Tobacco Use among School-Age Adolescents in Indonesia: Findings from the 2015 Indonesia Global School-Based Student Health Survey

Background: Although Indonesia has a considerable proportion of adolescent smokers, nationally representative studies of its determinants remain limited. The 2015 Indonesian Global School-Based Student Health Survey (GSHS) was conducted with school-age adolescents and provided information about smoking behavior. This study aimed to examine the prevalence, determinants, and correlates of tobacco use among adolescents in Indonesia using the GSHS survey. Methods: A secondary data analysis of a cross-sectional study was conducted using data from the 2015 Indonesian GSHS. Multivariate logistic regression was used to assess the determinants and correlates of tobacco use. Results: Our analysis showed that 9.1 of school-age adolescents had used tobacco products in the past 30 days. Most were 13-15 years (61.7) and had attempted to stop smoking (92.4). After adjusting for covariates, significant risk factors associated with tobacco smoking were older age groups (prevalence odds ratio POR, 3.01-9.40; 95% confidence interval CI, 1.71-23.1), male (POR, 13.7; 95% CI, 8.71-21.5), psychological distress (POR, 1.41; 95% CI, 1.05-1.90), smoking exposure (POR, 1.98-2.15; 95% CI, 1.35-3.42), and when both parents smoked (POR, 2.96; 95% CI, 1.78-4.94). In addition, tobacco use was associated with other risky behaviors, including sex with multiple partners, using drugs, drinking alcohol, and being involved in physical fights. Conclusion: Tobacco use is high among Indonesian adolescents. This prevalence highlights the need for a more stringent tobacco control policy and tailored cessation programs for adolescents by considering important modifiable determinants of tobacco use among adolescents, including risky smoking-related behaviors.