BACKGROUND: Smoking relapse refers to the resumption of smoking behavior after a quit attempt, often triggered by nicotine addiction and various enabling factors. In children, smoking relapse also can be influenced by cigarette prices, advertisements, and environmental factors. However, limited studies explore the causes of smoking relapse in Indonesian children, despite this being a failure to protect them from the adverse effects of smoking. Understanding the most significant risk factors is essential to inform future tobacco control interventions. This study aims to examine the incidence of smoking relapse in children and analyze the effects of cigarette prices and non-price factors.
METHODS: This study utilized data from the Global Youth Tobacco Survey (GYTS) conducted in 2006, 2009, 2014, and 2019. The category of smoking relapse was identified based on the question about whether participants had ever tried to quit smoking in the past 12 months as recorded in the GYTS. A multivariate logistic regression model was applied to predict the likelihood of relapse, incorporating key determinants from both price and non-price factors.
RESULTS: The results show that smoking relapse rates among children remain high, exceeding 50% between 2009 and 2019. Low cigarette prices significantly increase the coefficient likelihood of smoking relapse: Rp1,000/US$0.067–Rp1,500/US$0.10 (-0.036; p<0.001) and Rp1,600/US.11–Rp2,000/US$–0.13 (-0.075; p<0.001). Purchasing cigarettes by the pack reduces relapse rates more steeply than buying single sticks. Non-price factors contributing to relapse include peer influence (0.110; p<0.001), e-cigarette use (0.129; p<0.001), and exposure to cigarette advertising across various media (0.079; p<0.001). CONCLUSIONS:###HTMLTAG### The study concludes that both price and non-price factors drive smoking relapse in children. Policies to significantly increase cigarette prices and prohibit single-stick sales are crucial to preventing smoking relapse among Indonesian children.