Social Determinant of Health of Adults Smoking Behavior: Differences between Urban and Rural Areas in Indonesia

Abstract

Indonesia has the highest prevalence of smoking behavior among Southeast Asian countries. This study aimed to determine predictors of smoking behavior between rural and urban areas. Data were taken from The Global Adult Tobacco Survey (GATS). This study used ross-sectional analytical study and multiple logistic regression analysis. Samples were 8,305 Indonesian adults aged ≥ 15 years. The study showed that smokers in rural area were higher than in urban area, respectively 36.8% and 31.9%. Significant predictors of smoking behavior in rural and urban areas were age, occupation, sex, education level, economic status as well as smoking rule inside home. In urban area, age was also significant predictor and otherwise in rural area. The strongest predictor was smoking rule inside home and sex for smoking behavior, either in rural or in urban area. Tobacco control program should be relatively increased by considering the appropriate target population both in rural and urban area due to a little different of smoking behavior path, hence sex perspective should be involved also in tobacco control program. Regulation on smoke-free home should be encouraged to be implemented among houses of community.AbstrakIndonesia memiliki prevalensi perilaku merokok tertinggi di antara negara-negara di Asia Tenggara. Penelitian ini bertujuan untuk mengetahui prediktor terhadap perilaku merokok antara wilayah pedesaan dan perkotaan. Data diambil dari Global Adult Tobacco Survey. Penelitian menggunakan studi analitik potong lintang dan analisis regresi logistik ganda. Sampel berjumlah 8.305 orang dewasa Indonesia berusia ≥ 15 tahun. Penelitian menunjukkan bahwa perokok di wilayah pedesaan lebih tinggi dibandingkan di wilayah perkotaan, masing-masing 36,8% dan 31,9%. Prediktor signifikan terhadap perilaku merokok di wilayah pedesaan dan perkotaan adalah usia, pekerjaan, jenis kelamin, tingkat pendidikan, status ekonomi serta aturan merokok di dalam rumah. Di wilayah perkotaan, usia juga merupakan prediktor yang signifikan dan sebaliknya di wilayah pedesaan. Prediktor terkuat adalah aturan merokok di dalam rumah dan jenis kelamin untuk perilaku merokok di wilayah pedesaan atau perkotaan. Program pengendalian tembakau secara relatif harus ditingkatkan dengan mempertimbangkan populasi target yang sesuai, baik di wilayah pedesaan maupun perkotaan karena adanya sedikit perbedaan jalan perilaku merokok, maka sudut pandang jenis kelamin juga harus dilibatkan dalam program pengendalian tembakau. Aturan rumah bebas asap rokok harus didorong untuk diterapkan pada rumah penduduk.

Determinants of Tobacco Smoking Addiction in Rural Indonesian Communities

“…A study among the U.S. adults shows that it is more common in their rural areas compared with that in the urban settlements [ 3 ]. Similar findings in Indonesia also recorded the same result (36.8% vs 31.9%) [ 4 ].…”

Association of Smoking Related to Knowledge, Attitude, and Practice (KAP) with Tobacco Use in Community Health Center Working Area of Sungai Durian, Sintang Regency, West Kalimantan Province

“…Concerning knowledge, a previous study conducted in Indonesia has found educational level was a strong predictor of smoking behavior (Rahim et al, 2016). Knowledge about effects of tobacco consumption on health can be manifested in the long process.…”

“…Knowledge is not the only factor contributing to tobacco use, and most people understand the negative health effects of tobacco use, but they continue to smoke. Between urban and rural areas, the study has found rules inside the home, sex, and age were the most significant predictors of tobacco use (Rahim, Suksaroj, & Jayasvasti, 2016). Studies conducted in Jakarta, Semarang, Surabaya, Makassar, and Padang have reported that the risk of U5MR (Under Five Mortality Rate) accounted for 14% for urban areas and 24% for the rural areas (Central Bureau of Statistics Indonesia, 2011).…”

Social Support and Smoking Behavior in Traditional Islamic Boarding Schools of Aceh Besar

“…Smoking behavior is not only influenced by social support but is also influenced by age, occupation, gender, education level, economic status, smoking rules in the home, the influence of advertising, studying in private schools, having friends who smoke, smoking parents, perceptions. ill health and the perception of dissatisfaction with life (Alsubaie, 2018;Rahim, Suksaroj, & Jayasvasti, 2016). Also, socioeconomic position, depressive symptoms, physical dependence, and different gender functions determine whether a person should smoke and stop smoking (Castro, 2016).…”