| Literature DB >> 34886128 |
Al Asyary1, Meita Veruswati2, La Ode Hasnuddin S Sagala3, La Ode Ahmad Saktiansyah4, Dewi Susanna1, Hanns Moshammer5,6.
Abstract
Enforcement of a smoke-free policy is of vital concern in support of the health of smokers and bystanders. Indonesia has issued a smoke-free law, but implementation and enforcement lie with the regional and municipal governments. In a survey of 225 respondents recruited via schools, knowledge about the health effects of smoking and the smoke-free regulation, as well as attitudes towards and commitment and support of the enforcement of the smoke-free regulation in the Kendari City through an electronic whistleblowing system was examined. Furthermore, the participants were asked about the smoking status and smoking behavior. About half of the respondents were students (teenagers), the other half-their parents. Male respondents were strongly overrepresented (85%). Only 18% of the respondents declared to be smokers, mostly adults and males. Both the smokers and the non-smokers supported the smoke-free law and its enforcement through a whistleblowing system. Representatives of the local government were interviewed and participated in focus group discussions. In general, they also exhibited strong support of an electronic enforcement tool. However, issues of efficiency, costs, and responsibility must still be resolved. Nevertheless, an electronic whistleblowing system has the potential to further the health and livelihoods in a community like the Kendari City.Entities:
Keywords: Indonesia; law enforcement; smoke-free policy; whistleblowing
Mesh:
Substances:
Year: 2021 PMID: 34886128 PMCID: PMC8656714 DOI: 10.3390/ijerph182312401
Source DB: PubMed Journal: Int J Environ Res Public Health ISSN: 1660-4601 Impact factor: 3.390
Description of the participants of the survey.
| Characteristics | Total ( | Smokers ( | Non-Smokers ( |
|---|---|---|---|
| Age group | |||
| Students (11–19 years) | 119 (52.9%) | 14 (34.1%) | 105 (57.1%) |
| Adults (20–59 years) | 106 (47.1%) | 27 (65.9%) | 79 (42.9%) |
| Gender | |||
| Male | 190 (84.4%) | 40 (97.6%) | 150 (81.5%) |
| Female | 35 (16.6%) | 1 (2.4%) | 34 (18.5%) |
| Highest education | |||
| Elementary school | 10 (4.4%) | 2 (4.9%) | 8 (4.3%) |
| Junior high school | 89 (39.6%) | 11 (26.8%) | 78 (42.4%) |
| Senior high school | 59 (26.2%) | 15 (36.6%) | 44 (23.9%) |
| Undergraduate | 61 (27.1%) | 11 (26.8%) | 50 27.2%) |
| Postgraduate | 6 (2.7%) | 2 (4.9%) | 4 (2.2%) |
| Profession | |||
| Student/unemployed | 147 (65.3%) | 20 (48.8%) | 127 (69.0%) |
| Civil servant | 64 (28.4%) | 13 (31.7%) | 51 (27.7%) |
| Entrepreneur | 9 (4.0%) | 5 (12.2%) | 4 (2.2%) |
| Worker | 5 (2.2%) | 3 (7.3%) | 2 (1.1%) |
Determinants of the active smoker status.
| Active Smoker | Bivariate Logistic | Multiple Logistic | ||||
|---|---|---|---|---|---|---|
| Yes | No |
| OR (95% CI) |
| OR (95% CI) | |
| Age | ||||||
| Student | 14 (11.8%) | 105 (88.2%) | Ref. | Ref | ||
| Adult | 27 (25.5%) | 79 (75.5%) | 0.009 | 2.56 (1.26–5.21) | <0.001 | 4.08 (1.96–8.51) |
| Gender | ||||||
| Female | 1 (2.9%) | 34 (97.1%) | Ref. | Ref | ||
| Male | 40 (20.0%) | 150 (78.9%) | 0.032 | 9.07 (1.20–68.27) | 0.006 | 17.59 (2.28–135.85) |
| Education | N/A | N/A | ||||
| Elementary | 2 (20%) | 8 (80%) | 0.502 | 1.77 (0.33–9.45) | ||
| Junior high | 11 (12.4%) | 78 (87.6%) | Ref. | |||
| Senior high | 15 (25.4%) | 44 (74.6%) | 0.045 | 2.42 (1.02–5.72) | ||
| Undergrad. | 11 (18.0%) | 50 (82.0%) | 0.337 | 1.56 (0.63–3.87) | ||
| Postgrad. | 2 (33.3%) | 4 (66.7%) | 0.171 | 3.55 (0.58–21.69) | ||
| Education (adults only) | N/A | N/A | ||||
| Elementary | 1 (14.3%) | 6 (85.7%) | 0.243 | 0.26 (0.33–2.47) | ||
| Junior high | 1 (100%) | 0 (0%) | Dropped (only one case) | |||
| Senior high | 12 (38.7%) | 19 (61.3%) | Ref. | |||
| Undergrad. | 11 (18.0%) | 50 (82.0%) | 0.034 | 0.35 (0.13–0.92) | ||
| Postgrad. | 2 (33.3%) | 4 (66.7%) | 0.804 | 0.79 (0.31–5.01) | ||
| Profession (adults only) | N/A | N/A | ||||
| No work | 7 (23.3%) | 23 (76.7%) | 0.739 | 1.19 (0.42–3.39) | ||
| Civil servant | 13 (20.3%) | 51 (79.7%) | Ref. | |||
| Entrepreneur | 4 (57.1%) | 3 (42.9%) | 0.045 | 5.23 (1.04–26.33) | ||
| Employee | 3 (60.0%) | 2 (40.0%) | 0.066 | 5.88 (0.89–38.95) | ||
Figure 1The adults on average answered more questions on the SFE law correctly.
Smoking behavior among the 41 smokers (14 students, 27 adults).
| Smoking Behavior | Passive Smoking Is Harmless | |||
|---|---|---|---|---|
| Yes (%) | No (%) |
| OR (95% CI) | |
| Smoking indoors at work | 18 (43.9) | 23 (56.1) | 0.851 | 0.833 (0.124–5.606) |
| Smoking indoors at home | 22 (53.7) | 19 (46.3) | 0.235 | 4.0 (0.406–39.367) |
| Smoking near family | 19 (46.3) | 22 (53.7) | 0.762 | 0.745 (0.111–5.007) |
| Smoking near others | 18 (43.9) | 23 (56.1) | 0.116 | 6.286 (0.636–62.162) |
Attitudes, commitment, and support.
| Passive Smoking Is Harmless | ||||
|---|---|---|---|---|
| Yes (10) | No (215) |
| Difference | |
| Attitude (0–11) | 6.7 | 9.22 | 0.0001 | 2.52 |
| Commitment (0–2) | 1.3 | 1.83 | 0.0003 | 0.53 |
| Support (0–2) | 2 | 3.25 | 0.0002 | 1.25 |
Questions on the knowledge of the participants.
| Question | Correct Answer |
|---|---|
| Health effects of smoking | |
| Cigarette smoke is harmful to the health of smokers | Yes |
| Exhaled cigarette smoke is harmful to the health of others/pregnant women/children | Yes |
| SFE law | |
| The smoke-free environment (SFE) prohibits smoking | Yes |
| Health services are included in SFE | Yes |
| Places of teaching and learning are included in SFE | Yes |
| Children’s play areas are included in SFE | Yes |
| Places of worship are included in SFE | Yes |
| Public transportation is included in SFE | Yes |
| Workplaces are included in SFE | Yes |
| Public places are included in SFE | Yes |
| Sports facilities are included in SFE | Yes |
| Private houses are included in SFE | No |
| Smoking inside any building is an activity which is prohibited in the | No |
Questions on the attitude, commitment, and support.
| Question | Best Answer (Four Points) |
|---|---|
| Cigarette smoke has a negative impact only on smokers | Strongly disagree |
| Smoking in any place indoors must be banned | Strongly agree |
| Pregnant and breastfeeding mothers and children must be | Strongly agree |
| Smoking at home should be prohibited | Strongly agree |
| If one day you are invited to attend a socialization event for the implementation of the SFE regulations, will you come? | Yes |
| If officers from the Regency Government come to provide assistance and guidance on the implementation of SFE at your place of residence, place of work, are you willing to follow? | Yes |
| Do you fully agree with the implementation of WBS on SFE in the Kendari City? | Yes |
| Do you fully support the implementation of WBS on SFE in | Yes |
| Will you install the WBS application on your smartphone? | Yes |
| Will you use the WBS application regularly while in the No Smoking Area? | Yes |