BACKGROUND:Initial smoking exposure may occur during early adolescence (aged 10 to 12 years old), and it increases over time.  Although several factors for smoking behaviors exist among adolescents, there is few studies address determinant of smoking behavior by adding others variables in theory of plan behavior such as smoking refusal skills, self-regulation, parenting, family function, environment, and culture. AIM:The aim of this study was therefore to evaluate the determinant of smoking behavior among elementary student in Indonesia using a structural equation model. METHOD:A cross-sectional survey was carried out from June to October 2019 in West Java, Indonesia. For each school, students were selected using a systematic random sampling. technique. The study included girls and boys ages 10-12. The consent was obtained by the parent or guardian. Structural equation modelling was used for analysis. RESULTS:The mean age was 10.56 years (SD= 0.37). About 28.6% of them were currently smoking with aged of first use was 10.02 (SD=0.19). more than half (56%) of their family were currently smoking too and friend smoking was 41.7%. The final model accounted for 27% and 39% of the variance of intention and smoking behaviour, respectivelyhas both direct and indirect effect through empowerment on self-care behaviors toward pregnancy-related complication. CONCLUSION:The present study was intended to expand the theory of planned behavior by including additional variables in its model: smoking refusal skills, self-regulation, parenting, family function, environment, and culture. This study also provides a significant contribute for clinical a practice and policy maker as a basic data to establish future intervention to promote no tobacco use among elementary student to achieve optimal well-being to prevent a fatal disease.

BACKGROUND: Initial smoking exposure may occur during early adolescence (aged 10–12 years old), and it increases overtime. Although several factors for smoking behaviors exist among adolescents, there are few studies address determinant of smoking behavior by adding others variables in theory of plan behavior such as smoking refusal skills, self-regulation, parenting, family function, environment, and culture. AIM: The aim of this study was, therefore, to evaluate the determinant of smoking behavior among elementary student in Indonesia using a structural equation model. METHODS: A cross-sectional survey was carried out from June to October 2019 in West Java, Indonesia. For each school, students were selected using a systematic random sampling technique. The study included girls and boys ages 10–12. The consent was obtained by the parent or guardian. Structural equation modeling was used for analysis. RESULTS: The mean age was 10.56 years (SD = 0.37). About 28.6% of them were currently smoking with aged of first use was 10.02 (SD = 0.19). More than half (56%) of their family were currently smoking too and friend smoking was 41.7%. The final model accounted for 27% and 39% of the variance of intention and smoking behavior, respectively, has both direct and indirect effects through empowerment on self-care behaviors toward pregnancy-related complication. CONCLUSION: The present study was intended to expand the theory of planned behavior by including additional variables in its model: Smoking refusal skills, self-regulation, parenting, family function, environment, and culture. This study also provides a significant contribute for clinical a practice and policy-maker as a basic data to establish future intervention to promote no tobacco use among elementary student to achieve optimal well-being to prevent a fatal disease.

BACKGROUND: Family empowerment is a critical component for smoking prevention efforts among adolescents. Few information regarding the family empowerment model developed in preventing smoking initiation among adolescents in Indonesia. AIM: The aim of this study was to identify determinants of the family empowerment model in preventing smoking initiation among adolescents in Indonesia. METHODS: A cross-sectional research design was used for families with adolescent girls and boys (aged 10–14 years) in West Java, Indonesia. The convenience sampling procedure was employed. The study analyzed family demands and parenting stress as stressors. Family resources were divided into family functioning and communication process. The perception or judgment factor was assumed as parenting efficacy. Family empowerment has been identified as an indicator of adaptation. Structural equation modeling was used for data analysis. RESULTS: The survey respondents consisted of 175 respondents. The mean age was 40.56 (SD = 11.73) and 57.2% had graduated from above high school. These findings suggest that family demands and parenting stress have an indirect effect on family empowerment through parenting efficacy, family functioning, and communication processes. The contribution of the effect of family demands, parenting stress, parenting efficacy, family function, and communication process on family empowerment was 68%. CONCLUSION: The family empowerment could be defined in the Double ABCX model in the prevention of smoking in adolescents and that the numerous adverse effects of stress can be modulated through parental efficacy as well as the ability to function of the family and communication. It recommends making family interventions an integral part of public health initiatives for the prevention of smoking initiation, as well as health policy formation.

Latar Belakang: Masalah perilaku kesehatan remaja meliputi konsumsi alkohol dan obat-obatan terlarang, pola makan sehat, sanitasi atau kebersihan pribadi atau sekolah atau kesehatan reproduksi, kesehatan mental remaja, kesehatan reproduksi, aktivitas fisik, dan merokok. Survei literasi pertama di Indonesia tahun 2013-2014 menunjukkan bahwa 64% dari 1.029 responden memiliki tingkat literasi kesehatan yang rendah (tidak memadai dan bermasalah), dan proposisi mayoritas berusia 15-18 tahun (72%). Tujuan: Kegiatan ini bertujuan untuk memberikan pengetahuan dan kompetensi kepada remaja/siswa dan guru agar secara mandiri mampu melakukan perilaku preventif dan juga penanganan masalah kesehatan dasar yang berkaitan dengan remaja sehingga status kesehatan remaja di wilayah Jabodetabek. Metode: Metode yang digunakan dalam kegiatan ini meliputi kegiatan sosialisasi, FGD, pre and post-test dan deklarasi komitmen. Mitra kegiatan pengabdian masyarakat ini adalah 3 SMA dan SMK di wilayah Jabodetabek. Hasil: Kegiatan peningkatan literasi dan advokasi kesehatan masyarakat pada remaja di 3 (tiga) sekolah telah terlaksana dengan baik dan mendapat respon positif dan baik dari pihak sekolah, dan peserta (siswa) yang mengikuti kegiatan tersebut. Sebagian besar dari mereka menunjukkan bahwa para peserta dapat berpartisipasi selama kegiatan berlangsung. Hal ini dibuktikan dengan adanya perubahan pengetahuan peserta sebelum dan sesudah diberikan pendidikan. Sebagai hasil dari kegiatan ini, beberapa komitmen diajukan dan disepakati oleh kedua belah pihak. Kesimpulan: Terjadinya perubahan pengetahuan dari para peserta pada saat sebelum dan sesudah diberikan edukasi. Tindak lanjut dari keberlanjutan program pengabdian masyarakat ini adalah dengan penguatan sistem monitoring dan evaluasi komitmen sekolah.

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