International Journal of Science and Research (IJSR) ISSN: 2319-7064 ResearchGate Impact Factor (2018): 0.28 | SJIF (2018): 7.426 Volume 9 Issue 3, March 2020 www.ijsr.net Licensed Under Creative Commons Attribution CC BY School Promotion to Smoking-Related Knowledge, Attitude, Self-Efficacy and Practice of Sundanese Students in Indonesia Laili Rahayuwati 1 , Eleanor C. Castillo 2 1 Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung - Sumedang KM. 21 Jatinangor Kab. Sumedang, Jawa Barat, Indonesia 2 College of Public Health, University of the Phillipines Manila, Philippines 625 Pedro Gil St, Ermita, Manila, 1000 Metro Manila, Philippines Abstract: The impact of smoking is both a threat and challenge to the nation. Schools have particular advantage for educational initiatives because they have access to students and can encourage them to develop knowledge, attitude and practice concerning a healthy lifestyle. This research was conducted in the intervening program based on reducing or preventing smoking initiation. The design was quasi-experimental study, while data was analyzed inferentially using One Way ANOVA of Dependent Groups/Within Subjects and Independent Group/Between Subjects. Data analysis was assisted by using software STATA 12.0. The results showed the health education intervention affected positive changes in knowledge, attitude, self-efficacy, and practice either in Intervention 1 and 2 groups, even in the Control Group, slight behavior changes were found due to factors of school policy. Meanwhile, the best changes that linearly increased through three time measurements in variables of knowledge, attitude, self-efficacy, and practice were found in the Intervention 1 Group. It can be concluded that policy factors determine the success of health promotion and education. On one hand, schools are under the Department of Education and Culture, while community activities are referred to the Department of Home Affairs. Therefore, improved cooperation between these two relevant departments is needed to regulate smoking and enhance the implementation of smoking prevention policies in schools. Keywords: Adolescents, school-based intervention, smoking prevention 1. Introduction Smoking is also the major known cause of non- communicable diseases such as cancer and cardiovascular diseases. (1)Indicates smoking causes about 90% (or 9 out of 10) of all lung cancer deaths for men and women, along with 80% (or 8 out of 10) of all deaths from cardiovascular disease, are caused by smoking [1]. Nevertheless, smoking is one of the preventable causes of deaths in the world. It is recognized that, as the life expectancy of societies improve, the prominence of non- communicable chronic diseases, many of which are associated with smoking, will gain greater prominence [2]. In addition, most smokers begin smoking when they are in their teens. About 25 percent of all adolescents who experiment with cigarette-smoking become regular smokers, and among them, about one-third will die from a smoking- related health disease [3–6]. Yet, studies on smoking behavior among teens are scarce in most Asian countries. Identified the following significant risk factors for adolescent tobacco use: smoking among friends and siblings, poor academic performance, being older, being male, working, and having parents who were separated [7]. Also, studies on the effects of a school-based intervention program on smoking behavior in Indonesia are rare, with the most recent, a study focusing on the implementation of school-based smoking prevention and cessation programs in Aceh Province, Indonesia [8]. Currently, in Indonesia, approximately 215 billion cigarettes are consumed every year by 57 million smokers. In 2010, there are 34.4% of people aged above 10 years who smoked, with a higher prevalence in rural areas (36.6 percent), compared to 31.7% in urban areas, increasing from 31.5 in 2001. Furthermore, the number of adolescents smoking: among the youth (age 13-15), 12% currently smoke cigarettes (boys 24%; girls 2%); more than 78% of smokers start before age 19, one-third of whom reported trying their first cigarette before the age of 10 [9]. Additionally, in Indonesia, smoking exterminates at least 200,000 people each year. Secondly, more than 97 million Indonesian non-smokers are regularly exposed to secondhand smoke. Furthermore, 81% of youth (age 13-15) are exposed to secondhand smoke in public places, while 65%are exposed to secondhand smoke at home [10] . In some studies, especially in Indonesia, a correlation was found between knowledge and smoking practices: 52.22% respondents who had good knowledge also had high intention to quit smoking. However, other researches found no correlation between knowledge, atittude, and smoking practice [11]. These studies also showed the adolescents‟ attitudes toward smoking, most of whom stating that being a smoker was about being looked manly and being like their friends. With regard to self-efficacy and smoking, some findings showed that social self-efficacy, peer‟s smoking behavior, and the intention to smoke proved to have the strongest associations with smoking. Additionally, studies also showed that a decrease in self-efficacy is related to the increase in adolescent smoking [12],[13]. Smoking is a threat and challenge to the nation because of the increasing number of adolescents who are smoking. An Paper ID: SR20303072710 DOI: 10.21275/SR20303072710 252