{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T02:00:23Z","timestamp":1793325623687,"version":"4.5.0"},"reference-count":38,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"unspecified","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,9]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescent tobacco use (ATU) is a global public health concern, causing significant morbidity and premature death. This study aimed to assess trends in the prevalence of ATU in Indonesia between 2009 and 2019 and to identify factors contributing to the observed changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study performed secondary data analysis of three consecutive waves (2009, 2014, and 2019) of the Indonesian Global Youth Tobacco Survey (IGYTS). Weighted prevalence estimates and complex survey data analysed using multivariate logistic regression were established across the three-wave surveys. A pooled IGYTS data set was explored to determine the risk factors of the ATU. A multivariate decomposition analysis (MDA) was used to determine factors contributing to the prevalence change in male adolescents over the last two surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of ATUs was 21.1% (38.2% in males; 6.4% in females), 18.6% (32.7% in males; 3.9% in females) and 19.8% (36.8% in males; 3.5% in females) for the three consecutive surveys, respectively. Being older adolescents, male, exposed to SHS (secondhand smoke) at home, tobacco industry promotion, not knowledgeable of the dangers of tobacco smoke and SHS, and against banning smoking in public places were associated with ATU consistently across the surveys. In addition, inadequate anti-cigarette media and not being knowledgeable of the difficulty of quitting smoking were also identified as risk factors in the pooled data. MDA showed that 88.94% of the explained change was due to differences in the composition of explanatory variables between the last two surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study suggests that social influence and tobacco industry promotion significantly impact ATU in Indonesia. Governments should emphasise these factors in their tobacco control interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-105035","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T14:55:20Z","timestamp":1773327320000},"page":"e105035","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Changes in the prevalence of adolescent tobacco use and its associated factors in Indonesia: analysis of repeated cross-sectional survey 2009\u20132019"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7733-0126","authenticated-orcid":false,"given":"Antonius Yansen","family":"Suryadarma","sequence":"first","affiliation":[{"name":"Faculty of Public Health, Department of Epidemiology, Biostatistics, Population and Health Promotion, Universitas Airlangga, Surabaya, Indonesia"},{"name":"School of Medicine, Department of Public Health, Preventive Medicine, and Community Medicine, Universitas Ciputra, Surabaya, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8904-5525","authenticated-orcid":false,"given":"Sigit Ari","family":"Saputro","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Department of Epidemiology, Biostatistics, Population and Health Promotion, Universitas Airlangga, Surabaya, Indonesia"},{"name":"Center of Excellence for Patient Safety and Quality, Universitas Airlangga, Surabaya, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1057-5436","authenticated-orcid":false,"given":"Ronny","family":"Isnuwardana","sequence":"additional","affiliation":[{"name":"Laboratory of Public Health and Community Medicine, Mulawarman University, Samarinda, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0746-3716","authenticated-orcid":false,"given":"Monita","family":"Destiwi","sequence":"additional","affiliation":[{"name":"Centre for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8728-0639","authenticated-orcid":false,"given":"Philip Etabe","family":"Bassey","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2424-1776","authenticated-orcid":false,"given":"Santi","family":"Martini","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Department of Epidemiology, Biostatistics, Population and Health Promotion, Universitas Airlangga, Surabaya, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0470-8308","authenticated-orcid":false,"given":"Susy Katikana","family":"Sebayang","sequence":"additional","affiliation":[{"name":"Faculty of Health, Medicine and Life Sciences, Universitas Airlangga, Banyuwangi, Indonesia"},{"name":"Research Group for Health and Wellbeing of Women and Children, Universitas Airlangga, Surabaya, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"2026062609363167000_16.3.e105035.1","unstructured":"World Health Organization (WHO) . 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