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Background: The prevalence of adolescent tobacco use in Indonesia is among the highest in the world. Monitoring the extent and distribution of adolescent cigarette smoking is crucial to being able to target prevention and reduction strategies and evaluate the effectiveness of interventions. Objectives: To quantify the prevalence of adolescent cigarette smoking in Indonesia and assess the association with key socio-economic, demographic and geographic factors. Methods: We used data from the 2013 Indonesian Basic Health Research (RISKESDAS) national household survey to quantify the prevalence of cigarette smoking in adolescents aged 10–18 years by sex, age, education, economic status, place of residence and province. We used logistic regression to assess the adjusted association between adolescent smoking and these factors. Results: The overall smoking prevalence among Indonesian  adolescents was 7.2% (95% Confidence Interval/CI: 7.1–7.4). The prevalence was substantially higher among males (14.0%; 95% CI: 13.6–14.4) compared with females (0.2%; 95% CI: 0.1–0.4). After controlling for socio-economic, demographic and geographic characteristics, higher odds of smoking were observed among males (OR = 118.1; 95% CI: 91.2–153.0) as compared to female and among  adolescents aged 13–15 and 16–18 years as compared to those aged 10–12 years (OR = 13.2; 95% CI: 10.8–16.2 and OR = 72.7; 95% CI: 59.1–89.4, respectively). The odds of smoking were greater among adolescents with higher education as compared to those with lower education (OR = 1.3; 95% CI: 1.1–1.4) and adolescents in the poorest quintile had more than twice the odds of smoking compared with adolescents from the richest quintile (OR = 2.5; 95% CI: 2.2–2.8). Conclusion: Smoking prevention and cessation interventions in Indonesia need to be specific considering the sex, age, socioeconomic status and geographic location of adolescents. Ongoing monitoring of adolescent smoking is important for targeting interventions at higher-risk groups and assessing the effectiveness of current tobacco control strategies.

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Achieving the goal of ensuring healthy lives and promoting well-being for all at all ages in Indonesia necessitates having a more focused understanding of district-level inequalities across a wide range of public health infrastructure, service, risk factor and health outcomes indicators, which can enable geographical comparison while also revealing areas for intervention to address health inequalities.