ISSN 2086-4256 DJM 13(3) 161-236 October 2014
DAMIANUS Journal of Medicine VOLUME 13, NOMOR 3, 2014
PUBLISHED SINCE 2002
October 2014
ARTIKEL PENELITIAN 161-172
173-182 183-190 191-198 199-207
PENGARUH BLOK KEDOKTERAN ADIKSI TERHADAP PERSEPSI TENTANG ADIKSI ZAT PSIKOAKTIF PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK INDONESIA ATMA JAYA Michael Jaya, Yeremias Jena, Astri Parawita Ayu, Satya Joewana PERSEPSI TERHADAP ADIKSI ZAT PSIKOAKTIF PADA MAHASISWA PESERTA PROGRAM STUDI MAGISTER PSIKOLOGI DAN DOKTER UMUM PESERTA PROGRAM INTERNSHIP Mahaputra, Astri Parawita Ayu PENGARUH PEMBERIAN DOSIS MINIMAL KAFEIN TERHADAP PENINGKATAN ATENSI MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK INDONESIA ATMA JAYA Julia Rahadian, Laurensia Scovani GIGI KARIES DAN KELAINAN JARINGAN PERIODONTAL PADA PENGGUNA HEROIN YANG MENJALANI TERAPI RUMATAN METADON Isadora Gracia, Rensa, Minawati, Teguh Sarry Hartono, Surilena
GAMBARAN MASALAH EMOSI DAN PERILAKU PADA PELAJAR SMA REGINA PACIS JAKARTA DENGAN ADIKSI INTERNET Adrian, Ana Lucia Ekowati, Eva Suryani
208-217
WHY ADOLESCENT SMOKE? A CASE STUDY OF NORTH JAKARTA, INDONESIA Regina Satya Wiraharja, Charles Surjadi
TINJAUAN PUSTAKA 218-223
EFEKTIVITAS BERBAGAI PRODUK NICOTINE REPLACEMENT THERAPY SEBAGAI TERAPI UNTUK BERHENTI MEROKOK Bernardus Mario Vito, Irene
LAPORAN KASUS 224-232 KETERGANTUNGAN ALPRAZOLAM PADA LANJUT USIA DENGAN INSOMNIA DAN DEPRESI Surilena
ARTIKEL KHUSUS 233-236
MENGENAL KEDOKTERAN ADIKSI DI NIJMEGEN INSTITUTE FOR SCIENTIST PRACTIONERS IN ADDICTION Eva Suryani, Isadora Gracia
Damianus Journal of Medicine; Vol.13 No.3 Oktober 2014: hlm. 208-217
ARTIKEL PENELITIAN
WHY ADOLESCENT SMOKE? A CASE STUDY OF NORTH JAKARTA, INDONESIA MENGAPA REMAJA MEROKOK? STUDI KASUS JAKARTA UTARA, INDONESIA Regina Satya Wiraharja, Charles Surjadi
Department of Public Health, School of Medicine Atma Jaya Catholic University of Indonesia Jakarta, Pluit Raya 2, North Jakarta 14440 Korespondensi: Regina Satya Wiraharja. Department of Public Health, School of Medicine Atma Jaya Catholic University of Indonesia Jakarta. E-mail:
[email protected]
ABSTRAK Latar Belakang: Di Indonesia, rokok dapat diiklankan dengan mencantumkan risiko gangguan kesehatannya, sehingga penggunaan rokok masih tinggi. Remaja yang memiliki kebiasaan merokok merupakan masalah kesehatan masyarakat karena mereka akan menjadi perokok dewasa dengan segala masalah kesehatannya. Tujuan: Studi ini bertujuan untuk mengetahui prevalensi perokok muda dipemukiman kumuh di Jakarta dan faktor-faktor risikonya, sebagai dasar untuk melakukan promosi antirokok. Metode: Studi ini mencakup 255 sampel dari dua RW. Kriteria remaja dari WHO digunakan dalam studi ini adalah 12-24 tahun. Variabel tergantung adalah perilaku merokok. Variabel bebas adalah faktor demografi, sosial, lingkungan, dan personal. Analisis deskriptif dilakukan dengan menghitung persentase. Analisis logistik regresi dilakukan dengan metode Backward Stepwise (Wald). Odd ratio (OR), 95% CI, dan nilai p dihitung untuk setiap variabel bebas. Hasil: Hasil menunjukkan bahwa responden yang berusia lebih dari 16 tahun (OR=3,02; p=0,031), berpendidikan terakhir di sekolah dasar dan menengah pertama (OR=4,45; p=0,029), tidak merasa terganggu dengan perokok di sekitarnya (OR=4,40; p=0,001); dan memiliki persepsi bahwa rokok tidak berbahaya (OR=10,55; p=0,000), cenderung menjadi perokok. Kesimpulan: Remaja perlu didorong untuk tetap bersekolah, karena berada dalam sekolah dapat menjauhkan mereka dari lingkungan berperokok dan dapat membuat program promosi menjadi lebih fokus. Upaya pencegahan harus dimulai dari sekolah menengah pertama untuk mencegah naiknya prevalensi perokok pada usia yang lebih tua. Larangan merokok, pendidikan bagi remaja di tempat kerja, dan pendidikan orang tua sangat penting. Upaya pencegahan harus difokuskan untuk membuat rokok tidak dapat diterima secara sosial. Kata Kunci: Merokok, remaja, rokok, kesehatan perkotaan
ABSTRACT Introduction: In Indonesia, cigarette can be advertised with health warning incorporated. Therefore tobacco use in Indonesia is still high. Daily adolescent smokers are public health problem as they can become adult smokers and develop smoking related health problems.
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Why adolescent smoke? A case study of North Jakarta, Indonesia
Objection: Our study aims to estimate the prevalence of young smokers in slum areas of urban area as Jakarta and its risk factors, as a basis for further adolescent anti-smoking campaign. Methods: This study included 255 samples from two hamlets. WHO’s adolescent criteria was used (12-24 years old). The outcome studied was the smoking behaviour. The risk factors were demographic, social, environmental, and personal factors. Rates, percentages, and descriptive statistics were done. Logistic regression analyses were carried out by Backward Stepwise (Wald) method. Odd ratios, 95% confidence intervals, and p-values were calculated for each independent variable. Results: The results showed that respondents who were more than 16 years old (OR=3.02; p=0.031), had last education at elementary school to junior high school (OR=4.45; p=0.029), did not feel disturbed by smoker surrounded (OR=4.40; p=0.001) and had perception that smoking is not dangerous (OR=10.55; p=0.000), were tended to be current smokers. Conclusion: There is a need to keep adolescence to formal education, as being attached to school might protect them from smoking neighbourhoods and focused the effort of smoking cessation. Tobacco control must begin at junior high school to keep the rate from rising drastically in older adolescents. Smoking ban, education for teenage at workplaces, and education for parents are important. Effort should focus to make smoking is socially unacceptable. Key Words: Adolescence, cigarette,smoking, urban health
INTRODUCTION
Indonesia’s national prevalence on smokers
In Indonesia, government’s effort to reduce tobacco consumption is weak. This is showed with the policy toward tobacco advertising. Cigarette can be advertised and promoted. The advertisement can be in electronic, printed, or outdoor media and health warning must be incorporated. Sponsorship is allowed by those who produce and import cigarette in accordance with advertising and promotion regulations. Free samples or gifts in the form of cigarettes or other
aged more than 10 years old is 29.2% with the average of 12 cigarettes per day. Most smokers are men. The survey also showed that most of smokers are male (55.7% vs 4.4%). However, between 1995-2007, the prevalence of smoker among women is higher than men (3 times escalation among women vs 1.2 times among men). The average daily cigarettes consumption among women is also higher (16 cigarettes vs 12 cigarettes per day).2,4
products that carry cigarette brand names are
Daily adolescent smokers are a public health
prohibited.1 Besides that, Indonesia is one of
problem as they are more likely to become adult
countries that haven’t signed the WHO FCTC
smokers and to develop smoking related health
(WHO Framework on Tobacco Control).2,3 With
problems.5 In the year of 2005, it is estimated
this condition, it is not surprisingly that tobacco
there are 8,860,381 inhabitants in Jakarta, and
use in Indonesia is still high.
1,514,136 or about 17% is adolescent with the Vol. 13, No. 3, Oktober 2014
209
DAMIANUS Journal of Medicine
age from 10-19 years old of age. We also found
risk factors, as a basis for further empowering
that from 1995 to 2007 the escalation of start-
adolescent antismoking campaign.
ing age for smoking among 10-14 years of age group is higher (9.0-16.0%) than among 15-19 years of age group (54.6-50.7%).2 According to
METHODS
the Indonesia National Global Youth Tobacco Survey (GTYS) 2009, 30.4% of youth had ever
Participant
smoked cigarettes and 20.3% of them are cur-
Hamlet 01 and Hamlet 16 is part of slum areas
rent smoker. About 12.6% of youth are current
of Penjaringan district at North Jakarta. Medical
smoker; that is 41.0% among boys which is sig-
students of School of Medicine Atma Jaya Catho-
nificantly higher than girls (3.5%).6 Besides that
lic University of Indonesia do their field work as
30.9% had smoked their first cigarette before
part of their community health internship in this
they reach the age of 17.
area. We used adolescent criteria from WHO as
In the year 2005, the governor of Metropolitan Jakarta issued a local act on air pollution control no 2/2005 on outdoor pollution with one article on smoke free area (article 13) among 45 other articles. The Law was further elaborated in the subsequent Governor Decree no 75/2005 on smoking ban. The smoking ban includes public places, health facilities, workplaces, educational institutions, children playground, places of worship, and public transport.1 At 2010, new decree no 88/2010 on smoking ban inside the building was released. The reason of this new decree is the smoking room inside the building have been proved to be not effective to reduce indoor air pollution. Therefore it obligates the buildings management to unload smoking room and to force people to smoke outside buildings.
8
target population (12-24 years old).10 Samples A census done by medical students of School of Medicine Atma Jaya Catholic University of Indonesia showed that there were 644 adolescent. To do a reliable survey we calculated a minimum sample of 145 by one proportion descriptivecategorical formula and by two times design error, we got 290 as our sample size. However, we could not meet 35 (12%) of respondents. Therefore, we got 255 as our sample. Samples were selected by systematic random sampling. Interviews were done after informed consent was obtained from participants. Interviews were done by 18 medical students accompanied by 5 adolescent leaders from the areas.11
Some large studies have been done on adoles-
Variables and Measurement
cent smokers in Indonesia, however majority of
The outcome measure of the study, the smoking
data is data from school at various area, such as
behaviour was identified through question “Do
Sumatra and Java.6,7,9 Therefore our study aims
you currently smoke?”. The risk factors stud-
to estimate the prevalence of young smokers
ied were demographic factors, social factors,
in slum areas of urban area as Jakarta and its
environmental factors, and personal factors.
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Why adolescent smoke? A case study of North Jakarta, Indonesia
Demographic factors included age, sex, and
Rates, percentages, and descriptive statistics
marital status (yes/no). Social factors included
were calculated. The use of smoking behaviour
education (elementary-junior high school, senior
was used as dependant variable. Demographic
high school, and above; still study or no), work
factors (age, sex, and marital status), social fac-
status (yes/no; routine/not routine), and having
tors (education, work status, and having own in-
own income (yes/no). Environmental factors
come), environment factors (friends who smoked
included friends who smoked (yes/no), smokers
smokers at household, smoker environment at
at household (yes/no), smoker environment at
school, around house, and other) and personal
school (yes/no), around house and other (yes/
factors (perception on smoking) were treated as
no). Personal factors included perception on dan-
independent variables. Multivariate logistic re-
gerous of smoking (yes/no) and feeling disturbed
gression analyses were carried out by Backward
by smokers around (yes/no).
Stepwise (Wald) method. Groups of variables significantly found at bivariat analyses were
Data Analysis
entered into regression model. Odd ratios (OR),
Data were analysed using SPSS (Statistical Pack-
95% confidence intervals (95% CI), and p-values
age for Social Sciences) version 15 for windows.
were calculated for each independent variable.
Table 1. Characteristic of Respondents Characteristics ( n = 255)
n (%)
Age*(years old) ≤ 16
150 (58.8)
> 16
105 (41.2)
Sex Boys
123 (48.2)
Girls
132 (51.8)
Marital status Married
7 (2.7)
Not Married
248 (97.3)
Last Education Elementary-Junior High School
205 (80.4)
Senior High School and above
50 (19.6)
Still study at school Yes
186 (72.9)
No
69 (27.1)
Work Yes
43 (16.9)
No
212 (83.1)
Have income ** Yes
42 (16.5)
No
213 (83.5)
* Mean = 16.3; Median = 16; Modus = 15; Minimum = 12; Maximum = 22 ** Income
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DAMIANUS Journal of Medicine
RESULTS
Four of the six variables that did not significantly
Mean age of respondents were 16.3 years old. Among respondents, there were 51.8% girls, 2.7% married, 80.4% had last education at elementary to Junior High School, 27.1% did not study anymore, 16.9% had worked, and 77.3% were not actively involved in adolescents’ organizations (Table 1). Only 40 respondents (15.7%) were current smokers, 32.5% of boys (123 respondents) were current smoker while none of girls were current smokers. (Table 2)
predict smoking behaviour, had significant relationship with most of the variables significant in multivariate analysis. The four variables are still study at school (r=0.17-0.722), had worked (r= -0.46 till -0.19), had routine job (r= 0.23-0.45), and had own income (r= 0.20-0.47) (Table 5). This means that respondents who are still study at school were tended to be younger (16 years old or less) and felt disturbed by smoker surrounded. Respondent who had worked, had routine job, and had own income were tended
Prevalence of smoking was significantly higher
to be older (more than 16 years old), had last
among adolescent who were more than 16
education at senior high school or above, had
years old, had last education at senior high
perception that smoking is dangerous, but
school and above, did not study anymore, had
did not feel disturbed by smoker surrounded.
routine job, had own income, had smokers at their household, had friends who smoked, had smokers at neighbourhoods outside school, had perception that smoking was not dangerous, and did not feel disturbed by smokers surrounded (p<0.05). Most of smokers also were not active in any organisation (18.3%). (Table 3)
DISCUSSION The purpose of our study is to estimate the prevalence of young smokers in slum areas of urban area as Jakarta and its correlation to risk factors. We found that prevalence of smoking among
Multivariate analysis showed that respondents
adolescent (15.7%) was slightly lower than GYTS
who were more than 16 years old (OR=3.02),
2009 survey (20.3%) and study by Martini and
had last education at elementary school to junior
Sulistyowati (20%).6,9 However, these two stud-
high school (OR=4.45), did not feel disturbed by
ies are school based, which means that most
smoker surrounded (OR=4.40), and had percep-
of respondents might come from families with
tion that smoking is not dangerous (OR=10.55),
higher socioeconomic level, that can afford their
were tended to be current smokers. (Table 4)
children, not only for school but also to provide
Table 2. Distribution of Respondents by Sex and Prevalence of Smoking
212
Sex
Current Smoker (%)
Do not smoke (%)
Total (%)
Boys Girls
40 (32.5)
83 (67.5)
123 (100.0)
0 (0.0)
132 (100.0)
132 (100.0)
Total (%)
40 (15.7)
215 (84.3)
255 (100.0)
Vol. 13, No. 3, Oktober 2014
Why adolescent smoke? A case study of North Jakarta, Indonesia
Table 3. Bivariat Analysis of Prevalence of Smoking and Its Risk Factors Current Smoker (n = 40)
Risks Factors Age > 16 years old ≤ 16 years old Last education Senior high school and above Elementary-Junior High School Still study at school No Yes Work No Yes Routine Job No Yes Have income No Yes Smokers at household** No Yes Friends who smoked No Yes Smokers at neighbourhoods outside school*** No Yes Perception that smoking is dangerous No Yes Feel disturbed by smoker surrounded No Yes Involve actively in adolescent organizations No Yes
p value
n
%*
29 11
27.6 7.3
0.000
13 27
26.0 13.2
0.043
21 19
30.4 10.2
0.000
17 23
39.5 10.8
0.000
15 25
41.7 11.4
0.000
17 23
40.5 10.8
0.000
37 3
21.5 3.6
0.000
40 0
19.0 0
Na
36
22.6
0.023
4
7.8
16 24
61.5 10.5
0.000
28 12
34.6 6.9
0.000
28 12
18.3 11.8
0.968
* Percentage within risk factors (row percent) ** One cell les than 5; did not included i n multivariate analysis *** Missing values within Do Not smoke = 45 from 215.
them with daily food and pocket money. Some
they had enough money to buy cigarettes (80%
school based studies found that most of stu-
and 59%).9,12 This conditions might be a contra-
dents buy cigarettes from store or street vendor
diction with our study, where 30% of respondents
by themselves (24% till 67%).6,9,12 Studies from
did not study anymore, which means that those
Martini and Sulistyowati and Sreeramareddy et
respondents might come from families with lower
al., also found that most of the students said that
socioeconomic level that can not afford their chil-
Vol. 13, No. 3, Oktober 2014
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DAMIANUS Journal of Medicine
Table 4. Multivariate Analysis of Prevalence of Smoking and Its Risk Factors Risk Factors Age
p Value
OR
95% CI
0.031
3.02
1.11-8.23
Last education
0.029
4.45
1.16-17.07
Perception that smoking is not dangerous
0.000
10.55
3.41-32.66
Do not feel disturbed by smoker surrounded
0.001
4.40
1.83-10.54
Table 5. Analysis among Insignificant and Significant Factors in Multivariat Analysis Age
Last Education
Smoking is dangerous
Feeling Undisturbed by smokers Surround
Still study at school
0.531
0.722
na
0.172
Had worked
-0.432
-0.463
-0.194
-0.233
Had Routine Job
0.416
0.452
0.198
0.231
Had own income
0.423
0.473
0.200
0.242
dren for school and daily pocket money, or even
old). Martini and Sulistyowati found the older ado-
daily food. This condition might lead to different
lescents, the more smoking prevalence increase
access to cigarettes and lower prevalence than
(from 13% of 14 years old, to 70% of 17 years
GYTS survey. Our respondents might use their “a
old of adolescents).9 Martini and Sulistyowati and
don’t have to buy” social sources as their primary
GYTS 2006 also found that first smokers were
source to get cigarettes. This is in line with some
10 years of age.7,9 These facts mean that most
studies that have found that access to cigarettes
of younger smokers had tendency to continue
among youth usually from social sources, such
their smoking habit until older age and contribute
as borrowing, stealing, or buying cigarettes from
to higher prevalence of smoking in older age.
parents, siblings, peers, or requesting older
Moreover, 30% of our respondents did not study
people to buy cigarettes for them.13,14 However
anymore. They might stop their education level at
since our study did not explore this issues deeply,
elementary school (6-12 year old) or junior high
a further study on access to cigarettes among
school (13-15 year old). Therefore, especially
adolescent in slum areas will still be needed.
in slum area, school based efforts should focus
In multivariate analysis age and last education had significant relationship with smoking (OR= 3.02 and 4.45), where prevalence of smoking is significantly higher among adolescent more 16 years of age with last education at senior high
not only to adolescents more than 15 years old (senior high school students) but also to adolescents around 10 years old (elementary to junior high school students), to keep the rate of smoking from rising drastically in older adolescents.
school and above. These results indicated that
In multivariate analysis having perception that
adolescent might start smoking before they reach
smoking was not dangerous (OR= 10.55) and
the age for senior high school (before 15 years
feeling undisturbed by smokers surrounded
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Vol. 13, No. 3, Oktober 2014
Why adolescent smoke? A case study of North Jakarta, Indonesia
(OR= 4.4) were strong determinant to prevalence
Bivariat analysis with factors excluded in multi-
of smoking. This is in line with other studies.9,15
variate analysis showed that respondents who
Having perception that smoking is not danger-
had above perceptions usually had worked and
ous, indicated that knowledge on the dangers of
had own income (Table 5). Banks et al., found
smoking, should be given at early age. Feeling
that having more money is associated with an
undisturbed by smokers surrounded indicated
increased risk of smoking.18 Beside that, ado-
that most of smokers have permissive norms for
lescents might experience some pressures from
other to smoke. Study from Ahern et al., showed
work and also influence from neighbourhoods, in
that the norms of communities are associated
this case other workers (whom might be older)
with smoking, beyond an individual’s norm or
who smoke. Therefore there is need of differ-
opinion, especially or those without prior expe-
ent approaches for adolescences that are still
rience of smoking.16 Although someone might
attained to school and adolescences that are
believe that smoking is not dangerous or it is
already in the work world. Smoking ban and
acceptable to smoke, they maybe less likely to
education at workplaces, especially for teenage
be smokersif the community’s norms did not ac-
might be suitable. Moreover, there is a need to
cept smoking. For our respondents, the groups
focus on effort to keep adolescence to study.
of communities could be varied, such as school,
Because being attached to school might protect
house (parents), peers, workplace (regulation
them from influences from older adolescences
and other workers in the workplace), and other
or adults who are smoke.
parties such as promotion by tobacco company and government’s regulation and enforcement, which indicate that education to adolescence about the danger of smoking must be supported with education to people in common, to make smoking is socially unacceptable.
GYTS 2009 and study by Martini and Sulistyowati showed that most of adolescents were exposed by pro cigarette advertisement. 6,9 Therefore government regulation to avoid the excess of cigarette advertisement should be made.
Various studies has been done on influences of above communities to adolescent smoking
STUDY LIMITATION
behaviour. GYTS 2006, Martini and Sulistyowati,
Our survey was cross sectional and the inter-
Sun et al., and Banks et al, have found that smok-
views were done at the house of respondents.
ers at household are strong determinant to smok-
Therefore the smoking prevalence might be un-
ing.7,9,17,18 Therefore smoking cessation should
derreported, especially for girls and adolescent
also focus on educating parents as they give
who are more than 16 years old and did not study
influenced to motivate their children in selecting
anymore, as most our respondent are below 16
friends and to attain their children to school. They
years old. We also did not include influences of
are also important source of information, as well
parents’ socioeconomic level, access to cigarette
as influential role models.17
in slum area, type of cigarette and cost spending
Vol. 13, No. 3, Oktober 2014
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DAMIANUS Journal of Medicine
for smoking, workplace, income, government regulation, and promotion from tobacco company, which might be important factors for policy and intervention.
card.pdf. 2. TCSC, IAKMI, Pusat Penelitian dan Pengembangan Ekologi dan Status Kesehatan. Bunga Rampai: Fakta Tembakau Permasalahannya di Indonesia tahun 2009. Jakarta: Tobacco Control Support Center; 2010.
CONCLUSION There is a need to focus on effort to keep adolescence to study, because being attached to school might protect adolescence from smoking neigh-
3. WHO Framework Convention on Tobacco Control (WHO FCTC). Parties to the WHO Framework Convention on Tobacco Control. Zimbabwe: WHO. 2005 [cited Dec 10, 2010].
bourhoods outside school and might focused
Available from: http://www.who.int/fctc/signa-
the effort of smoking cessation. Campaign for
tories_parties/en/index.html.
tobacco control must begin at junior high school students to keep the rate from rising drastically in older adolescents.
4. Departemen Kesehatan Republik Indonesia. Laporan Hasil Riset Kesehatan Dasar RISKESDAS Indonesia tahun 2007. Jakarta:
For adolescence in work world, a different approach is needed. Smoking ban and education at workplaces, especially for teenage might be suitable.
Depkes RI; 2009. 5. Hublet A, De Bacquer D, Valimaa R, Godeau E, Schmid H, Rahav G, et al. Smoking trends among adolescents from 1990 to 2002 in
Smoking cessation should also focus on educat-
ten European Countries and Canada. BMC
ing parentsas they are an important source of
Public Health 2006; 6:280.
information, as well as influential role models.
6. WHO SEARO [South-East Asia Regional
Education to people in common is also important
Office. Indonesia (Ages 13-15) Global Youth
to ensure the change in norms. Effort should
Tobacco Survey Fact Sheet. 2009 [cited Dec
focus to make smoking is socially unacceptable.
10, 2010]. Available from: http://www.searo. who.int/entity/ noncommunicable_diseases/ data/ino_gyts_fs_2009.pdf.
REFERENCES 1. Rockefeller Foundation, Southeast Asia Tobacco Control Alliance (SEATCA). Indonesian Report Card: status of tobacco use and its control. Bangkok: Southeast Asia Tobacco Control Alliance (SEATCA). 2009 (cited Oct 2010). Available from: http://www.quittobac-
216
7. Aditama TY, Pradono J, Rahman K, Warren CW, Jones NR, Asma S, et al. Global Youth Tobacco Survey 2006. Jakarta: Fakultas Kedokteran Universitas Indonesia. 2006. 8. Anonim. Perda Rokok di DKI Dinilai Mandul. Beritajakarta.com. 2010 [cited Oct 2010].
cointernational.org/docs/resourcearticles/In-
9. Martini S, Sulistyowati M. The determinants of
donesia%20tobacco%20adv%20report%20
smoking behaviour among teenagers in East
Vol. 13, No. 3, Oktober 2014
Why adolescent smoke? A case study of North Jakarta, Indonesia
Java province IndonesiaWashington DC: the
Youths’ Social Sources of Cigarettes: the
World Bank Health Nutrition Population eco-
limits of youth access policy. Contemporary
nomic of tobacco control paper. 2005. Avail-
Drug Problems. 2001;28:507-26.
able from: http://siteresources.worldbank. org/HEALTHNUTRITIONANDPOPULATION/ Resources/281627-1095698140167/ IndonesiaYouthSmokingFinal.pdf.
14. Leatherdale SL. Predictors of different cigarettes access behaviours among occasional and regular smoking youth. Can J Public Health. 2005;96(5):348-52.
10. BKKBN. Tanya Jawab Kesehatan Reproduk-
15. Droomers M, Schrijvers CT, Casswell S,
si Remaja. 2008 [cited Dec 10, 2010]. Avail-
Mackenbach JP. Father’s occupational group
able from:http://ceria.bkkbn.go.id/referensi/
and daily smoking during adolescence: Pat-
substansi/detail/19.
terns and Predictors. Am J Public Health.
11. Tim Perencana VI. Laporan Kegiatan Per-
2005; 95(4): 681-8.
encanaan Program Pengembangan Pusat
16. Ahern J, Galea S, Hubbard A, Syme SL.
Informasi Kesehatan di Wilayah RW 06 dan
Neighbourhood Smoking Norms Modify
RW 16 Kelurahan Penjaringan. Jakarta:
the Relation between collective efficacy and
Departemen Ilmu Kesehatan Masyarakat
smoking behaviour. Drug Alcohol Depend.
Fakultas Kedokteran Unika Atma Jaya.
2009;100(1-2):138-145
2010.
17. Sun D, Anderson M, Shah A, Julliard K. Early
12. Sreeramareddy CT, Kishore P, Paudel J,
adolescents’ perceptions of cigarette smok-
Menezes RG. Prevalence and correlates
ing: A cross sectional survey in a Junior high
of tobacco use amongst junior collegiates
school. Adolescence, 1998. 33(132): 805-10.
in twin cities of western Nepal: a crosssectional, questionnaire-based survey. BMC Public Health. 2008;8:97.
18. Banks MH, Bewley BR, Bland JM, Dean JR, Pollard V. Long Term Study of smoking by secondary schoolchildren. Arch Dis in Child-
13. Friend K, Carmona M, Wilbur P, Levy D.
hood. 1978;53: 12-19.
Vol. 13, No. 3, Oktober 2014
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