Individual Factors and Contextual Effects of Peer Group on Smoking Behavior Among the High School Students in East Lampung, Lampung: A Multilevel Analysis Evidence

Retno Sulistiani1), Setyo Sri Rahardjo2), Pawito3)

1)Masters Program in Public Health, Universitas Sebelas Maret

2)Faculty of Medicine, Universitas Sebelas Maret

3)Faculty of Social and Political Sciences, Universitas Sebelas Maret


Background: Cigarettes contain 4,000 chemicals with 200 types of which are carcinogenic and can cause cancer and even death. The data from the Central Statistics Agency in 2018, preva­lence of smoking behavior in Lampung Province were 35.95%. This study aimed to analyze the determinants of smoking behavior in male adolescents.

Subjects and Method: This was a cross sectional study. The study was conducted in East Lampung, Sumatera, Indonesia, from Oktober to November 2020. A sample of 200 male adolescents was selected by simple random sampling. The dependent vari­able was smoking behavior. The independent variables were parental influence, peers, media exposure, pocket money, cigarette price, intention, and attitude, and school. The data were collected by questionnaire and analyzed by a multiple multilevel logistic regression run on Stata 13.

Results: Family influence (b= 2.88; 95% CI= 0.73 to 3.85; p= 0.004), peers (b= 2.85; 95% CI= 0.65 to 3.52; p= 0.004), media exposure toward cigarette (b= 3.04; 95% CI= 0.78 to 3.62; p= 0.002), high pocket money (b= 3.22; 95% CI= 0.87 to 3.59; p= 0.001), cigarette price (b= 2.73; 95% CI= 0.54 to 3.28; p= 0.006), strong intention to smoke (b= 2.80; 95% CI= 0.69 to 3.95; p= 0.005), and positive attitude on smoking (b=3.83; 95% CI= 1.80 to 5.58; p<0.001) increased smoking behavior in male adolescents School had contextual effect on smoking behavior in adolescents (ICC= 21.83%).

Conclusion: Family influence, peers, media exposure toward cigarette, high pocket money, cigarette price, strong intention to smoke, and positive attitude on smoking increase smoking behavior in male adolescents School had contextual effect on smoking behavior.

Keywords: smoking behavior, male adolescents, school

Correspondence: Retno Sulistiani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: Mobile: +6285867006699.


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