Contextual Effect of School and Other Determinants of Non Smoking Behavior among High School Students in Bantul, Yogyakarta: A Multilevel Analysis

Roviana Nurda Agustin, Endang Sutisna Sulaeman, Hanung Prasetya

Abstract

Background: Adolescence is a period of initiation of smoking and not smoking behavior. Non-smo­king behavior in adolescents is influenced by factors of knowledge, attitudes, subjective norms, perceptions of behavioral control, intention, parental support, teacher support, peer support, and in­formation media exposure. The purpose of this study was to analyze the contextual influence of schools on non-smoking behavior in adolescents in Bantul Regency, Yogyakarta.

Subjects and Method: This was a cross sectional study conducted on 13 high schools and 12 vo­ca­tional high schools in Bantul Regency, Yogyakarta, from September to October 2019. A sample of 200 male adolescents aged 15-18 years was selected by stratified random sampling. The dependent variable was non-smoking behavior in adolescents. The inde­pendent variables were knowledge, attitudes, subjective norms, behavioral control perceptions, intentions, parental support, teacher support, peer support, and information media exposure. The data collections were performed using a questionnaire and analyzed using multilevel multiple logistic regression with Stata 13.

Results: Non-smoking behavior in adolescents increases with high adolescent knowledge (b= 3.09; 95% CI= 0.86 to 5.33; p= 0.007), positive attitude (b= 2.92; 95% CI= 0.79 to 5.06; p= 0.007), norm subjective supportive (b= 2.81; 95% CI= 0.72 to 4.92; p= 0.009), perception of strong beha­vioral control (b= 3.60; 95% CI= 1.22 to 5.99; p = 0.003), non-smoking intention is strong (b= 3.09; 95% CI= 0.92 to 5.27; p= 0.005), strong family support (b= 2.80; 95% CI= 0.76 to 4.85; p= 0.007), strong teacher support (b= 2.98; 95% CI= 0.75 to 5.21; p= 0.009), strong peer sup­port (b= 2.58; 95% CI= 0.04 to 5.13; p= 0.046), and exposed to information media (b= 2.27; 95% CI= 0.45 to 4.09; p= 0.014). There was contextual effect of schools non-smoking be­ha­vi­or (ICC = 20.92%).

Conclusion: Non-smoking behavior in adolescents is influenced by knowledge, attitude, sub­jec­tive norm, perceived behavioral control, intention, parental support, teacher support, peer support, and information media exposure. School has a contextual influence on non-smoking behavior in adolescents.

Keywords: smoking, teenage behavior, school

Correspondence:
Roviana Nurda Agustin. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: roviananurda@gmail.com. Mobile: 085­747­082310

Journal of Health Promotion and Behavior (2019), 4(4): 274-286
https://doi.org/10.26911/thejhpb.2019.04.04.04

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