The Importance Of Exercise In Older People Physical Education Essay

The Importance Of Exercise In Older People Physical Education Essay In older adults, physical activity is a necessary action to provide and maintain health.1 A substantial amount of empirical evidence has demonstrated that the health benefits associated with participation in physical activity can maintain functional independence and ultimately improve quality of life.2-.3 In addition, participation in physical activity improves self-esteem, mental alertness and social interaction, and decreases levels of depression.4-5 Physical activity is also a major independent modifiable risk factor that has a protective effect against the onset of cardiovascular disease, ischemic stroke, type 2 diabetes, and cancer.6-7 However, a preliminary report in 2007 by the National Statistical Office of Thailand showed that more than 58% of Thai elderly engaged in physical activity less often than recommended for good health.8 Therefore, it is imperative that physical activity among the aged population is evaluated. A review of physical activity studies reveals that the physical environment is significantly associated with physical activity participation. According to Bandura, physical environment plays either the role of facilitator or obstacle in human motivation through the interaction between cognitive functions and environment.9-10 Both natural features and human constructs related to environment may affect physical activity engagement.11 Physical environment positively influences physical activity within older people.12-18 While the significance of physical environment is well recognized, an accurate measure is needed to identify the specific characteristics of the physical environment for physical activity, with respect to older people. If there is low error in the assessment, the explanation of the relationship between physical environment and physical activity will be raised. The concept of behavior setting helps to elucidate the influence of physical environment on physical activity.19 Behavior occurs within a physical and social context. So, the behavior of older people will be influenced by environment the neighborhood, community, or home environment. The home environment is a primary setting for the performance of daily activities among older people.20 In Thailand, most older people stay and participate in physical activity in their home. Although previous studies have assessed only convenience of facilities and access to equipment at home related to physical activity, the characteristics of home environment is the least studied potential determinant of participation in physical activity.11-12 Existing investigations use either neighborhood-focused scales to determine physical environment 14,21-22, or have applied both neighborhood and availability of facilities in the community.18,23 A review of relevant research indicates that aspects of the physica l environment, such as safety, traffic volume, street lighting, unattended dogs, having a sidewalk, and accessibility to public recreation places influence physical activity,14-18 whereas other evidence suggests equivocal results.21-22,24 At least one potential reason exists for this inconsistency which may be related to the physical environment measurement, particularly with older adults. Most physical environment questionnaires were developed in western countries. These measurements have involved different neighborhood and community settings; assessed in different dimensions such as convenience, safety, accessibility, and facility. Even though the physical environment questionnaires have been validated in western countries, they have not been tested in others settings. Due to differences of geographic features, culture, and patterns of living, a need exists to assess the physical environment of Thai elderly to confirm reliability and validity in this cultural context. Furthermore, the relationship of the physical environment of home and physical activity of older Thai people is still unknown. Understanding features of the physical environment related to physical activity may provide an effective implementation design to motivate older Thai people to participate in physical activity. For these reasons, a modified instrument, the Thai Environmental Support for Physical Activity for Older Thai people (TESPA) for assessing the physical environment including home, neighborhood, and community environment needs to be modified and validated for the older Thai population. This study addressed this shortcoming by modifying and confirming a three-factor structure for physical environment in a sample of older adults in Thailand. We hypothesized that a correlated three-factor structure for the TESPA would fit the data well and that these factors would possess good internal consistency. Additionally, we hypothesized that higher scores on the subscales of the TESPA would be significantly and positively correlated with higher levels of physical activity. Moreover, our study purpose was to prepare physical environment questionnaire for a large descriptive study related to physical activity in older Thai people. Objective The purpose of this project was modification and assessment of the TESPA scale in older Thai people to provide a reliable and valid measure that is culturally congruent and useful for future research. Measures Demographics. -A personal data sheet was used to obtain demographic and socioeconomic data including age, gender, income, marital status, education level, area of living, the length of living in their residence and medical history. The Chula Mental Test (CMT), an interviewing questionnaire developed by Jittapunkul, and colleagues was administered to determine the cognitive function of older Thai people who has difficulties in reading and writing.25 The CMT consists of 13 items related to cognitive function. Scales are coded on a dichotomous score of 0 (incorrect) and 1 (correct); items 5 and 12 have two sub-scales, and items 3 and 13 have three sub-scales each. Total scores indicate the cognitive function and range from 0-19. Scores 0-4 illustrate severe cognitive impairment, scores 5-9 depict moderate cognitive impairment, scores 10-14 reveal mild cognitive impairment, and scores 15-19 demonstrate normal cognitive function. Physical activity. -Physical activity was assessed by using the International Physical Activity Questionnaire Long form (IPAQ-L). The IPAQ-L was developed by the International Consensus Group for the Development of an International Physical Activity Questionnaire at the WHO in 1998.26 The IPAQ-L includes 5 parts: work-related activities, transport-related activities, domestic activities, and time spent sitting during the previous 7 days. In addition, the IPAQ-L assesses the frequency, intensity and duration of all daily physical activity. In summary, total physical activity equals the MET score, which is the sum of minutes spent in each domain multiplied by the MET value.26 We used a cut-off point 600 METs, as recommended by the Centers for Disease Control and Prevention of the United States of America and the American College of Sports Medicine.27 Threshold values for the IPAQ-L in the present study were categories insufficiently active ( 600 METs-min-week) We translated and adapted the IPAQ-L to fit the habits of older Thai people; content validity was determined by three experts. The content validity index of the IPAQ-L was .96. Numerous studies testing the test-retest reliability of the IPAQ-L revealed results ranging from 0.63 to 0.91, which indicated good repeatability.26,29 In the present study, the stability of the IPAQ-L questionnaire was reported to be 0.77 in 30 Thai elderly. Methods A cross-sectional design was used in the current study. The process of modification of the questionnaire included two phases (see Figure 1). In phase I, the instrument was modified as follows: 1) questionnaire improvement stage and 2) quantification stage. In phase II, instrument assessment was conducted to examine construct validity by confirmatory factor analysis and the known-group method. Insert figure 1 here Phase 1: Modification of instrument Stage 1: Questionnaire improvement stage consisted of measurement review, translation, instrument refinement and item construction. Measurement review and translation procedure: Physical environment is defined as older peoples perception of the physical environment to facilitate or hinder physical activity engagement in three settings: home, neighborhood, and community. We reviewed the relevant research regarding measurement of physical environment from the literature. The existing measurement was chosen based on definition and psychometric properties of measurement. After obtaining written consent from the author, the original questionnaire was translated into Thai versions by the researcher and an independent translator according to the translation-back translation method.28 The Thai version was evaluated by three Thai/English bilingual people. The questionnaire was translated back into English by two Thai-English independent translators who each had taught English to graduate students for more than 20 years. We then compared both versions in the original language, conducted checks with the translators, discussed the differences, and produced a final conse nsus version. 1.2 Instrument refinement and item construction: We modified the translated instruments to achieve a closer cultural fit for older Thai people. During October to December 2007, a preliminary study was conducted with ten elders: five who lived in a municipal area and five in a non-municipal area. The participants were selected from a broad range of backgrounds: five elders had elementary education and had worked in the agricultural sector, three elders had secondary education and had worked as small businesses owners, and two elders were retired and held bachelors degrees. Open-ended interviews were applied to ensure that instrument content and language were suitable for Thai elderly. They were interviewed in their home or a temple in their village. The participants were encouraged to share their opinions regarding the relevancy of items and appropriateness to the culture of older Thai people. Additionally, participants were encouraged to think of additional items that potentially could be used in the questionnaire. Each participant was interviewed twice for 30 minutes for each time, or until no new data occurred. In the preliminary study, no participant refused to participate. Interviews were audio taped and transcribed verbatim. Categories and coding were derived from data sources and previous related studies. Statements by participants about the physical environment were delineated and identified as a content domain. Representative phrases and terms were marked to be used as potential items so that the language of the participants could be preserved. Additional items then were discussed with two Thai experts and an American expert in geriatric nursing. As a consequence, the measurement was modified. Stage 2: Quantification stage This stage involved the validity and reliability of the psychometric properties of the modified measurement. Content validity of the scale was evaluated by three geriatric experts including one physician in geriatric physical activity, one expert in geriatric community nursing, and one expert in geriatric nursing. The experts were asked to rate the level of relevancy between the items and the definition of the concepts as represented. A four-point Likert-type scale ranging from 4 (strongly relevant) to 1 (strongly irrelevant) was used to rate each item. Data collection started in October 2008 after obtaining approval from the Institutional Review Board at Chulalongkorn University, Thailand. Both written and verbal informed consent was obtained in Thai on the same date as the data collection. The informed consent form explained the purpose of the study, benefits, risks, the types of questionnaires and tasks to be completed, and the length of time needed to complete the interview. In particular, it explained about risk prevention and treatment when the risk may occur during the interview or when collection of data is taking place. Permission was obtained from participants prior to data collection. At the setting, the participants were informed about the purpose of the study and their right to refuse participation. If participants chose not to answer the questionnaire, they could withdraw from the study at any time without penalty. They were also notified that their relationship with the health care team would not be affected. Their names were not used; instead, a code number was used to ensure confidentiality. There was no harm to the participants in this study. In addition, to assess the feasibility of using psychometric properties, the modified measurement was determined in the pilot study. The consent was obtained from the directors of primary care units, one in an urban area and the second in a rural area. A purposive sample of 15 older people from each setting was recruited in the pilot study; no respondent refused or dropped out in this stage. The participants were older people, with a mean age of 70+ 4.19 years. Most participants were female (76.7%), married (53.3%), had elementary education (80%), were employed (62.6%), with a household income of less than 5,000 Baht per month (approximately US$147) (76.7%). A substantial proportion (63.3%) lived in urban areas and had lived on average for 44.6 years in their residence. Of the sample, more than half reported sufficient physical activity level (50%), whereas 20% had a low physical activity level. A total of 23.3 % reported having no current health problems, while 16.7 % had hypertensi on. The most frequent type of physical activity reported was household related activity, followed by leisure time activity, transportation related activity, and occupational activity. Stability of reliability was obtained in two weeks, whereas internal consistency was assessed at baseline. Phase 2: Assessing the Instrument Construct validity of the modified scale was determined in the main study. Multi-stage random sampling was employed to obtain a sample of 336 elderly (aged 60 years and older) residing in 12 villages from six provinces of Thailand, who were not part of the preliminary study or the pilot study. In each village, 28 participants were selected by a systematic sampling technique from a name list obtained from the villages primary care unit. A simple random technique was applied and only one member in each family was included in the study. The participants were determined to be eligible to participate in the study if they scored >15 on the CMT, were able to ambulate without assistive devices, and were willing to participate in the present study. Data were collected from November 2008 to April 2009. An authorization letter was sent to officers of the primary care unit in all 12 settings to ask for their consent. After obtaining their consent, the public health nurses of the primary care units were asked by the researcher to make appointments with participants. When verbal agreement was obtained, the participants were asked to sign a consent form. The modified questionnaire was used to conduct interviews lasting between 15 to 20 minutes; each participant received a handkerchief in appreciation for their participation. A total of 336 questionnaires were selected for accuracy of data entry. Statistical analysis showed that two cases with a single or more than one missing value on community environment were deleted, leaving 334 cases for analysis. According to IPAQ Research Committee guidelines, the physical activity scores were processed to reduce data comparability. Ten cases were excluded by the truncation process due to the total duration value being more than 3 hours per activity, and four cases were eliminated because of multivariate outliers. Therefore, 320 cases remained for analysis. Most of the participants in the main study were female, married, had elementary education, and a household income less than 5,000 Baht per month (approximately US$147). Approximately 70% of the participants reported at least one health problem. Shared living was the most frequent living arrangement reported (92.8%) with an average of 4.11 persons per household. A substantial proportion (61.9%) lived in an urban area and stayed in their own residence. Data analysis Descriptive data are presented as mean + SD. The internal reliability of the scale was based on an alpha coefficient greater than or equal to .70; 30 stability of the scale was analyzed by product correlation coefficient. Reliability of each item, overall reliability, and construct validity of the scale were determined using structural equation modeling (SEM).31 The known-group technique was conducted using the multivariate analysis of variance, to compare the physical environment of those who reported sufficient physical activity and those who did not. Statistical significance for analyses except SEM was defined as p Results Phase 1: Modification of instrument Stage 1: Questionnaire improvement stage Following determination of the validity and reliability of the instrument, results were used to make modifications. The following procedures were undertaken. 1.1 Measurement review and translation procedure: Findings from prior studies demonstrated that most physical environment measurements were designed to identify specific characteristics of the built environment (e.g. distance between destinations, presence of sidewalk), and showed moderate to high reliability. Blocks of questions appeared to have different reliability among urban and rural respondents. Only one measurement was constructed for older people.12 A meta-analysis study by Duncan and colleagues concluded that the environmental characteristics in measurement presented in physical activity include facilities, sidewalks, shops and services in walking distance, heavy traffic, high crime, street lighting, and unattended dogs.32 The Social-physical Environmental Supports for Physical Activity Questionnaire (ESPA) is a measurement that designed to capture and assess the supporting social and physical environment for physical activity typically performed by all age.33 The ESPA was selected to collect data in this study because it is closely congruent with the Thai context, and indicates both neighborhood environment and community environment. In addition, the coefficient differences between urban respondents and rural respondents of this scale were small when compared with the other questionnaires.34 Moreover, the previous validity and reliability value of ESPA was acceptable.34 The ESPA is composed of two domains: the social and the physical environment domains. The physical environment is composed of 20 items: 10 neighborhood items (access, characteristics, barriers, use), and 10 community items (access, and barriers). A Likert-scale was used to assess neighborhood items, except for an item on public recreat ion facilities which allowed response options as 1(yes) or 0 (no). The community items have response options of 1(yes) or 2(no), with score form items on recreation facilities, whereas a community item used a Likert Scale. The higher the summary score the stronger the physical environment. The ESPA questionnaire was translated into Thai. Instrument refinement and item construction: All participants recommended that some items of the ESPA questionnaire be deleted and many remarked that the questionnaire format be reviewed. Most participants suggested that 21 physical environment items be eliminated including public swimming pools, sidewalks, parks, walking trails, bike paths, recreational centers, shopping malls (sometimes used for physical activity or walking programs), and being a private member of a recreational facility . These items reflected physical activities and sites that were uncommon in Thailand and thus were not deemed to be valid it this cultural context. As well, five pages of the scale and various types of choices took up too much time and were difficult to answer; for example: In general, would you say that motorized traffic in your neighborhood isà ¢Ã¢â€š ¬Ã‚ ¦. Heavy, Moderate or Light., When walking at night, would you describe the STREET lighting in your neighborhood asà ¢Ã¢â€š ¬Ã‚ ¦..Very good, Good, Fair, Poor or Very poor and How safe are the public recreational facilities in your community? would you sayà ¢Ã¢â€š ¬Ã‚ ¦ Very safe, Somewhat safe, Somewhat unsafe or Not safe at al. Additionally, the literal translation of the word physical activity into Thai git-ja-gam-taang-gaa or à  Ã‚ ¸Ã‚ Ãƒ  Ã‚ ¸Ã‚ ´Ãƒ  Ã‚ ¸Ã‹â€ Ãƒ  Ã‚ ¸Ã‚ Ãƒ  Ã‚ ¸Ã‚ £Ãƒ  Ã‚ ¸Ã‚ £Ãƒ  Ã‚ ¸Ã‚ ¡Ãƒ  Ã‚ ¸-à  Ã‚ ¸Ã‚ ²Ãƒ  Ã‚ ¸Ã¢â‚¬ ¡Ãƒ  Ã‚ ¸Ã‚ Ãƒ  Ã‚ ¸Ã‚ ²Ãƒ  Ã‚ ¸Ã‚ ¢ (git-ja-gam = activity; taang-gaai= physical) was unfamiliar to older people. Most participants thought this term was difficult to understand and felt that it was not applicable to them. The elders preferred the term kleuan-wai-ok-raeng or à  Ã‚ ¹Ã¢â€š ¬Ãƒ  Ã‚ ¸Ã¢â‚¬Å¾Ãƒ  Ã‚ ¸Ã‚ ¥Ãƒ  Ã‚ ¸Ã‚ ·Ãƒ  Ã‚ ¹Ã‹â€ Ãƒ  Ã‚ ¸Ã‚ ­Ãƒ  Ã‚ ¸Ã¢â€ž ¢Ãƒ  Ã‚ ¹Ã¢â‚¬Å¾Ãƒ  Ã‚ ¸Ã‚ «Ãƒ  Ã‚ ¸Ãƒ  Ã‚ ¸Ã‚ ­Ãƒ  Ã‚ ¸Ã‚ ­Ãƒ  Ã‚ ¸Ã‚ Ãƒ  Ã‚ ¹Ã‚ Ãƒ  Ã‚ ¸Ã‚ £Ãƒ  Ã‚ ¸Ã¢â‚¬ ¡ (kleuan-wai= movement; ok-raeng= expend energy) instead to define physical activity. The term kleuan-wai-ok-raeng was therefore applied to this study. The interview findings illustrated that the statements contribute to physical environment among participants was delineated and identified as a content domain. Home was most frequently mentioned as a favorite place for engagement in physical activity. The majority of participants expressed that they generally preferred engaging in physical activity at home because of safety concerns and convenience. Representative phrases and terms were marked to be used as potential items so that the language of the participants could be preserved. As a result, the home environment subscale was formulated, and it was consisted of safety and convenience both inside and around home. Based upon the experts suggestions, 21 items that were considered irrelevant on the ESPA were eliminated and four additional items related to home environment were added to the ESPA. Therefore, the modified scale was called Thai Environment Support for Physical Activity in older Thai people (TESPA). A Likert scale was used to assess physical environment for physical activity. Possible responses were 1(strongly disagree), 2(disagree), 3(neither agree nor disagree), 4(agree), and 5(strongly agree). The possible ranges of scores for home, neighborhood, and community sub-scale were 4-20, 3-15, and 3 15 respectively. The total score was calculated by computing the numerical ratings for each answer. The possible scores ranged from 10 to 50. Higher scores indicated a higher level of perceived physical environment supportive of physical activity. In short, the TESPA was conceptualized to include three subscales, with the six items serving as supportive neighborhood and community environments, and the four new items as supportive of home environment. Neighborhood environment was defined as the area around their home to which they could walk within 10 minutes.23 A supportive neighborhood environment referred to older peoples perceptions of support including: characteristics, access, and barriers of physical activity; a pleasant neighborhood for walking; low traffic volume; and lack of unattended dogs in their neighborhood.23 Secondary, community environment is defined as the area contained within a 20-minute drive from the respondents home.23 Community environment support refers to older peoples perceptions of convenience and safety of physical activity in their community: convenience of facilities of the Primary Care Unit; access to parks, playgrounds, and sports fields; and the safety of public recreation facilities.23 Finall y, home environment support is defined as participants perceptions of convenience and safety regarding their home environment, both in and around their home, in relation to their participation in physical activity. Stage 2: Quantification stage The Content Validity Index of the TESPA questionnaire was 0.92. The reliability coefficients of TESPA scale was 0.73 and the test-retest reliability of scale was .76. The results of the pilot study demonstrated that respondents took between 15 to 20 minutes to complete the questionnaire. The measurements were culturally appropriate for older Thai people and the procedures were followed without any difficulty. Phase 2: Assessing the Instrument The physical activity score ranged from 0 to 2203.50 MET-minute/week with a median of 849.25 (SD = 438.63), and the interquartile rang of 670.13 MET-minute score. The skewness coefficient (.26) and the kurtosis statistic (-.52) indicated that the majority of the subjects reported a moderate physical activity score and a close proximity to a normal distribution. Also, 65% of the participants of this study were sufficiently active and 35% were not. The total sum scores of physical environment ranged from 19.00 to 50.00, with a mean of 34.87 (SD = 6.47). The skewness value (.26) and the kurtosis value (-.49) indicated that the majority of the respondents had moderate physical environment scores and the variance was distributed normally. Construct validation was confirmed by confirmatory factor analysis, and the known-group technique. Based on confirmatory factor analysis, the findings demonstrated that the construct of TESPA was composed of three underlying subscales: home, neighborhood, and community environment. The correlation among items ranged from .02 to .77 and the total scale could explain 61.01% of the variance of physical environment. The home, neighborhood, and community subscale could account for 29.4%, 19.7%, and 12.0% of the variance, respectively. The next analysis tested the three-factor model. The measurement model testing was designed to estimate which ten items were used as indicators for the model. Although the original model was statistically significant, the model was not consistent with the data /df= 4.59 and RMSEA more than 0.05 (= 151.54, df= 33; p Insert figure 2 here Table 1 illustrates the loading with t-values and squared multiple correlation coefficients among each observed variables for TESPA scale. The results revealed that all indicators of the TESPA measurement had significant low to high parameter estimates, which were related to their specific constructs and validated the relationships among observed variables and their constructs. The squared multiple correlations for observed variables of the latent variables were ranged from 0.02 to 0.92. The R2 of item 2, 3, 4, 5, and 6 were acceptable indicators, except for the item 1, 7, 8, 9, and 10 which were less than .40. Insert Table 1 here The known-group technique is an examination of relationships based on theoretical prediction. 35 Table 2 shows the mean values for each of the TESPA subscales and physical activity subgroups for the complete sample. Those who demonstrated sufficient physical activity had significantly higher physical environment scores along all three subscales and total score. In addition, each subscale was positively correlated with participation in physical activity including neighborhood (r=.30, p Insert Table 2 here Discussion: Testing of the TESPA measurement model in the current study provided additional evidence for the validity and reliability. The findings are discussed in the following section. The content validity and construct validity of the newly designed TESPA scale were accepted. Continued support for the construct validity of the scale was also provided through confirmatory factor analysis and the known-group method. The TESPA measurement model demonstrated that all sub-scales of the measurement had significant low to high parameter estimates, which were related to their specific constructs and validated the relationships among observed variables and their constructs. Within the known-group method, the findings demonstrated that physical environment was significantly correlated with physical activity. This finding indicated that older people with high perceptions of safety, convenience, and accessibility in their home, neighborhood, and community environment were more likely to participate in physical activity. Similarly, active older people who met guideline recommendations for good health scored significantly higher in each of three factors supportive home, neighborhood, and community environment than those who did not. Physical environments affect the participation in behavior by means of the interaction between cognitive functions and environment through human motivation.9-10 Bandura argued that a better environment provides a great opportunity to perform a behavior.10 According to the empirical data in the present study, a plausible explanation for this result contributed to characteristics of the Thai elderly. The majority of the elders sampled have lived in their home for a median 30 years; consequently, they were familiar with the physical characteristics of their environment in and outside the home. It is possible that the friendly environment contributed to motivate them for physical activity engagement, while unfriendly environments discouraged activity. For reliability, although the R2 for item 1, 7, 8, 9 and 10 indicated that these items should be considered irrelevant for the TESPA scale, the measurement model was a good fit with the empirical data. Not only was this scale firstly modified and validated in older Thai adults, but also normative data for comparison in the elderly or other study were not available. Approximately 61 % of the variance in the TESPA scale was explained by the 10 items, whereas 39 % of the variance in this scale remains unexplained. Corresponding with the SCT approach, Bandura argued that nearly all aspects of the physical environment can influence physical activity.36 Owing to the fact that the TESPA measurement includes only safety, convenience, and accessibility aspects of physical environment, it is possible that other aspects may contribute more to physical activity than these aspects. Other aspects of the physical environment may still influence engaging in physical activity; a need is indicated for work to identify these aspects yet unidentified. Therefore, continued evaluation of the psychometric properties both in the other sample and new additional items are necessary to confirm this study. Limitations and recommendations: This study was limited by homogeneity of the sample. The majority of participants was female, married, low socioeconomic status, and lived in their home. Continued testing of the TESPA scale, particularly with socio-economically diverse older adults, is needed to insure that this measure is consistent. Additionally, using objective measurement should be considered, to further add to the validity of the findings and confirm the subjective report. Further, the item related to community environment should be explored via a qualitative study to explore and understand with the physical environment of Thai elderly. Nevertheless, based on factors of the TESPA, manipulation of these factors with cognitive behav

The Causes and Impacts of Youth Smoking on Hong Kong

Title: The causes and impacts of youth smoking on Hong Kong smoking young people’s quality of life |Content |Page | |Chapter 1 : Introduction |P. 3-4 | |Chapter 2 : Literature Review and Methodology |p. 5-11 | |2. 1 Literature Review | | |2. Methodology | | |2. 3 Limitations | | |2. 4 Chapter summary | | |Chapter 3 : Findings |p. 12-19 | |3. 1 Reasons of smoking among Hong Kong young people | | |3. Non-smokers’ view towards smoking | | |3. 3 Effects of smoking on smokers’ quality of life in the economic and social aspects | | |3. 4 Suggestions to help smokers to quit smoking | | |3. 5 The effectiveness of government measures in encouraging and helping smokers to quit smoking | | |3. Chapter summary | | |Chapter 4 : Analysis and Discussion |p. 20-26 | |4. 1 The truth about youth smoking | | |4. 2 The effectiveness of government measures on encouraging and helping smokers to quit smoking | | |4. 3 Suggestions to help smokers to quit smoking | | |4. Limitation of the study | | |4. 5 Areas for further study | | |4. 6 After thoughts | | |Bibliography |p. 27 | |List of Appendices |p. 8-43 | |Table of contents: | | |Summary table of the results of questionnaires | | |Questionnaire samples ( in Chinese and English versions) | | Chapter 1 : Introduction Smoking is not good for health and it smells bad. I want to know why some young people still smoke. Hong Kong government has passed some laws about banning smoking in indoor areas and some public areas such as parks.The government also shot some advertisement about quitting smoking, such as the smoke-free Hong Kong advertisement. I want to know whether these measures are effective in helping smokers to quit smoking. My grandfather died because of tuberculosis. He was a heavy smoker. I want to know how smoking affect people’s health. My uncle also has a smoking habit. I want to know some ways to help smokers to quit smoking through this Independent Enquiry Studies. The focus questions of my Independent Enquiry Studies are â€Å" Why do some Hong Kong young people start smoking? , â€Å"What are the non-smokers and smokers’ views towards smoking? †, â€Å" How does smoking affect Hong Kong young people’s quality of life in economic and social aspect? † and â€Å"What can we do to help the smokers to quit smoking? † In this Independent Enquiry Studies, â€Å"smoking† refers to the smoking of all forms of tobacco, including cigarette, cigar, hand rolled cigarette and pipe-smoking. â€Å"Hong Kong smoking young people† refers to Hong Kong residents aged 10-25 who at the time of doing the survey have a smoking habit, no matter what type of tobacco they smoked and their smoking pattern. People who smoked before and have now quitted smoking† refers to people who previously had a smoking habit for at least 1 month continuously. â€Å"Quality of life† refers to the degree of satisfaction in the material and s piritual aspects of life. There are 4 chapters in the Independent Enquiry Studies. Chapter 1 is Introduction. It includes the background of the Independent Enquiry Studies. Chapter 2 is Methodology. It includes the method of doing research in the Independent Enquiry Studies. Chapter 3 is Findings. It includes the findings of the research. Chapter 4 is Analysis.After analyzing the findings, I will suggest some possible answers to the focus questions. In the appendix, samples of questionnaires and a summarizing table of the findings are attached. Through the Independent Enquiry Studies, we should be able to gain knowledge of non-smokers view towards smoking, assess the effectiveness of government’s measures on helping and encouraging smokers to quit smoking and know some effective methods in helping smokers to quit smoking. Chapter 2 : Literature Review and Methodology 2. 1 Literature Review 2. 1. 1 Youth smokersAccording to the survey on Pattern of Smoking conducted by the Cen sus and Statistical Department during December 2007 to March 2008, 10500 people in Hong Kong aging from 15 to 19 smoked. 2. 4% of them are daily smokers. 107800 people in Hong Kong aging from 20 to 29 smoked. 15. 9% of them are daily smokers. The percentage of daily smokers was on a gradually decreasing trend over the past 15 years from 1993 to 2008. Average daily consumption of cigarettes of 15-19 smokers was 11 cigarettes in the survey conducted during Dec 2007-Mar 2008, while the average consumption of cigarettes of 20-29 cigarettes smokers was 12 cigarettes. 1] 2. 1. 2 Causes of youth smoking According to the survey on Pattern of Smoking conducted by the Census and Statistical Department during December 2007 to March 2008, 59. 8% of daily cigarette smokers started smoking because of â€Å"influence of friends†, 36. 7% â€Å"out of curiosity†. Other reasons included â€Å"necessity in social functions† (8. 1%), â€Å"influence of family members† (7. 8% ) , â€Å"easing tension† (4. 2%), â€Å"refreshing one’s mind† (3. 7%) and â€Å"killing time† (3. 4%). [2] 2. 1. 3 Impacts of youth smoking Many sources suggest that smoking can cause various diseases and hence has a negative impact on smoker’s health.On the website of Hong Kong Council on Smoking and Health, it suggests that cigarette smoking is hazardous to health. Smoking can cause different cancers, such as cancers of the mouth and throat, lung cancer, pancreatic cancer and stomach cancer. Smoking also causes cardiac diseases, pulmonary and respiratory diseases and genital diseases, such as impotence in male smokers. [3], The website of Tobacco Control Office Department of Health also suggests that smoking is a causative agent of many fatal diseases and cancers.Smoking can cause disorders and problems such as impotence, infertility, wrinkling and halitosis. Smoking would also bring about socio-economical consequences. [4] 2. 1. 4 Methods of q uitting smoking The website of Tobacco Control Office Department of Health includes some tips and methods that can help smokers to quit smoking. When you start to quit smoking, you will still have urges to smoke. The urge will last for just a few minutes and you will be able to get over it. The website provides some methods to help smokers get over this urge.For example, when smokers have urges to smoke, they can try to divert their attentions to smoke by washing face, listen to music, etc. [5] 2. 2 Methodology Questionnaire will be employed to collect the data for the IES. There are many good points. 1. Quantitative Research Orientation 1. Scientific approach Quantitative researchers work on simplifying complicated social phenomena into measurable figures. After calculation, the researcher can know the general situation of different social phenomena and their interrelationships. 2. Objective approachThe personal opinions of respondents may affect their answers to some questions. Fo r example, when the respondents are asked whether the government policy is effective in tackling smoking, it is difficult to define effective. However, the researcher can use a more objective approach, such as when using literature review, the researcher can compare the number of smokers before and after the government policies are implemented. Assume there are 10000 people quit smoking after the banning smoking in restaurants. Some people may think that it is effective while some people may think that it is not effective.From this figure, we can know the actual situation. 3. Require less time and resources Instead of arranging a time doing interview with the respondents face-to-face, we can send the questionnaire to target respondents through mails. We may also upload the questionnaire online and invite respondents to answer the questionnaire through online forums and social-networking software and websites. 4. Can reach more respondents As the time required for each respondent to give response is shorter, there is more time to invite more respondents to give responses.Some people may be scared or shy when doing a face-to-face interview, a questionnaire is more suitable to these respondents. Since Hong Kong people are busy, many of them cannot arrange time for doing the interview. Sending a questionnaire to them enables them to answer when they have time. 1. Research Procedures The mini pilot questionnaire Before actual questionnaires were distributed, the researcher discussed the questionnaire with his teacher and classmates to ascertain whether the questions are understandable and sensible to the respondents.This also gives rough ideas of the suitability of wording and the appropriateness of the sequence of questions and the questions being asked. The questionnaires The researcher used online questionnaire at first to save time and resources between 1 February 2011 and 20 March 2011. However, the number of respondents was not satisfactory (237), while the t arget sample size was 300 and the researcher decided to distribute questionnaires directly in Causeway Bay on 27 March 2011. In the research, the researcher divided the respondents into three target groups, including non-smokers, smokers and ex-smokers.Each target group had a unique set of questions in order to answer different focus questions in the research. The questions were provided with choices to make data analysis easier and save respondents’ time. Questionnaire questions Most of the questionnaire questions were provided with options and the option â€Å"others† for respondents to give answers that were not given in the options. There were a lot of options in the questions so as to cover most possible opinions of respondents. This surely saved respondent’s time in completing the questionnaire and the researcher can analyze the data easily.The questionnaire had both Chinese and English versions, so the respondents could understand the questions easily and give appropriate responses. Examples were also given after the some relatively difficult words to ensure the respondents understand the questions clearly. 1. Data Analysis Numerical expression of data In order to make the data comparable, all answers are arranged in different categories and both numbers of respondents choosing that option and the percentage of respondents choosing that option (only in questions that the respondents could only choose one option) were shown. . Limitations The questionnaires are distributed online and in the Causeway Bay, so people who do not live in Causeway Bay and cannot access to the internet cannot get the questionnaire. Therefore, the responses may be biased and confined. 3. Chapter Summary This chapter has given the theoretical framework for this research, including the literature review and methodology of this research. In this research, questionnaire was used mainly.To enhance readers’ understanding of the research, both the research p rocedure and data analysis with also its objective and scientific approach were included. Chapter 3: Findings In this chapter, the researcher is going to present the data collected through questionnaires. The research emphasizes on the causes and impacts of youth smoking on Hong Kong smoking young people’s quality of life. In 3. 1, there will be a discussion on the reasons why some Hong Kong young people start smoking. In 3. 2, the Hong Kong non-smoking young people’s view towards smoking will be investigated.In 3. 3, how smoking affects Hong Kong smoking young people’s quality of life in the economic and social aspects will be explored. In 3. 4, the researcher will attempt to give some suggestions to help Hong Kong smoking young people to quit smoking. In 3. 5, the researcher will give a discussion on the effectiveness of government measures on encouraging and helping smokers to quit smoking. 3. 1 Reasons of smoking among Hong Kong young people The researcher h as distributed 100 questionnaires to Hong Kong smoking young people.As shown in figure 1, the reasons why some Hong Kong young people smoke are influence of friends (60%), curiosity (36%), influence of family members (8%), releasing pressure (8%) killing time (4%) and refreshing one’s mind (4%) |Options |Number of respondents | |Influence of friends |60 | |Influence of family members |8 | |Curiosity |36 | |Release pressure |8 | |killing time |4 | |refreshing one’s mind |4 |Figure 1: Summary table showing the reasons why some Hong Kong young people smoke 3. 2 Non-smokers’ view towards smoking The researcher has also distributed 100 questionnaires to Hong Kong non-smoking young people. As shown in figure 2, among 100 Hong Kong non-smoking young people, 95 of them do not like people who smoke, only 5 of them like people who smoke. [pic] Figure 2: a pie chart showing the general opinions of Hong Kong non-smoking young people on Hong Kong smoking young people As show n in figure 3, among the 5 Hong Kong non-smoking young people who like smoking people, all of them like people who smoke because they think that smoking people are attractive. 4 of them also like the smell of cigarettes. Options |Number of respondents | |Smoking people are attractive |5 | |I like the smell of cigarettes |4 | |Secondhand smoke is good for my health |0 | Figure 3: Summary table showing the reasons why some Hong Kong non-smoking young people like people who smoke. (they can choose more than 1 option) As shown in figure 4, among the 95 Hong Kong non-smoking young people, 80 of them dilikes people who smoke because they think that smoking people are not attractive. 85 of them hate the smell of cigarettes. All of them agrees that secondhand smoke is bad for their health,so they dislike people who smoke. Options |Number of respondents | |Smoking people are not attractive |80 | |I hate the smell of cigarettes |85 | |Secondhand smoke is bad for my health |95 | Figure 4: Summ ary table showing the reasons why some Hong Kong non-smoking young people dislike people who smoke (Respondents can choose more than 1 option) 3. 3 Effects of smoking on smokers’ quality of life in the economic and social aspects As shown in figure 5, among the 100 Hong Kong smoking young people, 9% of them spend $0-50 in buying cigarettes per week. 80% of them spend $51-100 in buying cigarettes per week. 11% of them spend $101-150 in buying cigarettes per week. So, smokers have a greater expense and thus smoking have a negative impact on smokers’ quality of life in the economic aspect. Options |Number of respondents |percentage | |$0-50 |9 |9% | |$51-100 |80 |80% | |$101-150 |11 |11% | |$151-200 |0 |0% | |$201-250 |0 |0% | |$251-300 |0 |0% | |$301-350 |0 |0% | |$350 or above |0 |0% | Figure 5: Summary table showing how much do Hong Kong smoking young people spend on buying cigarettes per weekAs shown in figure 2, 95% of Hong Kong non-smoking young people responded dis like people who smoke. This shows that smoking has adverse impacts on the relationship between smokers and non-smokers. Hence, smoking adversely affects smokers’ quality of life in social aspect. 3. 4 Suggestions to help smokers to quit smoking The researcher has conducted questionnaires with 100 ex-smokers in Hong Kong. As shown in figure 6, among 100 ex-smokers responded, all of them discarded all cigarettes and ashtrays to quit smoking. 80 of them used medications for quitting smoking. 90 of them tried to avoid staying in places where people smoke. 77 of them used smoking cessation services provided by smoking cessation clinics. Options |Number of respondents | |Discard all cigarettes and ashtrays |100 | |Using medications for quitting smoking (such as nicotine |80 | |patch and nicotine gum) | | |Avoid staying in places where people smoke |90 | |Using smoking cessation services provided by smoking |77 | |cessation clinics | | Figure 6: Summary table showing what measure s ex-smokers took to quit smoking (Respondents can choose more than 1 option) 3. The effectiveness of government measures in encouraging and helping smokers to quit smoking According to figure 7, 76 of the 100 ex-smokers responded decided to quit smoking because of the advice from health care professionals. 54 of them decided to quit smoking because of health reasons. 23 of them decided to quit smoking because of influence of friends. 59 of them decided to quit smoking due to influence of family members. 9 of them decided to quit smoking as requested by boss or teachers. 43 of them decided to quit smoking due to government policies. |Options |Number of respondents | |Health reasons (with advice from doctors/ other health care 76 | |professional) | | |Smoking is not good to my health |54 | |Influence of friends |23 | |Influence of family members |59 | |Requested by boss/ teachers |9 | |Government policies(such as expanding statutory no smoking |43 | |areas) | |Figure 7: Summary ta ble showing why ex-smokers decided to quit smoking ( Respondents can choose more than one option) 3. 6 Chapter summary With the aids of pie charts and tables, the chapter attempts to give a discussion on the reasons why some Hong Kong young people start smoking, the non-smokers’ views towards smoking, how smoking affect smokers’ quality of life in the economic and social aspects, the effectiveness of government measures in helping and encouraging the smokers to quit smoking and suggestions to help smokers to quit smoking. The main reasons why some Hong Kong young people start smoking are influence of friends and curiosity.Most Hong Kong non-smoking young people dislike people who smoke. Smoking has adverse impacts on smokers’ quality of life in both economic and social aspects. Government measures are effective in helping the smokers to quit smoking as 77 of the 100 ex-smokers responded used smoking cessation services provided by government smoking cessation cli nics. Government measures are not effective in encouraging the smokers to quit smoking since only 43 of the 100 ex-smokers responded quit smoking because of government policies such as expanding statutory no smoking areas. Further discussion and analysis are to be followed in chapter 4. Chapter 4: Analysis and DiscussionBased on the findings done in Chapter 3 and related studies, this chapter would discuss the causes of youth smoking, the impacts of youth smoking on Hong Kong smoking young people’s quality of life in the economic and social aspect, the effectiveness of government measures in encouraging and helping the smokers to quit smoking and further explore some methods to help smokers to quit smoking. 4. 1. The truth about youth smoking 4. 1. 1. The causes of youth smoking As said in chapter 3, the causes of youth smoking are influence of friends, curiosity, influence of family members, releasing pressure, killing time and refreshing one’s mind. To explain the ca uses of youth smoking, the following may serve as reference. †¢ Influence of friends In general, adolescents value the relationship with their friends.In order to have a good relationship with their peers, they will try their best to obtain their affirmation and acceptance. So, influence of friends is a main reason why some Hong Kong young people start smoking. †¢ Curiosity Nowadays, smoking scenes frequently appears on television and films. Hong Kong young people and children often see people smoking on the street. They may have a wrong concept that smoking people are cool. They begin to develop the curiosity to smoke. When there are some chances for them to start smoking, such as being invited by friends they are more likely to start smoking. †¢ Influence of family members In the childhood, parents are the idols of their children. Children tend to follow what their parents do.If children see their parents smoking, they will have a higher tendency to follow their par ents and start smoking. They will also have a higher curiosity towards smoking. Smoking parents is harder to stop their children from smoking because the parents themselves smoke, too. So, influence of family members is also one main cause of youth smoking. 4. 1. 2 The impacts of smoking on smokers’ quality of life As mentioned of chapter 3, smoking has adverse impacts on smokers’ quality of life in the economic and social aspect. The following will explain the impacts of smoking on smokers in details. †¢ In the economic aspect Smokers have to spend money on buying cigarettes.The government has recently increased the tobacco tax and worked hare to tackle contraband and counterfeit cigarettes problem. The prices of cigarettes therefore increases and smokers have to pay more on cigarettes. As shown in chapter 2, smoking is detrimental to health as it may lead to different cancers and other diseases such as infertility. So, smokers may be easier to get a disease and their medical expenses may increase. Therefore, smoking brings negative impacts on smokers’ quality of life in the economic aspect. †¢ In the social aspect As shown in chapter 3, most non-smokers dislike people who smoke. Therefore, smokers have a poor relationship with most non-smokers.Smokers have a poorer relationship with non-smokers and hence the social aspect of quality of life of smokers is negatively affected. On the other hand, smokers may have a better relationship with other smokers. For example, cigarettes are often used as gifts among businessmen in China. People can get recognition from other smokers by smoking. So, smokers have a better relationship with other smokers and hence smoking brings positive impacts on smokers’ quality of life in the social aspect. 4. 2. The effectiveness of government measures on encouraging and helping smokers to quit smoking 4. 2. 1 The effectiveness of government measures Smokers are often addicted to cigarettes.They e xperience many withdrawal symptoms when they try to quit smoking, such as dizziness, headache and poor concentration. Therefore, it is difficult for smokers to quit smoking. As mentioned in chapter 3, the effectiveness of government measures on encouraging smokers to quit smoking is low. 2. The effectiveness of government measures on helping smokers to quit smoking As stated in chapter 3, many ex-smokers used smoking cessation services provided by smoking cessation clinics to quit smoking. This shows that government measures are effective in helping smokers to quit smoking. 2. Suggestions to help smokers to quit smoking It is difficult to quit smoking.However, smokers can use some methods adopted by most ex-smokers to quit smoking. Here are some examples. †¢ Discard all cigarettes and ashtrays †¢ Avoid staying in places where people smoke †¢ Using medications for quitting smoking ( such as nicotine patch and nicotine gun) 3. Limitation of the study First and foremost, the study involving 300 respondents for sampling may not be able to represent the opinions of non-smokers, smokers and ex-smokers. The distribution of questionnaires are done online and in Causeway Bay, so people who do not have the access to the internet nor live in Causeway Bay may not get the questionnaire. Therefore, the responses may be biased and confined.Due to the limited resources, the researcher has already tried to work out the generalized pattern of people’s opinions towards smoking as much as possible. The researcher has also studied similar studies done by the government in a much larger scale. Hence, the reliability of the study can be increased. Time has always been a constraint to the researcher. So as to ensure the general trend of people’s opinions, the researcher has spent considerable time on analyzing the data and arranging them into summary tables and pie charts. 4. Areas for further study Despite the limitations, the study can hopefully uphold the complexity of the causes and impacts of youth smoking. This study has brought some insights to the policy makers in encouraging and helping Hong Kong smoking people to quit smoking.The following suggestions may also serve as good topics for further studies †¢ New methods to stop people from starting to smoke †¢ New methods of encouraging and helping smokers to quit smoking by other stakeholders (besides the government and individuals) The rationale behind these suggestions is highly understandable. â€Å"Prevention is better than curing. † It is easier to stop people from starting to smoke than helping smokers to quit smoking because smokers are addicted to cigarettes. Therefore, looking for methods to encourage people not to start smoking is a more useful method to reduce the smoking population in Hong Kong. As stated in 4. 2. , the current government measures are not effective in encouraging smokers to quit smoking. Also, development of new cheaper and more co mfortable methods to quit smoking may encourage smokers to quit smoking. Therefore, a research on new methods to encourage and help smokers to quit smoking is contributive to reduce smoking population in Hong Kong. 5. Afterthoughts To the researcher’s belief, this study helps readers to gain knowledge of people’s view towards smoking and know some effective methods in helping smokers to quit smoking. This study has also assessed the effectiveness of government’s measures in encouraging and helping smokers to quit smoking. Bibliography Books: Census and Statistical Department. Pattern of smoking†, Hong Kong Monthly Digest of Statistics (Hong Kong, June 2009) Websites: Hong Kong Council on Smoking and Health. â€Å"Risks? Active Smoking† http://smokefree. hk/en/content/web. do? page=ActiveSmoking (Retrieved on 17 April 2011) Tobacco Control Office Department of Health. â€Å"Smoking and Health† http://www. tco. gov. hk/english/infostation_sh. h tml (Retrieved on 17 April 2011) Tobacco Control Office Department of Health. â€Å"Quitting Smoking† http://www. tco. gov. hk/english/quittting/quitting_vcqs. thml (Retrieved on 17 April 2011) Appendix I Summary table of the results of the questionnaires For non-smokers 1. How old are you? Choices |Number of respondents | |10-15 |23 | |16-20 |45 | |21-25 |32 | 2. What is your sex? |Choices |Number of respondents | |Male |79 | |Female |21 | 3. Can you suggest some methods that you think that are effective in helping smokers quit smoking? You may choose more than 1 option) |Choices |Number of respondents | |Discard all cigarettes and ashtrays |100 | |Using medications for quitting smoking (such as nicotine |90 | |patch and nicotine gum) | | |Avoid staying in places where people smoke |90 | |Using smoking cessation services provided by smoking |93 | |cessation clinics | | |Others(please state) |0 | 4. Do you like people who smoke? |Choices |Number of respondents | |Yes ( please go to question 5) |95 | |No (please go to question 6) |5 | 5. Why do you like people who smoke? You may choose more than 1 option) |Choices |Number of respondents | |Smoking people are attractive |5 | |I like the smell of cigarettes |4 | |Secondhand smoke is good for my health |0 | |Others(please state) |0 | 6. Why do you hate people who smoke? You may choose more than 1 option) |Choices |Number of respondents | |Smoking people are not attractive |80 | |I hate the smell of cigarettes |85 | |Secondhand smoke is bad for my health |95 | |Others(please state) |0 | 7. Do you have relatives or friends who smoke? Choices |Number of respondents | |Yes (please go to question 8) |63 | |No (Thank you for completing the survey) |37 | 8. Have you tried to persuade your relatives or friends to quit smoking? |Choices |Number of respondents | |Yes (please go to question 9) |27 | |No (Thank you for completing the survey) |26 | 9. After your persuasion, did your relatives or friends try to q uit smoking? Choices |Number of respondents | |Yes |8 | |No |15 | |I do not know |4 | For smokers 1. How old are you? |Choices |Number of respondents | |10-15 |3 | |16-20 |45 | |21-25 |52 | 2.How long have you been smoking? |Choices |Number of respondents | |1-3 years |63 | |4-6 years |19 | |7-10 years |15 | |10 years or above |3 | 3. Do you agree that smoking is bad to your health? Choices |Number of respondents | |Agree |92 | |Disagree |8 | 4. Do you agree that you are addicted to cigarettes? |Choices |Number of respondents | |Agree |87 | |Disagree |13 | 5. How many cigarettes you smoke per day? Choices |Number of respondents | |1-3 |12 | |4-6 |34 | |7-9 |40 | |10-12 |13 | |13-15 |1 | |16-18 |0 | |18-21 |0 | | 22 or above |0 | 6. How much do you spend on buying cigarettes per week? (Hong Kong Dollars) Choices |Number of respondents | |$0-50 |9 | |$51-100 |11 | |$101-150 |80 | |$151-200 |0 | |$201-250 | 0 | |$251-300 |0 | |$301-350 | 0 | |$350 or above |0 | ? $3 01-350 ? $350 or above 7. Where do your money buying cigarettes come from? You may choose more than 1 option) |Choices |Number of respondents | |Work |44 | |Petty cash from family members |78 | |From illegal ways |0 | |Borrow from family members/friends |23 | |Others(please state) |0 | 8. Do you relatives or friends know that you smoke? Choices |Number of respondents | |Yes (please go to question 9) |67 | |No (please go to question 10) |33 | 9. Generally, do they support you to smoke? |Choices |Number of respondents | |Yes |13 | |No |33 | |I do not know |21 | 10. Why do you smoke? (You may choose more than 1 option) Choices |Number of respondents | |Influence of friends |60 | |Influence of family members |8 | |Curiosity |36 | |Release pressure |8 | |Killing time |4 | |refreshing one’s mind |4 | |Others(please state) |0 | 11. What are the bad effects of smoking on you? You may choose more than 1 option) |Choices |Number of respondents | |I am not welcomed |23 | |I am less healthy |92 | |Not enough money |30 | |Makes me ugly |43 | |Bad image |33 | |Poor relationship with relatives |37 | |Poor relationship with friends |29 | |Others(please state) |0 | 12. What are the good effects of smoking on you? You may choose more than 1 option) |Choices |Number of respondents | |I am welcomed |63 | |I am more healthy |8 | |I have more money |47 | |I am more handsome/beautiful |57 | |Good image |57 | |Better relationship with relatives |10 | |Better relationship with friends |70 | |Others(please state) |0 | 13. Have you tried to quit smoking? |Choices |Number of respondents | |Yes (please go to question 14) |20 | |No (Thank you for completing the survey) |80 | 14. Why did you quit smoking? You may choose more than 1 option) |Choices |Number of respondents | |Health reasons(with advice from doctors/ other health care |3 | |professional) | | |Smoking is not good to my health |5 | |Influence of friends |2 | |Influence of family members |13 | |Requested by boss/ teachers |15 | |Government policies(such as expanding statutory no smoking |3 | |areas) | | |Others(please state) |0 | 15. What methods did you use to quit smoking? You may choose more than 1 option) |Choices |Number of respondents | |Discard all cigarettes and ashtrays |20 | |Using medications for quitting smoking (such as nicotine |17 | |patch and nicotine gum) | | |Avoid staying in places where people smoke |18 | |Using smoking cessation services provided by smoking |18 | |cessation clinics | | |Others(please state) |0 | 16. Why did you fail to quit smoking? You may choose more than 1 option) |Choices |Number of respondents | |Not determined enough |20 | |Smoking has become a habit/favourite |20 | |Quitting smoking is suffering |20 | |Others(please state) |0 | For ex-smokers 1. How old are you? |Choices |Number of respondents | |10-15 |0 | |16-20 |15 | |21-25 |85 | 2. Why did you smoke? (You may choose more than 1 option) Choices |Number of respondents | |Influence of fr iends |83 | |Influence of family members |15 | |Curiosity |40 | |Release pressure |13 | |killing time |15 | |refreshing one’s mind |3 | |Others(please state) |0 | 3. Why do you quit smoking? You may choose more than 1 option) |Choices |Number of respondents | |Health reasons(with advice from doctors/ other health care |76 | |professional) | | |Smoking is not good to my health |54 | |Influence of friends |23 | |Influence of family members |59 | |Requested by boss/ teachers |9 | |Government policies(such as expanding statutory no smoking |43 | |areas) | | |Others(please state) |0 | 4. What methods did you use to quit smoking? You may choose more than 1 option) |Options |Number of respondents | |Discard all cigarettes and ashtrays |100 | |Using medications for quitting smoking (such as nicotine |80 | |patch and nicotine gum) | | |Avoid staying in places where people smoke |90 | |Using smoking cessation services provided by smoking |77 | |cessation clinics | | 5. What is the most important factor that help you to quit smoking successfully? Choices |Number of respondents | |Health reasons(with advice from doctors/ other health care |76 | |professional) | | |Determination to quit smoking |100 | |Support from family member and/or friends |67 | |Requested by boss/ teachers |13 | |Government policies(such as expanding statutory no smoking |43 | |areas) | | |Others(please state) |0 | Appendix II Samples of Questionnaires ( ) 2007 10500? 15 19 , , 10 25 1. ? 10-15? 16-20? 21-25 2. ? ? ? ? 3. ( ) ? ( ) ? ? ? ( ) 4. ( 5? ) ( 6? ) 5. ( ) ? ? ? ( ) 6. ( ) ? ? ? ? ( ) 7. ( 8? ) ( ) 8. ( 9? ) ( ) 9. ( ) , 2007 10500? 15 19 , , 10 25 1. ? 10-15? 16-20? 21-25 2. ? ? 3. ?1-3? ?4-6? ? 6-10? ? 10 4. 5. 6. ?1-3 ? 4-6 ? 7-9 ? 10-12 ? 13-15 ?16-18 ? 19-21 ? 22 7. ( ) ?$0-50 ? $51-100 ? $101-150 ? $151-200 ? $201-250 ? $251-300 ? $301-350 ? $350 8. ( ) ? ? ? ? ? ( ) 9. ( 10? ) 11? ) 10. , 11. ( ) ? ? ? ? ? ? ? ? ( ) 12. ( ) ? ? ? ? / ? ? ? ? ? ( ) 13. ( ) ? ? ? ? ? ? ? ( ) 14. ( 15? ) ( ) 15. ( ) ? ( ) ? ? ? ? ( ) ? ( ) 16. ( ) ? ( ) ? ? ? ( ) 17. ( ) ? ? / ? ? ( ) ( ) , 2007 10500? 15 19 , , 10 25 2. ? 10-15? 16-20? 21-25 2. ? ? ? ? 3. ( ) ? ? ? ? ? ? ? ? ( ) 4. ( ) ? ( ) ? ? / ? ? ? ( ) ? ( ) 5. ( ) ? ( ) ? ? ? ( ) 6. ? ( ) ? ? ? ( ) ? / ? ( ) Youth Smoking (non-smokers)Background Information In recent years, the number of youth smoking increases steadily. A survey in 2007 reveals that 10500 Hong Kong people aged 15-19 smoked. Through this survey, I want to identify the opinions of non-smokers and smokers towards smoking, the reasons why smokers smoke and how smoking affect smoker’s and non-smoker’s quality of life. This survey is only set for people aged 10-25 1. How old are you? ? 10-15? 16-20? 21-25 2. What is your sex? ? male ? female 3. Can you suggest some methods that you think that are effective in helping smokers quit smoking? (You may choose more than 1 option) ? Discard all cigarettes and ashtrays Using medications for quitting smoking (such as nicotine patch and nicotine gum) ? Avoid staying in places where people smoke ? Using smoking cessation services provided by smoking cessation clinics ? Others(please state) 4. Do you like people who smoke? ? Yes (please go to question 5) ? No (please go to question 6) 5. Why do you like people who smoke? (You may choose more than 1 option) ? Smoking people are attractive ? I like the smell of cigarettes ? Secondhand smoke is good for my health ? Others(please state) 6. Why do you hate people who smoke? (You may choose more than 1 option) ? Smoking people are not attractive ? I hate the smell of cigarettes ?Secondhand smoke is bad for my health ? Others(please state) 7. Do you have relatives or friends who smoke? ? Yes (please go to question 8) ? No (Thank you for completing the survey) 8. Have you tried to per suade your relatives or friends to quit smoking? ? Yes (please go to question 9) ? No (Thank you for completing the survey) 9. After your persuasion, did your relatives or friends try to quit smoking? ? Yes? No ? I do not know Thank you for completing the survey Youth Smoking (smokers) Background Information In recent years, the number of youth smoking increases steadily. A survey in 2007 reveals that 10500 Hong Kong people aged 15-19 smoked.Through this survey, I want to identify the opinions of non-smokers and smokers towards smoking, the reasons why smokers smoke and how smoking affect smoker’s and non-smoker’s quality of life. This survey is only set for people aged 10-25 1. How old are you? ? 10-15? 16-20? 21-25 2. How long have you been smoking? ? 1-3 years? 4-6 years? 7-10 years ? 10 years or above 3. Do you agree that smoking is bad to your health? ? Agree ? Disagree 4. Do you agree that you are addicted to cigarettes? ? Agree ? Disagree 5. How many cigarettes you smoke per day? ? 1-3 ? 4-6? 7-9? 10-12? 13-15? 16-18 ?18-21? 22 or above 6. How much do you spend on buying cigarettes per week? (Hong Kong Dollars) ? $0-50 ? $51-100 ? 101-150 ? $151-200 ? $201-250 ? $251-300 ? $301-350 ? $350 or above 7. Where do your money buying cigarettes come from? (You may choose more than 1 option) ? Work ? Petty cash from family members ? From illegal ways ? Borrow from family members/friends ? Others(Please state) 8. Do you relatives or friends know that you smoke? ? Yes (please go to question 9) ? No (please go to question 10) 9. Generally, do they support you to smoke? ? Yes? No ? I don’t know 10. Why do you smoke? (You may choose more than 1 option) ? Influence of friends ? Influence of family members ? Curiosity ? Release pressure ? killing time ? refreshing one’s mind ?Others(please state) 11. What are the bad effects of smoking on you? (You may choose more than 1 option) ? I am not welcomed ? I am less healthy ? Not enough money ? M akes me ugly ? Bad image ? Poor relationship with relatives ? Poor relationship with friends ? Others(please state) 12. What are the good effects of smoking on you? (You may choose more than 1 option) ? I am welcomed ? I am more healthy ? I have more money ? I have better relationship with relatives ? I am more handsome/beautiful ? good image ? I have better relationship with friends ? Others(please state) 13. Have you tried to quit smoking? ? Yes (please go to question 14) No (Thank you for completing the survey) 14. Why did you quit smoking? (You may choose more than 1 option) ? Health reasons(with advice from doctors/ other health care professional) ? Smoking is not good to my health ? Influence of friends ? Influence of family members ? Requested by boss/ teachers ? Government policies(such as expanding statutory no smoking areas) ? Others(Please state) 15. What methods did you use to quit smoking? (You may choose more than 1 option) ? Discard all cigarettes and ashtrays ? Using medications for quitting smoking (such as nicotine patch and nicotine gum) ? Avoid staying in places where people smoke Using smoking cessation services provided by smoking cessation clinics ? Others(please state) 16. Why did you fail to quit smoking? (You may choose more than 1 option) ? Not determined enough ? Smoking has become a habit/favourite ? Quitting smoking is suffering ? Others(please state) Thank you for completing the survey Youth Smoking (Ex-smokers) Background Information In recent years, the number of youth smoking increases steadily. A survey in 2007 reveals that 10500 Hong Kong people aged 15-19 smoked. Through this survey, I want to identify the opinions of non-smokers and smokers towards smoking, the reasons why smokers smoke and how smoking affect smoker’s and non-smoker’s quality of life.This survey is only set for people aged 10-25 1. How old are you? ? 10-15? 16-20? 21-25 2. Why did you smoke? (You may choose more than 1 option) ? Influence of friends ? Influence of family members ? Curiosity ? Release pressure ? killing time ? refreshing one’s mind ? Others(please state) 3. Why do you quit smoking? (You may choose more than 1 option) ? Health reasons(with advice from doctors/ other health care professional) ? Smoking is not good to my health ? Influence of friends ? Influence of family members ? Requested by boss/ teachers ? Government policies(such as expanding statutory no smoking areas) ? Others(Please state) 4.What methods did you use to quit smoking? (You may choose more than 1 option) ? Discard all cigarettes and ashtrays ? Using medications for quitting smoking (such as nicotine patch and nicotine gum) ? Avoid staying in places where people smoke ? Using smoking cessation services provided by smoking cessation clinics ? Others(please state) 5. What is the most important factor that help you to quit smoking successfully? ? Health reasons(with advice from doctors/ other health care professional) ? Determinati on to quit smoking ? Support from family member and/or friends ? Requested by boss/ teachers ? Government policies(such as expanding statutory no smoking areas) ?Others(Please state) Thank you for completing the survey ———————– [1] Census and Statistical Departmen

The Message Of The Gospel And The Truth Of God - 1576 Words

The world in which we live is filled with confusion. Many people have come to believe that there is no such thing as absolute truth, and have thereby adopted a mindset of fatalism and hopelessness. God intends that men should â€Å"have life, and that they might have it more abundantly† (John 10:10). The message of the Gospel and the truth of the Word of God alone can supply the sweet savor that our world hungers for. To fully understand God’s plan and purpose for humanity and grasp at the complexity of His divine nature, it is crucial that we understand the truth of God’s word as it is, and not simply as we have been told. Only by fortifying our minds with the pure milk of the Word may we hope to know the richness of life that God intended for humanity, and discern truth from falsehood, â€Å"that we henceforth be no more children, tossed to and fro, and carried about with every wind of doctrine, by the sleight of men, and cunning craftiness, whereby they lie i n wait to deceive† (Eph. 4:14). The Bible teaches that God reveals Himself by both general and specific means. Creation is the primary method of general revelation. â€Å"The heavens declare the glory of God† (Psalm 19:1a) to all people who can view His divine handiwork. The voice of creation speaks to all men â€Å"day unto day† (Psalm 19:2) and â€Å"there is no speech or language where their voice is not heard† (Psalm 19:3; Romans 10:18). God sometimes reveals Himself by specific means, such as in physical manifestation (Exodus 3; 19) andShow MoreRelatedNotes On Experiences With Scripture918 Words   |  4 Pagesstrengthens me; the knowledge and the truth found within the pages allows me the personal witness that God exists and loves me. The scriptures are the way we find the divinity of Christ, the good message of the gospel, and the ability to find direct revelation from past prophets and missionaries. Partially throughout my mission, I relied on the scriptures to lead and guide my teachings in the way the savior wanted his message portrayed. The ultimate message that Latter-Day Saints share with foreignRead MoreApologetics620 Words   |  3 Pagessome ways the Christian gospel is perceived in our culture? Christian gospel in many ways is perceived in this day and age are a lost word. People have the art of praying and staying faithful to the word of God. God provided us with all kinds of blessings and opportunities in life so that we can flourish and prosper. Also God took all our sin to the cross and forgave us for everything we done that was not right in his eyes. We need to also understand that there is only one God and we need to cherishRead MoreThe Church And The Community967 Words   |  4 PagesThe Church and The Community The mission of the church, to share the message of Jesus Christ with the world, has not changed, however, culture is constantly changing forcing the church to adapt its approach to fulfill its mission. There is no specific way to reach a culture with message, as long as the message is Christ. The church and its leaders face many challenges contextualizing the message within their specific community they aim to reach. Each community provides challenges and opportunitiesRead MoreThe New Testament Gospel By Matthew, Mark, Luke And John Form1590 Words   |  7 PagesThe four New Testament gospel books, Matthew, Mark, Luke and John form a conclusive and powerful portrait of Jesus Christ as the sent son of God. The four books are not in any way explaining the biography of Christ’s complete life, but rather trying to give the fundamental truth of Christianity, the great truths of the gospel and who Jesus really is. Each of the named gospel writers gives a clear and personal perspec tive of Christ as guided by the Holy Ghost and the themes that correspond to JesusRead MoreThe Bible Offers Plenty Of Messages About Love, Tolerance, Harmony, And Culture861 Words   |  4 Pages God created humanity; He loves all cultures equally. Lane does a great job explaining how God created diversity and embraces His people and the different types of worship. â€Å"God’s truths do not vary from culture to culture. However, the expression and communication within a particular culture will be shaped and influence by that culture.†(Lane, 2002, p. 136). The bible offers plenty of messages about love, tolerance, harmony, respect, and how important relationships are. The sinful nature of theRead MoreThe Gospels Of The New Testament1272 Words   |  6 PagesThe Themes of the Four Gospels Introduction The Gospels of the New Testament are â€Å"ancient biographies focused primarily on an individual’s character. Biographers told their audiences about events they thought would present the person’s character effectively.† These biographies focused on the â€Å"circumstances of the individual’s birth, what other’s said about him or her, and the person’s own actions and statements.† The Gospels complement one another as they present four different aspects of Jesus’Read MoreBiblical Narratives Of The Gospels Of Matthew, Mark, Luke And John1332 Words   |  6 Pagesâ€Å"But These Are Written That You May Believe† The Meaning of the Gospels Nothing is so foundational as the reality of Jesus’ life, death and resurrection. Questions have been raised about the historical characters of biblical narratives. Historicity is the condition of having occurred in history; authenticity. The authors were holy men of God who wrote the gospels inspired by the Holy Spirit, the Spirit of Truth. They did not write according to the method and expectations of man’s modern historyRead MoreEssay on My Philosophy on Evangelism759 Words   |  4 PagesChristians we are only obligated to the Bible. We know it to be the literal Word of God. It explicitly tells us that evangelism is not just a necessity, it is a command. Jesus Himself claims to have been given authority from heaven over this sensitive issue. He desires us to â€Å"go,† â€Å"baptize,† and â€Å"teach† to â€Å"all nations† all that He â€Å"commanded† us (Matt 28:18-20). These words came from His lips. The writer of the Gospel of Matthew records them as if Jesus spoke directly to us. It was one of His greatestRead MoreBiblical World View Essay949 Words   |  4 Pagesreaders of the truth of the Gospel Message. The first area He presents is in regard to the natural world that surrounds all mankind. In Romans 1: 19,20 Paul writes â€Å"For what can be known about God is plain to them, because God has shown it to them. Ever since the creation of the world his eternal power and divine nature, invisible though they are, have been understood and seen through the things he has made.† I remember as a child in Sunday school that I was often taught about God by looking at naturalRead MoreWhat Qualities, Priorities And Values Of Jesus And God Do These Parables Underscore?1685 Words   |  7 Pagestelling the ageless story to this generation. Please write out your answers to this first set of questions before doing any of the reading. Read Luke 15. What qualities, priorities and values of Jesus and God do these parables underscore? Some of the Qualities, Priorities and Values of Jesus/ God highlighted in these parables are: Qualities: Love (15:4,20), Concern (15:4), Care(15:5,22), Commitment (15:4,8), Respect (15:12), Compassion (15:4,20), and Generosity(15:22,23,31,32). Priorities: Personal

Who Killed Jay Gatsby - 1123 Words

The True Killer of Jay Gatsby Jay Gatsby lies dead, sprawled across the floatie in his pool. But whose fault is it when the question question of responsibility comes up? At the end of the story The Great Gatsby by F. Scott Fitzgerald, Jay Gatsby, formerly known as James Gatz, is murdered. George Wilson is the gunman who took Gatsbys and his own life at the end of the story. However, is Wilson really to blame for Gatsbys death? With many people in the story who affect his life and his decisions, there is greater texture to the original question then noticed at first. There are many elements that contribute to the murder of Gatsby. It is clear that someone other than Mr. Wilson bears greater responsibility for this crime. Daisy Buchanan,†¦show more content†¦When Gatsby asked nick â€Å"want to go with me[hydroplaning], old sport?... Any time that suits you best†(Fitzgerald, ). Nick just was easily influenced and admires him so much that he couldn’t say no. Even when Gatsby asked Nick to have tea with Daisy, Nick said it was no problem, without hesitation.These are not the qualities of a man who is truly a killer. Anyone that can be easily manipulated as easy as that doesnt have the power to corrupt someones mind enough to get them killed. Tom Buchanan is a strong, powerful, and forceful picture of a man who cares only about himself. He first meets Gatsby in the second half of the book because Gatsby is trying to steal daisy from him. Although Tom is a powerful rich man he is also a coward. He told George â€Å"The yellow car that I was driving this afternoon wasnt mine†(Fitzgerald, 140). There were many more ways for tom to give out the information, from turning it to the police or for waiting for george to ask him. Even though Tom offers George false information, eventually leading him to Gatsbys home, he is still less culpable than others. Toms actions were unwarranted and could have been avoided. This is because his wife was the person who tempted Gatsby first. Daisy is one of the socially eccentric characters who is most responsible for Gatsbys death even though she did not pull the trigger largely because of her carelessness with the people around her. There are many points inShow MoreRelatedAffairs, Wealth, and Murder in F. Scott Fitzgerald’s The Great Gatsby638 Words   |  3 Pages In The Great Gatsby, Fitzgerald tells about affairs, describes wealth, and tells about Murder. There are three different murders in The Great Gatsby. An automobile hit and killed Tom’s mistress, Myrtle’s companion shot Jay Gatsby, and Wilson committed suicide. Most of these murders happened as a consequence of the love affairs that happened throughout the book. Two love affairs in particular are a cause for all three of these murders. One was Tom Buchannan and Myrtle Wilson and the other was DaisyRead MoreAffairs, Wealth, and Murder in F. Scott Fitzgeralds The Great Gatsby1545 Words   |  7 PagesIn The Great Gatsby, Fitzgerald tells about affairs, describes wealth, and tells about murder. There are three love affairs. One is Gatsby and Daisy and the other is Tom and Myrtle. Daisy cheats on Tom with Gatsby, Tom cheats on Daisy with Myrtle, and Myrtle cheats on her husband with Tom. In the end Tom and Daisy find out that they are cheating on each other. They blame ever ything on Gatsby and end up leaving town to get away from all the troubles they produced. One of the main love affairs wouldRead MoreAspirations And Greatness : F. Scott Fitzgerald s The Great Gatsby 1436 Words   |  6 PagesAspirations and Greatness; The Case of Jay Gatsby Dedication and tenacity are examples of attributes that allow one to accomplish a societal label for effort shown towards attaining goals and dreams. Through his work The Great Gatsby, F.Scott Fitzgerald used the protagonist, Jay Gatsby, to demonstrate the American Dream and greatness. Gatsby was a mysterious character, commonly mistaken as a mere criminal; but actually, he was a victim of his perseverance and the American Dream. Despite his criminalRead MoreThe Great Gatsby By F. Scott Fitzgerald1346 Words   |  6 Pages and polluted Valley of Ashes? James Gatz hidden behind the name of Jay Gatsby was a â€Å"destined man† according to Nick. The bond market on Wall Street frustrated Nick and doctor visits were a daily for Carraway, which gave him the opportunity to write about his admirations of Jay. The luscious parties, endless alcohol, â€Å"beautiful little fools†, and well Nick Carraway ‘s company made for the summer of 1922 in West Egg. Jay Gatsby, a man of superior wealth and somewhat loneliness was searching for hisRead MoreThe Great Gatsby By William Shakespeare1055 Words   |  5 PagesFitzgerald explores the similar dominance of love in his novel The Great Gatsby. Comparable to Romeo and Juliet many characters in The Great Gatsby exploit their marriage in order to be with another lover. In The Great Gatsby the desire for love of an outside companion to one s marriage inevitably generates misery in the lives of those who partake. Throughout The Great Gatsby, Myrtle Wilson, Daisy Buchanan, and Jay Gatsby and all experience agony from committing or contributing to affairs. TheseRead MoreCharacter Analysis of The Great Gatsby by F. Scott Fitzgerald1022 Words   |  5 Pages 1. Nick Carroway was a great narrator for The Great Gatsby because he was so unbiased and open-minded to the world. He was tolerant and an attentive listener to whoever was speaking. He represented a quiet, tolerant, and reflective man from the Midwest during the 1920’s. I was conscious of wanting to look squarely at every one, and yet to avoid all eyes. (15), this quote expresses Tom’s quiet feature and how he wants to avoid all unnecessary attention. Jordan Baker is a prime example for theRead MoreThe Great Gatsby Research Paper1217 Words   |  5 Pagescome from different economic backgrounds. In the novel, The Great Gatsby, F. Scott Fitzgerald successfully uses location to differentiate social status amongst his characters while the weather and seasons of those locations help guide them.   Ã‚  Each character helps represent and support the differences of social class and the four main locations, The East Egg, the West Egg, the Valley of Ashes, and New York City. In The Great Gatsby geographical locations separate social classes. East Egg representsRead MoreFitzgerald’s The Great Gatsby - Parallel between Jesus of Nazareth and Jay Gatsby711 Words   |  3 PagesThe Great Gatsby:  Ã‚   Parallel between Jesus of Nazareth  and Jay Gatsby In his critical essay, â€Å"The Mystery of Ungodliness†, Bryce J. Christensen writes about the parallel that F. Scott Fitzgerald creates between Jay Gatsby and Jesus of Nazareth from the New Testament of the Christian Bible. Christensen explains that Fitzgerald once wrote a letter to his friend, John Jamieson, explaining that he was going to write the story of Jay Gatsby’s youth, but he did not because he wanted to maintain theRead MoreJay Gatsbys Involuntary Suicide1425 Words   |  6 PagesNo, obliviously Jay Gatsby did not commit suicide, at least not in the literal or physical sense. Many characters in the novel The Great Gatsby, written by F. Scott Fitzgerald, played roles in the death of Gatsby, but none greater than the role played by Gatsby himself. Gatsby lived a life based entirely upon two things: achieving the American Dream and Daisy Buchanan. It is understandable for a young man such as Gatsby to attempt to search and work towards gaining the American Dr eam. However, theRead MoreThe Villain Of Gatsby By F. Scott Fitzgerald1056 Words   |  5 PagesThe Villain of Gatsby Here’s the thing about stories; they’re all different, but they’re all the same. Now, everyone knows how they’re different. Different letters make up different words which make up different sentences. It’s this difference that allows for multiple stories to be told. The other side of stories is much less understood. They’re all the same. This can be seen through the examination of archetypes, most importantly the hero vs the villain. It can be seen in every tale imaginable