Clarissa Mae Derecho,MD Jimson Rey Q. Intong,MD Author Department of Family and Community Medicine Vicente Sotto Memorial Medical Center Cebu City,Philippines Clarissa Mae Derecho,MD Co-author

Introduction The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing around 6 million people a year. More than 5 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.

Introduction The World Health Organization (WHO) has estimated that tobacco consumption kills 10 Filipinos every hour, due to cancer, stroke, lung and heart diseases brought on by cigarette smoking. Ten Filipinos die every hour from illnesses caused by smoking while the Philippines loses nearly P500 billion annually from healthcare costs and productivity losses.

Introduction The adult male smoking prevalence ranked 9th while adult female smoking prevalence ranked 16th in the world. Filipino women who are smokers have increased in number as well, with three out of ten female Filipino smokers are in their teens.

Introduction Tobacco consumption burden exerts most of its weight on health costs as more Filipinos get sick from tobacco-related diseases and a decrease in productivity cost. Dangers of smoking appear to have sunk in the minds of the Filipino public, however a lot of them particularly who are on the productive age group are unable to stop the habit.

Introduction Filipino smokers who need help to stop the habit can go to smoking cessation clinics spread across the country, usually in state hospitals. These clinics offer their services for free, as part of government’s proactive policy to curb the habit. Former DOH Secretary Enrique Ona stated that smoking cessation clinics offer needed support to smokers who want to quit and are experiencing much pressure in doing so.

Significance of the Study As a healthcare professional, it is essential that we provide an intervention to every tobacco user at each health care visit. A brief intervention is not easy to implement given time constraints and even willingness of the smokers. Even if the smoker is reluctant to seeking intensive treatments, a brief intervention received every clinic visit is beneficial.

Significance of the Study A research will be conducted on the probable factors affecting the readiness to stop smoking among male and female smokers seen at VSMMC OPD Room 1 ages 19-60 years old from April 2016-September 2016 which would provide a better understanding on the bio-psychosocial factor which influence smoking and would enable the healthcare provider to strategize smoking cessation support for male and female smokers who are ready to quit the habit.

Research Question Are the male and female cigarette smokers of VSMMC OPD Room 1 age 19 to 60 years old seen,from April 2016- September 2016 willing to quit smoking?

General Objective To identify the probable factors that affect the readiness for smoking cessation among male and female cigarette smokers seen at VSMMC Outpatient Department Room 1.

Specific Objectives To describe the demographics of male and female smokers seen at VSMMC OPD Room 1 patients ages 19-60 years old from April 2016 to September 2016 To describe the patients' smoking history and current smoking status as to age, occupation, level of literacy, exposure, and number of cigarette sticks per day. To determine the most common factors that motivate or lead to smoking.

Specific Objectives To determine the distribution of patients according to the level of Nicotine Dependence. To compare the population of patients with previous attempts to stop smoking, failure and relapse. To determine the distribution of patients according readiness for smoking cessation.

Review of Related Literature Cigarette smoking harms nearly every organ of the body, causes many diseases, and reduces the health of smokers in general. Cigarettes, cigars, and pipe tobacco are made from dried tobacco leaves, and ingredients are added for flavor and to make smoking more pleasant. The smoke from these products is a complex mixture of chemicals produced by the burning of tobacco and its additives. Tobacco smoke is made up of more than 7,000 chemicals, including over 70 known to cause cancer. Insert reference here

Review of Related Literature The Philippines was the 15th largest consumer of tobacco in the world in 2002 and currently has one of the highest smoking rates in Asia, as well as some of the lowest cigarette prices The World Health Organization estimates that 10 Filipinos die every hour due to cancer, stroke, lung and heart diseases brought on by cigarette smoking. Insert reference here

Review of Related Literature The World Health Organization released a document in 2003 entitled Policy Recommendations for Smoking Cessation and Treatment of Tobacco Dependence which clearly stated that as current statistics indicate, it will not be possible to reduce tobacco related deaths over the next 30-50 years unless adult smokers are encouraged to quit. Insert reference here

Review of Related Literature Considering that tobacco is addictive, many tobacco users will need support in quitting. Insert reference here

Operational Definition of Terms Substance Abuse – a patterned use of a drug which the user consumes the substance in amounts or with methods which are harmful to themselves or others. Nicotine Dependence/Tobacco Dependence – addiction to tobacco products caused by drug nicotine; a person who cannot stop smoking. Horn’s Smoker’s Self-test – a test to help assess an individuals dependence on tobacco. Fagerstrom test for Nicotine dependence – instrument that will be use for assessing the intensity of physical addiction to Nicotine. It contains six items that evaluate the quantity of cigarette consumption, the compulsion to use, and the dependence. Precontemplation – a client not intending to stop smoking for six months.

Operational Definition of Terms Contemplation – a client intending to stop smoking in next six months. Preparation – a client intending to stop smoking in the next month or have tried to stop in last twelve months or have made some behavioral changes. Action – a client has successfully stopped in the last six months. Maintenance – a client has 100% self-efficacy and does not feel any temptation to go back to the habit. Smoking Status – number of cigarette sticks consumed per day. Demographics – smoking population group.

This is a cross-sectional descriptive study Methodology A. Study Design This is a cross-sectional descriptive study

Methodology B. Study Setting The study will be conducted at the Vicente Sotto Memorial Medical Center Outpatient Department Room 1.

Methodology C. Study Population All male and female patients who come in for consult who are cigarette smoker’s ages 19 – 60 years old from April 2016- September 2016.

Methodology D. Inclusion Criteria All male and female patients who come in for consult, who are smokers ages 19 – 60 years old from April 2016- September 2016 at VSMMC Room 1 OPD from 8:00 am to 10:00 PM will be included in the study.

Methodology E. Exclusion Criteria Male and female patients ages below 19 years old and more than 60 years old will not be included. Male and female patients who are non-cigarette smokers will not be included in the study.

Methodology D. Data Collection and Procedure This study will utilize a descriptive cross-sectional design. All male and female patients age 19 – 60 years’ old seeking consult at the VSMMC OPD Room 1 who are cigarette smokers will be identified from April 2016 –September 2016.

Methodology The data enumerators are the Family Medicine Residents, Post Graduate Interns, and Interns. All patients who are smokers who come in for consult and those who qualify in the inclusion criteria will be identified.

Methodology Once identified, each patient will be given a series of questionnaires in the dialect for easier comprehension to the patients and would identify the following: Patients demographics History Smoking status as to sex, age, occupation, level of literacy, exposure, number of cigarette sticks per day Factors that leads or motivates to smoking, previous attempts to stop smoking, failure and relapse

Methodology Once identified, each patient will be given a series of questionnaires in the dialect for easier comprehension to the patients and would identify the following: Patients demographics History Smoking status as to sex, age, occupation, level of literacy, exposure, number of cigarette sticks per day Factors that leads or motivates to smoking, previous attempts to stop smoking, failure and relapse

Methodology E. Data Analysis 1) Results will be presented in means, proportions, and rates which will be depicted in graphs,figures and charts

Ganntt Chart March April May June July August September October November Orientation of Residents, PGI's, and Interns regarding the research March 1-3, 2016 Printing and reproduction of Questionnaires March 4-5, 2016 Dry Run for 1 week March 7-14, 2016 Analysis March 15,2016 Revisions March 16-18, 2016

Ganntt Chart March April May June July August September October November Collection of Data Proper Analysis of Data Revisions Printing of Final Paper Presentation of Research

Budget Item Price Bond Papers (2 reams) Php 1000.00 Ink Php 800.00 Ballpens Php 300.00 Folders Php 200.00 Total Php 2300.00