Faktor Risiko Keluarga sebagai Prediktor Perilaku Merokok di Kalangan Pelajar: Sebuah Tinjauan Empiris di Indonesia: Family Risk Factor as Predictor of Smoking Behavior Among Students: an Empirical Study in Indonesia

Mona  Lisa; Winnie Tunggal  Mutika; Disa Hijratul  Muharramah; Dwi  Sulistyorini

doi:10.51888/phj.v16i1.323

Authors

Mona Lisa Fakultas Kesehatan Masyarakat, Universitas Sriwijaya
Winnie Tunggal Mutika Program Studi S1 Kebidanan, Universitas Gunadarma
Disa Hijratul Muharramah Fakultas Kesehatan Masyarakat, Universitas Sriwijaya
Dwi Sulistyorini Pusat Data dan Informasi, Badan Narkotika Nasional

DOI:

https://doi.org/10.51888/phj.v16i1.323

Keywords:

Merokok, faktor keluarga, pelajar

Abstract

Hasil Survei Kesehatan Indonesia (SKI) tahun 2023 prevalensi merokok pada penduduk berusia ≥10 tahun mencapai angka 27.05%. Peningkatan yang signifikan terjadi pada kelompok usia remaja, terutama pada laki-laki yang berusia 15–19 tahun, yang mencapai angka 56,5%. Tujuan penelitian adalah mengetahui hubungan faktor-faktor keluarga terhadap perilaku merokok pelajar di Indonesia. Penelitian ini menggunakan jenis penelitian Cross-sectional. Survei meliputi kota kabupaten yang tersebar 34 provinsi dengan jumlah sampel 33,135 responden pelajar. Data yang digunakan adalah data sekunder. Analisa yang digunakan adalah analisa univariat dengan distribusi frekuensi dan analisa bivariat dengan menggunakan uji statistik Chi-square dan analisis multivariat dengan menggunakan regresi logistic ganda. Hasil Penelitian: Analisis menunjukkan 22,3% pelajar yang merokok dalam 30 hari terakhir. Setelah di adjust dengan kovariat diperoleh faktor keluarga yang berhubungan dengan perilaku merokok pada pelajar yaitu Pendidikan orang tua (AOR=1,14, 95% CI 1,05–1,19), status pekerjaan orang tua (AOR=1,14, 95% CI 1,03–1,26), Status pernikahan orang tua (AOR=1,2, 95% CI 1,08–1,31), perilaku berisiko keluarga (AOR=1,67, 95% CI 1,58–1,80), jarang ada kehangatan keluarga (AOR=1,18, 95% CI 1,20–1,26), tidak pernah merasakan kehangatan keluarga (AOR=1,41, 95% CI 1,29–1,54) dan kekerasan fisik dalam keluarga (AOR=1,43, 95% CI 1,29–1,59). Nilai R square=0.026 dimana model ini menjelaskan 2.6 % untuk mempredikasi perilaku merokok pada pelajar. Kesimpulan: Perilaku berisiko dalam keluarga memiliki kontribusi paling besar terhadap perilaku merokok pada pelajar. Perlu dilakukan intervensi berbasis keluarga yang fokus pada peningkatan kehangatan relasi keluarga, edukasi orang tua, serta pencegahan kekerasan dan perilaku berisiko dilingkungan rumah.

According to the 2023 Indonesia Health Survey (IHS), the prevalence of active smokers aged ≥10 years reached 27,05%, with a significant increase among adolescents, particularly males aged 15–19 years, reaching 56.5%. This study aims to examine the association between family-related factors and smoking behaviour among students in Indonesia. This research employed an analytical Cross-sectional design using secondary data. The survey covered districts and cities across 34 provinces in Indonesia, with a total sample of 33,135 student respondents. Data were analysed using univariate analysis with frequency distribution, bivariate analysis using the Chi-square test, and multivariate analysis using multiple logistic regression. The analysis showed that 22.3% of students had smoked in the past 30 days. After adjusting for covariates, several family-related factors were significantly associated with smoking behaviour, including parental education level (AOR=1.14; 95% CI: 1.05–1.19), parental employment status (AOR=1.14; 95% CI: 1.03–1.26), parental marital status (AOR=1.20; 95% CI: 1.08–1.31), risky behaviours within the family (AOR=1.67; 95% CI: 1.58–1.80), lack of family warmth (AOR=1.18; 95% CI: 1.20–1.26), absence of family warmth (AOR: 1.41; 95% CI: 1.29–1.54), and experience of physical violence within the family (AOR: 1.43; 95% CI: 1.29–1.59). The R-square value 0f 0.026indicate that the model explain 2,6% of variance in predicting smoking behaviour among student. Risky behaviours within the family contributed the most to student smoking behaviour. Family-based interventions are necessary, focusing on strengthening familial warmth, improving parental education, and preventing violence and risky behaviors within the household environment.

References

Amiri, S. et al. (2021) ‘Parental divorce and offspring smoking and alcohol use: a systematic review and meta-analysis of observational studies’, Journal of Addictive Diseases [Preprint]. Available at: https://www.tandfonline.com/doi/abs/10.1080/10550887.2021.1886576 (Accessed: 30 April 2025).

Baheiraei, A. et al. (2014) ‘Family and Peer Risk Factors as Predictors of Lifetime Tobacco Use among Iranian Adolescents: Gender Similarities and Differences’, Global Journal of Health Science, 6(4), p. p63. Available at: https://doi.org/10.5539/gjhs.v6n4p63.

Brook, D.W. et al. (2008) ‘Developmental Trajectories of Cigarette Smoking from Adolescence to the Early Thirties: Personality and Behavioral Risk Factors’, Nicotine & Tobacco Research, 10(8), pp. 1283–1291. Available at: https://doi.org/10.1080/14622200802238993.

Dangol, G., Poudel, K.C. and Kim-Mozeleski, J.E. (2022) ‘The Role of Parental Involvement in Cigarette Smoking among Adolescents in Nepal’, Journal of Psychoactive Drugs, 54(2), pp. 110–118. Available at: https://doi.org/10.1080/02791072.2021.1923875.

Flay, B.R., Snyder, F.J. and Petraitis, J. (2009) ‘The theory of triadic influence’, in Emerging theories in health promotion practice and research, 2nd ed. Hoboken, NJ, US: Jossey-Bass/Wiley, pp. 451–510.

Hidayati, N. and Arianto, D. (2024) ‘Pengaruh Orang Tua, Keluarga, dan Lingkungan Sosial terhadap Perilaku Merokok Remaja’, Jurnal Ekonomi Kependudukan dan Keluarga, 1(2). Available at: https://doi.org/10.7454/jekk.v1i2.01.

Kementerian Kesehatan RI (2023) Survei Kesehatan Indonesia (SKI). Jakarta: Kementerian Kesehatan.

Kharie, R.R. and Pondaag, N.L. (2014) ‘Hubungan Pola Asuh Orang Tua dengan Perilaku Merokok pada Anak Laki-laki Usia 15 -17 Tahun di Kelurahan Tanah Raja Kota Ternate.’, Jurnal Keperawatan [Preprint].

Lawrence, T.I., Merrin, G.J. and Ariel (2025) ‘(PDF) Family Violence and Adolescent Aggressive Behavior: The Direct and Indirect Effects of Depression and Substance Use’, ResearchGate [Preprint]. Available at: https://doi.org/10.1007/s11469-022-00971-2.

Lewis, T. et al. (2019) ‘The Role of Emotional Abuse in Youth Smoking’, American Journal of Preventive Medicine, 56(1), pp. 93–99. Available at: https://doi.org/10.1016/j.amepre.2018.08.020.

Li, X. et al. (2010) ‘Parental, Behavioral, and Psychological Factors Associated with Cigarette Smoking among Secondary School Students in Nanjing, China’, Journal of Child and Family Studies, 19(3), pp. 308–317. Available at: https://doi.org/10.1007/s10826-009-9299-1.

Mahabee-Gittens, E.M. et al. (2011) ‘The Protective Influence of Family Bonding on Smoking Initiation in Adolescents by Racial/Ethnic and Age Subgroups’, Journal of child & adolescent substance abuse, 20(3), pp. 270–287. Available at: https://doi.org/10.1080/1067828X.2011.581969.

Ramani, A. et al. (2024) ‘Does Parental Marital Status Matter in Male Adolescent’s Smoking Behaviors?’, Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education, 12(SI2), pp. 186–191. Available at: https://doi.org/10.20473/jpk.V12.ISI2.2024.186-191.

Rudatsikira, E., Abdo, A. and Muula, A.S. (2007) ‘Prevalence and determinants of adolescent tobacco smoking in Addis Ababa, Ethiopia’, BMC Public Health, 7(1), p. 176. Available at: https://doi.org/10.1186/1471-2458-7-176.

Septiana, N. (2016) ‘Faktor Keluarga Yang Mempengaruhi Perilaku Merokok Pada Siswa Sekolah Menengah Pertama’.

Septiono, W. et al. (2021) ‘The Mediating Role of Parental Factors in the Social Patterning of Smoking among Adolescents in Urban Indonesia’, Asian Pacific Journal of Cancer Prevention, 22(10), pp. 3127–3135. Available at: https://doi.org/10.31557/APJCP.2021.22.10.3127.

Thomas, R.E. et al. (2015) ‘Family‐based programmes for preventing smoking by children and adolescents - Thomas, RE - 2015 | Cochrane Library’. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004493.pub3/abstract (Accessed: 30 April 2025).

Thomas, R.E., McLellan, J. and Perera, R. (2013) ‘School‐based programmes for preventing smoking’, Cochrane Database of Systematic Reviews, 2013(4). Available at: https://doi.org/10.1002/14651858.cd001293.pub3.

Vundavalli, S. et al. (2021) ‘Exposure to parental and sibling smoking and future intentions to smoke among 13-15 years old school age children in Saudi Arabia’, The Pan African Medical Journal, 38, p. 158. Available at: https://doi.org/10.11604/pamj.2021.38.158.27825.

Widome, R. et al. (2011) ‘Health Risk Behaviors of Afghanistan and Iraq War Veterans Attending College’, American Journal of Health Promotion, 26(2), pp. 101–108. Available at: https://doi.org/10.4278/ajhp.090826-QUAN-278.

World Health Organization (2019) ‘Global Youth Tobacco Survey’.

World Health Organization (2024) WHO calls for bold, decisive legislative action to protect young people from tobacco industry interference. Available at: https://www.who.int/indonesia/news/detail/30-05-2024-who-calls-for-bold--decisive-legislative-action-to-protect-young-people-from-tobacco-industry-interference (Accessed: 29 April 2025).

Xie, J. et al. (2025) ‘Parental smoking is associated with adolescent loneliness: evidence from 71 low- and middle-income countries’, Frontiers in Public Health, 13, p. 1497136. Available at: https://doi.org/10.3389/fpubh.2025.1497136.

Yenti, M. et al. (2025) ‘Faktor Orang Tua dalam Perilaku Merokok Remaja: Studi Perbandingan di Daerah Rural dan Urban’, Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior, 6(2). Available at: https://doi.org/10.47034/ppk.v6i2.1075.

Yoon, S. (2020) Childhood physical abuse linked to heavy cigarette use among teens who smoke. Available at: https://news.osu.edu/childhood-physical-abuse-linked-to-heavy-cigarette-use-among-teens-who-smoke/.

Zaborskis, A. et al. (2021) ‘Family Support as Smoking Prevention during Transition from Early to Late Adolescence: A Study in 42 Countries’, International Journal of Environmental Research and Public Health, 18(23), p. 12739. Available at: https://doi.org/10.3390/ijerph182312739.