Determinants of cigarette smoking among school adolescents on the island of Java, Indonesia

Abstract

Background: The Integrated Model of Change has successfully explained the behavior change process. Cigarette smoking is a social phenomenon, which needs to be understood for devising effective preventive strategies. Objectives: The study aims to apply the Integrated Model of Change to determine predictive factors of cigarette smoking behavior among school adolescents in Indonesia. Methods: A school-based cross-sectional study was designed to collect data in Banten, Indonesia. A total of 698 students from eight high schools were recruited by multi-stage cluster sampling. The association between cigarette smoking and the independent variables was examined by multiple logistic regressions. Results: The majority of respondents (86.4%) were between the ages of 15 and 17 years (Mean=16.4 years; SD=1.01). Approximately half (48.8%) of the students ever tried a cigarette while 29.6% were current smokers. Curiosity was reported as the main reason for experimenting with cigarettes (32%). The significant factors regarding current cigarette smoking were attitude [adjusted odds ratio (AOR)=2.68], social norms (AOR=12.80), self-efficacy (AOR=15.85), and accessibility (AOR=4.39). Conclusion: The study revealed social influence and selfefficacy that were strongly associated with cigarette smoking can help authorities in guiding possible intervention programs for school adolescents.