Segmentation of socio-ecological factor for adolescent smoking in Indonesia: Fondations for healthcare preventation strategies contributing in SDG 3

Smoking leads to global threat due to the consequences of premature death. Tobacco epidemic soars gradually in Indonesia, specifically for adolescents (10 – 18 years old). Therefore, understanding multiple variables for smoking adolescents is essential to design healthcare prevention strategies in Indonesia. The purpose of this study is to identify socio-ecological aspects of smoking behavior among Indonesian adolescents for establishing appropriate prevention strategy to contribute in SDG 3. The search was performed across Web of Science, Global Health, PubMed, and Scopus for studies in English and Indonesian language. There are 1,454 articles discovered and assessed using eligibility criteria, then presented using PRISMA flowchart. This review includes 21 studies that identify variables at individual, interpersonal, organizational, and society levels with family factors that were mostly investigated (n=10). Older age, male, low-income family, higher pocket money, psychological distress, risky behavior, conventionally smoke, close-relatives, advertisement exposure, low price cigarettes are risk factors. In opposite, negative opinions of smoking, healthy life knowledge, family/peer and school support are protective factors. Regarding the findings, healthcare needs to integrate smoking education to school based settings to improve health quality. Education, knowledge, and school elements can protect the children from smoking, indicating the collaboration between school and healthcare to educate students is necessary.