Abstract

Perilaku merokok memberikan dampak negatif, baik bagi perokok aktif maupun pasif, ditinjau dari sudut pandang kesehatan maupun ekonomi. Regulasi mengenai Kawasan Tanpa Rokok (KTR) yang telah diterbitkan belum ada yang mengatur mengenai penerapan KTR di tingkat rumah tangga. Penelitian ini bertujuan untuk mengidentifikasi perubahan perilaku melalui intervensi terpadu KTR pada tingkat rumah tangga. Penelitian dilakukan pada bulan Juli - September 2014 menggunakan desain cluster trial pada empat desa di Kabupaten Ogan Ilir, Sumatera Selatan. Selanjutnya, 200 sampel kepala keluarga dipilih melalui metode cluster random sampling. Intervensi yang dilakukan meliputi konseling terpadu, pemberian permen pengganti rokok, dan tabungan sehat. Hasil penelitian menunjukkan bahwa proporsi responden yang merokok setiap hari dalam sebulan terakhir dan komitmen untuk tidak akan merokok di masa yang akan datang mencapai 71,6% dan 62% pada kelompok intervensi serta 91% dan 38% pada kelompok non-intervensi. Intervensi ini berpeluang 46% mengurangi perilaku merokok responden (RP = 0,46) setelah dikontrol oleh variabel pendidikan (RP = 0,152) dan sikap (RP = 0,216) dengan nilai p < 0,0001. Intervensi terpadu ini terbukti berhasil mengubah perilaku merokok pada kawasan rumah tangga sehingga diperlukan partisipasi masyarakat dan dinas kesehatan setempat untuk menindaklanjuti penerapan intervensi ini dalam jangka panjang. Smoking behavior has negative impacts, both for active and passive smokers, as reviewed from health and economic perspectives. Regulation concerning non-smoking area issued has not yet arranged implementation of non-smoking area at household level. This study aimed to identify any behavior change through integrated intervention of non-smoking area at household level. This study was conducted on July - September 2014 using cluster trial design in four villages at Ogan Ilir District, South Sumatra. Then 200 household head samples were selected through cluster random sampling method. The intervention included integrated counseling, distribution of candy as substitute for cigarette, and healthy saving. Results of study showed that proportion of respondents who smoked every day in a recent month and had a commitment not to smoke in the future reached 71.6% and 62% in the intervention group, then 91% and 38% in the non-intervention group respectively. This intervension had opportunity worth 46% reducing the smoking behavior of the respondents (RP= 0.46) after controlled by the variable of education (RP = 0.152) and attitude (RP = 0.216) with p value < 0.0001. This integrated intervention was profoundly successful changing smoking behavior at household level. So that, public participation and health agency need to follow up the implementation of this intervention in a long term.

References

1. Republic of Indonesia Ministry of Health. The tobacco source book: data to support nasional tobacco control strategy. Jakarta: Indonesia Ministry of Health; 2004.

2. Badan Pusat Statistik. Survey demografi dan kesehatan Indonesia. Jakarta: Badan Pusat Statistik; 2012.

3. Kementerian Kesehatan Republik Indonesia. Riset kesehatan dasar tahun 2007. Jakarta: Kementerian Kesehatan Republik Indonesia; 2008.

4. Kementerian Kesehatan Republik Indonesia. Riset kesehatan dasar tahun 2010. Jakarta: Kementerian Kesehatan Republik Indonesia; 2010.

5. Global Youth Tobacco Survey (GYTS). Indonesia-nasional 2006. Atlanta-USA: Centers for Disease Control and Prevention (CDC); 2009.

6. Dinas Kesehatan Kabupaten Ogan Ilir. Profil kesehatan Kabupaten Ogan Ilir tahun 2009. Indralaya: Dinas Kesehatan Kabupaten Ogan Ilir; 2009.

7. Dinas Kesehatan Provinsi Sumatera Selatan. Ringkasan eksekutif data dan informasi kesehatan Provinsi Sumatera Selatan. Palembang: Dinas Kesehatan Provinsi Sumatera Selatan; 2012.

8. Eriksen M, Hana R dan Judith M. The tobacco atlas, 4th edition. AtlantaGeogia: American Cancer Society; 2011.

9. Lemeshow S, Hosmer DW dan Klar J. Besar sampel dalam penelitian kesehatan. Dalam: Pramoni D, Kusnanto H, editor. Yogyakarta: Gadjah Mada University Press; 1997.

10. Perkins KA, Giedgowd GE, Karelitz JL, Conklin CA dan Parzyns CS. Expectancy for negative affect relief due to smoking may not be predictive under acute mood situations. Experimental and Clinical Psychopharmacology. 2012; 20 (2): 161–6.

11. Reimondos A, Utomo ID, McDonald P, Hull T, SuparnoH, dan Utomo A. Merokok dan penduduk dewasa muda di Indonesia, the 2010 Greater Jakarta Transition to Adulthood Survey-Policy Background No. 2. Canberra: Australian Demographic and Social Research Institute -the Australian National University ; 2012.

12. Broms U, Silventoinen K, Lahelma E, Koskenvuo M, Kaprio J. Smoking cessation by socioeconomic status and marital status: the contribution of smoking behavior and family background. Oxford Journals. 2004; 6 (3): 447-55.

13. Chotidjah S. Pengetahuan tentang rokok, pusat kendali kesehatan eksternal dan perilaku merokok. Makara Seri Sosial Humanioral. 2012; 16 (1): 49-56.

14. Berg C J, An LC, Thomas JL, Lusi KA, Sarem JR, Swam PW, et.al. Smoking patterns, attitudes and motives: unique characteristics among 2-year versus 4-year college students. Health Education Research. 2011; 26 (4): 614–23.

15. Vries, Hd, Engels R, Kremers S, Wetzels J, Mudde A. Parents’ and friends’ smoking status as predictors of smoking onset: findings from six European countries. Health Education Research. 2003;18 (5): 627-36.

16. Septiono W, Meyrowitsch DW. Family role towards smoking behavior among children in Jakarta. Kesmas: Jurnal Kesehatan Masyarakat Nasional. 2014; 9 (1): 58-63.

17. Azkha N. Studi efektivitas penerapan kebijakan perda kota tentang kawasan tanpa rokok (ktr) dalam upaya menurunkan perokok aktif di Sumatera Barat tahun 2013. Jurnal Kebijakan Kesehatan Indonesia, 2013; 2 (4): 171–9.

18. Prabandari YS, Ng N, Padmawati RS. Kawasan tanpa rokok sebagai alternatif pengendalian tembakau studi efektivitas penerapan kebijakan kampus bebas rokok terhadap perilaku dan status merokok mahasiswa di fakultas kedokteran UGM, Yogyakarta. Jurnal Manajemen Pelayanan Kesehatan. 2009; 12 (4): 218–25.

19. Blackburn C, Spencer N, Bonas S, Coe C, Dolan A, Moy R. Effect of strategies to reduce exposure of infants to environmental tobacco smoke in the home: cross sectional survey. British Medical Journal. 2003; 327 (1): 257-61.

20. Onyeonoro UU, Chukwuonye II, Madukwe OO, Ukegbu AU, Akhimien MO Ogah OS. Awareness and perception of harmful effects of smoking in Abia State, Nigeria. Nigerian Journal of Cardiology. 2015; 12 (1): 27- 33.

21. Terrades M, Coulter WA, Clarke H, Mullally BH, Stevenson M. Patients’ knowledge and views about the effects of smoking on their mouths and the involvement of their dentists in smoking cessation activities. British Dental Journal. 2009; 207 (E22): 1-6.

22. Berg CJ, Carpenter MJ, Jardin B, Ostroff JS. Harm reduction and cessation efforts and interest in cessation resources among survivors of smoking-related cancers. Journal of Cancer Survivorship. 2013; 7 (1): 44–54.

23. Dietz NA, Hooper MW, Byrne M, Messiah A, Baker EA, Parker DF, et al. Developing a smoking cessation intervention within a communitybased participatory research framework. Journal of Smoking Cessation. 2012; 7 (2): 89–95.

24. Carpenter MJ, Alberg AJ, Graya KM, Saladin ME. Motivating the unmotivated for health behavior change: a randomized trial of cessation induction for smokers. Clinical Trials. 2010; 7 (1): 157–66.

Share

COinS