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.