Determination of the Stress Level of Active Smokers after 3 Days of

Intake of Vitamin C Tablets

Endang Susilawati

Muhammad Taufik

, Afniwati

, Mariany Razali

and Desi Ardilla

Nursing Department, Poltekkes Kemenke,s Medan, Indonesia

Chemistry Department, Faculty of Mathematic and Natural Science, Universitas Sumatera Utara, Medan, Indonesia

Pharmacy Department, Universitas Tjut Nyak Dhien, Medan, Indonesia

Agricultural Technology Department, Universitas Muhammadiyah Sumatera Utara, Medan, Indonesia

Keywords: Stress Level, HARS, Vitamin C, Active smokers.

Abstract: Stress is the body's reaction that occurs when someone faces a threat, pressure, or a change. Stress can also

occur because of situations or thoughts that make a person feel hopeless, nervous, angry, or excited. The

instrument used in determining the level of stress is the HARS method. This study aims to determine the

stress level of active cigarette users after 3 days of vitamin C intake. To quasi experimental was carried out

in one group pre test - post test design with a cross sectional approach. The results showed that Correlation

0,800, Sig.: 0,000 at level 0,01, Df: N- 1. t = 1,000: in this research, t = 6,679 > 2,4620 (significant). Sig.

(2-tailed): p value at T Paired = 0,000. In means : there is a difference between before and after treatment.

Because: p value > 0,05 (95% confidence). The relationship between giving Vitamin C to stress levels gave

a very strong relationship after the third day of giving Vitamin C.

1 INTRODUCTION

Stress is a state when a person feels mental and

mental discomfort caused by feeling depressed (Das,

Mishra, and Murari 2020). Stress is individual and is

basically destructive when there is no balance

between individual mental endurance and the stress

load that is felt (Wang et al. 2020). The sources of

stress or causes of stress are recognized as stressors

(Bawuna;, Julia Rottie, and Onibala 2017).

External stressors come from outside the

individual such as stressors in the environment and

social stressors, namely pressure from outside

caused by the individual's interaction with their

environment (Wolniak 2020). Unavoidable

traumatic social stressors, such as losing loved ones,

losing jobs, retiring from work, divorce, financial

problems, moving house and others. Meanwhile,

internal stressors are stressors that come from within

the individual, such as psychological stressors,

usually negative internal stress, such as frustration,

anxiety, guilt, excessive worry, anger, hate, sadness,

jealousy, self-pity, as well as a sense of inferiority

(Bawuna;, Julia Rottie, and Onibala 2017).

Biological stressors such as the release of

neurotrasmitters during stress from the adrenal

glands, the medulla ie epinephrine and

norepinephrine in response to stress. The release of

neurotransmitters causes physiological effects such

as increased heart rate, increased alertness and

others (Wolniak 2020).

A person who consumes a cigarette for the first

time experiences several symptoms such as

coughing, a bitter tongue, and nausea, but some of

the beginners ignore these symptoms (Williamson

and Proud 2011). Usually this situation continues to

become tobacco dependency or tobacco dependence.

Tobacco dependency itself can be defined as

sedentary tobacco use. Usually more than half a

pack of cigarettes per day, and done repeatedly. This

means that smoking behavior is a fun behavior and

shifts into an obsessive activity, which if stopped

suddenly will cause distress. This is because nicotine

is addictive and if it is stopped suddenly it will cause

stress (Defie et al. 2018). Even though active

smokers know the harmful effects of smoking, many

of these smokers persist.

Determination of the stress level of smokers can

use the HARS method. Stress is a stimulus or

situation that causes distress and creates physical

and psychological demands on it. someone. Stress

requires coping and adaptation (Bawuna;, Julia

596

Susilawati, E., Tauﬁk, M., Afniwati, ., Razali, M. and Ardilla, D.

Determination of the Stress Level of Active Smokers after 3 Days of Intake of Vitamin C Tablets.

DOI: 10.5220/0010614300002775

In Proceedings of the 1st International MIPAnet Conference on Science and Mathematics (IMC-SciMath 2019), pages 596-600

ISBN: 978-989-758-556-2

Rottie, and Onibala 2017). Stress is a disorder of the

body and mind caused by changes and demands of

life, which are influenced by the environment and

the appearance of individuals in the environment

(Bawuna;, Julia Rottie, and Onibala 2017). There are

6 stages of stress, with the following characteristics:

Stage 1

The characteristic of this phase : High morale,

excessive, unusual sharp eyesight, feeling able to

complete work more than usual, but without

realizing it, energy reserves are running low

(Rahmayani, Liza, and Syah 2019).

Stage 2

The characteristic of this phase : feeling tired when

waking up in the morning who should feel refreshed,

feeling tired easily after lunch, feeling tired quickly

in the afternoon, often complaining of other

uncomfortable, heart rate kerns more than usual

(palpitations), back and nape muscles feel tense,

unable to relax (Musradinur 2016).

Stage 3

The characteristic of this phase : stomach and

intestinal disorders are getting more pronounced ;

for example, complaints of gastritis, irregular bowel

movements (diarrhea), increased muscle tension,

feelings of restlessness and increased emotional

tension, insomnia (Rahmayani, Liza, and Syah

2019).

Stage 4

It feels very difficult to survive the whole day alone,

work activities that are fun and easy to complete

become boring and feel more difficult, from being

responsive to the situation, losing the ability to

respond adequately, sleep disturbance accompanied

by tense dreams (Apriyana, Widianti, and Muliani

2020).

Stage 5

The characteristic of this phase : physical and

psychological exhaustion, increasingly severe

digestive system disorders (gastro-intestinal

disorder), inability to complete light and simple

daily work and arise. (Defie et al. 2018).

Stage 6

This is the climax stage, a person experiences panic

attacks and a feeling of fear of death. (Hasanah et al.

2020). Stress levels can be grouped using the HARS

(Hamilton Anxiety Rating Scale) criteria. The

elements assessed include: feelings of anxiety,

tension, fear, sleep disorders, intelligence disorders,

feelings of depression, somatic symptoms,

respiratory symptoms, cardiovascular symptoms,

gastrointestinal symptoms, urinary symptoms,

autonomic symptoms, behavioral symptoms (Aditya

Tarupay, Indra Fajarwaty Ibnu 2010).

2 METHODS

Collecting samples

The sample was collected by purposive sampling,

namely the technique of determining the sample

based on the characteristics of the population that

had been previously known. The number of samples

that met the criteria was 60 male volunteers aged 17-

28 years (active smokers), namely 30 as the

Intervention sample and 30 as the control. 10 ml of

urine were taken before and after treatment with

Vitamin C 50 mg x 2. Samples were taken on day 1

and 3.

Design of research

This study used a Quasi Experiment design whose

design used the non-randomized control group

pretest - post test design technique. Grouping of

sample members into the experimental group and the

control group was not done randomly.

Operational Defenition

The operational definition is shown in Table 2.1. the

following:

Table 2.1: Operational Defenition

Giving Vitamin C

Sample of 30 people was given Vitamin C 50 mg x 2

Tabs (Pacier and Martirosyan, 2015) in the morning

at 08.00 WIB and in the afternoon at 16.00 WIB.

The treatment is carried out continuously until day 3.

Stress level Analysis

Stress level analysis is done by giving stress level

questionnaire (HARS method) (Ruqaiyah,

Nusratuddin Abdullah, Mochammad Hatta,

Nasrudin A Mappeware, Ayatullah Harun, and

Baharuddin 2020) (Das, Mishra, and Murari 2020).

Determination of the Stress Level of Active Smokers after 3 Days of Intake of Vitamin C Tablets

597

3 RESULT

3.1 Demografi Analysis

Respondents' Data Frequency Distribution by Age as

in Figure 2.1. the following:

(a) (b)

Figure 2.1. Demographic analysis of intervention samples

(a) and control samples (b)

3.2 Relationship of Vitamin C to Stress

Levels

Relationship of Vitamin C to stress levels dapat

dilihat pada Table 2.2. Table 2.2. indicates that the

Stress Level of the intervention sample has

decreased on the third day. This decrease is due to

the binding of nicotine compounds to the free radical

group found in Vitamin C (Paci et al. 2018).

Nicotine which has silent hydrogen in the "N"

element will be bound by the double bonds found in

vitamin C (Pacier and Martirosyan 2015a).

Nicotine levels that attack the central nervous

system (CNS) will decrease, this is what triggers a

decrease in stress levels in the body of the

intervention sample. Stress is a stimulus or situation

that causes distress and creates physical and

psychological demands on it. someone. Stress

requires coping and adaptation. The body's response

can be predicted without regard to certain stressors

or causes. Stress is the body's nonspecific response

to any demands on it. If someone after experiencing

stress experiences disturbances in one or more

organs of the body so that the person concerned is

no longer able to carry out his sensitivity function

properly, it is called experiencing distress (Pacier

and Martirosyan 2015b).

Table 2.2: Data of paired t test on the relationship of

giving Vitamin C to stress levels on day 3

Stress Level of

Intervention

Stress Level

of Control

Day

1 4 4 3 3

2 3 2 4 4

3 3 3 2 2

4 2 2 2 2

5 4 4 4 4

6 4 4 4 3

7 3 2 2 2

8 1 1 2 2

9 4 4 4 3

10 4 3 4 3

11 2 2 3 2

12 3 2 2 2

13 2 1 3 2

14 3 2 2 2

15 4 3 3 2

16 1 0 2 2

17 1 1 3 2

18 4 3 4 4

19 1 0 2 2

20 2 1 3 3

21 2 2 2 2

22 3 3 3 3

23 2 1 3 2

24 2 2 2 2

25 1 0 2 2

26 2 2 3 3

27 1 1 2 2

28 2 2 2 2

29 2 1 4 4

30 1 0 3 3

IMC-SciMath 2019 - The International MIPAnet Conference on Science and Mathematics (IMC-SciMath)

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Statistic using SPSS Ver 23 follows Figure 3.1. the

following:

Figure 3.1. Statistical data Relationship of Vitamin C to

stress levels on day 3

Figure 3.1 above shows that the changes that

occurred in the control sample on the first and third,

day did not change much. This shows that the

control sample used is good and can be used as a

comparison in the study. In this work, the correlation

value between these 2 variables: Result 0.800 means

that there is a very strong relationship. The level of

significance of the relationship = 0.000 means that it

is significant at the 0.01 level. Df: degree of freedom

For Paired T analysis it is always N- 1. Where N is

the number of samples. the value of t count = 1,000.

In this study: 6,679> 2,4620 (significant). There is a

difference between before and after treatment.

Because: p value> 0.05 (95% confidence). Mean:

0.66667 = positive value: This means that there is a

tendency to decrease stress levels. The average

decline was 0.66667.

4 CONCLUSION

Determination of the stress level of active smokers

after 3 days of vitamin C administration can be done

by administering a stress level questionnaire used

HARS method. The relationship of giving Vitamin

C on the third day to stress levels gave a very strong

relationship = p value> 0.05 (95% confidence).

ACKNOWLEDGEMENTS

The authors gratefully acknowledge Director

Poltekes Kemenkes Medan for the financial support

via Penelitian Kerjasama Dalam Negeri Tahun 2019.

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