Dra. Yayi Suryo Prabandari , M.Si, PhD1) 2)

dr. Arika Dewi, MKM2) 3)

1 Department of Health Behavior, Environment Health & Social Medicine, Faculty of Medicine, UniversitasGadjah Mada, Yogyakarta, Indonesia; 2 Quit Tobacco Indonesia, Center for Health Behavior and Promotion, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia; 3 Center for Health Economics and Policy Studies, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia

•Not ratified the

FCTC

• TAPS are occurred

•Electronic media &

outdoor cigarette

advertising in

relation to

decentralization

policy in 2000 •Industry claims

TAPS targets adult

•TAPS

aggressiveness in

line with the

increase of smoking

prevalence among

adolescents in

Indonesia

•Previous studies

have reported an

association between

cigarette advertising

and smoking

behavior

•TAPS put adolescent

at risk of smoking

•Has been reported

extensively in the West,

• Less in SEA countries

that have not completely

banned TAPS including

Indonesia

2

In a country like Indonesia, where TAPS is aggressive and tobaccocontrol is not strict, information is needed on whether youthsperceive cigarette ads as being related to smoking initiation/statusor whether smoking initiation/status is related to other variables,such as social influence.

3

4

DESIGN

Cross sectional study

Self reported survey

SITE

Yogyakarta Municipality

Public & Private Jr& Sr High Schools

RESPONDENT

Female and Male Students

Age: 10-19 y.o

ETHICS

Ethics aproval

Consent students

Informed consent from parents

SAMPLING

Multistage Random Sampling

SAMPLING NUMBER

N = 2,115

1,943 (Completed)

Dependent Variables

• Smoking Initiation

• Smoking Status

Independent Variables

• Perception of cigarette ads targeted at youth

• Perception of cigarette ads encouraging youth to smoke

• Perception of cigarette ads message

• Attitude toward TAPS

• Exposure to cigarette ads

• Exposure to cigarette marketing

Covariate Measurements

• Sociodemographic variables (gender, grade level, pocket money, parents education)

• Psychosocial variables (friends & family smoke, exposure to TC education, knowledge, susceptibility)

5

6

Male

48%Female

52%

SEX

Class 7

47%

Class 8

15%Class 9

6%

Class 10

33%

Class 11

22%

Class 12

5%

CLASS

Mean Age : 15 years old

Mean Pocket money: IDR 7000/daily

Prevalence Current Smoker: 21.36%

7

44%

68%

44%

66%

94%

11%

56%

32%

56%

34%

6%

89%

Cig ads targeted toyouth

Cig ads encouraging tosmoke

Cig ads message

Exposure to cig ads

Exposure to cigmarketing

Attitude toward TAPS(pos/neg)

Low High

negative

56% Youth has high perception of cigarette ads

targeted at youth

h

positive

High perception of cigarette ads targeted at youth (OR 1.53)

High perception of cigarette ads message (OR 1.47)

High perception of cigarette ads encourage youth to smoke (OR 4.77)

Having positive attitude toward TAPS (OR 3.74)

High exposure to cigarette advertisement (OR 1.47)

High exposure to cigarette marketing (OR 1.49)

Susceptible to smoke (OR 3.35)

Has friends who smokes (OR 3.48), family (1.61)

Gender : male (OR 3.63)

Higher pocket money (OR 1.03)

Grade 8 ,10,11

Older age ** (OR 1.1)

8p < 0.05; p < 0.001, 95% CI

High perception of cigarette ads targeted at youth (OR 2.09)

High perception of cigarette ads message (OR 1.42)

High perception of cigarette ads encourage youth to smoke (OR 20.26)

Having positive attitude toward TAPS (OR 10.48)

High exposure to cigarette advertisement (OR 1.59)

High exposure to cigarette marketing (OR 3.31)

Susceptible to smoke (OR 15.38)

Has friends who smokes (OR 9.33), family (2.12)

Gender : male (OR 9.99)

Higher pocket money (OR 1.03)

Grade 8 ,10,11

Older age (OR 1.1)

Low Knowledge on Tobacco Harm (OR 1.62)

Parents Education

9

ODDS

ARE

HIGHER

p < 0.05; p < 0.001, 95% CI

10

11

12

Gender, age, pocket money, and mother’s education were the sociodemographic variables that had an association with smoking status

Perception of cigarette ads targeted at youths, attitude toward TAPS, and susceptibility were consistently associated with smoking status as were smoking friends and family

Although exposure to cigarette ads &marketing did not relate to smoking status after being integrated into the model, still the study found that cigarette advertising and promotional messages indeed are targeted at youths and their perception was strongly associated with smoking status.

Regulations to ban TAPS in order to prevent youths from smoking should be applied rapidly in Indonesia.

The authors thank all the teams involved in the research

This survey was a collaborative project between Quit Tobacco Indonesia, Faculty of Medicine Universitas Gadjah Mada and the Provincial Health Office of Yogyakarta Province

The authors are grateful for the financial assistance from Provincial Health Office of Yogyakarta

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Published in Journal Global Health Action Volume 9, 2016 - Issue 1

Free access: http://dx.doi.org/10.3402/gha.v9.30914

Author emails: yayisuryo@ugm.ac.id; arika.dewi@cheps.or.id

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