Schools Have Contextual Influence on Smoking Behavior among High School Students in Dumai, Riau

Abstract

Background: Adolescence is prone to smoking behavior. Smoking behavior in adolescents is influenced by parental income factors, pocket money, media exposure, peers, the influence of parents, and attitudes towards smoking behavior. The purpose of this study was to analyze the contextual influence of school on smoking behavior in adolescents in Dumai City, Riau. Subject and Method: This was a cross sectional study conducted at 13 senior high schools and 12 junior high schools in Dumai, Riau, Indoneisa, from September to October 2019. A sample of 200 male adolescents aged 12-18 years was selected by stratified random sampling. The dependent variable was smoking behavior. The independent variables were parental income, pocket money, media exposure, peer, parental influence, intention, attitude, subjective norm, and perceived behavior control (PBC). The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression run on Stata 13. Results: Smoking behavior in male adolescents increased with high parental income (b= 2.06; 95% CI= -0.02 to 4.15; p=0.053), high pocket money (b=2.75; 95% CI= 0.80 to 4.71; p= 0.006), high exposure to cigarette advertising media (b= 2.45; 95% CI= 0.52 to 4.37; p=0.012), peer (b=2.10; 95% CI= 0.46 to 3.74; p=0.012), parental smoking behavior (b= 2.23; 95% CI= 0.47 to 3.99; p=0.013), and positive attitude to smoke (b= 2.67; 95% CI= 0.78 to 4.55; p=0.005). Smoking behavior decreased with weak PBC (b= -2.33; 95% CI= -405 to -0.60; p= 0.008), weak intention (b= -3.85; 95% CI= -6.32 to -1.39; p= 0.002), and weak subjective norm (b=-3.03; 95 % CI= -5.16 to 5.16; p= 0.005). There was strong contextual effect of school on smoking behavior in male adolescents with intra-class (ICC)= 25.14%. Conclusions: Smoking behavior in male adolescents increases with high parental income, high pocket money, high exposure to cigarette advertising media, peer, parental smoking behavior, and positive attitude to smoke. Smoking behavior decreases with weak PBC, weak intention, and weak subjective norm. There is strong contextual effect of school on smoking behavior in male adolescents.

Meta-Analysis: Effect of School-Based Health Promotion Strategy on Smoking Habits in Adolescents

“…This is evidenced by the fact that 75% of school students have seen advertisements for tobacco products. With this exposure, school students have a high potential to become active smokers into adulthood (Islami et al, 2019).…”

Meta-Analysis the Effect of School Based Intervention on Smoking in Adolescents

“…Adolescents are the easiest targets to be influenced by tobacco product manufacturers, with 75% of school students having seen tobacco product advertisements. With this exposure, school students have high potential to become active smokers until adulthood (Islami et al, 2019).…”

Meta-Analysis the Effect of Nicotine Replacement Therapy on the Successful Smoking Cessation

“…Smoking usually begins with trial and error behavior as a teenager, many factors support this behavior. Research in Riau and Bantul states that smoking behavior in male adolescents increases along with high family income, high pocket money, the influence of advertising media on cigarettes, smoking behavior in parents, lack of knowledge, lack of parental support, peer influence, and the perception of low cigarette prices (Islami et al, 2019;Arifianti et al, 2019) In 2015, Indonesia contributed more than 130,000 deaths due to tobacco consumption each year (Ministry of Health, 2019). Smoking is the leading cause of preventable death worldwide.…”

“…Most smokers are aware that smoking is a dangerous health behavior and in the end they have a desire to quit smoking, but trying to quit smoking is challenging and some of them end up in failure, despite many studies which claim that some smoking cessation methods are effective but the rate of quitting smoking remains low, the addictive nature of smoking can be attributed to the pharmacological effects of nicotine where nicotine can affect the social interaction function of smokers, people who smoke have higher anxiety disorders compared to nonsmokers, people who smoke have barriers to memory fear in the context of self-safety , this is caused by a nicotinergic or dopaminergic mechanism. Where this can be an inhibiting reason in efforts to quit smoking (Islami et al, 2019;Arifianti et al, 2019) Tobacco smoking has a correlation with an increased risk of developing 17 types of cancer in humans. There are about 60 known cancer-causing molecules called carcinogens in tobacco smoke (Linda et al, 2015).…”