Understanding Adolescent Smoking Behavior in ‘Cigarette City’ Kudus, Indonesia: An Ecological Perspective

Abstract

Adolescent smoking behavior is a significant public health issue worldwide, including in Indonesia. Despite anti-smoking campaigns being implemented, the number of adolescent smokers has not reduced, especially in Kudus, Indonesia, known as the “cigarette city” where numerous cigarette industries operate. This study aims to understand the dynamic interactions between adolescents and their surrounding environments. We conducted ethnographic fieldwork in the Gringsing District, Kudus, for five months. In addition to participant observations, we conducted interviews with 18 adolescents, 11 pairs of parents, 3 adolescent fathers or mothers, five religious figures, three community leaders, and two cultural figures. Five themes emerged from the thematic analysis, including: from trying to get used to it, ways to overcome temptation to smoke, allowing smoking if employed, violation of prohibition at school, and penetration of cigarette culture. The findings indicate a dynamic interaction among adolescents and their broader family, peer, school, and socio-cultural environments. We analyzed the findings using Bronfenbrenner’s ecological theory. We conclude that adolescent smoking behavior in the ‘cigarette city’ of Kudus is influenced by the entrenched cigarette industry, which permeates societal norms, values, cultural traditions, and everyday behaviors, including those of adolescents.