Abstract
Background: Smokeless tobacco (SLT) use is a new trend since the banning of smoking in many public places, including among adolescents. Many people believe that SLT is a harmful reduction method compared to cigarettes. However, there are many risks of using the SLT, such as Head and neck cancer (HNC), cancer of the mouth, and coronary heart disease.
Objective: This study aimed to examine the prevalence and the factors associated with SLT use among adolescents in Indonesia.
Methods: This study used the cross-sectional data from the Global Youth Tobacco Survey (GYTS) Indonesia 2019. The national school was selected by proportional random sampling. Around 8,828 students were eligible for this study.
Results: This study found the prevalence of SLT use was 3.25%. The bivariate test found each independent variable was significantly associated with the SLT use. However, the adjusted test found that age, smoking parent, smoking teacher, knowledge, and attitude were significantly associated with SLT use.
Conclusion: The variables mostly related to SLT use come from the family and school environment. The appropriate intervention needs to be arranged to reduce the prevalence of smokers, including SLT use.
References
Barker, A. B., Whittamore, K., Britton, J., & Cranwell, J. (2019). Content analysis of tobacco content in UK television. Tobacco Control, 28(4), 381-385. https://doi.org/10.1136/tobaccocontrol-2018-054427
Bigwanto, M., & Soerojo, W. (2020). Content analysis of cigarette packs in Indonesia: Regulatory non-compliance and product promotion advantage. Public Health Indonesia, 6, 18-27. https://doi.org/ 10.36685/phi.v6i1.330
Blencowe, H., Cousens, S., Jassir, F. B., Say, L., Chou, D., Mathers, C., Hogan, D., Shiekh, S., Qureshi, Z. U., You, D., & Lawn, J. E. (2016). National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. The Lancet Global Health, 4(2), e98-e108. https://doi.org/10.1016/s2214-109x(15)00275-2
Boffetta, P., Aagnes, B., Weiderpass, E., & Andersen, A. (2005). Smokeless tobacco use and risk of cancer of the pancreas and other organs. International Journal of Cancer, 114(6), 992-995. https://doi.org/10.1002/ijc.20811
Centers for Diseases Control and Prevention. (2020). Smokeless tobacco: health effects. USA: Centers for Diseases Control and Prevention
Chang, J. T., Levy, D. T., & Meza, R. (2016). Trends and factors related to smokeless tobacco use in the United States. Nicotine and Tobacco Research, 18(8), 1740-1748. https://doi.org/10.1093/ntr/ntw090
Delnevo, C. D., Wackowski, O. A., Giovenco, D. P., Manderski, M. T., Hrywna, M., & Ling, P. M. (2014). Examining market trends in the United States smokeless tobacco use: 2005-2011. Tobacco Control, 23(2), 107-112. https://doi.org/10.1136/tobaccocontrol-2012-050739
Ebbert, J. O., Elrashidi, M. Y., & Stead, L. F. (2015). Interventions for smokeless tobacco use cessation. Cochrane Database of Systematic Reviews, 2015(10), Cd004306. https://doi.org/10.1002/14651858.CD004306.pub5
Eriksen, M., Mackay, J., & Ross, H. (2012). The tobacco atlas (4th ed.). Atlanta, GA, USA: American Cancer Society.
Hatsukami, D. K., Lemmonds, C., & Tomar, S. L. (2004). Smokeless tobacco use: Harm reduction or induction approach? Preventive Medicine, 38(3), 309-317. https://doi.org/10.1016/j.ypmed.2003.10.006
Hecht, S. S., & Hatsukami, D. K. (2022). Smokeless tobacco and cigarette smoking: chemical mechanisms and cancer prevention. Nature Reviews Cancer, 22(3), 143-155. https://doi.org/10.1038/s41568-021-00423-4
Jalilian, F., Karami Matin, B., Ahmadpanah, M., Ataee, M., Ahmadi Jouybari, T., Eslami, A. A., & Mirzaei Alavijeh, M. (2015). Socio-demographic characteristics associated with cigarettes smoking, drug abuse and alcohol drinking among male medical university students in Iran. Journal of Research and Health Sciences, 15(1), 42-46.
Jamal, H., Abdullah, A. Z., & Abdullah, M. T. (2020). Determinan sosial perilaku merokok pelajar di Indonesia: analisis data global youth tobacco survey tahun 2014. Jurnal Kesehatan Vokasional, 5(3), 141-150. https://doi.org/10.22146/jkesvo.56718
Kementerian Kesehatan Republik Indonesia. (2018). Hasil utama RISKESDAS 2018. Jakarta: Kemenkes RI.
Lalithambigai, G., Rao, A., Rajesh, G., Ramya, S., & Pai, B. H. (2016). Predictors of cigarette smoking among young adults in Mangalore, India. Asian Pacific Journal of Cancer Prevention, 17(1), 45-50. https://doi.org/10.7314/apjcp.2016.17.1.45
Lyons, A., McNeill, A., & Britton, J. (2014). Tobacco imagery on prime time UK television. Tobacco Control, 23(3), 257-263. https://doi.org/10.1136/tobaccocontrol-2012-050650
Maretalinia, M., Juliansyah, E., Suyitno, S., Yulianto, A., & Suryani, D. (2021). 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. Buletin Penelitian Sistem Kesehatan, 24(1), 38-45. https://doi.org/10.22435/hsr.v24i1.3544
Mbatchou Ngahane, B. H., Atangana Ekobo, H., & Kuaban, C. (2015). Prevalence and determinants of cigarette smoking among college students: A cross-sectional study in Douala, Cameroon. Archives of Public Health, 73, 47. https://doi.org/10.1186/s13690-015-0100-1
Mbongwe, B., Tapera, R., Phaladze, N., Lord, A., & Zetola, N. M. (2017). Predictors of smoking among primary and secondary school students in Botswana. PLoS One, 12(4), e0175640. https://doi.org/10.1371/journal.pone.0175640
Ministry of Education Republic of Indonesia. (2015). The Regulation of Minister of Education of Indonesia Number 64 2015 concerning No Smoking Areas in School Environments stated that school principals, teachers, education staff, students, and other parties are prohibited from smoking. Jakarta: Ministry of Education Republic of Indonesia.
Ministry of Finance Republic of Indonesia. (2021). The Regulation of Minister of Finance Indonesia No 198/PMK 010/2020. Jakarta: Ministry of Finance Republic of Indonesia.
Muthukrishnan, A., & Warnakulasuriya, S. (2018). Oral health consequences of smokeless tobacco use. Indian Journal of Medical Research, 148(1), 35-40. https://doi.org/10.4103/ijmr.IJMR_1793_17
Pengpid, S., & Peltzer, K. (2019). Prevalence and Predictors of Current and Former Tobacco Use among Older Adults in Indonesia. Asian Pacific Journal of Cancer Prevention, 20(2), 395-401. https://doi.org/10.31557/apjcp.2019.20.2.395
Prasetyo, B. W., & Adrison, V. (2020). Cigarette prices in a complex cigarette tax system: Empirical evidence from Indonesia. Tobacco Control, 29(6), 618-623. https://doi.org/10.1136/tobaccocontrol-2018-054872
Saari, A. J., Kentala, J., & Mattila, K. J. (2014). The smoking habit of a close friend or family member--how deep is the impact? A cross-sectional study. BMJ Open, 4(2), e003218. https://doi.org/10.1136/bmjopen-2013-003218
Sinha, D. N., Palipudi, K. M., Rolle, I., Asma, S., & Rinchen, S. (2011). Tobacco use among youth and adults in member countries of South-East Asia region: Review of findings from surveys under the Global Tobacco Surveillance System. Indian Journal of Public Health, 55(3), 169-176. https://doi.org/10.4103/0019-557x.89946
Skulberg, K. R., Hamid, S., & Vaktskjold, A. (2019). Smoking among adolescent males at Pulau Weh, Indonesia. Public Health of Indonesia, 5(3), 62-70. https://doi.org/10.36685/phi.v5i3.287
Somatunga, L., Sinha, D., Sumanasekera, P., Galapatti, K., Rinchen, S., Kahandaliyanage, A., Mehta, F., & Jayasuriya-Dissanayake, N. (2012). Smokeless tobacco use in Sri Lanka. Indian Journal of Cancer, 49(4), 357.
Statista. (2020). Average retail price of a packet of white cigarettes in Indonesia from 2011 to 2020. https://www.statista.com/statistics/1182176/indonesia-average-retail-price-of-a-packet-of-cigarettes/
Suryati, T., & Tarigan, I. U. (2019). Perilaku konsumsi tembakau pelajar SMP usia 13–15 tahun di Sumatra dan Jawa (Analisis Indonesia–Gyts 2009) [Behavior Tobacco Consumption of Junior High School Student Aged 13–15 Years in Sumatra and Java (Analysis of Indonesia–Gyts 2009)]. Buletin Penelitian Sistem Kesehatan, 16(3), 20854.
Syachroni, S. S., Syarifah, U., Kom, S., & Yulianto, A. (2013). Riset kesehatan dasar. Jakarta: Ministry of Health of Indonesia
Sylvestre, M. P., Hanusaik, N., Berger, D., Dugas, E., Pbert, L., Winickoff, J., & O'Loughlin, J. L. (2018). A tool to identify adolescents at risk of cigarette smoking initiation. Pediatrics, 142(5). https://doi.org/10.1542/peds.2017-3701
Thakur, J. S., & Paika, R. (2018). Determinants of smokeless tobacco use in India. Indian Journal of Medical Research, 148(1), 41-45. https://doi.org/10.4103/ijmr.IJMR_27_18
Timberlake, D. S., Nikitin, D., Johnson, N. J., & Altekruse, S. F. (2017). A longitudinal study of smokeless tobacco use and mortality in the United States. International Journal of Cancer, 141(2), 264-270. https://doi.org/10.1002/ijc.30736
Tun, N. A., Chittin, T., Agarwal, N., New, M. L., Thaung, Y., & Phyo, P. P. (2017). Tobacco use among young adolescents in Myanmar: Findings from global youth tobacco survey. Indian J Public Health, 61(Suppl 1), S54-s59. https://doi.org/10.4103/ijph.IJPH_236_17
Wibowo, M., Sofiana, L., Ayu, S. M., Gustina, E., & Khoeriyah, I. (2019). Adolescent smoking behaviour determinants in the city of Yogyakarta, Indonesia. International Journal of Community Medicine and Public Health, 6(12), 5064-5070. https://doi.org/10.18203/2394-6040.ijcmph20195445
Windiarto, T., Yusuf, A. H., Santoso, A., Nugroho, S., Latifah, S., Solih, R., & Rahmawatiningsih, A. (2018). Profil anak Indonesia. Jakarta: Kementerian Pemberdayaan Perempuan dan Perlindungan Anak (KPPA).
World Health Organization. (2013). WHO report on the global tobacco epidemic, 2013: Enforcing bans on tobacco advertising, promotion and sponsorship. Geneva: World Health Organization.
World Health Organization. (2019). Tobacco key fact. Geneva: World Health Organization.
World Health Organization. (2020). Global youth tobacco survey (GYTS) Indonesia 2019. Geneva: World Health Organization.
Wyss, A. B., Hashibe, M., Lee, Y. A., Chuang, S. C., Muscat, J., Chen, C., Schwartz, S. M., Smith, E., Zhang, Z. F., Morgenstern, H., Wei, Q., Li, G., Kelsey, K. T., McClean, M., Winn, D. M., Schantz, S., Yu, G. P., Gillison, M. L., Zevallos, J. P., . . . Olshan, A. F. (2016). Smokeless Tobacco use and the risk of head and neck cancer: Pooled analysis of US studies in the INHANCE Consortium. Am J Epidemiol, 184(10), 703-716. https://doi.org/10.1093/aje/kww075
Zhao, L., Palipudi, K. M., Ramanandraibe, N., & Asma, S. (2016). Cigarette smoking and cigarette marketing exposure among students in selected African countries: Findings from the Global Youth Tobacco Survey. Preventive Medicine, 91s, S35-s39. https://doi.org/10.1016/j.ypmed.2015.12.015
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2022 Syamsuriansyah Sayamsuriansyah, Salman Salman, Heni Rusmitasari, Marlynda Happy Nurmalita Sari, Maretalinia Maretalinia