BACKGROUND: Indonesia ranked first among Southeast Asian countries in 2021 with the youngest age of smoking initiation at an average of 16.8 years old. While previous studies have demonstrated significant roles of tobacco control measures, including cigarette prices to prevent adolescents’ uptake of smoking, there is no evidence yet in Indonesia regarding the effects of cigarette prices and other smoking-related factors on youth smoking initiation.
METHODS: This study examines the effect of cigarette prices, parental smoking, and exposure to secondhand smoke on youth smoking initiation in Indonesia, employing discrete-time hazard models and a pseudo-longitudinal dataset constructed from the 2023 Indonesian Health Survey and the National Consumer Price of Selected Goods and Services 2014-2023. All analyses use the sample weights that were provided with the data.
RESULTS: Higher prices for cigarettes, particularly filtered kreteks (clove-mixed cigarettes), significantly decreased the risk of smoking initiation, with a 1% price increase associated with a 1.9% and 2.2% reduction in the risk of smoking initiation (95% CI -3.8% to -0.1% and 95% CI -3.52% to -0.9%, respectively). No significant impact was found for the prices of white cigarettes and kreteks on youth smoking initiation. Meanwhile, having one or both parents who smoke and exposure to cigarette smoke increased the hazard of adolescents to start smoking (HR=-1.27 [95% CI -1.15 to -1.40] and HR=-6.73 [95% CI -5.66 to -8.01], respectively).
CONCLUSIONS: Cigarette prices, parental smoking, and exposure to cigarette smoke are significant predictors of smoking initiation among adolescents in Indonesia. The government should raise cigarette prices by setting higher excise taxes and minimum retail prices while at the same time enforcing smoke-free laws and increasing access to smoking cessation, especially for parents, to significantly reduce smoking uptake among Indonesian youth.