REVIEW OF RELATED LITERATURE

Smoking is a major public health problem worldwide, resulting in many tobacco

associated deaths. It has been more than half a century since scientists first pointed out the

dangers of tobacco use.

According to the World Health Organization (WHO), over one billion people are smokers

globally, and 80% of them are from developing countries. It has been suggested that by 2030,

tobacco smoking will kill more than eight million people each year. Scientific data indicate the

harmful effects of smoking and identify its contributions to the emergence of various types of

cancers. Smoking causes about 90% of all lung cancer deaths in the United States and more

women die from lung cancer each year than from breast cancer.

According to Global Youth Tobacco Survey (GYTS) results from 2013 and 2018 showed

a significant increase over this time period in the use of tobacco and other tobacco products

among 13 to 15 year old students, from 7.9% in 2013 to 9.1% in 2018. The percentage of

students who had smoked at least once increased from 36.5% in 2013 to 38.9% by 2018.

Worldwide, tobacco-use prevention measures remain focused on adolescents and young people.

Although various social and behavioral factors of smoking have been identified globally, there is

a need to understand the country-specific risk factors of smoking, especially among young

people. The majority of adult smokers started smoking in their teenage or adolescent years, and it

is essential to identify the factors associated with youth smoking behavior and take measures to

reduce those. In adolescence, cigarette smoking also contributes to other risk behaviors, such as

risky sexual behavior, drug and

According to Dumapig (2015) To address the growing tobacco epidemic, the Philippines

started implementing tobacco control measures as early as 1987. Several tobacco control policies
were enacted to: 1) increase tobacco taxes, 2) ban tobacco advertising or promotion, 3) designate

smoke-free places, and 4) ban the sale of tobacco products to minors.

According to the Theory of Planned Behavior, a behavior is a result of the intention to do

the behavior and the perceived control over it. Behavioral intentions are often influenced by the

attitude towards the behavior, the subjective evaluation of the results of the behavior, and the

perceived control over the behavior. While the relationship between intention and behavior is not

always perfect, the intention is often used as a proxy for actual behavior. Given inadequate

information, young people often underestimate the risk of becoming addicted to smoking due to

nicotine, which relates to underestimating future costs and consequences5. This myopic view on

the ills of tobacco use and the external costs imposed on others, which result in premature death

and illness, justifies government intervention through strategies including regulation, taxation,

and information dissemination

According to a 2009 survey conducted under the auspices of the Philippines' Department

of Health, Philippine Statistics Authority, the World Health Organization, and the United

StatesCenters for Disease Control and Prevention, 28.3 percent of the population are "current

tobacco smokers". This figure represents 17.3 million of 61.3 million adult Filipinos.

According to US National Library of Medicine, National Institutes of Health. (2017) As

part of the Global Burden of Disease Study carried out by the Harvard University School of

Public Health in 1997, it was projected that mortality and morbidity from tobacco use will

increase by almost threefold worldwide in 20 to 25 years. Similar predictions have been made by

the Oxford University Center headed by Sir Richard Doll, who was one of the first researchers to

link cigarette smoking with lung cancer in the 1950s. Cancer, cardiovascular diseases and

chronic obstructive pulmonary disease continue to be the main health problems associated with
cigarette smoking. An extensive database has accumulated, which has consistently documented a

relationship between smoking and these specific diseases. The strength of the association is

further demonstrated by measuring the RR and the presence of a dose-response relationship (ie,

direct relationship between the intensity of exposure to cigarette smoke and the risk of disease).

According to Inquirer.net (2021, March) It is not just “noynoying” that young Filipinos

are adopting from President Benigno Aquino III’s known habit.

According to Doll et al. (2020) stated that tobacco smoke contains nicotine and

monoamine oxidase (MAO) inhibitor, both combined to result in addictive stimulant and

euphoriant properties. American Cancer Society (2019) has confirmed that prolonged smoking

causes a wide range of diseases leading to premature morbidity and mortality.

According to the American Cancer Society (2022) and United States (US) Surgeon

General (2019), its intake also causes fatal diseases such as chronic obstructive lung disease

(emphysema and chronic bronchitis), lung cancer, ischemic heart disease, bladder cancer, upper

respiratory tract cancers and pancreatic cancer.

According to Ershler et al. (2018),Chassin et al.(2020), and Escobedo et al.(2018) have

shown that smoking initiation during adolescence increases the likelihood of continued smoking

during young adulthood and smoking during young adulthood also decreases the chance of

quitting. A national survey based in US observed that high school students who had smoked

cigarettes more often and in greater quantity during childhood are at an increased risk of

becoming long-term smokers than those who initiate smoking in adolescence.

According to Pierce et al.(2021) reported that the large majority of long-term smokers

take up smoking during the ages 10–25 year. Through smoking, most young people show their
power and importance. They smoke ultimately to express the thought that they have moved into

adulthood.

According to the Theory of Triadic Influence stipulates that factors from three different

levels of contacts can influence youth smoking onset: individual characteristics (eg age and

gender), characteristics in the immediate social environment surrounding youth (eg friends and

family members) and characteristics in the broader social environment surrounding youth (eg

school community) as documented by Koushki and Bustan (2019).

According to the World Health Organization, adolescents are widely considered to be

prone to recklessness and risk-taking behaviours, which can lead to substance abuse, car

accidents, unsafe sex, and andjuvenile delinquency. There is some evidence that this risk-taking

is biologically driven, caused by the social and emotional part of the brain (amygdala)

developing faster than the cognitive-control part of the brain (frontal cortex). Although most

adolescents are psychologically healthy, they can (like adults) exhibit signs of established habits

due to its acquaintance in the early adolescence.

According to Durie M, (2022) Higher smoking prevalence is seen as contributing to

higher rates of morbidity and mortality among Māori. Māori females, in particular, share a

disproportionate burden of smoking-related morbidity and mortality and they suffer lung cancer

rates that are among the highest in the world.

According to Ling P & Glantz S, 2023 the first, preparatory, stage is where prospective

smokers form attitudes and beliefs about the utility of smoking and advertising. The second,

trying, stage is characterised by the person smoking a few cigarettes. The third stage is

experimental where the person smokes repeatedly but irregularly. During the fourth, regular,

stage the person moves into regular use of cigarettes, where they are smoking at least weekly,
across a variety of situations and personal interactions. The final, addicted/dependent, stage is the

move to become a dependent or addicted smoker; at this point the person has developed the

physiological need for nicotine.

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