2005年-世界发展银行全球_The_Determinants_of_Smoking_Behavior_among_Teenagers_in_East_Java_Province_Indonesia_47页_1mb

Summary of "The Determinants of Smoking Behavior among Teenagers in East Java Province, Indonesia"

Core Content

This document presents a study on the determinants of smoking behavior among high school students in East Java Province, Indonesia. The research was conducted as part of the World Bank Study on the Economics of Tobacco and Tobacco Control in Indonesia, with financial support from SIDA and US CDC/OSH. The study aimed to understand the factors that influence youth smoking behavior and to provide insights for effective tobacco control interventions.

Main Points

1. Smoking Prevalence in Indonesia and East Java

• Indonesia has a high number of smokers, with 4.2% of the global 1.2 billion smokers being from Indonesia.
• In 2001, 32% of Indonesian adults smoked, with male smoking prevalence increasing dramatically in East Java from 33% in 1995 to 62% in 2001.
• Female smoking rates are significantly lower, with only 1-3% of women aged 10 or older smoking, and 0.8% in East Java in 2001.
• Youth smoking prevalence is also high, with 32% of students identified as ever smokers and 20% as current smokers.
• Among current smokers, 70% are 17 years old or younger, and the majority first tried smoking between the ages of 10 and 17, with 15 years being the most common age of initiation.

2. Factors Influencing Smoking Behavior

Predisposing Factors

• Knowledge and Awareness: Students are aware of the health risks of smoking but underestimate its addictive nature.
• Social Norms and Beliefs: There is a perception that smoking is socially acceptable, especially among males.
• Perception of Advertising: Students believe that cigarette advertising influences smoking behavior.

Enabling Factors

• Accessibility and Affordability: Cigarettes are generally affordable and accessible to students, especially in urban areas.
• Availability at Home and School: Students who have access to cigarettes at home or school are more likely to smoke.
• Purchasing Power: Students who perceive cigarettes as affordable tend to smoke more frequently.

Reinforcing Factors

• Peer and Family Influence: Students who have family members, friends, or teachers who smoke are more likely to smoke.
• Cigarette Advertising: Exposure to cigarette ads in various media (TV, radio, billboards, magazines) is widespread and influences smoking behavior.
• Social Approval: The perception that smoking is acceptable among peers and teachers reinforces smoking behavior.

3. Methodology

• The study was based on a survey of 1,630 high school students from 40 randomly selected schools in Madiun City, Malang City, Jember Regency, and Bangkalan Regency.
• The survey used a modified version of the Global Youth Tobacco Survey (GYTS) questionnaire.
• The theoretical framework was based on Green's PRECEDE model, which categorizes factors into predisposing, enabling, and reinforcing.
• Multivariate logistic regression analysis was used to assess the relationship between these factors and smoking behavior.

4. Key Findings

• Gender Disparity: Female students showed an unexpectedly high smoking rate, which is a significant finding.
• Age Trends: The average age of smoking initiation is 15 years, with a notable increase in smoking intensity as students age.
• Affordability and Accessibility: Students who perceive cigarettes as affordable and easy to obtain smoke more frequently.
• Social Environment: Schools are considered smoker-friendly, and parental disapproval is associated with lower smoking rates.
• Advertising Influence: Cigarette advertising is prevalent and has a strong impact on youth smoking behavior.
• Policy Implications: The study suggests that tobacco control interventions should focus on educational campaigns, restricting access, raising awareness of addiction, and changing social norms.

Key Information

• Sample Size: 1,630 students from 40 high schools in four areas of East Java.
• Data Sources: The survey included questions on demographics, knowledge, attitudes, beliefs, and behaviors related to smoking.
• Geographic Focus: East Java, which is a major producer of tobacco in Indonesia.
• Economic Context: The region has a significant proportion of the population living in poverty, which may contribute to the affordability of cigarettes.
• Policy Recommendations: The findings suggest that a combination of strategies including higher taxes, banning tobacco advertising, implementing smoke-free policies, and educational interventions could be effective in reducing youth smoking rates.

Conclusion

The study highlights the importance of understanding the complex interplay of factors that influence youth smoking behavior in Indonesia. It emphasizes the need for targeted interventions that address both individual and environmental determinants of smoking, especially in a region where smoking is culturally accepted and economically accessible. The findings also underscore the urgency of implementing comprehensive tobacco control measures to prevent the rise of smoking-related diseases in future generations.