Tobacco control policies and youth smoking in Indonesia

Indonesia has achieved wide notoriety for its high rate of smoking in global comparison although progress on tobacco control has been made recently. Tobacco smoking is an even greater challenge as the tobacco industry targets Indonesian youth with attractive marketing strategies. This thesis aims at identifying potential smoking prevention strategies to target Indonesian adolescents by investigating impacts on smoking from the tobacco control policies now in place and assessing social network factors and social inequalities in tobacco use by adolescents. Our findings indicated geographical clusters in local smoke-free policy (SFP) adoption as the adoption was more likely to occur if adjacent districts had previously done so. However, the local SFP adoption among districts and provinces did not present sufficient impacts in preventing smoking among adults and adolescents as the associations between SFP adoption and smoking outcomes were inconsistent. Moreover, adolescents were frequently exposed to tobacco advertising, promotion, and sponsorship (TAPS) on both online and offline platforms, particularly on most social media platforms, on television, on the streets, in minimarkets, and at live music events. Odds of smoking were significantly higher among boys with lower parental education and among girls with wealthier family background. This association among boys was partially mediated by father’s smoking status, parental control, and parental permissiveness. Substantial work remains for Indonesian tobacco control, as commitment to smoking prevention currently seems inadequate. This thesis therefore seeks to reinforce knowledge and insights about preventive strategies to curb tobacco smoking in Indonesia, specifically with regard to specific group of adolescents.