Validation Sheet for Survey Questionnaire

Name of Evaluator: ________________________________

Degree: ________________________________

Position: ________________________________

Number of years in teaching: ________________________________

To the evaluator: Please check the appropriate box for your ratings

Points evaluation: 5 - strongly agree

4 - agree

3 - neither agree or disagree

2 - disagree

1 - strongly disagree

Items 1 2 3 4 5

1. CLARITY OF THE DIRECTION AND ITEMS

The vocabulary level, language, structure, and conceptual level of questions

suit of participants. The best directions and the items are written in clear and
understanding manner.

2. PRESENTATION AND ORGANIZATION OF ITEM

The items are presented and organized in logical manner

3. SUSTAINABILITY OF ITEMS

The items are appropriate and represents the substance of the research. The
questions are designed to determine the conditions, knowledge, perception and
attitudes that are supposed to be measured.

4. ADEQUATENESS OF ITEMS PER CATEGORY OR INDICATOR

The items represent the coverage the courage of research adequately. The
number of questions per area category is representative enough of all the
questions needed for research.
5. ATTAINMENT OF PURPOSE

The instruments as well as it whole, fulfill the objectives for which it was
constructed.

6. OBJECTIVELY

Each item questions only one specific answer or measures only one behavior
and no aspect of the questionnaire is suggestion of the researcher.

7. SCALE AND EVALUATION RATING SCALE

The scale accepted is appropriated for the items.

Title of the Research: The effect of Anti-Smoking Ordinance to the Cigarette Vendors in Davao City

Name of the Researcher: Ronalyn T. Pace____________

Date of Evaluation of Questionnaire: _________________________________

Remarks of Evaluator: _________________________________

__________________________

(Signature over printed name)

Statement of the Problem

The general objective of the study will be to determine what are the effects of

Anti-Smoking Ordinance and how it affects to the cigarette vendors in Davao City

specifically; it will answer to the following queries:

1. What is the business profile of the respondents in terms of :

a. Capitalization

b. Location

c. No. of years in business operation

2. What is the level of the effect of Anti-Smoking Ordinance to the cigarette vendors in

Davao City in terms of:

a. Sales

3. Is there a significant difference in the effects of anti-smoking ordinance to the

cigarette vendors when categorized according to their Capitalization, Location, and No.
of years in business operation.

PART I. DEMOGRAPHIC PROFILE

This part consists of some personal information needed from you.
Instruction: Please fill in the blanks that corresponds to your answer.

Respondent’s Details:
Name: _________________________________________________________
Location: _______________________________________________________
Capitalization: (500 - 1,000) _____________ (3,100 - 5,000) ___________

(1,100 - 3,000) ____________ (above 5,000) ___________

No. of years in business operation: ______________________

PART II. The level of the effect of Anti-Smoking Ordinance to the cigarette
vendors in Davao City
This part of the instrument measures the effect of Anti-Smoking Ordinance in Davao City
Instruction: Below are list of statements which measures the effect of Anti-Smoking
Ordinance in Davao City. Indicate your agreement regarding the behavior implied in
every question. Please put a check (/) mark in the box that reflects your views.
 Strongly Agree (SA) - 5
Agree (A) - 4
Moderately Agree (MA) - 3
Disagree (D) - 2
Strongly Disagree (SD) - 1

A. Survey Questionnaire

5 4 3 2 1
SALES (SA) (A) (MA) (D) (SD)

1. The smokers are aware to the cigarette

advertisements and health warnings in the
cigarette packs.

2. The smoking ordinance affects the

cigarette supplier to supply more
cigarettes.
3. The smokers are prefer to buy
cigarette sticks than cigarette packs.

4. The vendors can’t sell cigarettes in the

street because it is strictly prohibited by
the city government.

5. The smoking ordinance affect the

perception of the cigarette smokers to
smoke.
6. There are limited places where the
vendors can sell cigarettes.

7. The population of cigarette buyers is

decreasing because of the smoking
ordinance.
8. The smoking ordinance affect the
perception of the cigarette vendors to sell.

9. There are limited places where the

smokers can smoke cigarette.

10. The vendors are prefer to lessen their

supply of cigarettes.

11. The vendors purchased lower-priced

cigarettes.

12. The perceived effectiveness of

pictorials health warnings of cigarette
smokers on tobacco packs.
13. The cigarette vendors are prefer to
stop selling cigarettes in order to avoid
fines because of the smoking ordinance
14. The smokers are noticing
anti-cigarette information in newspapers or
magazines.
15. .The smokers are prefer to buy
tobacco products over the Internet.

16. Cigarette vendors can’t sell in all public

places (bars, restaurants, terminals,
workplaces, shops, etc. )
17. The cigarette smokers are prefer to
use e-cigarette (vape) than cigarette
sticks.
18. The cigarette vendors are prefer to
lessen their capitals in purchasing
cigarettes.
19. The cigarette vendors are prefer to
stop selling cigarettes in order to follow the
implemented smoking ordinance of the
government.
20. There is use of signage prohibiting
smoking on designated places.