Influences of fatherhood and masculinity on the smoking tobacco behavior of young Indonesian fathers

Abstract

Tobacco smoking among men constitutes a major problem in Indonesia: 75.9% of Indonesian males are smokers, with 72% smoking at home, endangering the health of secondhand smokers in domestic settings, especially children. This study aimed to identify and understand the reasons and beliefs behind maintaining smoking behavior among young Indonesian fathers. Semi-structured in-depth qualitative interviews were conducted with 30 young fathers who are active smokers recruited via the Public Health Center in Samarinda City, Indonesia. The interview guideline was built on a combination of the Health Belief Model, Social Constructionism, Toxic Masculinity, and Role theory concepts to capture the impact of psychological, social, and cultural factors on the smoking trajectory of informants. Grounded theory coding procedures were used to identify codes and themes. Smoking behavior is a crucial element of the socially constructed image of masculinity in Indonesia. This identity and the correlated tobacco-related beliefs play major roles in the initial stages of tobacco smoking. Young fathers continue smoking because of their nicotine dependence and lack trust in tobacco-related harm prevention messages. Furthermore, fathers utilize neutralization techniques and rationalization to legitimize their tobacco smoking behavior. Consequently, they unintentionally maintain the vicious cycle of male smoking in which children witness older men smoking and link tobacco smoking with masculinity. Smoking behavior prevention programs including the socio-cultural specificities of Indonesian masculinity targeting young fathers need to be developed to break this cycle of children reproducing their fathers' smoking behavior.