Bayambang National High School

Bayambang, Pangasinan
S. Y. 2017- 2018
QUESTIONNAIRE

EXTENT OF ALCOHOL INTAKE AMONG SENIOR HIGH SCHOOL STUDENTS

Name (Optional):_____________________________________________

Part I. Profile of the Respondents

Directions: Put a check mark (/) to the most accurate response to the left of each number.

Sex: Monthly Family Income:

Male Less than 7,890
Female Between 7,890 to 15,780
Between 15,780 to 31,560
Between 31,560 to 78,900
Between 78,900 and above

Part II. Extent of Alcohol Intake among Grade 12 Students

Directions: Put a check mark (/) to the most accurate response to the questions.

INDICATORS
4 – Always
3 – Often
2 – Sometimes
1 – Never
4 3 2 1
1. I am drinking liquor without knowing that I already get used to it.
2. I enjoy drinking liquor.
3. I drink too much.
4. I am an active alcohol drinker.
5. I can handle drinking alcohol.
6. I get extra drinks when others won’t know about it.
7. I can stop drinking.
8. I feel problematic about my alcohol intake.
9. I just drink few times a year.
10. I drink during occasions.
11. I drink after my friends say they’ve had enough.
12. I feel depressed or anxious before, during or after periods of heavy drinking.
13. I regret whatever I did or said while drinking when I’m sober.
14. I feel comfortable and relax when drinking.
15. I feel so sick after drinking alcohol.

Part III. A. Preferred Alcohol Drinks

Directions: Put a check mark (/) to the most wanted response among the choices.
 What type of alcohol did you usually have/drink?

Wines
Beer
Whiskey
Rum
Brandy
Gin
Liqueur/Herbal Liquor

B. Number of Glasses Use to Drink

Directions: Put a check mark (/) to the most wanted response among the choices.
How many glasses of alcoholic beverages do you use to drink?

1 to 2
3 to 4
5 above

C. Frequency of Alcohol Intake

Directions: Put a check mark (/) to the most wanted response among the choices.
How frequent do you drink alcoholic beverages?

Once a year

Occasional

Once a month

Thrice a week

Plan of Action

EXTENT OF ALCOHOL INTAKE AMONG SENIOR HIGH SCHOOL STUDENTS

Alcohol is the most used drug in the world. It is mainly because alcohol is legal and
socially acceptable in most countries (Keller and Vaillant, 2010)1. Majority of people drink
alcohol, generally for enjoyment, relaxation and sociability. Most people belongs to group of
moderate drinkers and at this level, alcohol causes only a few adverse effects (NHMRC, 2009).
 This action plan tends to give interventions for the negative effects of alcohol intake.
Alcoholism can be prevented through interventions. A wide range of interventions has been
identified in the literature as being effective in reducing alcohol consumption in general and
amongst heavy drinkers in particular. These includes GP interventions, school-based
interventions, mass media campaign, legislative changes, the provision of normative
information, and one-to-one customized communications.

THE INTERVENTIONS FOR THE ALCOHOL INTAKE OF SENIOR HIGH SCHOOL

STUDENTS

AREAS OF CONCERN OBJECTIVE SUGGESTED PERSONS EXPECTED

ACTIVITIES INVOLVED OUTCOME
Information disseminations To seek Presentation of DepEd, Information
regarding school-based information the findings of Principal,Teachers, disseminated
interventions from school this study School to the persons
and through Administrators, involved
disseminate symposiums Coordinators and
the gathered and seminars Students
information imposing
posters and
slogans
regarding the
reduction of
alcohol use
Advocate mass media To give Create a page Subject Teachers, Updated
campaign information and to social media Researchers, and information to
update to and upload the Students, Public public
public study. Make an
advocacy
campaign to
reduce the
alcoholic
teenagers
Coordination to legislators To send Send School Approved
for legislative changes permission and suggestion letter Administrators, suggestion
suggest Subject Teachers, and new
possible Researchers, and innovated
interventions Legislators policies
for the
innovation of
laws and
policies
Provision of normative To give right Conduct Principal, School Proper and
information knowledge to seminar and Administrators, enough
public specially information Subject Teachers knowledge for
students dissemination and Students everyone
regarding the meeting
alcohol
consumption
and the
interventions
One-to-one customized To asses Free counseling Guidance Good attitude
communications counseling and Counselor, towards
give guidance Teachers, Parents alcohol intake