smoking tendecy

Chapter 1

THE PROBLEM

Introduction
According to Eagleman (2011) that despite the known catastrophic effects on health of smoking, profits from tobacco continue to soar and sales of cigarettes have increased: they have risen from 5,000 billion sticks a year in the 1990s to 5,900 billion a year in 2009. They now kill more people annually than alcohol, Aids, car accidents, illegal drugs, murders and suicides combined.
According to the National Nutrition and Health survey that cigarette smoking causes lung cancer. This fact has been recognized in the United Kingdom and the United States in the early 1950s yet. Subsequent studies have confirmed this claim. “Scientific data shows that smoking is associated with 30-40 percent of all cancer deaths,’’ says Dr. Tanquilino Elicano Jr., one of the country’s cancers experts. “ Cancer risk increases with the intensity of the habit, duration and the amount of tar in the cigarettes.’’ But despite this, Filipinos continue to smoke. It was showed in the survey that smoking prevalence in the country is higher than that in Singapore (24.2 percent), Japan (47.4 percent) and the United States (24.1 percent). Unknowingly, lung cancer is just one of the many diseases smokers likely to get (Tacio,2012) .
According to the Department of Health ,who amplifies the need to scale up anti-tobacco efforts in the country, the Philippines are among the top 20 nations with high “smoking population,”, The number of Filipino male smokers in 2008 was estimated at 17.6 million. And Filipino women are getting hooked to smoking primarily because they have become the target of cigarette companies (Crisostomo, 2012).
In Davao City smoking in public areas and the sale of cigarettes to minors had been banned since 2001, but in the year 2012, the Sangguniang Panlungsod decided to tighten the anti-smoking ordinance by including places previously identified as smoking areas into places where lighting cigarettes is now prohibited. The DOH said that 240 Filipinos die each day from tobacco-related illnesses. The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing nearly six million people a year. More than five million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke. Approximately one person dies every six seconds due to tobacco, accounting for one in 10 adult deaths. Up to half of current users will eventually die of a tobacco-related disease (Quiros, 2013).
And with the scenarios stated above, despite the known catastrophic effects on health of smoking, people still indulge to this bad habit and the rise of tobacco industries continue to rise and the death from tobacco-related illness may not change from the years to come and may become worse than ever. That’s why we the researchers have decided to pursue this study and in this small effort we can prevent the rise of such epidemic especially here in Brokenshire College.

Statement of the Problem
This study will investigate the relationship between psychosocial factors and tendency of adolescents to smoke specifically this will answer the following questions:
1. What is the extent of adolescents’ perception on the risk and benefits of smoking?
2. What is the level of psychosocial factors in terms of :
2.1 peer pressure
2.2 family smoking
2.3 self-projection
2.4 advertisement and media
3. Is there a significant difference in the extent of adolescents’ perception on the risk and benefits of smoking when analyzed according to gender?
4. Does a psychosocial factor significantly influence the adolescents’ perception on the risk and benefits of smoking?

Hypothesis The following hypothesis will be tested at 0.05 level:
H01: There is no significant difference in the adolescents’ perception on the risk and benefits of smoking when analyzed according to gender.
H02: Psychosocial factors do not influence the adolescents’’ perception on the risk and benefits of smoking.

Theoretical Framework

Social learning theory describes how we learn by example from others. We are strongly influenced by our parents, and other people we look up to, such as peers, actors and pop stars. This can lead us to emulate their behavior and try smoking. There is an almost immediate effect on our brains with those first cigarettes, so we keep smoking to get this reward. Later we learn to associate smoking with other activities such as drinking coffee, going to the pub, etc. We can become conditioned so just the thought of the activity triggers the need for a cigarette, just like Pavlov's dogs learned to drool at the sound of a bell. These psychological associations remain when smokers try to quit. Finally, you learn to keep smoking, because if you try to quit you are punished by withdrawal symptoms - irritability, snappiness, lack of concentration. Having a cigarette gets rid of these symptoms, negatively reinforcing the desire to carry on smoking. Such conditioning keeps you hooked on smoking because the reward when you smoke is instant, whereas it takes years before you become aware of the damage in terms of your health. Similarly, when you try to quit, the 'punishment' of withdrawal symptoms comes quickly, whereas the benefits of better health take longer to realize (S.Bonas 2006).

Conceptual Framework

Independent Variable Dependent Variable

Moderator Variable

Figure 1. Schematic Diagram showing the relationship of the variables in the study.

Based on the diagram, the independent variables is a psychosocial factor which has four indicators namely; peers pressure, image projection, family smoking, advertisement and media. On the other hand, the dependent variable is the adolescents’ tendency to smoke. And the mediator for this study is gender. Our independent variable affects the dependent variable in terms of an individual’s exposure to the one or more psychosocial influences, thus the adolescent may or may not be involved in the habit of smoking. However this depends solely in the respondents if he or she will continue to indulge to such dangerous habit.
Significance of the study
In this study of adolescents’ tendency to smoke and we the researchers aim to share what we have learned to the following people/organization(s). Thus:
Local Health Organizations. This study is beneficial for this institution because they can determine as early as now what is the cause or the root among adolescents’ tendency to smoke so that they can help both the family and individuals involved.
Brokenshire College. This will be very beneficial for this academic institution because they have a large number of adolescents’ that are mainly involved in this study and will be advantageous for most of them to know the adolescents’ tendency to smoke.
Parents/Family. This research study will be helpful for the parents and the significant others surrounding the adolescent so that they may avoid all those risks in smoking.
Adolescents. This research study is beneficial to the adolescents who have the tendency to smoke because if they will realize how bad smoking can be they can realize that it does nothing good and just ruins one’s body.
Future Researchers. And lastly for the future researchers, this research study will be helpful to them as a source of information and reference to enhance their knowledge and skills about the psychosocial influences that affects an adolescents’ tendency to smoke.

Scope and Limitation
This Research Study is only limited to the purposely selected respondents of Brokenshire College and their perception in the said habit.
This study was limited to the Psychosocial Factors (peer pressure ,family smoking, image projection, and advertisement and media) encountered by the researchers in terms of time availability and some biases of information that will be given by the respondents that is beyond the researcher’s control.
Compared with the demographic profile of the study (e.g. gender, and residence) the researchers need only to know the gender of the respondents, since the focus of the researchers are the age differences and the psychosocial factors that changes the adolescent’s tendency in smoking

Definition of terms
For the purpose of this study we the researchers have defined the following terms both conceptually and operationally.

Family smoking. A family member who has a habit of smoking maybe it the father, mother or the siblings (S.Reinberg 2013). In this study it indicates the immediate family member who engages in smoking, especially the parents of the adolescents who are the respondents of this study.

Media and advertisements. According to Bonas (2005) cultural images involving cigarettes are strong, and generally positive about smoking and have great effects in the factors for adolescents to smoke. And for this study it is the influences that can be seen around the adolescents’ environment thus engaging into smoking.
Peer Pressure. Is a strong desire to fit into certain groups, and they are becoming more and more self-reliant. (B. Epstein, author of “The Importance of Peer Pressure”). In this study it refers to the level of peer pressure experienced by the students in Brokenshire College.
Psychosocial Factors. The definition of psychosocial factors is then; an agent of the mind or behavior of an individual or group that actively contributes to a result. For this research study psychosocial factors (peer pressure, image projection, smoking in the family and advertisement and media) are the thing that influences adolescents’ views about smoking.

Chapter 2

REVIEW OF RELATED LITERATURE

The review of related literature covers (1) Conceptual Literature whereby the psychosocial factor affects adolescents’ views on smoking is presented. (2) Research literature wherein recent and past studies are cited and (3) synthesis.

Psychosocial Factors Almost one fourth of adolescents are regular smokers. The majority began smoking during adolescence and progressed to a regular habit by age 18.Given that adolescence is a critical period for the initiation of smoking experimentation and the progression to a regular habit, it is important to identify and to intervene regarding factors that influence smoking progression. In this study, smoking is associated with peer pressure, family smoking, media and advertisement and image projection that will be discussed further on (McGovern et.al 2005). Peer pressure. For an adolescent can be hard for anyone to resist, no matter what your age. Smoking can play an important role in friendships, while offering a cigarette or asking for a light can be ice-breakers to start a conversation. It can create a bond between smokers, for example the huddled groups who smoke outside offices. If your friends smoke, deciding to quit can be awkward (McGovern et.al 2005).
Media and advertisements. Over the year’s television shows and films have effectively built up associations between smoking and glamour, sex and risk-taking. From classic movies with Humphrey Bogart to Uma Thurman in Pulp Fiction, cultural images involving cigarettes are strong, and generally positive about smoking. In addition, individuals subjects to advertising that deliberately promotes smoking and makes positive associations with brands (S.Bonas,2005).
Family smoking. Children are greatly influenced by their environment. If they see an adult they admire smoking they are much more likely to pick up the habit. They view it as something cool, grown up, or even expected. It probably won't be a surprise to learn that children who grow up with smokers are more likely to become smokers themselves. A child is more likely to smoke if one parent is an active smoker -- and that likelihood rises if both parents smoke. Boys are more influenced by a smoking father, while girls are influenced by either a smoking mother or a smoking father. The younger and longer a child is exposed, the more likely they are to become smokers themselves. This is especially true if a child is exposed to a smoking parent before the age of 13. And if a mother smoked more than a pack a day during her pregnancy, there is an even higher chance that her baby will become dependent on nicotine if he or she starts to smoke (M. Oz, 2014)

Benefits of Smoking
All of us have this far range negative feedback on smoking but surprisingly, Smoking lowers risk of knee-replacement surgery. While smokers might go broke buying a pack of cigarettes, they can at least save money by avoiding knee-replacement surgery. Surprising results from a new study have revealed that men who smoke had less risk of undergoing total joint replacement surgery than those who never smoked. The study, from the University of Adelaide in Australia, appears in the July issue of the journal Arthritis & Rheumatism. Knee-replacement surgery was more common among joggers and the obese; smokers rarely jog, and they are less likely to be morbidly obese. It could be that the nicotine in tobacco helps prevent cartilage and joint deterioration. Smoking lowers risk of Parkinson's disease. Harvard researchers were among the first to provide convincing evidence that smokers were less likely to develop Parkinson's. Smoking lowers risk of obesity. Smoking — and, in particular, the nicotine in tobacco smoke — is an appetite suppressant. This has been known for centuries, dating back to indigenous cultures in America in the pre-Columbus era. Tobacco companies caught on by the 1920s and began targeting women with the lure that smoking would make them thinner. The relationship between smoking and weight control is complex: Nicotine itself acts as both a stimulant and appetite suppressant; and the act of smoking triggers behavior modification that prompts smokers to snack less. Smoking also might make food less tasty for some smokers, further curbing appetite. As an appetite suppressant, nicotine appears to act on a part of the brain called the hypothalamus, at least in mice, as revealed in a study by Yale researchers published in the June 10, 2011, issue of the journal Science. Smoking lowers risk of death after some heart attacks. Compared with non-smokers, smokers who have had heart attacks seem to have lower mortality rates. Smoking helps the heart drug clopidogrel work better. However, cigarette smoking has been confirmed to provide numerous benefits to the health of smokers. Surprisingly, the tobacco plant appears to have more to offer our bodies than a guarantee of certain death. Although the health benefits of smoking are far outweighed by the many very dire risks, tobacco may provide alternative relief or prevention for some diseases in certain individuals. The most fascinating and widely recognized health benefit of smoking is its ability to seemingly alleviate symptoms of mental illnesses, including anxiety and schizophrenia. According to an article published in 1995 in Neuroscience & Bio behavioral Reviews, schizophrenics have much higher smoking rates than people with other mental illnesses, and appear to use it as a method of self-medicating. The article postulates that nicotine found in cigarettes reduces psychiatric, cognitive, sensory, and physical effects of schizophrenia, and also provides relief of common side effects from antipsychotic drugs (Wariscrime, 2011).

The University of Melbourne confirmed the claims made by many smokers that tobacco itself is a strong appetite suppressant, and many use it to self-treat compulsive overeating disorders or obesity. Many smokers experience weight loss and decreased appetite after they begin smoking.Cigarette smoking has also been linked to a decrease in risk of certain inflammatory disorders, since nicotine itself appears to be an anti-inflammatory agent. Perhaps most shockingly, tobacco smoke's anti-inflammatory effects may actually provide some benefits to children who are exposed to secondhand smoke. While this is certainly not worth at-home experimentation, one astonishing study conducted in Sweden observed two generations of Swedish children and found that the children of smokers had lower rates of allergic rhinitis, allergic asthma, atopic eczema, and food allergies. Other surprising academic findings reveal that tobacco may have a positive effect on pregnancy. A study published in the American Journal of Obstetrics and Gynecology revealed that preeclampsia, an extremely common but potentially deadly condition, is significantly less common in expectant mothers who smoke cigarettes than in expectant mothers who do not smoke. Smoking also reveals a surprising link to decreased mortality and morbidity for some conditions. Emerging research may soon reveal an ability to synthesize and isolate the few positive chemicals in cigarettes and use them to manufacture new treatment options (Brownstein, 2011).

Risks of Smoking

Advantages and disadvantages never go separarate ways, and in this case smoking causes emotional distress can be attributed to financial worries in these economically uncertain times. Looking at the dismal employment situation, many students with college loans fret about how they will be able to repay them. Furthermore, family support systems are not what they used to be for students whose parents are separated, divorced or remarried. Even with colleges there may now be less support from peers with the increase in none-traditional students who lived on their own off campus rather than in dormitories. These challenges can land on top of traditional causes of student’s distress like broken romantic relationships, bad grades, insufficient sleep, difficulty making friends, failing to join fraternities or sororities, home sickness, or simply feeling overwhelmed by the amount of work that has to be done (Brody, 2003) Heart disease is the leading cause of death in the United States today, and the leading cause of death among smokers. Cigarette smoke contains over 4,000 chemical compounds; 200 of which are known to be poisonous, and upwards of 60 have been identified as carcinogens. Viewed in that light, it's no wonder that the effects of smoking are so widespread and destructive.(Martin,2013)

Smoking causes cataracts and contributes to the development of osteoporosis, thus increasing the risk for fracture in the elderly. During 1995-1999, smoking caused approximately 440,000 premature deaths in the United States annually, leading to 13.2 years of potential life lost for male smokers, and 14.5 years lost for female smokers. Changes in cigarettes that reduce machine yields of tar and nicotine have not had any clear benefits for public health. Smoking harms nearly every organ of the body, causing many diseases and reducing the health of smokers in general. Quitting smoking has immediate as well as long-term benefits, reducing risks for diseases caused by smoking and improving health in general. Smoking cigarettes with lower machine-measured yields of tar and nicotine provides no clear benefit to health. The list of diseases caused by smoking has been expanded to include abdominal aortic aneurysm, acute myeloid leukemia, cataract, cervical cancer, kidney cancer, pancreatic cancer, pneumonia, periodontitis, and stomach cancer. These are in addition to diseases previously known to be caused by smoking, including bladder, esophageal, laryngeal, lung, oral, and throat cancers, chronic lung diseases, coronary heart and cardiovascular diseases, as well as reproductive effects and sudden infant death syndrome (T.Thompson, 2004).

Smoking raises blood pressure, which can cause hypertension (high blood pressure) – a risk factor for heart attacks and stroke. It worsens asthma and counteracts asthma medication by worsening the inflammation of the airways that the medicine tries to ease. The blood vessels in the eye are sensitive and can be easily damaged by smoke, causing a bloodshot appearance and itchiness. Heavy smokers are twice as likely to get macular degeneration, resulting in the gradual loss of eyesight. Smokers run an increased risk of cataracts. It takes 25 percent sicker day’s year than non-smokers and stains your teeth and gums. Smoking increases your risk of periodontal disease, which causes swollen gums, bad breath and teeth to fall out. It causes an acid taste in the mouth and contributes to the development of ulcers. It also affects your looks: smokers have paler skin and more wrinkles. This is because smoking reduces the blood supply to the skin and lowers levels of vitamin A. Erection problems in smokers may be an early warning signal that cigarettes are already damaging other areas of the body – such as the blood vessels that supply the heart. There are many health-related reasons to give up cigarettes – not just for smokers, but to protect those around you (Marcair,2009) .
Teen smokers are more likely to have panic attacks, anxiety disorders and depression. The lungs of teens that smoke will not develop fully, which puts them at higher risk for lung disease. Adolescent smokers were found to have impairments in accuracy of working memory performance irrespective of recency of smoking. Performance decrements were more severe with earlier age of onset of smoking. Adolescent smokers experienced further disruption of working memory and verbal memory during smoking cessation. Adolescent daily tobacco smokers experience acute impairments of verbal memory and working memory after smoking cessation, along with chronic decrements in cognitive performance that are consistent with preclinical evidence that neurotoxic effects of nicotine are more severe when exposure to nicotine occurs at earlier periods in development (Jacobsen,et.al,2010) .
The illnesses caused by smoking extend beyond the well-reported links with cancer, heart disease and respiratory illnesses. Smoking can cause impotence, ulcers and fertility problems and it's doesn't just harm smokers. Passive smoking causes lung cancer and is linked to cot death, glue ear and asthma in children. Children whose parents smoke are twice as likely to start compared to those with non-smoking parents. A Scottish study of teenage girls found that smoking was part of an image cultivated by the girls who were seen as leaders of their groups. Smoking went along with wearing short skirts, jewelry and make-up. In contrast, a study by the World Health Organization found that the 11 to 15 year olds who were most likely to be smokers were lonely, had difficulty talking to parents, had problems at school and had started drinking alcohol (S. Bonas 2006).

Research Literature
For the past four years, the smoking rates for high school seniors have remained flat, a trend that now threatens the historic near 30-year decline in youth smoking (Johnston, O’Malley, Bachman, &Schulenberg, 2008). In the United States, 23% of high school seniors smoke at least monthly (Centers for Disease Control and Prevention, 2006), far short of the Healthy People 2010 (US Department of Health and Human Services, 2000) national goal of 16%. Basic research on the psychosocial influences on adolescent smoking acquisition is therefore needed to improve youth smoking prevention programs. A major contemporary theory pertinent to understanding adolescent smoking acquisition is the Theory of Triadic Influence (TTI; Petraitis, Flay, & Miller, 1995; Flay, Petraitis, & Hu, 1999), which is based on over 20 years of extant research. TTI posits that there are direct and interactive influences of social and psychological factors on adolescent smoking acquisition.Consistent with TTI, the major influences on adolescent smoking are social environments and three types of psychological factors: (1) interpersonal, (2) attitudinal, and (3) intrapersonal (Flay et al., 1999). TTI states that examining these factors at the distal-level helps in understanding the intermediate causes of smoking behavior (Petraitis et al., 1995). Distal-level social environments refer to the behaviors of influential role models (Petraitis et al., 1995). These include having: (a) parents who smoke and (b) close friends who smoke. Distal-level interpersonal factors refer to emotional attachments to influential role models (Flay et al., 1999). These include having: (a) a weak desire to comply with parents (i.e., parent-noncompliance; Martin et al., 1994) and (b) a strong desire to comply with friends (i.e., friend-compliance; Santor, Messervey, &Kusumakar, 2000). Distal-level attitudinal factors refer to general values that contribute to attitudes toward tobacco use. These include: (a) a weak desire for achievement (i.e., low achievement motivation; McClelland, Atkinson, Clark, & Lowell, 1953) and (b) rebelliousness, defined as the extent to which adolescents prefer behavior that does not conform to authority in general (Santor et al., 2000). TTI suggests that the impact of various social factors is moderated by an individual’s psychological susceptibility to influence by those factors (J.Bricker, 2009).

Gender and age differences among current smokers in a general population survey. Quitting smoking is a major public health goal throughout the life span. Benefits of smoking cessation exist even at the age of over 60 years. Although there is large and consistent evidence that the proportion of current smokers declines by age including those above 65, there are substantial subpopulations that maintain this health detrimental behavior . Even among the oldest olds, individuals maintain smoking. Little is known about associations with gender in this process. The proportion of current smokers among male ever smokers aged 65 or older in the USA was 18.5 % (CI 15.0 – 21.0 %) in 1994, which was lower than the equivalent proportion among female ever smokers aged 65 or more (29.3 %; CI 26.1 – 32.5 %). With increasing age, the proportion of current smokers tended to be higher among female than among male ever smokers. One reason for the higher proportion of current smokers among older female compared to older male ever smokers might be that the women may be lighter smokers than men and thus are less prone to smoking-attributable disease. Women at a certain age might have smoked less over the lifetime and might have started smoking later in life than men at that age. Female smokers might feel fewer burdens from consequences of smoking compared to men. This assumption is supported by evidence showing a lower tobacco-attributable mortality and fewer years of potential life lost from smoking in women than in men. Accordingly, current smokers among women might fear less threat from disease and death that is attributable to smoking. Evidence suggests a higher proportion of current smokers among female than among male ever smokers at the age above 50. The proportions of current smokers among ever smokers were analyzed dependent on age, age of onset of smoking and cigarettes per day including effect modification by gender. No such interaction existed for age of onset of smoking or cigarettes per day (John et al., 2005).
Several theories suggest that perception of the risks of smoking motivate individuals to adopt or maintain non-smoking status, the research literature has generally failed to demonstrate the relationships between perceived benefits and smoking behavior among adolescents. The results from logistic regression indicate that perceived social benefits, such as easier to make friends and attractive to opposite sex, was the most significant predictor of smoking experience after controlling for gender and knowledge. Perceived benefits and risks of smoking were also significant predictors of smoking experience (M. Chaiton, 2001).
There is a substantial body of research suggesting that the lines of friendship are often characterized by smoking behavior, where smokers befriend smokers, and nonsmokers befriend other non-smokers. Non-smokers who affiliate with smokers have been found to be at greater likelihood for transitioning to tobacco use than youth without smoking friends. In addition, transitions to increased levels of smoking have been linked to friends’ encouragement and approval (Duncan et al . 1995; Flay et al. 1998), and the message conveyed that smoking is an enjoyable activity that promotes popularity (McAlister et al.1984).
Despite this large research base, many questions remain unanswered about the mechanisms by which peers affect youths’ smoking behavior. Understanding these processes of influence is key to the development of prevention and intervention programs designed to address adolescent smoking as a significant public health concern. Social learning theory, primary socialization theory, social identity theory and social network theory are discussed. Empirical findings regarding peer influence and selection, as well as multiple reference points in adolescent friendships, including best friendships, romantic relationships, peer groups and social crowds, are also reviewed. Review of this work reveals the contribution that peers have in adolescents’ use of tobacco, in some cases promoting use, and in other cases deterring it. This review also suggests that peer influences on smoking are more subtle than commonly thought and need to be examined more carefully, including consideration of larger social contexts, e.g. the family, neighborhood, and media. Recommendations for future investigations are made, as well as suggestions for specific methodological approaches that offer promise for advancing our knowledge of the contribution of peers on adolescent tobacco use. Adolescence is clearly a sensitive time period in the onset of cigarette smoking. Peers and peer relationships have been cited frequently as major factors involved in this cigarette use (O’Loughlin et al. 1998).

Smoking continues to be a leading cause of preventable deaths and rates of trying cigarettes and progression to daily smoking among adolescents continues to remain high. A plethora of risk factors for smoking among adolescents has been addressed in the research literature. One that is gaining particular interest is the relationship between adolescent mental health and smoking (both initiation and progression). This paper reviews the evidence for adolescent mental health as a risk factor for cigarette smoking. The focus on the specific mental health conditions that have been more thoroughly addressed as possible risk factors in community-dwelling adolescents (J.Hockenberry,et al. 2011).
Each year, approximately 1 million additional people become daily cigarette users, 44.2% of whom are younger than 18 years. Every day, more than 4000 adolescents aged 12 to 17 years try their first cigarette, and 1300 of them go on to become daily smokers. Given these statistics, it is clear that preventing initiation of tobacco use among adolescents is crucial to reducing adult-onset disease and mortality. A prominent explanation for adolescent smoking is that adolescents have poor decision making and risk-judging skills, leading them to believe they are invulnerable to harm. This explanation is consistent with major theories of health behavior, including decisional balance theory, the health belief model, and the theory of planned behavior. These theories serve as the basis for many tobacco-use intervention programs that aim to decrease initiation and increase cessation by giving adolescents information about tobacco risks (A. Song, et.al, 2008).

Despite the large number of studies identifying an association between adolescent peer relationships and smoking, our understanding of how peers contribute to this behavior remains limited. For example, the processes by which teenagers are socialized to smoke, including both being influenced by and influences on their friends, is unclear. Even less is known about the complementary process of selection, where youth are selected by peers to enter friendships or are excluded from such relationships based on smoking. In sum, current research findings only scratch the surface with regard to the dynamic nature of adolescents’ peer relationships and their impact on the non-uniform patterns of tobacco use and non-use. The current paper presents a review of existing knowledge about the role that peers play in teenage smoking. Although at times the more general terms tobacco use and smoking are used, in all cases, the information presented refers to cigarette smoking. In examining the role of peers on cigarette use, this paper reviews critically research in the tobacco literature, as well as related findings from studies that have targeted other high-risk behaviors, including delinquency, drinking and drug use. Findings from the adolescent peer relationship literature are considered, including research on developmental trends in friendship patterns, the process of peer influence and the role of peer social networks and contexts. The paper begins with a discussion of theoretical frameworks for understanding social– contextual influences on health-risk behaviors, including social learning, primary socialization, social identity and social network theories. Next, it turns to the empirical literature, discussing what is currently known and what needs to be better understood about adolescent peer relationships and their contribution to tobacco use. The processes of peer influence and selection are addressed in this section, as well as the multiple points of reference that have been considered in studying peer relationships, including best friendships, romantic relationships, peer groups and social crowds (Kobus et al., 2003).

Synthesis: Smoking is dangerous to your health, that’s one thing were sure about. It may still have some beneficial use but still outweighed by the risks. And now that chapter two is done and the variables have been stated in relation to the literatures we will continue to use this information for further improvement of the study. Our study focuses on the tendency of adolescents’ to smoke and why these people do not stop to indulge to such habits. The authors in the researches have provided us an ample amount of sources to be able to get what we wanted. And all these information will be used accordingly for our study.

Chapter 3
METHODOLOGY

The primary purpose of this chapter is to describe method and procedure that will be used to conduct the study. This will include the research, respondents of the study ,research instrument and procedure.

Research Design:
This study will use descriptive-correlational design in determining the adolescents’ views on the risk and benefit of smoking: exploring gender differences and psychosocial factors. Is one that helps to determine if two or more variables are associated with each other by explaining their relationship but not necessarily implying that this relationship is also a cause. Almost similarly is a descriptive correlational design, which uses existing mutual relationships between data to describe it but does not endeavor to establish whether these are statistically significant correlations. In relation to our study we used more than two variables which are the psychosocial influences (peer pressure, family smoking, media/advertisement, image projection) risks and benefits of smoking and gender differences.

Research Instrument
The instrument contain descriptive question. This question is self-made and base on the information gathered in review of related literature in chapter II. The questionnaire contains two parts wherein the first part of the questionnaire contains profile and the second part contains indicators that measure the adolescents’ tendency to smoke using four point likert scale.5 strongly agree, 4 agree, 3 fairly well agree, 2 disagree, 1 strongly disagree. For them to answer the questions we provided questionnaires and also numbers in which they have to check that corresponds to their answer.

Data Gathering
During the pre-collection the researchers sought permission from the Dean of Nursing College Department for the approval of the title that researchers decided to study after the approval of the Dean, the researchers is divided into group to make the introduction, review of the related literature and making the method containing the research design.\
After sometime, the researchers were able to determine the number of respondents; the respondents took the survey proper. Researcher oriented the respondents on the purpose of the study and instructed them how to accomplish the test.
When questions arise, if any, they where been duly answered. Researchers administered the research or testing instrument within specified time frame, and retrieve the duly accomplished research or testing instruments. Then, collated and tabulated the gathered research or achievement test data that was submitted for statistical treatment and analysis.

Data Analysis The researchers used the following to describe the respondent’s profile and the distribution that was used. Frequency distribution is use to get the percentage distribution of the respondent’s profile involving gender, age, if smoker or non-smoker , and if living with a smoker or non-smoker . Mean will be computed to know the psychosocial effects of adolescents’ tendency to smoke in Brokenshire College . Descriptive statistics will be used to find out the respondents’ tendency to smoke in terms of peer pressure, family smoking , image projection and media/advertisement which will be classified according to strongly agree, agree, fairly well agree, disagree, strongly disagree.
Pearson r is to determine whether or not there is correlation between the dependent and independent variable.