Determinants of smoking behavior among young males in rural Indonesia

Introduction: A high prevalence of tobacco smoking has been reported among adolescents and young adults, especially men, in lower-middle-income countries such Indonesia. Understanding the extent and determinants of smoking within this population, particularly those living in rural areas where smoking rates are anecdotally higher than in city areas, is essential to inform development of targeted smoking prevention and reduction programs. This study analyzes the prevalence and determinants of smoking behavior among young men in rural Indonesia. Methods: Secondary data analysis of the 2012 Indonesia Demographic and Health Survey: Adolescent Reproductive Health (IDHS ARH) were used. Data from 4811 rural males (15-24 years of age) were selected through two-stage stratified cluster sampling techniques. The chi-square (χ2) test and binary logistic regression were used to determine significant factors associated with tobacco smoking. Results: More than half of this population in rural Indonesia were smokers. Significant factors associated with smoking were: age 20-24 years (odds ratio (OR) 2.8, 95% confidence interval (CI) 2.4-3.2), working status (OR = 2.24, 95% CI: 1.95-2.57), low education level (OR = 1.93, 95% CI: 1.52-2.45), access to magazines (OR = 0.78, 95% CI: 0.68-0.89) and access to the radio (OR = 1.28, 95% CI: 1.12-1.48) at least once a week. Conclusions: A significant proportion of adolescents and young men in rural Indonesia smoke tobacco. Exposure to media with likely cigarette advertising (radio and magazines) and access to money via employment in the context of lower socio-economic and education levels elevate the risk of smoking. While Indonesian government campaigns targeting smoking are in place, further work is required to decrease smoking rates and prevent a future smoking-related health crisis for rural Indonesia's young men.