Ballesteros National High School

BALLESTEROS NATIONAL HIGH SCHOOL 1
Chapter 1
PROBLEM AND ITS BACKGROUND
INTRODUCTION
Smoking cigarette rolls have always been and still considered to be
detrimental to the health of the general public. Even the effects of “second hand
smoke” have proved time and again able to negatively affect the body’s
respiratory system.
But at last, through the thriving of science and technology, an electronic
battery operated cigarette named as “e-cigarette” has been developed which
holds a vaporized solution that typically contains nicotine which has a negative
impact on a teen’s brain development including increased risk for depression,
mood disorders and future substance misuse. Also known as “e-juice”, e-
cigarettes are liquids which turns into vapor when using the devices. The liquid
comes in flavors such as mint, fruit and bubble gum which appeal to kids on
which the flavorings also hides possible toxins.
E-cigarette during the last decade has gained immense popularity and
recognition especially in the medical rehabilitation programs and institutions.
However, a number of people have the common misconception that e-cigarettes

provide nicotine, the substance that when inhaled exposes you to toxic elements
such as arsenic and chromium.
Furthermore, e-cigarettes also aim to resemble cigarettes but without
burning tobacco. However, few who use e-cigs to refrain from smoking the
traditional rolls also fail to achieve their primary usage reason.
Because e-cigs have only thrived recently, few studies have been
conducted and reviewed about the status of e-cigs and their general impact.
In line with this, the researchers conducted this study to further develop
concrete studies about the impact of e-cigarettes, their extent of usage and the
general awareness of the users regarding the impact of the said devices to their
health.
STATEMENT OF THE PROBLEM
Generally, this study aimed to determine the impacts of e-cigarette to the
High School students in Ballesteros, Cagayan.
Specifically, this study aimed to answer the following questions.
1. How do e-cigarettes impact the High School student users?

2. How often do the High School students use e-cigarettes?
3. Why High School students in Ballesteros, Cagayan use e-cigarettes?
4. How to help users stop from using e-cigarettes?
SIGNIFICANCE OF THE STUDY
The study intends to investigate on the effects of e-cigarette on the mental
health of High School students that may benefit the following:
Students. This study will help them to be aware on the effects of e-
cigarette on their mental health.
Community. This study will help them to know further information about
the effects of e-cigarette.
Researchers. This study will help the researchers to gain knowledge that
will contribute the future studies.
Future Researchers. This study will give the future researchers an
additional information that can be basis forfurther improvements.

Medical Community. This study aims to show a preview of how e-
cigarettes are generally valued and used bythe public.
Scope and Delimitation
This study aimed to determine the perceptions, motives and behaviors of
e-cigarette users which is the main focus of the researcher.
This study is delimited only to 15 high school students of Ballesteros,
Cagayan, ages 14-18 school year 2018-2019.
The information were being gathered through interview. All information
gathered from the respondents will confine only to e-cigarette users.
Definition of Terms
For better understanding of the study, the following terms are conceptually
defined:
Arsenic. It is a naturally occurring element that is found in combination
with either inorganic or organic substances to form many different compounds.

Electronic Cigarettes. It is also known as e-vaporizers, are battery
operated devices thatpeople use to inhale.
Nicotine. This is one of more than 4000 chemicals found in the smoke
from tobacco products. Itaffects the heart, hormones and gastrointestinal system.
Smoker. Someone who smokes tobacco, cigarette substitutes or various
other drugs.
Smoking Cessation. It is the process of discontinuing tobacco smoking.
Traditional Cigarette. It is a cylindrical roll of shredded or ground tobacco
that is wrapped in paper.
Toxins.These are small molecules, peptides or proteins that are capable
of causing disease on contact with or absorption by body tissues interacting with
biological micro-molecules.
Chapter 2
REVIEW OF RELATED LITERATURE AND STUDIES
Introduction
A background study about the effect of e-cigarette on the mental health of
e-cigarette users were outlined. In this chapter, a literature based analysis will be
undertaken to understand the concepts that define the research problem earlier
stated.
RELATED LITERATURE
Foreign Literature
Use of electronic cigarettes (e-cigarettes), referred to as vaping, is a
relatively new phenomenon that is quickly gaining the interest of many long-time
tobacco smokers. E-cigarettes are becoming a preferred alternative for nicotine
delivery among many smokers because of their realistic look, feel and taste
compared to traditional cigarettes. Furthermore, many cigarette smokers have
turned to vaping because e-cigarette vendors have previously marketed their
product as cheaper and safer smokeless alternative to traditional cigarettes, and
a possible smoking cessation tool. (Palazzolo, Dominic 2013)

Although there are limited data on the short and long-term health effects of
e-cigarettes, a few studies evaluated their health effects. Findings of an
experimental laboratory-based intervention study showed that after five minutes
of using e-cigarettes containing nicotine, propylene glycol, linalool, tobacco
essence, and methyl vanillin, there was an associated increase in lung flow
resistance and decrease in fractional exhaled nitric oxide concentration. Nitric
oxide has an important role in the respiratory track and is a marker of
pathophysiology of airway 18 diseases associated with smoking. (Vardavas et.
al., 2012)
Once you get rid of the smoke, e-cigarettes and traditional cigarettes still
share at least one poison in common: nicotine. Users of e-cigarettes have the
option of choosing the quantity (usually in percentages) of nicotine that their e-
cigarette contains. In most cases, it is estimated that the majority of e-cigarettes
contain at least 1.2%, usually more, and sometimes more than 4% nicotine.
(Grana et al., 2013)
More research needs to be conducted to determine the safety and efficacy
of e-cigarettes as a smoking cessation tool. Individuals who have successfully
quit smoking in favor of vaping should continue to use e-cigarettes as a healthier
alternative to conventional cigarettes. (Foulds et al. 2013)

E-cigarettes, with or without nicotine, were modestly effective at helping
smokers to quit, with similar achievement of abstinence as with nicotine patches,
and few adverse events. (Bullen et al. 2013)
Although smoking cessation is currently the only guaranteed way to
reduce the harm caused by tobacco smoking, a reasonable secondary tobacco
control approach may try and reduce the harm from continued tobacco use
amongst smokers unable or unwilling to quit. Possible approaches to reduce the
exposure to toxins from smoking include reducing the amount of tobacco used,
and using less toxic products, such as pharmaceutical, nicotine and potential
reduced-exposure tobacco products, as an alternative to cigarettes. (Lindson-
Hawley N, et al. 2016)
E-cigarettes with higher nicotine content are more successful in the
smoking cessation process. (Farsalinos et al. 2013)
Nicotine in e-cigarette aerosol is lower than in cigarette smoke. Efficacy
and consistency of nicotine vaporization between brands is variable. Longer puff
durations may help e-cigarette users to compensate for poor nicotine delivery.
(Goniewicz et al. 2013)

Local Literature
The Department of Health (DOH) on Saturday, August 25, 2018 said that
there is “barely any evidence” to prove that electronic cigarettes (e-cigarettes) do
not cause harm to users. “Contrary to the claim regarding the effectiveness of e-
cigarette as a smoking cessation aid, there is barely any evidence-based
researches to prove so,” the DOH said. The DOH made the statement in
response lawmakers who proposed, through House Resolution (HR) 1885, that
the DOH promotes the use of e-cigarettes as part of its “harm reduction
measures” against smoking. HR 1885 urged the DOH to promote the use of e-
cigarettes as part of its tobacco control strategy. “Despite all the regulations and
strict policies enforced by governments, people still find a way to smoke. E-
cigarettes offer an alternative…. Public health experts predict that smokers who
switch to combustion-free products can substantially reduce smoking and the risk
of developing smoking related diseases and eventually overall population harm,”
the resolution said. HR 1885 was sponsored by Quezon 4th District
Representative Angelina Tan, House Health Committee chairperson; and Iloilo
4th District Representative Ferjenel Biron, chair of the House Trade and Industry
Committee. No evidence: The health department said a series of long-term and
peer-reviewed studies that deal with the incidence, distribution, and control of
diseases are needed to conclude that e-cigarettes are an effective alternative to
smoking. The DOH said that with "the lack of conclusive data regarding the long-
term effects of using e-cigarettes, its health risks cannot be ignored." Based on
the August 2016 World Health Organization (WHO) report on e-cigarettes or
Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery
Systems, scientific evidence regarding the effectiveness of these devices as a
smoking cessation aid "is scant and of low certainty, making it difficult to draw
credible inferences." The report also said while it is likely e-cigarettes are “less
toxic than cigarette smoke,” they are “unlikely to be harmless." It added that long-
term use is also expected to increase the risks of pulmonary diseases, lung
cancer, cardiovascular disease, and other diseases related to smoking. The DOH
said until there is conclusive data on the safety of e-cigarettes, “regulatory
measures should aim at reducing exposure to these products” as a precautionary
measure. (READ: Can PH regulate its e-cigarette industry?) For the Food and
Drugs Administration (FDA) to authorize e-cigarettes as health products, it must
follow requirements on listing ingredients, reporting both harmful and potentially
harmful substances, and submission of research documents proving the use of
e-cigarettes as an effective alternative to smoking. The DOH said no e-cigarette
company or product has applied for a license to operate or certificate of product
registration with the FDA. (Tomacruz, Sofia 2018)
Engr. Emer Rojas, cancer survivor and president of the New Vois
Association of the Philippines (NVAP), speaks against the dangers of smoking
using a voice apparatus during a press conference in Quezon City. (Camille

Ante/Manila Bulletin).E-cigarette that is used as alternative must be stopped by
the users because it has also the same hazardous effects as tobacco. Local
vaping groups maintained the government should trek the path of the United
Kingdom with its relaxed regulations on e-cigarettes, insisting that these have
reduced the harms associated with tobacco use and help more people quit
smoking. However, Emer Rojas, president of the New Vois Association of the
Philippines (NVAP), remains steadfast in its lobbying for government to prohibit
e-cigarettes in the country until its safety is fully determined by expert studies.
Rojas noted that the Department of Health (DOH) had already issued a
statement that the reduced harm of e-cigarettes is “unsubstantiated and remain
unproven.” On the other hand, Joey Dulay, president of the Philippine E-
Cigarette Industry Association (PECIA), said at a recent forum in Quezon City
that the Philippines will remain a backwater country in the area of tobacco harm
reduction if the DOH continues its supposed “ill-informed and myopic position” on
e-cigarette. “It’s high time that the Department of Health take its cue from the UK
and other countries that have acknowledged the growing body of scientific
evidence supporting e-cigarettes and tobacco harm reduction,” Dulay said.
Published recently by the House of Common Science and Technology
Committee, the report titled “E-cigarettes” concluded that e-cigarettes should not
be treated in the same way as conventional cigarettes, noting that e-cigarettes
are 95 percent less harmful than conventional cigarettes. (Chavez, Chito 2018)
Electronic nicotine delivery systems (ENDS), of which electronic cigarettes
are the most common prototype, are devices that do not burn or use tobacco
leaves but instead vaporizes a solution the user then inhales. The main
constituents of the solution, in addition to nicotine when nicotine is present, are
propylene glycol, with or without glycerol and flavoring agents. ENDS solutions
and emissions contain other chemicals, some of them considered to be toxicants.
Smoking is the leading cause of preventable death. Tobacco is responsible for
the death of up to half of its users, killing nearly 6 million people worldwide each
year. Around 80 percent of the world’s smokers live in low- and middle-income
countries, the very same countries that bear the greatest burden of smoking-
related illness and death (World Health Organization). The link between smoking
and lung disease, cardiovascular disease, lung cancer, and several other types
of cancer is well established. Smoking is known to affect every organ in the body,
not only of smokers themselves, but also those around them who are passively
exposed to exhaled or “second hand” smoke. Smoking harms the body in many
ways. It causes stroke, heart disease, diabetes, pregnancy complications
(stillbirth and preterm delivery), infertility, cataracts, and bad breath. It has also
been shown to accelerate the aging process, leading to the early development of
wrinkles and osteoporosis. (Santos, Malaya 2016)
Philippine health authorities are being urged to endorse electronic
cigarettes (e-cigs) as part of the country’s tobacco control program after an

international study found them to be far less harmful than smoking. Professor
John Newton, director for Health Improvement of Public Health England (PHE),
said vaping was found to be “95 percent less harmful” than cigarette smoking.
PHE recommended that e-cigarettes, alongside nicotine replacement therapies,
be made available at hospital shops for smokers who want to quit. A local vapers’
group said the latest PHE report validated its position that e-cigarettes were far
safer than cigarettes. “Listen to the experts,” said Tom Pinlac, head of The
Vapers Philippines. He said it was “time for the Department of Health to look into
this report so they can recommend e-cigarettes and heated-tobacco products to
smokers who want to quit.” Edward Gatchalian, president of Philippine E-Liquid
Manufacturers Association, said more than 17 million Filipinos could benefit from
vaping. (Pangalanan 2018)
After President Duterte signed an executive order banning smoking in
public places, the Department of Health (DOH) is considering regulating the use
of electronic cigarettes and vapes. Health Secretary PaulynUbial said e-
cigarettes and vapes are not covered by the smoking ban. “We will make a
separate issuance, like a Food and Drug Administration (FDA) order,” she said.
Ubial said she could not yet provide details about the proposed regulation since it
is still under study. The FDA had previously issued an advisory warning the
public against the use of e-cigarettes. Vaping is an alternative to smoking. It is
the act of inhaling and exhaling the water vapor produced by an electric device
called a vaporizer. E-cigarette, on the other hand, is a plastic and metal device
that heats a liquid nicotine solution (e-juice) in a disposable cartridge while
creating a light at the tip and producing a vapor that simulates the act of smoking.
Some groups claimed that vapes and e-cigarettes are a safer alternative to
tobacco products. But medical experts said there is no evidence to prove this.
(Jaymalin, Mayen 2017)
Foreign Studies
Electronic Cigarettes. Potential Harms and Benefits. Use of electronic
cigarettes, devices that deliver a nicotine-containing vapour, has increased
rapidly across the country and globally. Perceived and marketed as a “healthier
alternative” to conventional cigarettes, few data exist regarding the safety of
these devices and their efficacy in harm reduction and treatment of tobacco
dependence; even less is known about their overall impact on population health.
This review highlights the recent data regarding electronic cigarette toxicity,
impact on lung function, and efficacy in smoking reduction and cessation. Studies
show that the vapour generated from electronic cigarettes has variable amounts
of nicotine and potential harmful toxins, albeit at levels lower than in conventional
cigarettes. The long-term carcinogenic and lung function effects of electronic
cigarettes are not known. Although some data demonstrate that electronic
cigarettes may be effective in reducing conventional cigarette consumption, there

are no data demonstrating the efficacy of electronic cigarettes as a tool to
achieve cessation. Until robust longitudinal evaluations demonstrate the safety of
electronic cigarettes and efficacy in treatment of tobacco dependence, their role
as a harm reduction tool is unclear. (Drummond, 2014)
Safety Assessment of Electronic Cigarettes and Their Relationship
with Cardiovascular Disease. Smoking leads to the occurrence and
development of a variety of diseases. Most importantly, it is an independent risk
factor of cardiovascular atherosclerosis. In recent years, electronic cigarettes
have become a popular alternative to traditional cigarettes, since modern micro-
electronic techniques provide the possibility of simulating the process of
traditional smoking. Additionally, it is convenient and fashionable. Nevertheless,
comments about the safety of electronic cigarettes remain controversial.
Although the research about electronic cigarettes increased exponentially, there
has been no systematic study of its safety. The aim of the current study is to
review the literature reports about the safety of electronic cigarettes, and to
understand their hazards and disadvantages. It was found that most of the
current research about electronic cigarettes comprises short-term and in vitro
studies. There are few reports of in vivo and long-term studies. Notably, the level
of harmful components such as volatile organic compounds, tobacco-specific
nitrosamines and heavy metals in electronic cigarettes are even higher than in
traditional cigarettes. Therefore, the harm of electronic cigarettes should not be

underestimated. In conclusion, the question of whether electronic cigarettes are a
safe and sufficient substitute for traditional smoking needs further investigation.
(Zhang et al., 2018)
Nicotine levels, withdrawal symptoms, and smoking reduction
success in real world use: A comparison of cigarette smokers and dual
users of both cigarettes and E-cigarette. Dual users did not smoke fewer
cigarettes than smoke-only participants during ad lib periods, but quadrupled
their use of e-cigarettes during smoking reduction periods. Dual users were
significantly more likely to maintain 100% reduction (97.1% vs. 81.2%). Amongst
women, dual use was associated with higher nicotine levels and withdrawal
suppression. Among a group of experienced dual users, e-cigarettes helped
maintain smoking reduction and reduced some withdrawal symptoms, although
both withdrawal symptoms and nicotine levels varied as a function of gender.
(Jorenby et al., 2016)
Electronic cigarettes: Human Health Effects. With the rapid increase in
use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes
(e-cigarettes), users and non-users are exposed to the aerosol and product
constituents. This is a review of published data on the human health effects of
exposure to e-cigarettes and their components. Literature searches were
conducted through September 2013 using multiple electronic databases. Forty-

four articles are included in this analysis. E-cigarette aerosols may contain
propylene glycol, glycerol, flavorings, other chemicals and, usually, nicotine.
Aerosolized propylene glycol and glycerol produce mouth and throat irritation and
dry cough. No data on the effects of flavoring inhalation were identified. Data on
short-term health effects are limited and there are no adequate data on long-term
effects. Aerosol exposure may be associated with respiratory function
impairment, and serum cotinine levels are similar to those in traditional cigarette
smokers. The high nicotine concentrations of some products increase exposure
risks for non-users, particularly children. The dangers of second hand and third
hand aerosol exposure have not been thoroughly evaluated. Scientific evidence
regarding the human health effects of e-cigarettes is limited. While e-cigarette
aerosol may contain fewer toxicants than cigarette smoke, studies evaluating
whether e-cigarettes are less harmful than cigarettes are inconclusive. Some
evidence suggests that e-cigarette use may facilitate smoking cessation, but
definitive data are lacking. No e-cigarette has been approved by FDA as a
cessation aid. Environmental concerns and issues regarding non-user exposure
exist. The health impact of e-cigarettes, for users and the public, cannot be
determined with currently available data. (Callahan-Lyon 2014)
E-Cigarette Use Among Youth and Young Adults: A Report of the
Surgeon General. E-cigarette use among U.S. youth and young adults is now a
major public health concern. E-cigarette use has increased considerably in

recent years, growing an astounding 900% among high school students from
2011 to 2015. These products are now the most commonly used form of tobacco
among youth in the United States, surpassing conventional tobacco products,
including cigarettes, cigars, chewing tobacco, and hookahs. Most e-cigarettes
contain nicotine, which can cause addiction and can harm the developing
adolescent brain. Compared with older adults, the brain of youth and young
adults is more vulnerable to the negative consequences of nicotine exposure.
The effects include addiction, priming for use of other addictive substances,
reduced impulse control, deficits in attention and cognition, and mood disorders.
Furthermore, fatal exposure to nicotine during pregnancy can result in multiple
adverse consequences, including sudden infant death syndrome, altered corpus
callosum, auditory processing deficits, effects on behaviors and obesity, and
deficits in attention and cognition. Ingestion of e-cigarette liquids containing
nicotine can also cause acute toxicity and possibly death if the contents of refill
cartridges or bottles containing nicotine are consumed. This report highlights
what we know and do not know about e-cigarettes. Gaps in scientific evidence do
exist, and this report is being issued while these products and their patterns of
use continue to change quickly. For example, the health effects and potentially
harmful doses of heated and aerosolized constituents of e-cigarette liquids—
including solvents, flavorants, and toxicants—are not completely understood.
However, although e-cigarettes generally emit fewer toxicants than combustible

tobacco products, we know that aerosol from e-cigarettes is not harmless.
Although we continue to learn more about e-cigarettes with each passing day, we
currently know enough to take action to protect our nation’s young people from
being harmed by these products. Previous reports of the Surgeon General have
established that nearly all habitual tobacco use begins during youth and young
adulthood. To prevent and reduce the use of e-cigarettes by youth and young
adults, we must work together as a society. We must implement proven
prevention and education strategies. Health care providers, parents, teachers,
and other caregivers should advise youth about the dangers of nicotine and
discourage tobacco use in any form, including e-cigarettes. They can set a
positive example by being tobacco-free and encouraging those who already use
these products to quit. (Rockville 2016)
Risk Factors for Exclusive E-Cigarette Use and Dual E-Cigarette Use
and Tobacco Use in Adolescents. This study aims to describe electronic
cigarette (e-cigarette) use and cigarette use among adolescents and determine
whether established risk factors for smoking discriminate user categories.
School-based survey of 1941 high school students (mean age 14.6 years) in
Hawaii; data collected in 2013. The survey assessed e-cigarette use and
cigarette use, alcohol and marijuana use, and psychosocial risk and protective
variables (eg, parental support, academic involvement, smoking expectancies,
peer smoking, sensation seeking). Analysis of variance and multinomial

regression examined variation in risk and protective variables across the
following categories of ever-use: e-cigarette only, cigarette only, dual use (use of
both products), and nonuser (never used either product). Prevalence for the
categories was 17% (e-cigarettes only), 12% (dual use), 3% (cigarettes only),
and 68% (nonusers). Dual users and cigarette-only users were highest on risk
status (elevated on risk factors and lower on protective factors) compared with
other groups. E-cigarette only users were higher on risk status than nonusers but
lower than dual users. E-cigarette only users and dual users more often
perceived e-cigarettes as healthier than cigarettes compared with nonusers. This
study reports a US adolescent sample with one of the largest prevalence rates of
e-cigarette only use in the existing literature. Dual use also had a substantial
prevalence. The fact that e-cigarette only users were intermediate in risk status
between nonusers and dual users raises the possibility that e-cigarettes are
recruiting medium-risk adolescents, who otherwise would be less susceptible to
tobacco product use. (Wills et al., 2013)
Electronic Cigarettes. This study aims to define electronic cigarettes
(ECs) and to examine the safety and potential health effects of ECs. Using
published articles performed using online databases with key words to define the
searches, 222 articles were yielded. Of these 222 articles with manual review
and elimination 18 articles were selected to complete the literature review. The
literature review yielded discussions on key components and effects of ECs such
as propylene glycol, nicotine, the respiratory system, the cardiovascular system,
cytotoxicity, etc. Through a review of 18 research articles, information saturation
was reached to conclude that the use of ECs has multiple health risks
comparable to traditional smoking, as well as new concerns specific to ECs
alone. With increasing popularity of ECs, additional research is needed on safety
and long-term effects. (Gallogly, Kim 2016)
Examining the Awareness and Use of Electronic Cigarettes among
Young Adults in New York City. She added important knowledge to potential
future studies by considering electronic cigarettes as a key smoking cessation
aid for the youths of New York City. It concluded that the awareness of e-
cigarettes as less harmful than conventional cigarettes may be associated with
the increased e-cigarette use among young adults. (Essel 2015)
Local Studies
The Extent of Influence of Factors on Cigarette Smoking Among
Teenagers in Baguio City. Although there are several studies conducted on
teenage smoking, the causes to become smokers in adolescence remain
unclear. Several factors were identified but the extent of its influence still
obscure. Therefore, the purpose of this study is to investigate the significant
difference in the extent of influence of these identified factors when teens are
group according to gender and age group of 13 to 16 years old versus 17-19
years of age. A quantitative study was conducted to determine the extent of
influence of factors on cigarette smoking among teenagers in City high school
and St. Louis high school. A total of 100 respondents were investigated using a
structured questionnaire. The study sought to explore the factors that influenced
cigarette smoking among teenagers and to what extent they can influence. A
questionnaire, in the form of a checklist was the primary tool used in the data
gathering relevant to the study. The questionnaire explored the extent of
influence of factors affecting smoking among teenagers in Baguio City. The
design used for this study was the quantitative research design. The subjects
were 100 students (Male and female) studying in Baguio City, Philippines. The
age bracket for subjects was 13-19 years for males and females. The sample for
this quantitative study was constructed by purposive sampling students in Baguio
City who were asked to voluntarily answer the questionnaire. Descriptive
statistics which included frequency, % distribution, average and weighted mean
was used. Average mean was used to determine the extent of influence of
factors on smoking among teenagers of Baguio City. Standard deviation and t-
test were used to determine the extent of influence when the teenagers were
grouped according to age and gender. The study found out that there was a
significant difference in the extent of influence of factors when the teenagers
were grouped according to gender, the females smoked more than the males.
However, when grouped according to age (13-16 & 17-19), there was no
significant difference in their extent of influence. The teenagers were very much
aware of the effects of cigarette smoking on the biological, physical and social
implications. Despite this awareness, the drive to perform the behavior is strong.
Finding solutions to modify the belief on the identified potent factor will alter the
attitude in the performance of smoking behavior. Successful cessation often
requires multiple strategies since continuous smoking is associated with several
factors. The researchers would recommend the formulation programs and
campaigns on anti-smoking. The researchers are also optimistically looking for
the possibility of this study to help assess the need to strictly or creatively
implement enacted laws stated in Republic Act 2011. The researchers believe an
epidemic of tobacco use is imminent if drastic action is not taken, and
recommend that anti-smoking campaigns with an emphasis on the religious
aspect should start as early as in elementary school. Intervention programs to
encourage behavior modification of adolescents are also recommended. (Retuta
et al., 2013)
Awareness, Knowledge, Attitudes, and Practices (AKAP) toward
Electronic Cigarettes among 3rd and 4th Year Undergraduate Students of
the University of the Philippines Manila. Electronic cigarettes, though
unproven, have become widespread in the Philippines where they remain
unregulated. Information on the awareness, knowledge, attitudes, and practices

(AKAP) of the youth toward e-cigarettes can serve as local scientific data for the
planning of health promotion activities and policies to counteract the popularity of
the product. To describe the level of AKAP among UP Manila students toward
electronic cigarettes and to determine if there are differences in these levels by
sex, course classification, and socioeconomic status. A 41-item self-administered
questionnaire was completed by randomly selected classes with 3rd and/or 4th
year UP Manila undergraduate students in them. A total of 589 students
participated in the study. Awareness of e-cigarettes was found in 92.5% (n=545)
of the students though 96.1% (n=566) were found to have insufficient knowledge.
Furthermore, 72.8% of the students exhibited attitudes opposing e-cigarette use
and no respondent reported current use of e-cigarettes. Intention to use e-
cigarettes was reported by 0.9% (n=5) of the students. Comparing AKAP levels
by sex, course classification, and socioeconomic status, only attitudes between
course classifications showed a noticeable difference. Students taking health-
related courses have a lower prevalence of attitudes supporting e-cigarette use
compared to students belonging to non-health-related courses (PR=0.68). There
is no immediate threat of electronic cigarette use among undergraduate students
of UP Manila at present; however, there is a need to address the inadequacy of
knowledge among the students. The findings in this study can be utilized to guide
the establishment of health promotion activities/materials and the development of
health policies. This study adds to the growing body of knowledge on e-

cigarettes, but further research is needed to elucidate the broader scheme of e-
cigarette use and perception among the Filipino youth. (Lozano et al., 2015)
Young adult e-cigarette users’ reasons for liking and not liking e-
cigarettes. To gain an in-depth understanding of what young adult electronic- or
e-cigarette users like or dislike about e-cigarettes. We aimed to determine the
reasons that may encourage young adults to use e-cigarettes or discourage them
from using e-cigarettes. Twelve focus group discussions were conducted with 62
current daily e-cigarette users (63% men) of mean age = 25.1 years (Standard
Deviation = 5.5). Data were analyzed following principles of inductive content
analysis. Results indicated 12 categories of reasons for liking e-cigarettes (e.g.,
recreation, smoking cessation) and 6 categories of reasons for not liking e-
cigarettes (e.g., poor product quality, poor smoking experience). Young adults’
motives for using or not using e-cigarettes appear to be varied and their relative
importance in terms of predicting e-cigarette use initiation, dependence, and
cigarette/e-cigarette dual use needs to be carefully studied in population-based,
empirical studies. The current findings suggest that e-cigarettes may serve
social, recreational, and sensory expectancies that are unique relative to
cigarettes and not dependent on nicotine. Further, successful use of e-cigarettes
in smoking cessation will likely need higher standards of product quality control,
better nicotine delivery efficiency and a counselling component that would teach
smokers how to manage e-cigarette devices while trying to quit smoking
cigarettes. (Fagan et al., 2015)
Using Experimental Auctions to Examine Demand for E-Cigarettes.
E-cigarettes are the latest in a line of potentially reduced exposure products that
have garnered interest among smokers. In this paper, we use experimental
auctions to estimate smokers’ demand for e-cigarettes and to assess the impact
of advertisements on willingness to pay. These are actual auctions, with winners
and losers, which means hypothetical biases often seen in surveys are
minimized. We find smokers have positive demand for e-cigarettes, and that the
print advertisements used in our study had greater effectiveness than video ads
(b = 2.00, p < .05) in terms of increasing demand for disposable e-cigarettes.
Demand was greater for reusable versus disposable e-cigarettes. In multivariate
models, demand for e-cigarettes was higher among non-white participants and
among smokers willing to pay more for cigarettes. Our findings suggest that
cigarette smokers are interested in e-cigarettes as alternatives to traditional
products, particularly for reusable forms, and that this demand can be influenced
by messaging/advertising. Given these reduced harm products are appealing, if
smokers are able to switch completely to e-cigarettes, there is a good chance for
accrual of significant harm reduction. (Corrigan et al., 2017)

E-cigarettes: Balancing risks and opportunities. Increasing numbers of
smokers are using e-cigarettes, with many people finding them helpful in cutting
down or quitting cigarette use. There are clear potential benefits to e-cigarettes in
reducing the harms associated with smoking, and consensus that e-cigarette use
is likely to be significantly safer than smoking. It remains important, however, that
in realizing any benefit to health, any potential risks associated with e-cigarette
use are minimized. Written specifically for policymakers, the British Medical
Association (BMA) paper aims to highlight the association members’ concerns,
and potential opportunities surrounding the use of e-cigarettes. It sets out what
the BMA believes is an appropriate policy response, taking into account the
evolving regulatory and policy environment for these devices in the UK. The BMA
is the professional association of doctors in the UK. The BMA paper has three
key messages for policymakers on tobacco harm reduction: First, there is a
growing consensus that e-cigarette use is significantly less harmful than
smoking. Second, e-cigarettes are the most popular device used in attempts to
stop smoking. Although there is a lack of high quality research proving
“effectiveness” as required for drugs, most reported studies demonstrate a
positive relationship between e-cigarette use and cessation. Third, consumer
regulations and feasible standards should be kept under review but are sufficient
to address concerns about e-cigarette use, something which would not have
been possible if e-cigarettes were regulated as medicines, noted the BMA.
(Pinlac 2017)
Smoking-attributable Burden of Lung Cancer in the Philippines. In
the Philippines, smoking is highly prevalent and tobacco control policies fail to
fully implement the WHO Framework Convention on Tobacco Control provisions.
To aid in policy change, intervention implementation, monitoring and evaluation,
this study aimed to provide the first internally consistent and latest Philippine
estimates of the following: disability-adjusted life-years (DALYs) lost due to lung
cancer; population-attributable fractions (PAFs)of smoking ;and smoking-
attributable lung cancer DALYs. This study applied the Global Burden of Disease
and Comparative Risk Assessment frameworks to secondary data,
supplemented by expert opinion. A comprehensive internally consistent
assessment of disease epidemiology was conducted using DISMOD II and
disease impact was quantified as DALYs. PAFs were calculated using the
smoking impact ratio and Monte Carlo uncertainty analyses were conducted. For
2008, lung cancer incidence and mortality estimates were 1087 cases and 9871
deaths respectively. Lung cancer accounted for an estimated 267787 DALYs
lost, 99% of which were due to years of life lost. Overall, the PAF of smoking was
65% and a total of 17 3103 DALYs were smoking –attributable. There were
increasing trends in incidence, mortality and DALY rates with age. The majority
of incidence (72%), mortality(71%) and disease burden (72%) occurred among

men, who also had higher PAF estimates. Considerable health gains could be
achieved if smoking exposure were reduced in the Philippines. Strong
enforcement of measures like increasing taxation to the WHO-endorsed rate,
expanding smoke-free environments, and requiring large graphic warnings within
a comprehensive tobacco control program is recommended. (Cruz et al., 2015)
SYNTHESIS
E-cigarette is getting its immense popularity. As a result, most of the
students are getting addictive and keep on craving for its presence. There are
lots of studies concerning the effects of e-cigarette. It says that we need to
consider the attributes of using e-cigarette as a conceptual of mental health, and
they need to take some strategies in order to help students move on from using
it. All of these can increase the knowledge about e-cigarettes on the students.
The similarities of the study to others is that e-cigarette can be an alternative but
also contains a nicotine like traditional cigarettes which may affect the health of
the users. The effects include addiction, priming for use of other addictive
substances, reduced impulse control, deficits in attention and mood disorders.
The present studies differ from the above studies in terms of kind of
studies to be conducted where the researchers conducted quantitative and
qualitative research. Hence, the present study is different from studies that have
been already done because the researchers approached the study in a holistic
way while the present study is just encompassing the part. The present study
reads about the effects of e-cigarette on the mental health of High School
students.
Chapter 3
RESEARCH METHODOLOGY
Methodology Used for the Study
The study used descriptive manner of inquiry that pursues to understand
and survey the student’s problems about the effects of electronic cigarette that
enable underlying structures and commodities in meanings to be understood.
Respondents
In this study, the researchers approached fifteen High Schoole-cigarette
student users around Ballesteros, Cagayan in order to gather information and
knowledge about their perceptions and uses of e-cigarettes.
Data Collection and Analysis
The researchers used recordings and one-on-one interview to gather data.
Each respondent completes the session lasting between 4-8 minutes, depending
on the approach uses by the interviewer. After the interview, the researchers
transcribed, analyzed, reviewed and replayed their records so that they could be
able to gather the needed and accurate data. After transcribing the recorded
data, the researchers encoded them in verbatim. Then, the researchersdrew the
conclusions.
Sub-Questions
1. Is e-cigarette a helpful aid for smoking cessation?
2. When did you start using e-cigarette?
3. What flavors do you tend to choose or mostly prefer?
4. Have you ever tried cigarette traditional smoking?
5. What motivated you to use e-cigarette?
6. What do you know about vapes before you used it?
7. Is e-cigarette worth it to buy?
8. What is your motive of using e-cigarette?

Trustworthiness
To establish credibility, transferability and dependability of the
study, data source in naturalistic approach were employed.
Participants gave advance written and verbal consent to record the
interview. They were also given an assurance that the recorded interview will be
kept confidently if the topic is sensitive. The voice-recorded interviews were then
transcribed and analyzed using narrative approach. Data were collected until
saturation was complete.

Transcription of Interviews
RESPONDENT 1
Interviewer: How does e-cigarette affects the health of High School student
users?
Respondent 1: You’ll be addicted once you use it
Interviewer: What changes did you perceived on your health after using it?
Respondent 1: I get dizzy everytime I use it too much
Interviewer: Is e-cigarette a helpful aid for smoking cessation:
Respondent 1: No
Interviewer: How often do you use e-cigarette?
Respondent 1: Two times a week
Interviewer: When did you start using vapes?
Respondent 1: When I was in Grade 9

Interviewer: What flavors do you tend to choose or mostly prefer?
Respondent: Cinnamon and Cheesecake
Interviewer: Did you ever tried smoking traditional cigarette?
Respondent 1: Yes
Interviewer: Why do you use e-cigarette?
Respondent 1: It is better than using traditional cigarette
Interviewer: What motivated you to use it?
Respondent 1: My group of friends
Interviewer: What do you know about vapes before you used it?
Respondent 1: Stress reliever
Interviewer: Is e-cigarette worth it to buy?
Respondent 1: Yes
Interviewer: What is your motive of using vapes?

Respondent 1: It’s chilling and stress reliever
Interviewer: How to help users stop from using e-cigarettes?
Respondent 1: It can destroy our lives so it is better to avoid using it.
RESPONDENT 2:
Interviewer: How does e-cigarettes affects the health of High School student
users?
Respondent 2: It feels good
Interviewer: What changes did you perceived on your health after using e-
cigarette?
Respondent 2: None
Interviewer: Is e-cigarette a helpful aid for smoking cessation?
Respondent 2: Yes
Interviewer: How often do the High School students use e-cigarettes?
Respondent 2: Once a month

Interviewer: When did you start using e-cigarette?
Respondent 2: Grade 10
Respondent 2: Strawberry
Respondent 2: No
Interviewer: Why do you use e-cigarettes?
Respondent 2: I just want to use it
Interviewer: What motivated you to use e-cigarette?
Respondent 2: No one, it’s just myself
Respondent 2: None

Respondent 2: No
Interviewer: What is your motive of using e-cigarette?
Respondent 2: None, I just want to try it
Respondent 2: Don’t stop using vapes because it is good as stress reliever
RESPONDENT 3
Interviewer: How does e-cigarettes affects the health of High School student,
users?
Respondent 3: It causes bad effects to our health
Interviewer: What did you perceived on your health after using it?
Respondent 3: Headache
Respondent 3: No
Interviewer: How often do you use e-cigarettes?
Respondent 3: Once a week
Respondent 3: Since Grade 8
Respondent 3: Bubble gum
Respondent 3: No
Respondent 3: For chilling
Interviewer: Who/what motivated you to use e-cigarette?
Respondent 3: Julius and Khaine
Respondent 3: It’s exciting
Respondent 3: Yes
Respondent 3: For stress reliever
Respondent 3: I will advice them to stop and avoid using e-cigarette
RESPONDENT 4
users?
Respondent 4: It makes me feel dizzy when I use it too much
cigarette?
Respondent 4: I feel dizzy after using it

Respondent 4: Yes
Interviewer: How often do you use vape?
Respondent 4: Everyday
Interviewer: What flavors do you tend to choose?
Respondent 4: Blueberry
Respondent 4: Not yet
Interviewer: Why do you use vape?
Respondent 4: For chilling and for past time
Interviewer: Who/what motivated you to use e-cigarette?

Respondent 4: Friends
Respondent 4: It doesn’t contain nicotine
Respondent 4: Yes it’s worth it
Respondent 4: For past time
Respondent 4: It tightens our chest so it is better to stop using it
RESPONDENT 5
users?
Respondent 5: None
cigarette?
Respondent 5: There’s no changes
Respondent 5: No
Respondent 5: When I was in my 11th grade
Respondent 5: Cheesecake
Respondent 5: Yes
Interviewer: Why do you use vape?
Respondent 5: It’s just for fun
Interviewer: What/who motivated you to use e-cigarette?
Respondent 5: I am motivated to use e-cigarette because of my brother and
cousins
Interviewer: What do you know about vapes before you use it?
Respondent 5: I know that it is rechargeable and there are many kind of flavors
Respondent 5: I don’t have my own e-cigarette, but for me I think it is worth it to
buy
Interviewer: What is you motive of using e-cigarette?
Respondent 5: Just for fun
Respondent 5: It causes me asthma so I’ll advice other users to stop using vape
RESPONDENT 6
Interviewer: How do e-cigarettes affects the health of High School student users?
Respondent 6: For me, it doesn’t affect our health
cigarette?
Respondent 6: None
Respondent 6: Yes and for me, it’s better to use vape
Respondent 6: When I was in Grade 8

Respondent 6: Strawberry, cheesecake, gulaman and caramel
Respondent 6: Only once
Respondent 6: To avoid smoking
Interviewer: What/who motivated you to use e-cigarette?
Respondent 6: None, I was just impressed on the ability of e-cigarette
Respondent 6: It’s great
Respondent 6: It depends if the e-cigarette is original or local but yes, it is worth it
Respondents 6: It’s relaxing

Respondent 6: Continue using it because it’s better to use e-cigarette than
traditional cigarette
RESPONDENT 7
Interviewer: How does e-cigarette affects the health of high school student
users?
Respondent 7: Very addictive
cigarette?
Respondent 7: It’s good and I keep on craving for it
Respondent 7: Yes
Respondent 7: Every time I wake up in the morning and after eating meals
Interviewer: When did you start using it?
Respondent 7: Since I was Grade 6
Interviewer: What is your favorite flavor?
Respondent 7: Ube halo-halo
Respondent 7: Stress reliever
Interviewer: What/Who motivated you to use vapes?
Respondent 7: My older brother
Respondent 7: A little but it depends on the quality of the product if it is legit or
not
Respondent 7: Past time
Interviewer: How to help users stop from using e-cigarette?
Respondent 7: Avoid using e-cigarette, it can affect your health
RESPONDENT 8
Interviewer: How do e-cigarettes affects the health of High School student users?
Respondent 8: Addictive
Respondent 8: It makes me weak
Respondent 8: Yes
Respondent 8: Mentol, Deep throat, Naked and Sir Jack
Respondent 8: Yes, I smoked a while ago
Respondent 8: Past time and stress reliever
Respondent 8: Peer Pressure
Interviewer: What do you know about vape before using it?
Respondent 8: It’s good, taste delicious and it makes you feel cool
Interviewer: Is it worth it to buy?

Respondent 8: Yes
Interviewer: What is your motive of using vapes?
Respondent 8: To be in and to escape from reality
Respondent 8: Stop using it because e-cigarette can make us feel weak
RESPONDENT 9
Interviewer: How does e-cigarette affects you?
Respondent 9: I keep on craving for it
Respondent 9: It makes me feel weak and I always cough
Respondent 9: Yes
Interviewer: How often do you use?

Respondent 9: Every month
Interviewer: When did you start using vapes?
Respondent 9: When I was Grade 7, year 2015
Interviewer: What flavors do you tend to use?
Respondent 9: Decang, Deep Troat, Chelly and Grapes
Respondent 9: To look cool
Interviewer: What motivated you to use e-cigarette?
Respondent 9: None, I just want to use it
Interviewer: What do you know about vapes before using it?
Respondent 9: It’s just like the traditional cigarette and can be used to impress
Respondent 9: No, I’m just borrowing my friend’s e-cigarette
Interviewer: What is your motive of using it?
Respondent 9: For stress reliever
Respondent 9: Avoid using vapes because it can make us feel weak
RESPONDENT 10
users?
Respondent 10: It makes me chill
cigarette?
Respondent 10: It soothes and relieves my breathing

Respondent 10: Yes
Respondent 10: Cheesecake
Respondent 10: I was envious to my friends who are using it
Respondent 10: None

Respondent 10: Yes
Respondent 10: To chill
Respondent 10: It depends if they want to stop using or not
RESPONDENT 11
Interviewer: How do e-cigarette affects the health of high school student users?
Respondent 11: None
cigarette?
Respondent 11: Difficulty in breathing

Respondent 11: Yes
Respondent 11: I just started this year, 2019
Respondent 11: Turon
Respondent 11: Yes
Respondent 11: To avoid using traditional cigarette
Respondent 11: None

Respondent 11: Yes if you have vices
Respondent 11: Avoid using e-cigarette, it is not good
RESPONDENT 12
users?
Respondent 12: None, I never get sick
cigarette?
Respondent 12: It makes me thin/slim

Respondent 12: Yeah
Respondent 12: Juice
Respondent 12: Yes
Respondent 12: To avoid smoking traditional cigarette
Respondent 12: None

Respondent 12: Yes
Respondent 12: To make me chill
Respondent 12: It depends on the user but for me you should keep on using it
RESPONDENT 13
Respondent 13: None
cigarette?
Respondent 13: It makes me feel dizzy and unconcious

Respondent 13: Yes
Respondent 13: Once a week
Respondent 13: Tobacco
Respondent 13: Yes, last week
Respondent 13: I Just want to be in
Respondent 13: My cousin

Respondent 13: Yes
Respondent 13: Stop using it because it can affect your lungs
RESPONDENT 14
Respondent 14: It affects my health
cigarette?
Respondent 14: I easily get tired

Respondent 14: No
Respondent 14: When I was Grade 10
Respondent 14: Strawberry
Respondent 14: Because of curiosity and to impress
Respondent 14: Peer Pressure and Social Media Influence

Respondent 14: No because it is very expensive
Respondent 14: To be in
Respondent 14: E-cigarette is bad for your health so better not try it
RESPONDENT 15
users?
Respondent 15: It helps to relieve my stress
cigarette?
Respondent 15: It makes me weak

Respondent 15: Yes
Respondent 15: Pistacio Sundae
Respondent 15: I just tried it once
Respondent 15: For past time if I have nothing to do
Respondent 15: None

Respondent 15: Yes
Respondent 15: Stop using it while you’re still young because it can affect your
health
CHAPTER 4
RESULTS AND DISCUSSION
After the analysis of the collected data, there were four themes that
emerged from the data analysis. These were: 1) Effects of e-cigarette on the
High School students; 2) Time of use of the users of e-cigarettes in Ballesteros,
Cagayan; 3) Reasons why the users use e-cigarettes; 4) Ways on helping the
users to stop using e-cigarette. These were taken from the experiences of the
participants.
The detailed discussion follows.
1. Effects of E-Cigarette on the Health of High School Students
Most of the respondents mentioned that using e-cigarettes is very
addictive but it has a detrimental impact on the health of the users. It can cause
dizziness, imbalanced movement, slimming, difficulty in breathing and
enfeeblement which affects their everyday life. These emerged as the most
commoneffects that users experience when using e-cigarettes.
The responses are connected to the findings of Rockville (2016) as he
said that, most e-cigarettes contain nicotine, which can cause addiction and can
harm the developing adolescent brain. Compared with older adults, the brain of
youth and young adults is more vulnerable to the negative consequences of
nicotine exposure. The effects include addiction, priming for use of other
addictive substances, reduced impulse control, deficits in attentionand mood
disorders.Ingestion of e-cigarette liquids containing nicotine can also cause acute
toxicity and possibly death if the contents of refill cartridges or bottles containing
nicotine are consumed. Several strategies exist to prevent and reduce the use of
e-cigarettes on youths by implementing proven prevention and education
strategies.
This study emphasized that E-cigarette can affect the health of the student
users and may cause different problems amidst their student lives.
2. Times of Use the users of Ballesteros, Cagayan smoke E-
cigarettes
Due to the addictive quality of e-cigarette, users continue to crave for its
presence. With that, it has proven that most of the respondents use
vapeeveryday which has a higher chance of adopting sicknesses.

It is related to the findings of Vardavas et.al., (2012) who stated that after
five minutes of using e-cigarettes containing nicotine, propylene glycol, linalool,
tobacco essence, and methyl vanillin, there was an associated increase in lung
flow resistance and decrease in fractional exhaled nitric oxide concentration.
Added from the study of Malaya Santos (2016) who said that, too much
use of e-cigarette can harm the body in many ways. It causes stroke, heart
disease, diabetes, pregnancy complications (stillbirth and preterm delivery),
infertility, cataracts, and bad breath. It has also been shown to accelerate the
aging process, leading to the early development of wrinkles and osteoporosis.
Sofia Tomacruz (2018) also said that the long-term use of e-cigarette is
also expected to increase the risks of pulmonary diseases, lung cancer and
cardiovascular disease.
3. Reasons why the users use e-cigarettes
E-cigarettes are quickly gaining the interest of smokers. They arebecoming a
preferred alternative for nicotine delivery among many smokers because of their
realistic look, feel and taste compared to traditional cigarettes.Most of the
responses show that users use e-cigarette because it is better than traditional
cigarette. They said that using vape can lower the risk of getting bad effects on
their health than using traditional cigarette which has a higher content of nicotine.
The responses connect to the study of Pinlac (2017) who said that
increasing numbers of smokers are using e-cigarettes, with many people finding
them helpful in cutting down or quitting cigarette use. Dominic Palazzolo (2013)
also stated that many cigarette smokers have turned to vaping becausee-
cigarette vendors have previously marketed their product as cheaper and safer
smokeless alternative to traditional cigarettes, and a possible smoking cessation
tool.
In this study, it was accentuated that users are using e-cigarette as
smoking cessation tool.
4. Ways on Helping the Users to Stop using E-cigarette
The study revealed that e-cigarettes have brought many bad effects
amongthe participants. Most ofthem admitted that vapes can affect the health of
the users and know that it is better to avoid and stop using it. E-cigarettescan be
a great help as smoking cessation tool but it also contains a nicotine like
traditional cigarettes. Using it too much is a bad idea especially to the users who
have asthma.
It is related to the findings of Lindson-Hawley N, et al. (2016)Although
smoking cessation is currently the only guaranteed way to reduce the harm
caused by tobacco smoking, a reasonable secondary tobacco control approach
may try and reduce the harm from continued tobacco use amongstsmokers
unable or unwilling to quit. Possible approaches to reduce the exposure to toxins
from smoking include reducing the amount of tobacco used, and using less toxic
products, such as pharmaceutical, nicotine and potential reduced-exposure
tobacco products, as an alternative to cigarettes.

Chapter 5
CONCLUSION AND RECOMMENDATION
This chapter presents the whole study having as its salient features the
findings surfaced in answer to the problems posed for the investigation. It has its
components the conclusion drawn out of the findings and the recommendation
also as off-shoot of the findings surface at.
Conclusion
Most of the respondents considered that using e-cigarette can truly affect
the health of the users. Some stated that using vapes can be a great help as
smoking cessation but using it too much can affect the health of the users. It was
deliberated that it can give a big factor on their health because their everyday
routine is affected. It can cause dizziness, imbalanced movements, slimming,
difficulty in breathing and enfeeblement.
Recommendations
As logical off-shoots of the findings, the researchers recommend to the
students, parents and stakeholders the following:

Students. They must think and consider the great impact of using e-
cigarettes on their health. For the users who experienced bad effects, they
should consider the experience as a lesson and motivation in avoiding e-
cigarette. Try to seek the help of others if the users have any problems rather
than using e-cigarette as a way of escaping the reality and as stress reliever.
Consult and go under rehab, if they must.
Community. They must be aware about the possible effects of e-
cigarette which is not good for their health.
Stakeholders. They must continue to bring up programs that give
information about e-cigarettes and strengthen their implemented programs for
students who needmotivation to do better things. Aside from this, they must also
impose rules and regulations against the usage of e-cigarettes inside the campus
and even a certain distance away from the campus.
E-cigarette Producers .They must be held accountable with their
products. Their products must include a pamphlet which informs the users the
important key factors they must consider before buying e-cigarettes.
The Government. The government should give certain health institutions
like Department of Health or Department of Science and Technology memoranda

requiring them to conduct various seminars not only in the cities but in the rural
areas as well regarding the rising percentage of e-cigarette users and its impact
on the health of the people.
Future Researchers. For better data accuracy, they should conduct the
study on a wider scope of respondents. They should interview a larger number to
come up with a more stronger data reference.
BIBLIOGRAPHY
Palazzolo, Dominic. 2013. Use of electronic cigarettes
Vardavas et. al. 2012.
Grana et al. 2013
Foulds et. al.2013
Bullen et al.2013
Hawley N, et al. 2016
Farsalinos et al. 2013
Goniewicz et al. 2013
Sofia Tomacruz. 2018
Malaya Santos. 2016
Pangalanan. 2018
Mayen Jaymalin. 2017

Drummond. 2014. Electronic Cigarettes. Potential Harms and Benefits.
Zhang et al., 2018. Safety Assessment of Electronic Cigarettes and Their

Relationship with Cardiovascular Disease
Jorenby et al., 2016. Nicotine levels, withdrawal symptoms, and smoking

reduction success in real world use: A comparison of cigarette smokers and dual
users of both cigarettes and E-cigarette.
Callahan-Lyon. 2014. Electronic cigarettes: Human Health Effects
Rockville. 2016. E-Cigarette Use Among Youth and Young Adults: A

Report of the Surgeon General
Wills et al., 2013. Risk Factors for Exclusive E-Cigarette Use and Dual E-
Cigarette Use and Tobacco Use in Adolescents
Kim Gallogly. 2016. Electronic Cigarettes
Essel. 2015. Examining the Awareness and Use of Electronic Cigarettes

among Young Adults in New York City
Retuta et al., 2013. The Extent of Influence of Factors on Cigarette

Smoking Among Teenagers in Baguio City.
Lozano et al., 2015. Awareness, Knowledge, Attitudes, and Practices

(AKAP) toward Electronic Cigarettes among 3rd and 4th Year Undergraduate
Students of the University of the Philippines Manila.
Fagan et al., 2015. Young adult e-cigarette users’ reasons for liking and
not liking e-cigarettes
Corrigan et al., 2017. Using Experimental Auctions to Examine Demand

for E-Cigarettes
Pinlac. 2017. E-cigarettes: Balancing risks and opportunities
Cruz et al., 2015. Smoking-attributable Burden of Lung Cancer in the

Philippines

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BALLESTEROS NATIONAL HIGH SCHOOL 1

PROBLEM AND ITS BACKGROUND

Smoking cigarette rolls have always been and still considered to be

But at last, through the thriving of science and technology, an electronic

battery operated cigarette named as “e-cigarette” has been developed which

impact on a teen’s brain development including increased risk for depression,

mood disorders and future substance misuse. Also known as “e-juice”, e-

which the flavorings also hides possible toxins.

recognition especially in the medical rehabilitation programs and institutions.

However, a number of people have the common misconception that e-cigarettes

such as arsenic and chromium.

Furthermore, e-cigarettes also aim to resemble cigarettes but without

traditional rolls also fail to achieve their primary usage reason.

STATEMENT OF THE PROBLEM

Generally, this study aimed to determine the impacts of e-cigarette to the

High School students in Ballesteros, Cagayan.

Specifically, this study aimed to answer the following questions.

1. How do e-cigarettes impact the High School student users?

2. How often do the High School students use e-cigarettes?

3. Why High School students in Ballesteros, Cagayan use e-cigarettes?

4. How to help users stop from using e-cigarettes?

SIGNIFICANCE OF THE STUDY

The study intends to investigate on the effects of e-cigarette on the mental

health of High School students that may benefit the following:

Students. This study will help them to be aware on the effects of e-

cigarette on their mental health.

the effects of e-cigarette.

will contribute the future studies.

Future Researchers. This study will give the future researchers an

additional information that can be basis forfurther improvements.

Medical Community. This study aims to show a preview of how e-

cigarettes are generally valued and used bythe public.

Scope and Delimitation

This study aimed to determine the perceptions, motives and behaviors of

e-cigarette users which is the main focus of the researcher.

This study is delimited only to 15 high school students of Ballesteros,

Cagayan, ages 14-18 school year 2018-2019.

The information were being gathered through interview. All information

gathered from the respondents will confine only to e-cigarette users.

Arsenic. It is a naturally occurring element that is found in combination

with either inorganic or organic substances to form many different compounds.

Electronic Cigarettes. It is also known as e-vaporizers, are battery

operated devices thatpeople use to inhale.

Smoker. Someone who smokes tobacco, cigarette substitutes or various

Smoking Cessation. It is the process of discontinuing tobacco smoking.

Traditional Cigarette. It is a cylindrical roll of shredded or ground tobacco

that is wrapped in paper.

Toxins.These are small molecules, peptides or proteins that are capable

of causing disease on contact with or absorption by body tissues interacting with

REVIEW OF RELATED LITERATURE AND STUDIES

A background study about the effect of e-cigarette on the mental health of

Use of electronic cigarettes (e-cigarettes), referred to as vaping, is a

tobacco smokers. E-cigarettes are becoming a preferred alternative for nicotine

compared to traditional cigarettes. Furthermore, many cigarette smokers have

turned to vaping because e-cigarette vendors have previously marketed their

product as cheaper and safer smokeless alternative to traditional cigarettes, and

a possible smoking cessation tool. (Palazzolo, Dominic 2013)

e-cigarettes, a few studies evaluated their health effects. Findings of an

experimental laboratory-based intervention study showed that after five minutes

of using e-cigarettes containing nicotine, propylene glycol, linalool, tobacco

resistance and decrease in fractional exhaled nitric oxide concentration. Nitric

oxide has an important role in the respiratory track and is a marker of