THE EFFECTIVENESS OF THE IMPLEMENTATION OF THE SMOKE-FREE

ORDINANCE OF LIGAO CITY

An Undergraduate Thesis Proposal

Presented to the Faculty of the Political Science Department

College of Social Sciences and Philosophy

Bicol University

Daraga, Albay

In Partial Fulfillment of the Requirements for the Degree

Bachelor of Arts in Political Science

Baby Jean P. Bello

Allyana B. Millano

Ronielyn O. Obeña

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NOVEMBER 2022

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 TABLE OF CONTENTS

Page

TITLE PAGE i

TABLE OF CONTENTS ii

LIST OF FIGURES iii

LIST OF TABLES iv

CHAPTER 1. THE PROBLEM AND ITS SETTING

Introduction 1

Statement of the Problem 3

Scope and Delimitation 4

Significance of the Study 4

CHAPTER 2. REVIEW OF RELATED LITERATURE AND STUDIES

Related Literature 6

Related Studies 15

Synthesis of the State Art 22

Gap to be Bridged by the Study 24

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 Theoretical Framework 25

Theoretical Paradigm 27

Conceptual Framework 28

Conceptual Paradigm 29

Definition of Terms 30

CHAPTER 3. RESEARCH DESIGN AND METHODOLOGY

Research Method 32

Sources of Data 33

Respondents of the Study 33

Research Instrument 34

Data Gathering Procedures 34

Statistical Treatment of Data 35

References 38

IV
 LIST OF FIGURES

Figures Title

1 Theoretical Paradigm 27

2 Conceptual Paradigm 29

LIST OF TABLES

Tables Tittle

1 Respondents of the Study 33

2 Three-point Likert’s Scale 36

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 CHAPTER 1

THE PROBLEM

Introduction

Smoking as defined by ordinance No. 2011-004, means being in possession or control of

a lit tobacco product regardless of whether the smoke is being actively inhaled or exhaled.

According to US National Library, cigarette smoking is bad for our health and harms nearly

every organ of the body. It causes 87% of lung cancer deaths, it’s also responsible for many

health problems. Cigarette contains at least 43 carcinogenic substances causing cancer of the

mouth, larynx, pharynx, esophagus, kidney, bladder, pancreas, and uterine cervix, not just cancer

but also stroke, heart disease, tuberculosis, and many more that will lead to premature death. In

fact, smoking decreases a person's life expectancy by 10 -12 years. Smokers between the ages of

35 and 70 have death rates three times higher than those who have never smoked (World Health

Organization 2011).

Smoking is also health threatening to non-smokers through secondhand smoke. It also

affects particularly the health of young children and babies causing asthma, bronchitis, or sudden

infant death syndrome (Environmental Protection Agency, 1992). Studies showed that about 600

million people worldwide already live with chronic obstructive pulmonary disease (COPD), but

its occurrence is predicted to rise to become the world’s third leading cause of death by 2020.

COPD kills more than 2.75 million people every year and is the fourth leading cause of death

worldwide (World Health Organization 2011).

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 Accordingly, governments around the world seek to reduce the adverse health effects of

smoking and decided to create Smoke-free laws and policies. Smoking bans or smoke-free laws

are public policies, including criminal laws, occupational safety, and health regulations, which

prohibit tobacco smoking in workplaces and other public spaces. These laws motivate and help

tobacco users quit and prevent the initiation of tobacco use. Similarly, policies focus on

discouraging smoking through tobacco taxes, restrictions on tobacco advertising, providing

services to assist smokers to quit, and taking various steps to inform the community of the health

risk associated with smoking. Health warning in tobacco products packaging becomes a way to

lessen the increasing number of smokers and gives information for them to know what will

happen when they use the cigarette, which will help to encourage or convince them to quit using

tobacco products and this will serve as the awareness to the nonsmokers for them to not try using

it anymore. (BMC Public Health Biomed Central,2021)

The researchers decided to tackle the study to determine the effectiveness of the

implementation of Ordinance No. 2011-004 known as the Smoke-free ordinance of Ligao City

which was implemented on February 28, 2011. This ordinance prevents the use, sale,

distribution, and advertisements of cigarettes and other tobacco products in certain places.

Imposed penalties for the violations thereof provided funds thereof and for other purposes. Ligao

City Anti-Smoking Task Force conducted the market inspection and removed posters and ads of

tobacco products together with the City Health Office and the Chief of Police of the PNP Ligao

City. The smoke-free legislation has no significant effect in a short term.

The salient features of the Smoke-free ordinance include Safeguard Public Health,

application to all persons, whether natural or juridical, revocation or suspension of Business

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License, Citation Ticket System, Smoking Cessation Program, Smoke-Free Task Force, Public

Billboards, Notice in Barangay, Conduct of Orientation Seminars and Trainings, Penalties,

Community Service, Enforcement on Establishments, and Information Dissemination.

Observations show that individuals persist to buy, sell, and smoke cigarettes in public

areas despite advertisements' warnings about the health risks of smoking and other regulations

such as the Smoke-free Ordinance. In fact, data from the Office of Smoke Cessation Program of

Ligao City have shown cases of apprehended smokers with citation tickets issued and warnings;

in 2018, 32 violators had been recorded; 501 in 2019; 209 in 2020; 105 in 2021 and 89 violators

had been recorded in 2022. This study aims to provide the need to address this problem by

determining the effectiveness of the implementation of the said ordinance.

Statement of the Problem

This study aims to determine the Effectiveness of the Implementation of the Smoke-free

Ordinance of Ligao City. Specifically, this will seek answer to the following questions:

1. What is the status of the implementation of the ordinance as to:

a. Enforcement

b. Information Campaign

2. What is the level of implementation of the ordinance as perceived by the respondents

along:

a. Prohibition

b. Duties and Obligations of Person-In-Charge

c. Penalty Imposed

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 3. What are the problems encountered by the respondents in the implementation of the

ordinance?

4. What strategies may be proposed to strengthen the implementation of the ordinance?

Scope and Delimitation of the Study

The study will determine the effectiveness of the implementation of the Smoke-free

ordinance of Ligao City. The entirety of the ordinance delimited only to consider those smokers

who use traditional tobacco products without the inclusion of electronic cigarettes like vape pens,

vaporizers, e-pens, e-pipes, e-cigars, and such.

It will be delimited in urban areas specifically to barangays: Guild, Dunao, Bagumbayan,

Calzada, and Sta. Cruz, since these barangays comprise mostly the public places, where the

ordinance is implemented.

Significance of the Study

This study is beneficial for the following:

Department of Health. This study will have a greater contribution to the existing body

of knowledge that could help the department to provide policy direction and guidelines on

health.

Local Policy Maker. The findings of this study will help policymakers to recognize the

need to improve their policy regarding the imposition of smoke-free ordinances.

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 Philippine National Police. This study may help them in the proper designation of

officers where they are most needed to further ensure the proper enforcement of the said

ordinance. It may also serve as an instrument of the fair assessment of their job performances.

Smoke-free Taskforce. The Smoke-free task force will be benefited from this study in

terms of their function in assessing the effectiveness of the implementation of the ordinance.

This could also be used as supplementary research on topics relevant to their line of work.

Political Science Department. The study's findings will operate as a roadmap for

advancing the department of community development's goals and will provide students a chance

to put their knowledge into practice by bringing issues and concerns from the community to the

attention of the appropriate authorities.

Future Researchers. The results of this study may serve as a future reference in

conducting similar research related to the present study. This study could provide them with

relevant information that they might need and can further widen the range of their study

hereafter.

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 CHAPTER 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents the different reviews of related literature and studies after the

thorough and in-depth forage of the researchers. The literature and studies presented in this

chapter are retrieved from various books, published articles, and undergrad thesis. Also, this

chapter would address the different concepts, generalizations, conclusions, and the different

developments related to the study that starts from the past up to the present. Furthermore, the

synthesis of the art, the gap to be bridged by the study, the theoretical framework and paradigm,

the conceptual framework and paradigm, and the definition of terms are also included in this

chapter.

Review of Related Literature

Smoking is one of the most widespread issues we have today that is killing people. Many

people develop this habit because of stress, personal troubles, and other factors. In fact, some

even start flaunting it. When a person smokes, they harm not only themselves but also those

around them. To solve this issue, numerous ordinances and regulations are being passed.

Smoking is prohibited in public places for several reasons, one of which is the serious health

concerns smoking poses to both smokers and non-smokers. Protecting nonsmokers from

secondhand smoke is the main goal of smoke-free legislation and practices. Smoke-free

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regulations, however, can also encourage and aid tobacco users in quitting, as well as prevent the

commencement of tobacco use. (World Health Organization)

Bakhturidze et al (2021) discuss the impact of comprehensive smoke-free policy

compliance on SHS exposure and the health condition of the Georgian population. Georgia made

steps forward in 2017 and adopted new amendments to its tobacco control legislation, which

mostly correspond to the FCTC requirements. Among other changes in the regulations is a ban

on smoking in public buildings and public transport, with a few exemptions (casinos, big slot

clubs, performances in theaters, taxis). The regulation entered into force on 1 May 2018. A

comprehensive smoke-free policy with a high level of compliance (≥95%) had a positive impact

on the decline of SHS exposure and tremendous improvement of indoor air quality in public

places and promotes a decrease in illnesses related to the cardiovascular system in Georgia. Also,

demand increased for smoking-cessation services.

Exposure to secondhand smoke (SHS) among adults is also linked with increased risks of

several diseases such as cardiovascular diseases (atherosclerosis, heart attack, stroke); diseases of

the respiratory systems (asthma, chronic respiratory symptoms, decreased pulmonary function,

chronic obstructive pulmonary diseases); different types of cancers (lung cancer, nasal sinus

cancer, larynx cancer, breast cancer, etc. Secondhand smoke is one of the prominent reasons why

smoke-free laws are pushed to be implemented. Smoke-free law had been enacted in Georgia

wherein there is a positive result regarding the implementation of the said ordinance as stated

above. It is related to the current study because one of the aims of the study is to assess the

outcomes smoke-free ordinance in Ligao City

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 Martin J Dockrell et. all (2014) written an article entitled “Smoke-free public places and

their impact on public health. In 2003, across the UK an estimated 617 people died from the

effects of passive smoking at work, 54 of these were long-term employees of the hospitality

industry. Another 11,000 deaths were attributable to passive smoking exposure in the home in

adults aged 20–65 years. This accounts for approximately 2% of the current annual toll from all

smoking-related deaths in the UK. According to the Office for National Statistics, approximately

70% of smokers in England want to quit. A survey conducted by UK Action on Smoking and

Health (ASH) and the British Thoracic Society found that 39% of smokers expressed an

intention to quit: 31% within 1 year of England’s smoke-free legislation coming into force and a

further 8% at an unspecified time after that. The distinction between ‘wanting’ to quit and

‘intending’ to quit is the difference between the ‘contemplation stage’ and ‘preparation stage’ in

Prochaska and Diclemente’s Stages of Change model.

The article is connected to the ongoing study for the reason it tackles the making of

smoke-free legislation in the UK due to the alarming effects of smoking on the citizen the

present study would also like to know the effectiveness of the smoke-free ordinance in Ligao

City proper brgys. Guilid, Bagumbayan, Sta Cruz, Dunao, and Calzada regarding the number of

smokers.

The monograph also represents a social barometer regarding the seriousness with which

communities view the smoking problem and the range of remedial actions taken to reduce

tobacco use through socially responsible public policies. These ordinances are not based on

social whim, however, but are based on decades of scientific research, which has increasingly

documented the health consequences of tobacco for users and non-users alike. Since the early

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1960s, medical science has left no doubt about the deadly nature of tobacco use, especially the

practice of cigarette smoking. The scientific database establishing a causal connection between

smoking and increased death rates from various cancers, cardiovascular diseases, chronic

obstructive lung diseases, fetal distress, and other chronic and debilitating conditions is truly

staggering. This exerts from a book that provides clear documentation of the extent to which

local communities are enacting legislation to restrict or severely curtail tobacco use. (Major

Local Tobacco Control Ordinances in the United States)

Warner (2013) reported that about 30 states ban smoking in workplaces, including

restaurants and bars. These laws reduce worker exposure to secondhand smoke (Callinan et al.,

2010), decrease daily consumption of cigarettes, and increase the likelihood to quit smoking

(Bauer et al., 2005; Fichtenberg and Glantz, 2002). The restriction also decreases employer costs

by requiring fewer cleanings and lengthening the life span of certain electronic equipment, said,

Warner. There is also substantial evidence that adopting smoke-free workplace laws reduces the

number of heart attacks (IOM, 2009b). “Is there anything else in the entire field of medicine or

public health that can have that much of a health impact with that modest of a policy change?”

Warner asked. The benefits of smoke-free laws and other tobacco restriction efforts have been

clearly demonstrated in New York and California. Stevens showed how tobacco control efforts

such as smoke-free laws saved more than 1 million lives with reductions in tobacco-related

diseases and $86 billion in health care savings (Lightwood et al., 2008).

Even within states that have not adopted smoke-free laws, many cities, towns, and

municipalities have adopted such ordinances, at least in bars and restaurants, according to

McGoldrick. About two-thirds of the U.S. population resides in a state, town, or city that has

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smoke-free restaurants and bars, and many of these have smoke-free workplaces as well. The

findings above show a positive result of smoke banning in workplaces in some countries in the

US it is related to the ongoing study as it both tests the effectiveness of the implementation of the

ordinances concerning the smoke problem.

Semple et al (2022) stated that the adoption of smoke-free measures has been one of the

central elements of tobacco control activity over the past 30 years. The past decade has seen an

increasing number of countries and a proportion of the global population covered by smoke-free

policies to some extent. Despite reductions in global smoking prevalence, population growth

means that the number of non-smokers exposed to the harms caused by secondhand smoke

remains high. Smoke-free policy measures have been shown to be useful in protecting non-

smokers from secondhand smoke and can additionally increase cessation and reduce smoking

initiation. Policies tend to be aimed primarily at enclosed public or workplace settings with very

few countries attempting to control exposure in private or semi-private spaces such as homes and

cars, and, as a result, children may be benefiting less from smoke-free measures than adults.

Compliance with legislation also varies by country and there is a need for education and

empowerment together with guidance and changing social norms to help deliver the full benefits

that smoke-free spaces can bring. Restrictions and policies on use of electronic cigarettes (e-

cigarettes) in smoke-free settings require more research to determine the benefits and

implications of bystanders’ exposure to secondhand e-cigarette aerosol, dual use, and smoking

cessation. The primary purpose of smoke-free laws and policies is to protect people who do not

smoke from secondhand smoke. However, smoke-free laws can also motivate and help tobacco

users quit and prevent the initiation of tobacco use. The article is related to the current study it

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shares the same purpose which is to examine the effectiveness of the ordinance in the

community.

In 2008 Balanga City’s Mayor – Jose Enrique S. Garcia III – successfully introduced a

ban on tobacco products in all public places and public utility vehicles in the city’s University

Town area. The city also launched a tobacco-free program called YOYO Balanga (“No to

cigarettes in Balanga”). The following year, the City Health Office spearheaded the “Teaming

Up for a Smoke-Free Balanga City” program 2009 in collaboration with stakeholders to carry out

information drives against smoking. However, in 2010 the City Health Office conducted a study

on tobacco prevalence using the WHO Global Adult Tobacco Survey tools and found that while

23.8% of the residents smoked – below the 28.3% national rate – there was still room for

improvement. In response, in 2010 the city council passed a Comprehensive No-Smoking

Ordinance and declared 31 May as “The City of Balanga’s No Tobacco Day”.

The city also initiated a “Tobacco-Free Generation” campaign to eliminate tobacco

smoking among those born after 2000. In 2013, Mayor Garcia then wrote to neighboring

municipalities to request a halt to “blitzkrieg promotional activities” conducted near city borders

by the tobacco industry. In 2014, the city launched a campaign to promote healthy lifestyles

during adolescence, including not smoking tobacco. And for the 2015 World No Smoking

Month, the city launched a campaign entitled “I love my family, say no to Cigarettes”, which

saw young people promoting smoke-free homes by writing letters to relatives to encourage them

to quit smoking. In 2016, the city council expanded the coverage of Balanga City’s smoke-free

ban to cover a further 3 km radius. The ultimate goal was to prohibit all sales, distribution, use,

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and advertising or promotion of tobacco and tobacco products, including ENDS (such as e-

cigarettes). A Smoke-Free Task Force was also created to support the enforcement of the law.

Overall, the City’s anti-tobacco efforts have been very popular. Mayor Garcia won re-

election twice, showing that a strong stance on tobacco control can be a positive asset for local

leaders. In relation to the current study, one of the objectives of the researcher is to examine the

effectiveness of the smoke-free ordinance in Ligao and to formulate recommendations that could

help to improve the policies.

In a press conference, Dr. Fulbert Alec Gillego, City Health Officer, said the

implementation of the city’s smoke-free ordinance is a shared responsibility among different

groups like religious organizations, national government agencies, business sector, law enforcers,

with CHO as the lead implementing office. "We want everybody in the community to know that

the smoke-free ordinance is still in effect, and we are here to implement one of the most

important ordinances of Legazpi City in terms of health regulation," Gillego said. He said that

for the past two years, the search for smoke-free establishments was stopped because of the

restrictions due to the coronavirus disease (Covid-19) pandemic.“We are not banning smoking

but we are only regulating it in Legazpi,” he said. Legazpi City’s Smoke-Free Program started

with the implementation in 2009 of Ordinance No. 0007-2009 or the revised smoke-free measure

authored by former councilor and now Board Member Roly Rosal. Gillego said the city's smoke-

free committee has added some criteria that must be complied with by establishments to be

awarded as 100 percent compliant. "As a requisite in the selection, establishments must not have

violated the smoke-free ordinance and have a valid business permit. As to the criteria, the

establishments must not have the selling of any tobacco product, comply with non-smoking

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signage, non-visible cigarette butts within the establishment and perimeter, non-advertisement of

a cigarette butt brand, carry information and advocacy initiative, non-designation of a smoking

area, and no visible and ashtrays/bins in the vicinity of the establishment," he added. Gillego also

said the search does not only cover business establishments but also the academe, universities,

schools, barangay halls, hospitals, and offices. For 2022, the inspection of different

establishments will begin in July and the awarding for the 100 percent smoke-free compliant

establishments will be in August. This article contains pieces of information regarding the

enactment of the smoke-free ordinance in Legazpi City which is related to the present study as it

discusses a similar ordinance on health regulations.

The Department of Health (DOH) has identified tobacco as the primary risk factor in the

Philippines for a range of non-communicable diseases. Health harms caused by tobacco use and

exposure to second-hand smoke cost the Philippines’ economy more than USD3.95 billion

(Php188 billion) (Dans et al., 2012) in health care costs and productivity losses. According to the

Global Adult Tobacco Survey, the Philippines, 2015, 15.9 million adult Filipinos smoke

cigarettes. Tobacco use prevalence among adults was 23.8%, including 41.9 percent of adult

males and 5.8 percent of adult females. In recent years, there has been a significant increase in

the number of smokers who are interested in quitting (76.7 percent of smokers) or who have

made a quit attempt (52.2 percent of smokers). The Tobacco Atlas notes that tobacco causes 19.6

percent of adult male deaths and 9.4 percent of adult female deaths – higher than the average in

other middle-income countries. It is estimated that more than 71,850 Filipinos – eight people

every hour – are killed by tobacco-related diseases every year. The Philippine Cancer Society

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estimates that around 3,000 non-smoking adult Filipinos die every year of lung cancer as a result

of inhaling second-hand smoke.

The Philippines 2011 Global Youth Tobacco Survey found that more than two in five 13-

15-year-olds are exposed to SHS at home and nearly three in five are exposed to SHS outside the

home. According to The Tobacco Atlas, SHS increases the risks of contracting lung cancer by 30

percent (small cell lung cancer by 300 percent) and coronary heart disease by 25 percent.

Exposure to SHS killed more than 600,000 non-smokers globally in 2010. There are numerous

scientific studies conducted that prove the dangerous effect of smoking tobacco on the human

body as well as the alarming effect of SHS this leads to the creation of different laws as a

resolution to these health problems the very why this article is connected to the current study.

The present study aims to assess whether the smoke-free ordinance helps to lessen the smoker in

Barangay Guilid, Ligao City.

Francisco (2022) wrote an article concerning on the effectiveness of the smoking ban in

the Philippines. Despite the numerous measures lawmakers in the Philippines have taken to

combat the tobacco problem, tobacco use and exposure in the country remain disturbingly high.

Based on statistics from 2015, nearly one-fourth of the Filipino population above the age of 15

use tobacco products; 40% of these are men, while women account for about 5%. Meanwhile,

2017 data indicate that 16% of Filipinos aged 13 to 15 use tobacco products, and 12% smoke

cigarettes. er 2020 numbers, tobacco-related illnesses cause the deaths of approximately 110,000

Filipinos every year. Consumption of tobacco products accounts for over 23% of male deaths

and 12% of female deaths, while tobacco smoke — including secondhand smoke — is

responsible for 21.8% of male deaths and 9.7% of female deaths. In the same year, the Tobacco

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Regulation Act was approved, and the Philippines signed the WHO’s Framework Convention on

Tobacco Control, said to be the first public health treaty in the world. The Philippines joined 167

other signatories in establishing “common goals” toward tobacco regulation, setting “minimum

standards for tobacco control policy,” crafting laws to eradicate passive smoking from public

spaces, public transport, and offices, and taking a more active role in handling the problem of

tobacco smuggling and other “cross-border challenges” involving tobacco products.

The Department of Health (DOH), together with the Philippine Pediatric Society (PPS),

rallied behind tobacco cessation to further protect the public from the spread of COVID-19.

Joining Usec. Maria Rosario Singh-Vergeire during the November 4 media forum was Dr.

Rizalina Racquel H. Gonzalez, chair of the PPS Tobacco Control Advocacy Group who talked

about the risks of both cigarette and vape smoking, and how these can possibly spread the

COVID-19 virus. According to Usec. Singh-Vergeire, ceasing tobacco use has always been part

of the campaigns of the DOH and has been one of its health priorities due to the long-term

adverse effects of smoking, not only on smokers but on the people around them and the

environment. “It has been challenging to push for total tobacco cessation among the public, but

we are not giving up. Therefore, it is part of the department’s health priorities that are being

championed by the Health Promotion Bureau,” said Usec. Singh-Vergeire. Meanwhile, Dr.

Gonzalez revealed a startling connection between cigarette or vape smoking and COVID-19,

which can cause critical hospitalization or even death. This article is connected to the current

study as the article stated some of the problems that the implementors are facing regarding the

implementation of the anti-smoking ordinance and added on that their struggle to prevent the

spread of Covid-19 that can possibly be transferred through vaping and smoking cigarettes.

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Review of Related Studies

Agudo, et al (2016) conducted a study entitled “Implementation of the revised Smoke-

free ordinance no. 0007- 2009 in Legazpi City”. The study focused on evaluating the

implementation of the said ordinance by assessing the level of awareness of PUJ drivers and

commuters. Based on the results of the interview conducted, 5 out 5 respondents interviewed

answered that the ordinance is fully implemented. The ordinance has been undergoing strict

implementation over the years and the ordinance has already known to the public. The study

showed that PUJ drivers are not aware of some of the revised smoke-free ordinances. On the

other hand, the PUJ drivers are not aware of some of the provisions of the ordinance specifically

on the procedures of apprehension and penalties. The commuters particularly the students are

not aware of most of the salient provisions of the ordinance. The students are not aware of

Section-A, Prohibited Acts. Their study also showed that employees are not aware of the

provisions on the procedure of apprehension and penalties. It is related to the current study in the

sense that it also focuses on the level of implementation of the smoke-free ordinance as well as

evaluated the awareness and the problems encountered by the respondents (PUJ drivers and

commuters) and the suggested solutions to it.

A study conducted by Mojares et al. entitled "Awareness on the implementation of Anti-

Smoking Ordinance No. 1S. 2012," identified the public's level of awareness on the Anti-

Smoking Ordinance and identified any statistically significant differences in that level of

awareness when grouped by profile variables. The respondents are aware of the implementation

as it was clearly stated and widely publicized. However, they've agreed as well that they are less

aware of the specific boundary that the ordinance covered. The researchers advised the

16
Pamahalaang Panglunsod to keep up the strict enforcement of the Anti-Smoking Ordinance; the

administration should specify the area it covers and should have enough staff to do so.

Additionally, it is advised that educational institutions keep improving their programs that raise

awareness among young adults about the negative effects of smoking.

The results of the study by Maneja K. C. and Deluna Jr. R. S. (2015) titled "The effect of

sin tax and Anti-smoking Campaign in regulating Cigarette smokers in Davao City, Philippines"

have shown that, in the respondents' perceptions, anti-smoking media campaigns had no impact

on the respondents' smoking behavior. Most smokers, however, are aware of the ban on smoking

and have decreased their usage as a result. The study is relevant to the current study because it

stressed the need to examine the efficacy of governmental intervention in tobacco use, especially

the Sin Tax of the 2013 Republic Act. No. 10351 and the anti-smoking campaign to comprehend

how these tactics affect consumer behavior. Understanding the underlying causes that influence

how responsively people respond to smoking-control programs is equally crucial.

The study entitled “The effect of community-level smoke-free ordinances on smoking

rates in men based on Community Health Surveys” (Lee et., al. 2014) revealed that overall

current smoking rates and daily mean number of cigarettes smoked were lower in

communities with Smoke-Free Ordinances in place compared to those without, and there was

a significant difference in smoking rates between 2010 and 2008. After 2008, there was a

tendency toward declining smoking rates; while this change wasn't significant, it did help to

reduce smoking rates in age groups under 30 and older than 65. The review is related to the

present study because it has identified that for compelling smoking control, it is important to

17
assess current strategies and foster files to assess the pragmatic execution of mandates. As

additional networks to pass the Smoke-Free Ordinance.

According to a study by Nguyen et al. from 2021 titled "Impact of smoke-free ordinance

strength on smoking prevalence and lung cancer incidence," counties with stricter smoke-free air

laws had lower smoking rates and fewer annual lung cancer occurrences. To reduce the

incidence of lung cancer, the smoke-free ordinance must be strengthened. The review is relevant

to the current study since it found that smoke-free laws are effective instruments for reducing the

prevalence of smoking and enhancing outcomes related to public health. However, although anti-

smoking laws have improved, tobacco use remains the main known cause of avoidable disease

and mortality in the United States.

According to the study by Byron et al. (2016) titled "Using the theory of normative

social behavior to understand compliance with a smoke-free law in a middle-income country,"

compliance behavior can be improved by either changing the descriptive norm directly or by

making use of the moderating constructs of injunctive norms, outcome expectations, and/or

group identity. According to the notion, the moderators could potentially interact with one

another or serve as a bridge between behavior and descriptor standards. Based on each

construct's findings, the following are the theory-supported suggestions for enhancing

compliance in Bogor: (a) Address signs of smoking as a source of descriptive norms; (b)

Promote the injunctive norm of following the law; (c) Change outcome expectations to include

social and legal punishment; (d) and understand and possibly reframe the relationship between

smoking and masculinity. The evaluation is pertinent to the current study because TNSB offers a

18
framework for analyzing current norms surrounding a smoke-free law and figuring out how to

boost compliance in environments where implementation has been sluggish.

A study entitled “Measures to assess the effectiveness of smoke-free policies”

conducted by WHO FTCT in 2003 enumerated the three types of smoke-free policy

compliance measures the following: (a) self-report of policy type implemented; (b) direct

observation of compliance; and (c) government enforcement and compliance records. Self-

reported exposure measurements can give a quick indication of the effects of a smoke-free

policy. The percentage of people who say their workplace is smoke-free should increase after

the installation of a comprehensive smoke-free policy, whereas the percentage of people who

say they last saw smoking in a restaurant, for instance, should decrease. The degree of

compliance may not be accurately measured by this measure, but it does offer a good

barometer of compliance. Observational studies of compliance, in which an unbiased observer

determines whether smoking is taking place in a venue, have been validated (see subsequent

subsection), and the pollution levels between smoke-free and smoking-observed venues differ

significantly. Observational studies may offer a more accurate measure of compliance than

self-reported measures of compliance. In this research, field workers can see if there are any

traces of smoking, like ashtrays or cigarette butts. The observational study's design is the most

important factor to consider. If the assessment periods are not typical of activity levels and the

venue selection is not random, the results can be skewed.

The study "Smoke-Free Policy Implementation: Theoretical and Practical

Considerations" by Fallin et al. (2014) noted that while research on the most effective ways to

implement smoke-free policies is few, best practices for adopting them are widely understood.

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The Institutional Analysis and Development (IAD) Framework was used to guide the article's

presentation of theoretical and practical concerns for the implementation of smoke-free policies

in three communities in Kentucky. Although Lexington-Fayette County, Kentucky, and Danville,

Kentucky, both have comprehensive smoke-free policies, Danville's implementation and results

were better. To fully comprehend the crucial components of smoke-free policy implementation

and how they relate to population outcomes, more research is required. The IAD is a potential

framework for the investigation of both the adoption and application of policy. The review is

relevant to the current study because the intent to fully understand the adoption and

implementation of smoke-free policies is a similar objective to the present study. Lower

exposure to secondhand smoking, raising demand for cessation services, reducing the use of

healthcare, and promoting other favorable health outcomes will serve as a basis to identify the

effectiveness of SFO.

According to a study by (Golechha, 2016) titled "Health Promotion Methods for Smoking

Prevention and Cessation: A Comprehensive Review of Effectiveness and the Way Forward,"

tobacco use is one of the leading causes of mortality worldwide, accounting for more than 5

million deaths per year. Numerous control strategies have been implemented as measures to

promote health in response to the mounting amount of research showing the harmful effects of

tobacco on health. However, the effectiveness of many health promotion strategies used for

quitting and preventing smoking has not been adequately examined. The review is relevant to the

current study since it aims to identify and evaluate the efficacy of health promotion strategies

used for smoking prevention and cessation.

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 The present study is related to a study by Basnet et al. (2022) titled "Compliance with the

Smoke-Free Public Places Legislation in Nepal: A Cross-Sectional Study from Biratnagar

Metropolitan City," which sought to evaluate the observance of smoke-free laws in public places

and the causes of active smoking in public places in Biratnagar Metropolitan City, Nepal. In all,

56.4% of buildings complied with smoke-free laws. Office buildings owned by the government

had the highest compliance (75.0%). Restaurants, entertainment, and retail establishments had

the lowest compliance rates (26.3%). There was a statistically significant correlation between

active smoking and "no smoking" signs posted at the entrance, and the likelihood of active

smoking in restaurants, entertainment, hospitality, shopping areas, vehicles, and transit was

higher than it was in institutions of higher learning and healthcare. None of the posted "no

smoking" signs completely conformed to their content as required by law.

In a dissertation titled A National Study on 100% Tobacco-Free Campuses in the United

States by Lisa Augustine (2015), the issues with evaluating the policies, practices, and

procedures of 100% tobacco-free campuses and the degree to which they follow the ACHA

recommendations to promote tobacco-free, higher-education environments were discussed. This

review is connected to the current study since its goal was to give researchers and higher

education officials a thorough analysis of the current situation in relation to policy compliance on

campuses that were designated as being completely tobacco-free. Compliance is the most

difficult problem, given the review's conclusions. Taking on a "shared responsibility" makes it

everyone's job to implement the tobacco-free campus policy. In other words, it is on to all parties

involved to make tobacco users aware of the smoke-free campus policy. The use of an

appropriate reporting system, such as a compliance hotline, was crucial if non-compliance

21
became a problem. To alter the cultural norm, a thorough strategy is required. Finally, the

findings of this study may aid administrators in higher education in thinking about the best ways

to create, implement, uphold, and enforce tobacco-free policies since it is simply the right thing

to do.

The current study is like an IARC study from 2009 titled "Evaluating the Effectiveness

of Smoke-free Policies" because it focuses mostly on public acceptance of the smoke-free law.

For the following reasons, it is crucial to understand how the general population feels about

smoke-free laws: (a) In democratic nations, supportive public attitudes are often necessary for

facilitating the process of passing smoke-free legislation or regulations by local or national

governments; (b) Once such legislation or regulations exist, public attitudes are likely to impact

how well such laws are complied with and enforced; hence, how well these laws achieve health

protection goals of reducing SHS exposure. The attitudes of the public are likely to be important

in terms of the extent to which voluntary control measures (e.g., smoke-free homes and, in most

jurisdictions, also cars) are adopted and complied with by individuals and families. There is

evidence for this social diffusion model for the adoption of smoke-free homes from a study of

smokers in four countries (Borland et al., 2006a); (c) Public attitudes concerning SHS may

conceivably impact the extent to which governments make progress on other aspects of tobacco

control that benefit from public support (e.g., high tobacco taxes, funding of mass media

campaigns, and restrictions on tobacco marketing). Similarly, public attitudes can help guide

appropriate policy in areas that are controversial among tobacco control experts (e.g., smoking

restrictions in some outdoor settings) (Chapman, 2007). Appropriate care with such

22
policymaking could minimize the risk of a public backlash regarding tobacco control

interventions in general.

Synthesis of the State of the Art

All the related studies and literature compiled discusses the same subjects which is the

implementation of smoke-free laws its effectiveness and the difficulties encountered by the

implementers, the smoke-free legislation, the background of the creation of smoke-free

ordinances, the level of awareness of the citizens regarding the ordinance as well as the effect of

second-hand smoking (SHS) exposure.

Martin J D.et. all (2014), Warner (2013), Sean S. et. al (2022), and the Department of

Health (DOH) provides information about the dangerous effect of secondhand smoking and the

creation of ordinances to solve to the serious problem on health. It is stated that a comprehensive

smoke-free policy with a high level of compliance (≥95%) had a positive impact on the decline

of SHS exposure and tremendous improvement of indoor air quality in public places and

promotes a decrease in illnesses related to the cardiovascular system in Georgia. Eleven

thousand deaths deaths in the UK were attributable to passive smoking exposure in the home in

adults aged 20–65 (Martin J D. et al). Smoke-free policy measures have been shown to be useful

in protecting non-smokers from secondhand smoke and can additionally increase cessation and

reduce smoking initiation. Health harms caused by tobacco use and exposure to second-hand

smoke cost the Philippines’ economy more than USD3.95 billion (Php188 billion) (Dans et al.,

2012) in health care costs and productivity losses (DOH). United States Department of Health

23
(2014), Balanga City government, Golechha (2016), and Augustine (2015) provided information

about the government restricting the use of tobacco due to its harmful effect on smokers and non-

smokers. US DOH states that the ordinances are not based on social whim, however, but are

based on decades of scientific research, which has increasingly documented the health

consequences of tobacco for users and non-users alike. Balanga City Health Office conducted a

study on tobacco prevalence using the WHO Global Adult Tobacco Survey tools and found that

while 23.8% of the residents smoked – below the 28.3% national rate – there was still room for

improvement. Tobacco use is one of the leading causes of mortality worldwide, accounting for

more than 5 million deaths per year (Golechha).)

Legazpi City Health Office and Department of Health stated the struggle of implementing

the ordinance amid the COVID-19 pandemic and some policies added to prevent the spread of

Covid 19 through vaping and smoking. According to the Legazpi City health office, Gillego said

that for the past two years, the search for smoke-free establishments was stopped because of the

restrictions due to the coronavirus disease (Covid-19) pandemic. “We are not banning smoking,

but we are only regulating it in Legazpi,” he said. Department of Health (DOH), together with

the Philippine Pediatric Society (PPS), rallied behind tobacco cessation to further protect the

public from the spread of COVID-19. Lee et. al (2018), Byron (2016), Nguyen et al (2021), and

Agudo et.al (2016) provided results and recommendations on the implementation of the smoke-

free ordinance. Lee et. al (2018) revealed that overall current smoking rates and daily mean

number of cigarettes smoked were lower in communities with Smoke-Free Ordinances in place

compared to those without, and there was a significant difference in smoking rates between 2010

and 2008. Smoke-free air laws had lower smoking rates and fewer annual lung cancer

occurrences. To reduce the incidence of lung cancer, the smoke-free ordinance must be

24
strengthened (Nguyen). PUJ drivers are not aware of some of the revised smoke-free ordinances.

On the other hand, the PUJ drivers are not aware of some of the provisions of the ordinance

specifically on the procedures of apprehension and penalties. The commuters particularly the

students are not aware of most of the salient provisions of the ordinance (Agudo et. al 2016).

Gap to be bridged by the Study

In the review of related studies and literature, the abovementioned researchers already

conducted studies concerning the implementation of anti-smoking policies in their chosen study

settings both in a national and international setting. The studies gathered focused on the

effectiveness of the implementation of Smoke-free ordinances however the respondents are the

PUJ drivers, the commuters, and the students. There was no single study conducted in Ligao City

that tackles the effectiveness of the implementation of ordinance no. 2011-004 known as the

Smoke-free ordinance of Ligao City wherein the respondents are the implementers of the

ordinance and the residents from Ligao City proper specifically barangays: Guilid, Dunao, Sta

Cruz, Bagumbayan, and Calzada. Therefore, there is no single study done exactly like the present

study and that is the gap that the study would like to bridge.

Theoretical Framework

This study is anchored on John Stuart Mill’s Harm Principle and David Easton’s Public

Policy Theory.

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 The harm principle regulates the relations between government and individuals. It values

individual rights and personal liberty, and it is especially significant since societies are

comprised of multiple individuals. Mill states that individual liberties must consider others living

in the same society and that people should be free to act as they wish if their actions do not cause

harm to others. Many people will agree that they do not want the government to have complete

control over their lives. However, certain people believe that a healthy society necessitates some

paternalistic action on the part of the state. The harm principle asserts that an action that causes

harm to another person is not only wrong but also wrong enough for the state to intervene and

prevent the harm from occurring. The present study is supported by the harm principle as we can

apply it prospectively to prevent someone from acting in certain ways and causing harm. An

example of the harm principle would be preventing smoking in public areas since that would be

an action that causes harm to others who don’t smoke. The person affected by such practice

would be harmed, but the common good of society would also be harmed if it was not prevented

among people.

Public policy theory aims to determine how much demand, support, or need the people

have for such legislation for a policy to be effectively implemented for their current needs.

According to Easton, a policy is created through a cycle that allows it to be applicable and

community adaptive. Hence, Constituents’ demands, and support influence public policy

decisions made by actors, institutions, and legislators, therefore, it is evident that public policy is

a significant factor in emphasizing the public and its problems. The present study is supported by

the concept of public policy theory since it explains how policies are formulated and executed. In

relation, the study aims to determine the effectiveness of the ordinance's implementation by

26
identifying the status of its implementation, the level of implementation as perceived by

respondents, the problems encountered, and the strategies that can be proposed to strengthen the

implementation of the ordinance.

Figure 1

Theoretical Paradigm of the study

27
 Harm Principle

Individual

Harmful Acts

Government

Policy

General Welfare

Conceptual Framework

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 This study aims to identify the effectiveness of the implementation of the Smoke-free

Ordinance of Ligao City. The ordinance serves as a guide to the researchers in responding to

queries regarding the status of the implemented ordinance as well as the level of implementation

of the ordinance as perceived by the respondents. The actions carried out were in accordance

with the problems encountered. Following that, the suggestions given will be forwarded as

feedback on the study relating to the implementation of anti-smoking laws.

As shown in Figure 2, the study will be done through the following procedures: to

determine the status of the implementation of the ordinance in terms of enforcement and

information campaign. Thus, the perception of the respondents regarding the implementation of

the ordinance will be measured along its prohibitions, duties and obligations of person-in-charge

and penalty imposed. In succeeding procedure, the respondents may have encountered problems

regarding the implementation of the Smoke-free ordinance. In addition, the researchers aim to

find out the problems and the strategies that will be gathered from the respondents which will be

discussed thoroughly to formulate strategies to strengthen the implementation of the ordinance.

Figure 2

29
Conceptual Paradigm of the Study

The Effectiveness of the

Implementation of the Smoke-free
Ordinance of Ligao City

The status of the implementation of the

ordinance as to:
a. Enforcement
b. Information
Campaign

Level of implementation of the

ordinance as perceived by the
respondents along:
Prohibition
Duties and Obligations of Person-In-
Charge
Penalty Imposed

Problems encountered by the

respondents in the implementation
of the ordinance

Strategies that may be proposed

to strengthen the implementation
of the ordinance

30
Definition of Terms

To avoid confusion, the following terms have been defined conceptually and

operationally.

Effectiveness. According to Merriam-Webster (n.d), it is the capability of producing the

desired result or the ability to produce desired outputs. In this study, it pertains to the degree of

effectiveness in the implementation of the smoke-free ordinance of Ligao City.

Enforcement. According to Oxford Dictionary (n.d), it is the act of compelling

observance of or compliance with a law, rule, or obligation. In this study, it refers to the

provision of the ordinance, the term will be used to determine the status of implementation of the

ordinance.

Information Campaign. According to Merriam-Webster (n.d), it is the traditional means

of delivering information about services or driving awareness of a certain subject. In this study, it

refers to a clause in the ordinance, and the term will be utilized to assess the ordinance's state of

implementation.

Level Implementation. According to Oxford Dictionary (n.d), it is the process of putting

a decision or plan into effect, execution, a method, or any design for doing something. In this

study, the term will be used as a measuring tool wherein it will be interpreted as fully

implemented, partially implemented, and not implemented to determine the effectiveness of the

implementation of the ordinance. Duties and Obligations of persons in-charge and penalty

imposed are the instrument to measure the level of implementation.

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 Ligao City. Located in Region 5 Province of Albay, consists of 55 barangays, wherein

11 are urban barangays and 44 are rural barangays. This is the place of study by the researchers.

Penalties. According to Cambridge Dictionary (n.d), it is the punishment imposed upon a

person who has violated the law, whether or a contract, a rule, or a regulation. In this study, it

pertains to the salient features of the ordinance, it will be used to assess the degree of

implementation.

Prohibition. According to the ordinance, it is referring to the action that are declared

unlawful and prohibited by such. In this study, prohibited acts pertain to the clause of the

Ordinance and the phrase will be used to determine the level of implementation.

Smoke-free Ordinance no. 2011-004. This pertains to the Ligao City Smoke-free

ordinance which was enacted by the Sangguniang Panglungsod and authored by the former City

councilor Jorlan Guanzon and Ana Manlangit. Approved by Former City Mayor Patricia Alsua

on February 28, 2011. It is an ordinance prohibiting the use, sale, distribution, and advertisement

of cigarettes and other tobacco products in certain places, imposing penalties for violations

thereof and providing funds thereof for other purposes.

Status. According to Oxford Dictionary (n.d), it is the position or rank of affairs at a

particular time, especially in a political or commercial context. In this study, it pertains to the

current standing of the ordinance whether it is highly implemented, partially implemented, or not

implemented at all bases on the perception of the respondents.

32
 Problem Strategies. According to Cambridge Dictionary (n.d), it is a plan used to find a

solution or overcome a challenge. In this study, the term pertains to the formulation of strategies

that the study will aim to answer.

CHAPTER III

RESEARCH DESIGN AND METHODOLOGY

This chapter discusses the procedure that was used in the conduct of the study. It presents

the following information: research method, sources of data, respondents of the study, research

instrument, data gathering procedure, and statistical treatment of data.

Research Method

This study will use the descriptive method of research using a quali-quantitative

approach. Qualitative-Quantitative approaches are designed to give different perspectives,

whereas qualitative approach is designed to give a detailed and in-depth insights on topics that

are not well understood, and quantitative approach is used to test or confirm theories and

assumptions. The study will be utilizing one-on-one interviews based on the questionnaire as the

primary source of acquiring data from the respondents alternating closed and open-end

questions. The questionnaire is open enough to let respondents express their views.

In addition, A descriptive type of research will be used in this study. According to

(William, 2007) it aims to accurately and systematically described a population, situation, or

phenomenon. It involves the collection of data that answered the questions concerning the status

33
of implementation in the study. It is designed to gather information or conditions existing at a

particular period. This method will be used to determine the level of implementation of the

smoke-free ordinance of Ligao City. The first statement of the problem will be answered through

an interview by the Smoke-free Task force of the ordinance. The second, third and fourth

statement of the problem will be answered by the respondents through a survey questionnaire.

Sources of Data

Both primary and secondary data will be used in this study. The primary sources of data

will be the answers gathered from the respondents through the questionnaires given to them. The

secondary sources of data will be derived from books, articles, journals, other manuscripts, and

previous research works.

Respondents of the Study

The respondents of this study are the implementers of the ordinance and residents of the

Barangays Guilid, Bagumbayan, Dunao, Sta. Cruz and Calzada. In particular, the researchers

will conduct an interview with the smoke-free task force. It is stated in section 11 of the

ordinance, that the smoke-free task force is comprise of 11 appointed offices wherein one

representative of each will be interviewed. The researchers will use stratified random sampling

as a sampling technique to identify the total number of residents of this study. The researchers

were able to identify 351 residents wherein, 115 are from Barangay Guilid, 81 are from

Barangay Bagumbayan, 22 in Barangay Dunao, 71 from Barangay Sta. Cruz and 62 are from

Barangay Calzada. They were randomly chosen to give valuable and additional information

34
about the effectiveness of the said ordinance. The table below will show the distribution of

respondents per Barangay.

Respondents of the study

Name of Barangay Total No. of household Sample Size
Guilid 941 115
Bagumbayan 660 81
Dunao 178 22
Sta. Cruz 576 71
Calzada 503 62

Research Instrument

The research will use a survey questionnaire and interview guide to conduct this study.

The latter will be used to determine the status, the level of implementation, problems

encountered and strategies to be proposed to strengthen the implementation of the smoke-free

ordinance of Ligao City.

Data Gathering Procedure

To make this study orderly and systematic, the researchers will follow the following

procedures.

1. Request for a copy of ordinance No. 2011-004 and the total number of households of

Barangays Guilid, Bagumbayan, Dunao, Sta.Cruz and Calzada from the Mayor’s office

of Ligao City.

35
 2. Formulate the survey questionnaire/interview guide to be validated by the panel

members.

3. A letter of consent will be sent to the barangay chairman of selected barangay once the

research instrument is validated.

4. If the barangay captain approves the request, the researchers will now distribute the

survey questionnaires to the identified respondents.

5. Conduct an interview with the implementers of the ordinance.

6. Retrieve the answered survey questionnaires, and interpret the data gathered and

formulate findings and conclusions.

Statistical Treatment of Data

This study will use the percentage and frequency count. The percentage was computed

out of the given number of the frequency count. The frequency count will be used to tally the

responses and to organize the results statistically for interpretation and the percentage is the

actual quantity represented by the percent. After calculating the percentage, it will be arranged

and classified from the highest to the least response. To establish the quantitative integrity of the

data and to properly interpret it, the study will use the following statistical tools:

Frequency and Percentage Distribution

36
 Frequency and percentage distribution are representations of data that specifies the

number of observations within a given interval. The frequency (f) of a particular observation is

the number of times the observation occurs in the data.

The distribution of a variable is the pattern of frequencies of the observation. Frequency

and percentage distribution are portrayed in tables, histograms, or polygons.

Formula:

f
%= x 100
N

Where:

% = Percentage

F = Frequency

N = Total number of respondents

100 = as the constant variable

The weighted mean will be used to measure the general response of the survey samples,

whether the ordinance is fully, partially, or not implemented. It will likewise use to distinguish

the peak of the responses to the questionnaire.

37
Weighted Mean

A weighted mean equation is a statistical method that calculates the average in which

weights are assigned to individual values in order to determine the relative importance of each

observation.

Formula:

Σ [(f )(w)]
𝑥̅=
n

Where:

𝑥̅ = weighted mean

f = frequencies

w = weights

n = Total number of respondents

Moreover, the three (3) point Likert scale will be used to interpret items in the

questionnaire. The analysis will be based on computed frequency percentage and weighted mean

and its corresponding interpretation. A three-point Likert scale will be used to determine the

respondents’ assessment of the effectiveness of the implementation of the smoke-free ordinance

of Ligao City.

Quantification of Variables

Scale Range Interpretation

3 2.34-3.0 Fully implemented

38
 2 1.67-2.33 Partially implemented

1 1.0-1.66 Not Implemented

Where:

3 (Fully Implemented)- The ordinance is fully implemented; the respondents greatly felt

the impact and are excellently aware of the ordinance. The respondents gained positive effects

from the implementation of the ordinance

2 (Partially Implemented) – the ordinance is partially implemented, and the respondents

partially felt the impact and are greatly aware of the existence of the ordinance. The respondents

gained favorable effects from the project being implemented

1 (Not Implemented)- the ordinance is not implemented; the respondents did not feel the

impact of the ordinance. The respondents did not gain effects from the ordinance being

implemented

References

Bakhturidze, G., Peikrishvili, N., & Gvinianidze, K. (2021). Impact of comprehensive smoke-
free policy compliance on SHS exposure and health condition of the Georgian population.
Tobacco Prevention & Cessation, 7. https://doi.org/10.18332/tpc/143329

Martin J Dockrell, Amanda Sandford & Sarah Ward (2007) Smoke-free public places and their
impact on public health,Expert Review of Pharmacoeconomics & Outcomes Research,
https://doi.org/10.1586/14737167.7.4.309

U.S. Department of Health and Human Services, National Institutes of Health , National Cancer
Institute. Major Local Tobacco Control Ordinances in the United States: Smoking and Tobacco
Control Monograph No. 3 Paperback – May 22, 2014

39
Reducing Tobacco-Related Cancer Incidence and Mortality: Workshop Summary. National
Cancer Policy Forum; Board on Health Care Services; Institute of Medicine. Washington (DC):
National Academies Press (US); 2013 Apr 16.

Semple S, Dobson R, O'Donnell R, et al Smoke-free spaces: a decade of progress, a need for

more?TobaccoControl 2022;31:250-256.
https://tobaccocontrol.bmj.com/content/31/2/250.citation-tools

Creating a smoke-free city – Balanga City, the Philippines29 November 2021.

https://www.who.int/news-room/feature-stories/detail/creating-a-smoke-free-city-balanga-city-
the-philippines

Legazpi revives search for smoke-free compliant establishments Connie Calipay May 30, 2022,
https://www.pna.gov.ph/articles/1175472

Filipinos will benefit from Smoke-Free Executive Order.

https://www.vitalstrategies.org/filipinos-will-benefit-from-smoke-free-executive-order/

Mikael Angelo Francisco. Do Smoking Bans Really Work — And Are They Enough?. April 30,
2022. https://www.flipscience.ph/health/do-smoking-bans-really-work-and-are-they-enough/
DOH, PPS: A SMOKE-FREE PHILIPPINES LESSENS COVID-19 RISK, TOBACCO USE
WEAKENS LUNGS AND IMMUNE SYSTEM.
HTTPS://DOH.GOV.PH/PRESS-RELEASE/DOH-PPS-A-SMOKE-FREE-PHILIPPINES-
LESSENS-COVID-19-RISK-TOBACCO-USE-WEAKENS-LUNGS-AND-IMMUNE-
SYSTEM

Awareness on the Implementation of Anti-Smoking Ordinance No. 1S. 2012,

research.lpubatangas.edu.ph, https://research.lpubatangas.edu.ph › ...PDF

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