barangays of Santa

Cruz, Laguna particularly in barangay Poblacion I and in Sitio Maligaya barangay

Pagsawitan are sometimes influenced by their peers to engage in cigarette smoking and

alcoholism.

Furthermore, the results show that the major possible health effects of cigarette

smoking and alcoholism are the increase of blood pressure and heart rate while the major

possible reason why adolescents still continue on cigarette smoking and alcoholism

regardless of the possible health effects that might occur in the short or long run is the
 P a g e | 49

alleviation of depression. Identified possible reasons why adolescents still continue on

cigarette smoking and alcoholism as perceived by adolescents bordered between agree

and disagree. This further denotes that the identified possible reasons may or may not be

true.

The correlation between peer pressure and the possible reasons why adolescents still

continue on cigarette smoking and alcoholism were found out to be correlated. This

implies that peer pressure is a major predictor of cigarette smoking and alcoholism

among adolescentsin selected barangays of Santa Cruz, Laguna particularly in barangay

Poblacion I and in Sitio Maligaya barangay Pagsawitan

RECOMMENDATIONS

Based on the finding and conclusions of the study, the following

recommendations are hereby submitted:

The researchers recommend to help and educate adolescents to develop

competencies that allow them to resist peer pressure to become involve with behavior

that puts their health and well-being at risk. Measures should be developed at school,

home, and in the community, the success of which depends on the involvement of peers

and parents, given the role they play in behavior modelling.

Adolescents should become aware on the possible health effects that might occur

as they continue on cigarette smoking and alcoholism. They should likewise be aware on

the effects of peer pressure and the act of choosing the acceptable peer groups to engage

with.
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On the part of the parents of the adolescents, they should provide for the suitable

parenting styles like involving in their teenager’s life, knowing who their friends are and

encourage independence but set appropriate limits, teaching the science of cigarette and

alcohol and help find alternative activity options for their children. They should

continuously and regularly monitor their children to show their affection towards their

children that may help them to reflect what are their peers’ behavior effects.

Public officials in barangay Poblacion I and in Sitio Maligaya barangay

Pagsawitan Santa Cruz, Laguna must strictly enforce the rules and regulations with

regards to the proper use of cigarette and alcohol. They should raise awareness and

should give appropriate measures to help both adolescents and their parents so that the

number of abusers will decrease.

Replication of the study is also recommend

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