Communicating Smoke-Free Messages to Children and Women in Rural and Urban Indonesia
Abstract
Introduction: The increase in cigarette production use in Indonesia has contributed to the rise of non-communicable diseases, affecting both active and passive smokers. Based on the 2023 Indonesian Health Survey around 70 million people in Indonesia smoke actively, with 7.4% of them being between the ages of 10 and 18 years old. Effective tobacco control and public education communications are essential to protect vulnerable populations from the dangers of passive smoking.
Objective: To increase awareness among active smokers, this study analyzed communication messages about the impact of smoking on children and women regarding communication messages as tobacco-free education.
Method: This qualitative study employed Focus Group Discussions (FGDs) involving active smokers from rural and urban areas in Indonesia. Participants were recruited from urban university students living in Surabaya and rural areas of Banyuwangi through online brochures distributed at multiple universities in each region. Eligible participants were both female and male active smokers who had been smoking for the last 3 years, consumed more than five conventional cigarettes, and had used electronic cigarettes more than five times. The study included two discussion groups, each with six participants. Data analysis was using thematic analysis.
Result: Six types of media communications were conducted for each child and woman. The respondents in rural East Java equally favored messages A and C. Regarding the children communication in Urban East Java, most participants preferred message C, whereas one selected message B. Regarding the women’s communication, most urban participants chose message C, with two selecting message C and one choosing message B. Most participants acknowledged the adverse health impacts of cigarette smoking on passive smokers. Both rural and urban participants selected communication messages on children’s and women’s mortality data as impactful for tobacco-free education for active smokers.
Conclusion: Communication messages focusing on children and women can effectively influence the perceptions and emotions of active smokers as tobacco-free education. Media development is needed to convey educational messages that inform both active and passive smokers, encouraging awareness and behavior change.
References
Tauras JA. Tobacco control in low-income and middle-income countries: findings from WHO FCTC investment cases. Tob Control. 2024 May 2;33(Suppl 1):s1–2.
Effendi DE, Ardani I, Handayani S, Agustiya RI, Nugroho AP, Oktriyanto O, et al. Factors associated with quitting smoking among males: Findings from Indonesian national health survey. Clin Epidemiol Glob Health. 2024 Jul;28:101672.
Gallucci G, Tartarone A, Lerose R, Lalinga AV, Capobianco AM. Cardiovascular risk of smoking and benefits of smoking cessation. J Thorac Dis. 2020;12(7):3866–76.
Lu R, Qin Y, Xie C, Tan X, Zhu T, Tan J, et al. Secondhand smoke exposure can increase the risk of first ischemic stroke: A 10.7-year prospective cohort study in China. Ann Epidemiol. 2024 Apr;92:25–34.
Fithria F, Adlim M, Jannah SR, Tahlil T. Indonesian adolescents’ perspectives on smoking habits: a qualitative study. BMC Public Health. 2021;21(1):1–8.
Hirst RJ, Cassarino M, Kenny RA, Newell FN, Setti A. Urban and rural environments differentially shape multisensory perception in ageing. Aging, Neuropsychology, and Cognition. 2022 Mar 4;29(2):197–212.
Park HJ. Smoking, as a Death Messenger. Tuberc Respir Dis (Seoul). 2020 Oct;83(4):324–5.
Onwuzo CN, Olukorode J, Sange W, Orimoloye DA, Udojike C, Omoragbon L, et al. A Review of Smoking Cessation Interventions: Efficacy, Strategies for Implementation, and Future Directions. Cureus. 2024 Jan;16(1):e52102.
Sixtus E, Krause F, Lindemann O, Fischer MH. A sensorimotor perspective on numerical cognition. Trends Cogn Sci. 2023;27(4):367–78.
Nivedha K, Parangimalai Diwakar Madan kumar, S A. Role of Social Media Marketing in Cigarette Smoking Cessation- A Systematic Review. International Journal of Community Dentistry. 2023 Nov 17;11(2):75–90.
Lim CCW, Rutherford B, Gartner C, McClure-Thomas C, Foo S, Su FY, et al. A systematic review of second-hand smoking mass media campaigns (2002–2022). BMC Public Health. 2024;24(1):693.
Beasley SJ, Barker A, Murphy M, Roderick T, Carroll T. What makes an effective antismoking campaign – Insights from the trenches. Public Health Res Pract. 2020;30(3):1–7.
Negi NS, Gill VM, Maharjan M, Sinha P, Puri P, Mallik V, et al. An Observational Study of the Implementation of the Tobacco-Free Film and Television Policy in India. 2023;16:1–13.
Sharkiya SH. Quality communication can improve patient-centred health outcomes among older patients: a rapid review. BMC Health Serv Res. 2023 Aug 22;23(1):886.
Ridha A, Ramadhani D, Trisnawati E, Radiana D, Ruhama U. Improving knowledge and attitudes about prevention and cessation of smoking using comics: study on youth with smoker’s social environment. Pan African Medical Journal. 2022;43.
Smith MJ, Hilton S. Youth’s exposure to and engagement with e-cigarette marketing on social media: a UK focus group study. BMJ Open. 2023 Aug 23;13(8):e071270.
Riyadi S, Marm M. The Influence of Cigarette Advertising Exposure on Teenage Smoking Cessation Intention. Indonesian Journal of Global Health Research. 2024 Dec 20;7(1):637–44.
Lestari PW, Agestika L, Dewi GK. Predisposing, Enabling, and Reinforcing Factors of COVID-19 Prevention Behavior in Indonesia: A Mixed-methods Study. Journal of Preventive Medicine and Public Health. 2023 Jan 31;56(1):21–30.
Fu D, Xiao L. The Progress of the Global Tobacco Cessation Strategies. China CDC Wkly. 2023 May 26;5(21):475–8.
Cham B, Mdege ND, Bauld L, Britton J, D’alessandro U. Exposure to second-hand smoke in public places and barriers to the implementation of smoke-free regulations in the gambia: A population-based survey. Int J Environ Res Public Health. 2021;18(12).
Lee Westmaas J, Chantaprasopsuk S, Bontemps-Jones J, Stephens RL, Thorne C, Abroms LC. Longitudinal analysis of peer social support and quitting Smoking: Moderation by sex and implications for cessation interventions. Prev Med Rep. 2022 Dec;30:102059.
Nurhasana R, Ratih SP, Djaja K, Hartono RK, Dartanto T. Passive smokers’ support for stronger tobacco control in Indonesia. Int J Environ Res Public Health. 2020;17(6):1–9.
Romeo-Stuppy K, Huber L, Lambert P, Aghi MB, Soon-Young, Yoon, et al. Women, tobacco, and human rights. Tob Induc Dis. 2021;19(48).
Simanjuntak MM, Uswar Y. Improving Students’ Listening Skills By Using Song. Journal MELT (Medium for English Language Teaching). 2021;5(2):142.
Rath JM, Dimaya B, O’Connor KM, Kreslake JM, Vallone DM, Hair EC. Content analysis of tobacco imagery in popular music Videos, 2018–2021. Prev Med Rep. 2023;33(2023):102188.
Durkin SJ, Brennan E, Wakefield MA. Optimising tobacco control campaigns within a changing media landscape and among priority populations. Tob Control. 2022;31(2):284–90.
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