Tobacco Use, Knowledge Of Tobacco Risks, And Perception Of Smoking Behaviors Among Urban And Rural Youth In South Sulawesi, Indonesia

Author

Ryan Andrew SutherlandFollow

Date of Award

January 2020

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Marney White

Second Advisor

Tomoyuki Shibata

Abstract

This observational study surveyed knowledge, practice, and attitudes (KAP) of N=959 youth 13 – 18 years of age in South Sulawesi, Indonesia and assessed how age, sex, familial smoking status, friend group smoking status, teacher smoking status, parental education, parental employment, exposure to tobacco-related advertisements, access to internet-connecting technological devices (INT-D) and television, and monthly pocket money were associated with youths’ perceptions of tobacco users and smoking, knowledge of tobacco health risks, and smoking status. This study also examined how urban or rural environment and schooling — access or lack of access to formal education — shaped youths’ decisions to smoke cigarettes and influenced their perceptions and knowledge of health risks.

In this study, sex, age, schooling and environment, paternal education, pocket money, and friend group smoking status had significant effects on youths’ decisions to smoke. After adjusting for covariates, female youth were less likely to smoke than male youth, rural island youth and those from street children communities enrolled in alternative education were less likely to smoke than those from urban communities enrolled in formal education, those who reported some, most or all of their friends smoked were more likely to smoke than those who indicate that none of their friends smoked, those whose fathers had higher education were less likely to smoke than those whose fathers had only completed high school or less, and for every increase in 100,000Rp (Indonesian Rupiah) of monthly pocket money, youth were more likely to smoke.

Considering that more than 225,000 Indonesians die each year from cigarette-related illnesses (14.7% of all deaths) and that the percentage of adult smokers in Indonesia is among the highest in the world at over 61.4 million, understanding the motivations that encourage youth to smoke and recording their perceptions of tobacco risk are vitally important to develop prevention programming.

Table of Contents.

1. Abstract, Research Questions and Acknowledgements page i - ix

a. Abstract and Extended Abstract page i

b. Research Questions page iv

c. Research Methodology page iv

d. Acknowledgements page v

2. Introduction, Background and Rationale page 1 - 7

3. Methods page 8 - 18

a. Procedure page 8

b. Participants page 9

c. Ethical Considerations page 10

d. List of Stakeholders page 11-12

i. Overview of The Floating School (TFS) page 11

ii. Overview of Komunitas Peduli anak Jalanan, or Community for

Caring for Street Children (KPAJ) page 12

e. Measures page 12 - 17

i. Demographics page 12

ii. TAPS (Tobacco Advertising, Promotion, and Sponsorship) page 14

iii. Perception of Smoking Behaviors and Tobacco Use and Knowledge

of Smoking Risk page 15

f. Data Analysis Methodology, Statistics page 17 - 18

4. Results page 18 - 35

a. Preliminary Analyses page 18

b. Characteristics of Current and Former Smokers (Tables 2, 3, 4) page 19

c. Unadjusted and adjusted logistic regression models predicting increased risk

of smoking (current and former) (Table 5) page 25

d. Adjusted logistic regression models predicting correct knowledge of smoking

risk and positive perception of smoking (Table 6) page 28

e. Adjusted logistic regression models predicting correct knowledge of smoking

risk and positive perception of smoking related to smoking status (Table 7) page 34

5. Discussion and Recommendations page 36 - 42

6. Conclusions page 43 - 44

7. Executive Summaries of Results page 45 - 50

a. Executive Summary: Sepuli, Saugi, Satando (The Floating School) page 45

b. Executive Summary: Makassar (Komunitas Peduli anak Jalanan, or

Community for Caring for Street Children (KPAJ))) page 47

c. Executive Summary: Urban Makassar (Public, Private,

and Islamic Schools) page 49

8. Tables

a. Table 1. Description of Sample Stratified by Location page 22

b. Table 2. Description of Smokers and Non-Smokers Stratified by

Location and Sex page 23

c. Table 3. Description of Sample stratified by Smoking Status and

Regular Access to INT-D (Internet Connecting Technological Devices)

and/or Television page 23

d. Table 4. Characteristics of Current and Former Smokers page 24

e. Table 5. Inferential Statistics: Unadjusted and Adjusted Logistic Regression

Models Predicting Increased Risk of Smoking (Current or Former) page 27

f. Table 6. Inferential Statistics: Adjusted Logistic Regression Models Predicting

Correct Knowledge of Smoking Risk and Positive Perception of Smoking page 33

g. Table 7. Inferential Statistics: Adjusted Logistic Regression Models Predicting

Correct Knowledge of Smoking Risk and Positive Perception of Smoking Related

to Smoking Status page 35

9. Appendix page 51 - 168

a. Analyzed Survey Questions, English page 51

b. Analyzed Survey Questions, Bahasa Indonesia page 56

c. KPA Survey, English page 60

d. KPA Survey, Bahasa Indonesia page 80

e. Thesis translation (English to Bahasa Indonesia) page 100 - 164

f. IRB Reliance Agreement (Northern Illinois University, Yale) page 165

Comments

This is an Open Access Thesis.

Recommended Citation

Sutherland, Ryan Andrew, "Tobacco Use, Knowledge Of Tobacco Risks, And Perception Of Smoking Behaviors Among Urban And Rural Youth In South Sulawesi, Indonesia" (2020). Public Health Theses. 2000.
https://elischolar.library.yale.edu/ysphtdl/2000