FACTORS ASSOCIATED TO SMOKING BEHAVIOR IN WORSHIP PLACES IN DENPASAR BALI INDONESIA
Keywords:Smoking behavior, worship places, compliance, smoke-free law, Denpasar Bali
Since 2013, City of Denpasar government has adopted smoke-free law regarding smokefree areas including worship places. However, compliance with smoke-free law at worship places
remains low. The implementation of the law faces several obstacles particularly at Hindu temples since
it is mostly semi-opened spaces and high social acceptability of smoking where cigarette and smoking
have been deeply engrained within social and religious life. Hence, this study aims to assess factors
that associated with smoking behavior at worship places particularly at Hindu temple in Denpasar Bali
Indonesia. This study was a cross-sectional study, conducted in the city of Denpasar, involving 192
samples which selected using multistage random sampling. The data was collected using a structured
questionnaire then analyzed using path analysis. There were 12 factors analyzed such as past behavior
of smoking, exposure to anti-smoking policies, nicotine dependence, knowledge and attitude regarding
second-hand smoke, knowledge and attitude regarding implementation of smoke-free law,
sociodemographic (age, education), social norms of smoking (descriptive and injunctive). Of the 11
factors, 5 factors had a significant effect on smoking behavior. Past behavior of smoking had a direct
negative effect with a standardized coefficient (beta) -0.34 (p<0.01); followed by nicotine dependence
which had an indirect negative effect (beta -0.07; p=0.01). Meanwhile, positive direct and indirect
effects showed by descriptive norms (beta 0.14; p=0.04); injunctive norms (beta 0.15; p=0.02) and
education (beta 0.14; p=0.03). Past behavior of smoking had the highest effect on smoking behavior
in worship places. Hence, continuous education, socialization and improved supervision to the
implementation of smoke-free law remain crucial. Moreover, social norm factors also need more
attention, so that a culture-sensitive strategy could be considered
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