Perceived Benefits

Table 3a. Perceived Benefits of Nicotine Use Among Respondents (N = 202)

Stron
Strong M
gly Disag Neut Agre S
Statement ly ea
Disag ree ral e D
Agree n
ree

Using nicotine helps people feel 18 42 68 52 22

3.0 1.1
more comfortable or confident in (8.9% (20.8 (33. (25. (10.9
9 5
social situations. ) %) 7%) 7%) %)

3.0 1.1
Total Perceived Benefits
9 5
Note: Higher scores indicate greater perceived benefits of nicotine use. Interpretation: 1.00–2.49 = Low; 2.50–3.49 = Moderate;
3.50–5.00 = High.

Perceived Barriers
Table 3b. Perceived Barriers to Avoiding Nicotine Use Among Respondents (N = 202)

Very M
Nev Rare Someti Ofte S
Statement Ofte ea
er ly mes n D
n n

48 55 45 34 20
I would feel left out if I refused 2.6
(23. (27. (22.3% (16. (9.9 1.30
nicotine when my friends are using it. 2
8%) 2%) ) 8%) %)
 Very M
Nev Rare Someti Ofte S
Statement Ofte ea
er ly mes n D
n n

62 58 35 28 19
In my home, it is acceptable for 2.4
(30. (28. (17.3% (13. (9.4 1.35
people to smoke or vape. 3
7%) 7%) ) 9%) %)

2.6
Total Perceived Barriers 0.98
9
Note: Higher scores indicate greater perceived barriers to avoiding nicotine use. Interpretation: 1.00–2.49 = Low; 2.50–3.49 =
Moderate; 3.50–5.00 = High.

Perceived Self-Efficacy
Table 3c. Perceived Self-Efficacy for Nicotine Abstinence Among Respondents (N = 202)
Fairl Fairly Very Not M
Very S
Statement y Diffic Diffic Applic ea
Easy D
Easy ult ult able n

How easy or difficult would you find

22 32 58 68 22
it to go without smoking cigarettes or 3. 1.1
(10. (15. (28.7 (33.7 (10.9%
other smoked tobacco products for as 18 7
9%) 8%) %) %) )
long as a week?

How easy or difficult would you find

18 28 62 72 22
it to give up smoking cigarettes or 3. 1.1
(8.9 (13. (30.7 (35.6 (10.9%
other smoked tobacco products 26 5
%) 9%) %) %) )
altogether if you wanted to?
 Fairl Fairly Very Not M
Very S
Statement y Diffic Diffic Applic ea
Easy D
Easy ult ult able n

How easy or difficult would you find 15 25 58 78 26

3. 1.1
it to go without using electronic (7.4 (12. (28.7 (38.6 (12.9%
37 6
cigarettes for as long as a week? %) 4%) %) %) )

How easy or difficult would you find

12 22 62 85 21
it to give up using electronic 3. 1.1
(5.9 (10. (30.7 (42.1 (10.4%
cigarettes altogether if you wanted 40 2
%) 9%) %) %) )
to?

3. 0.9
Total Perceived Self-Efficacy
30 8
Note: Higher scores indicate greater perceived difficulty (lower self-efficacy). Interpretation: 1.00–2.49 = Low; 2.50–3.49 = Moderate;
3.50–5.00 = High.
 Tables 3a, 3b, and 3c present the respondents' perceived benefits of nicotine

use, perceived barriers to avoiding nicotine use, and perceived self-efficacy for

nicotine abstinence. These psychosocial determinants are important because

adolescents' and young adults' beliefs, perceived obstacles, and confidence in resisting

nicotine can influence their decisions to initiate, continue, or avoid smoking and

vaping. These constructs are central components of Pender's Health Promotion Model

(HPM), which identifies perceived benefits, perceived barriers, and perceived

self-efficacy as important cognitive determinants of health-promoting behaviors

(Pender et al., 2023). Examining these psychosocial determinants provides a better

understanding of the cognitive and social factors that may influence nicotine use

among adolescents and young adults in Tacloban City, Leyte.

As shown in Table 3a, respondents demonstrated an overall moderate level of

perceived benefits of nicotine use with an overall mean score of 3.09 (SD = 1.15).

Based on the interpretation provided in the table, this indicates that the respondents

moderately perceived nicotine use as having beneficial effects. The single indicator,

"Using nicotine helps people feel more comfortable or confident in social situations,"

likewise obtained a moderate mean score of 3.09 (SD = 1.15). Among the 202

respondents, 68 (33.7%) selected Neutral, 52 (25.7%) agreed, and 22 (10.9%)

strongly agreed, indicating that 36.6% of the respondents believed that nicotine use

could enhance comfort or confidence in social settings. Meanwhile, 42 (20.8%)

disagreed and 18 (8.9%) strongly disagreed, representing 29.7% of the respondents

who did not perceive nicotine as beneficial for social confidence. The relatively large

proportion of neutral responses suggests that many respondents remained uncertain

regarding the social benefits of nicotine use. These findings suggest that respondents
expressed moderate perceptions regarding the social benefits of nicotine use, a

considerable proportion perceived nicotine as a means of feeling more comfortable or

confident in social interactions. During adolescence and young adulthood, social

acceptance and peer relationships are important developmental influences.

Consequently, beliefs that nicotine use enhances confidence or facilitates social

interaction may increase the attractiveness of smoking or vaping, particularly in social

environments where nicotine use is perceived as common or acceptable.

The findings are consistent with Pender's Health Promotion Model (HPM),

which proposes that individuals are more likely to engage in a behavior when they

perceive it as offering desirable or beneficial outcomes (Pender et al., 2023). In the

context of nicotine use, adolescents and young adults who believe that smoking or

vaping promotes confidence, reduces social discomfort, or improves interpersonal

interactions may be more inclined to initiate or continue nicotine use despite

awareness of its adverse health effects.

Regarding perceived barriers to avoiding nicotine use (Table 3b), respondents

likewise demonstrated an overall moderate level (M = 2.69, SD = 0.98). Based on the

interpretation provided in the table, this finding indicates that the respondents

experienced a moderate degree of obstacles that may hinder their ability to avoid or

refuse nicotine use. Among the two indicators, the statement "I would feel left out if I

refused nicotine when my friends are using it" obtained the highest mean score (M =

2.62, SD = 1.30), indicating a moderate level of perceived barrier. More than half of

the respondents reported never (23.8%) or rarely (27.2%) experiencing this feeling,

suggesting that peer pressure was not a frequent barrier for many respondents.

However, 22.3% answered sometimes, while 16.8% and 9.9% reported often and very
often, respectively. Collectively, 26.7% of the respondents acknowledged that they

often or very often felt they would be left out if they refused nicotine when their

friends were using it. These findings suggest that although peer-related pressure was

not universally experienced, social belonging remained an important barrier for a

considerable proportion of adolescents and young adults. During this developmental

stage, peer acceptance and group affiliation often influence health-related behaviors,

making some individuals more susceptible to nicotine use in social settings.

The second indicator, "In my home, it is acceptable for people to smoke or

vape," obtained the lowest mean score (M = 2.43, SD = 1.35), corresponding to a low

level of perceived barrier. Approximately 59.4% of the respondents answered never

(30.7%) or rarely (28.7%), indicating that smoking or vaping was generally not

perceived as acceptable within their home environment. Only 23.3% reported that

smoking or vaping was often or very often acceptable in their household. This finding

suggests that most respondents came from home environments where nicotine use

was not commonly accepted, indicating that family norms may discourage smoking or

vaping. Nevertheless, despite the generally unfavorable home environment toward

nicotine use, the overall moderate level of perceived barriers indicates that influences

outside the home, particularly social interactions with peers, may continue to affect

adolescents' and young adults' ability to avoid nicotine use.

These findings are consistent with Pender's Health Promotion Model, which

proposes that perceived barriers are among the most influential determinants of health

behavior because they represent the obstacles individuals anticipate when attempting

to perform a health-promoting action (Pender et al., 2023). Adolescents and young

adults who perceive social exclusion or peer disapproval when refusing nicotine may
find it more difficult to avoid smoking or vaping, even when they recognize its

harmful health consequences. Recent evidence likewise supports these findings. Ling

et al. (2023) identified peer influence as one of the most consistently reported factors

associated with e-cigarette use among adolescents in Southeast Asia, highlighting the

important role of social relationships in shaping nicotine-related behaviors.

As presented in Table 3c, respondents demonstrated an overall moderate level

of perceived self-efficacy for nicotine abstinence (M = 3.30, SD = 0.98). However,

based on the interpretation provided in the table, higher scores indicate greater

perceived difficulty, reflecting lower self-efficacy. Thus, the findings suggest that

respondents generally experienced a moderate level of difficulty in resisting or

discontinuing nicotine use, indicating only moderate confidence in their ability to

abstain from nicotine products.

Among the four indicators, the statement "How easy or difficult would you

find it to give up using electronic cigarettes altogether if you wanted to?" obtained the

highest mean score (M = 3.40, SD = 1.12), approaching the threshold for a high level

of perceived difficulty. Notably, 42.1% of respondents indicated that quitting

electronic cigarettes altogether would be very difficult, while only 5.9% reported that

it would be very easy. This finding suggests that respondents perceived complete

cessation of electronic cigarette use as the most challenging aspect of nicotine

abstinence. The availability of flavored vape products, discreet use, frequent nicotine

delivery, and habitual vaping behaviors may contribute to users' perceived difficulty

in quitting electronic cigarettes.

Similarly, respondents reported a moderate level of difficulty in going without

using electronic cigarettes for one week (M = 3.37, SD = 1.16). Nearly 38.6%
considered abstaining from vaping for one week to be very difficult, whereas only

7.4% perceived it as very easy. This finding indicates that even short-term abstinence

from vaping was perceived as challenging by many respondents, suggesting that

electronic cigarette use may have become integrated into their daily routines and

nicotine-seeking behaviors.

For conventional cigarette smoking, respondents likewise demonstrated a

moderate level of perceived difficulty in giving up smoking altogether if they wanted

to (M = 3.26, SD = 1.15). More than one-third (35.6%) reported that quitting smoking

completely would be very difficult, while only 8.9% considered it very easy. This

suggests that respondents recognized the challenges associated with complete

smoking cessation, likely due to nicotine dependence, withdrawal symptoms, and

habitual smoking behaviors that make quitting difficult despite awareness of its

harmful health effects.

Likewise, the statement "How easy or difficult would you find it to go without

smoking cigarettes or other smoked tobacco products for as long as a week?" obtained

a moderate mean score (M = 3.18, SD = 1.17). Approximately 33.7% of respondents

perceived abstaining from smoking for one week as very difficult, compared with

10.9% who considered it very easy. Although this indicator yielded the lowest mean

among the four self-efficacy items, the findings still indicate that a substantial

proportion of respondents experienced difficulty refraining from smoking even for a

relatively short period. This may reflect the reinforcing effects of nicotine dependence

and respondents' perceived difficulty in resisting nicotine cravings.

Overall, the moderate mean score indicates that respondents possessed only

moderate confidence in their ability to resist nicotine use or successfully quit smoking

or vaping. Although some respondents perceived nicotine abstinence to be

manageable, many considered quitting difficult, suggesting that confidence in

maintaining nicotine abstinence remains limited among a considerable proportion of

the respondents.

These findings are consistent with Bandura's Social Cognitive Theory, which

emphasizes that self-efficacy, or an individual's confidence in performing a desired

behavior, is one of the strongest determinants of successful behavior change

(Bandura, 1997). Likewise, Pender's Health Promotion Model identifies perceived

self-efficacy as an important determinant of health-promoting behaviors, proposing

that individuals who are more confident in their ability to perform a behavior are more

likely to initiate and sustain positive health actions. Conversely, lower self-efficacy

may reduce an individual's confidence to resist cravings, refuse nicotine products in

social situations, and successfully maintain abstinence despite awareness of the

harmful consequences of nicotine use (Pender et al., 2023). Moreover, recent

evidence supports these theoretical perspectives. A systematic review by Mylocopos

et al. (2024) reported that interventions aimed at preventing e-cigarette use among

children and adolescents consistently emphasized strengthening refusal skills and

self-efficacy because these factors were associated with lower initiation and greater

success in avoiding nicotine use.

To sum it all up, the findings from Tables 3a, 3b, and 3c demonstrate that the

respondents exhibited moderate levels of perceived benefits, perceived barriers, and

perceived difficulty in abstaining from nicotine use. The findings suggest that

respondents hold moderate perceptions regarding the benefits of nicotine use,

experience moderate barriers to avoiding nicotine, and possess only moderate

confidence in their ability to abstain from nicotine products. Collectively, these

findings support Pender's Health Promotion Model, which emphasizes that health
behaviors are shaped by the interaction of perceived benefits, perceived barriers, and

self-efficacy. The results further suggest that interventions aimed at reducing nicotine

use should simultaneously address favorable perceptions of nicotine, minimize

environmental and social barriers, and strengthen adolescents' and young adults'

confidence in refusing and quitting nicotine products.