Analysis of Digital Media Convergence and Social Modeling on Smoking Behavior Among Urban Secondary School Students in Four Indonesian Cities

Abstract

The prevalence of youth smoking in Indonesia continues to escalate, driven not only by conventional tobacco products but also by the ubiquitous penetration of electronic cigarettes (vapes) via digital platforms. This study aims to analyze the associations between exposure to social media advertisements, proximal social modeling (teachers and parents), and religious perceptions regarding smoking behaviors among secondary school students across four distinct urban areas (Medan, Banda Aceh, Padang, and Bogor). Utilizing a quantitative cross-sectional design, this study involved a representative sample of 2,845 students. Data were examined through Chi-Square () cross-tabulation analysis to map specific risk profiles for each municipality. The findings reveal pronounced geographical disparities in smoking determinants. In Medan and Bogor, social media exposure to vape advertising and smoking behaviors of teachers/religious instructors (ustadz) were consistently and significantly associated with student smoking initiation (). Conversely, in Banda Aceh and Padang, students' subjective interpretation of Islamic jurisprudence (fiqh) on tobacco served as a varied yet statistically significant determinant of smoking decisions. This study concludes that the implementation of Smoke-Free Zone (Kawasan Tanpa Rokok) policies within educational institutions remains sub-optimal without stringent regulations restricting digital tobacco marketing alongside robust role-modeling from school authorities. These findings urge municipal governments to integrate a total ban on digital tobacco advertisements into the enforcement of local smoke-free ordinances.