Factors Affecting Participation Levels among College Student in
the Implementation of Smoke Free Area (SFA) in Universitas
Airlangga Surabaya
Qurry Annisak
Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia
Keywords: Non-smoking area, Policy, Surabaya, College student.
Abstract: Smoking has become a major issue for public health that needs to be overcome, because it involves various
aspects of life such economic, social, political and especially health aspects. Indonesia in 2007 was ranked
as the fifth largest consumer of cigarettes (239 billion) behind China (2163 billion). The objective of this
study is to get to know the participation of students in the implementation of Smoke Free Areas (SFA) both
in relation to smokers and non-smokers, and the factors that influence the level of student participation in
the implementation of SFA in Universitas Airlangga. An observational analytic study using a cross-
sectional approach was selected. The population in this study is 1-7 semester student of Universitas
Airlangga. The research sample was taken by using the simple random sampling method. This obtained a
large sample of 95 respondents. Univariate and bivariate analysis was conducted by using a Chi-Square test
and the research instrument was a questionnaire. The result of chi-square test showed that there is a
relationship between knowledge and participation in the Smoking Free Area implementation (p=0.024). The
attitude about SFA cannot be analysed because all of the respondents show constant results; all of the
respondents have a good attitude toward SFA implementation.. The conclusion of this study is that there is a
significant relationship between the level of knowledge and the participation in the Smoking Free Area
implementation.
1 INTRODUCTION
Smoking has become a major issue for public health
because it involves various aspects of life such
economic, social, political and especially health
aspects. The smoking habit is a lifestyle that can
affect human health, and not only affect the users of
the cigarette itself but it can have a negative impact
on others around them. More than 6 million of the
deaths listed are the result of direct tobacco use
while around 600,000 are the result of non-smokers
being exposed to second-hand smoke. Nearly 80%
of the more than 1 billion smokers worldwide live in
low- and middle-income countries, where the burden
of tobacco-related illness and death is heaviest
(WHO, 2011).
Based on WHO (2011), Indonesia in 2007
ranked as being the fifth largest consumers of
cigarettes (239 billion) behind China (2163 billion),
the USA (351 billion), Russia (331 billion), and
Japan (259 billion). In Indonesia, the smoking
behaviour of the population at 15 years of age is
likely to increase from 34.2 percent in 2007 to 36.3
percent in 2013. In 2013, the most regular smokers
initiated smoking between 15-19 years old (55.4%).
The prevalence of smoking based on age at the start
of smoking, starting from age 5-9 years is as much
as 1.6%, age 10-14 years at 18%, age 15-19 years at
55.4%, age 20-24 year at 16.6%, age 25-29 years at
4.6% and at the age of more than 30 years at 3.8%
(Badan Penelitian dan Pengembangan Kesehatan
Kementrian RI, 2013).
This is a serious problem because the increase in
smoking behaviour in the population aged ≥15 years
greatly affects the quality of the younger generation
in Indonesia. One effort that can be done by the
government is to establish public policies. Public
policies essentially aim to solve the problems that
occur in society, as well as on the exact issue of
smoking behaviour.
Annisak, Q.
Factors Affecting Participation Levels among College Student in the Implementation of Smoke Free Area (SFA) in Universitas Airlangga Surabaya.
In Proceedings of the 4th Annual Meeting of the Indonesian Health Economics Association (INAHEA 2017), pages 209-212
ISBN: 978-989-758-335-3
Copyright © 2018 by SCITEPRESS – Science and Technology Publications, Lda. All r ights reserved
209

The Government enacted Law No. 36 in 2009
concerning health in section seventeen about
ensuring the safe use of addictive substances. In
article 115, section 2, it is the obligation of the local
governments to designate smoke free zones in their
jurisdiction. The government also enacted a
Government Regulation of the Republic of
Indonesia No. 109 in 2012 ‘Concerning Materials
that Contain Addictive Substances in Tobacco
Products in the Interests of Health’, specifically in
part five to regulate Smoke Free Zones. In article 49,
it is the obligation of the central government and
local governments to designate Smoke Free Zones.
Surabaya City government also enacted Government
Local Regulation No 5 in 2008 ‘About No Smoking
Area And Restricted Smoking Areas’. According to
Government Local Regulation No 5 in 2008, smoke
free areas are a space or area which has been
declared to be prohibited for smoking activities or
the activities of producing, selling, and/or promoting
cigarettes. Areas declared prohibited in the local
regulations include health care facilities, educational
facilities, children’s playing grounds, religious
places and public transport.
Universitas Airlangga as an educational facility
for student, additionally as a working place for
employees, it is necessary that it should have
implemented a Smoke Free Area based on the local
regulations. However, since the enactment of
Government Local Regulation No 5 in 2008 About
Smoke Free Area and Restricted Smoking Areas,
until now, not all areas in Universitas Airlangga
have implemented this policy. In the enforcement
and implementation of a Smoke Free Area, it should
be supported by the participation and contribution of
the entire community of Universitas Airlangga
especially the students as they are the main actors of
the campus world. The contribution is not limited to
funds and finance but can also take the form of
power and ideas.
Therefore, the objective of this study is to know
level of the participation of students in the
implementation of a Smoke Free Area (SFA) both in
smokers and non-smokers, and the factors that
influence the level of student participation in the
implementation of SFAs at Universitas Airlangga.
2 METHODS
This was an observational analytic study using a
cross-sectional approach was selected. The
population in this study is 1-7 semester student of
Universitas Airlangga. The research sample was
taken by using the simple random sampling method.
This obtained a large sample of 95 respondents. The
study was conducted from early August to early
September. The instrument used in this research was
a questionnaire. Data collection was done by
distributing an online questionnaire.
The independent variable in this research is the
knowledge and attitude about the Smoke Free Area
(SFA), and the dependent variable in this research
study was the participation level to do with the
implementation of a Smoke Free Area (SFA). The
data analysis was done by using univariate analysis
and bivariate analysis. Bivariate analysis using Chi-
square test (x2) aims to determine the relationship
between the independent variables and is bound to a
scale of nominal and ordinal data.
3 RESULTS
3.1 Univariate Analysis
Table 1 shows the characteristics of the respondents
and their level of knowledge, attitudes and
participation about the implementation of a Smoke
Free Area (SFA). The total of 95 respondents had a
distribution of 16 male respondents (16.8%) and 79
female respondents (83.2%). The distribution of
respondents in the 1
st
semester was 4 respondents
(4.2 %), 3
rd
semester 38 respondents (40.0%), 5
th
semester 21 respondents (22.1%), and 7
th
semester
32 respondents (33.37%).
Based on the univariate analysis results, the
respondent's distribution at a low knowledge level
about SFA policy consisted of 23 respondents
(24.2%) and the respondents with a high knowledge
level was made up of 72 respondents (75.8%). The
distribution of respondents with a bad attitude about
SFA was 0 respondents (0%) and the respondents
with a good attitude was made up of 100
respondents (100%). The distribution of the
respondents based on the participation rate of SFA
was that those with a low participation rate was 21
respondents (24.2%) and those with a high
participation rate was 74 respondents (77.9%).
Table 1: Univariate Analysis Result Resume
Characteristics n (%)
Sex
Male
Female
16
79
16.8
83.2
Semester
1
st
4 4.2
INAHEA 2017 - 4th Annual Meeting of the Indonesian Health Economics Association
210

Characteristics n
(
%
)
3
rd
5
th
7
th
38
21
32
40.0
22.1
33.7
Knowledge level about SFA
Low
High
23
72
24.2
75.8
Attitude level about SFA
Bad
Good
95
0
100
0
Participation level about SFA
Low
Hi
g
h
21
74
22.1
77.9
3.2 Bivariate Analysis
Table 2: Relationship between Knowledge and
Participation level on SFA
Participation
Total
Knowledge Low Hi
g
h
n % n % n %
Low
High
9
12
39.1
16,7
4
60
60.9
83.3
23
72
100
100
*p value = 0.024
Based on Table 2, the results show that 23%
respondents had a low level of knowledge, 39.1%
had a low level of participation and 60.9% had a
high level of participation. The respondents with a
high amount of knowledge were as many as 72
respondents with a presentation of 60.9% with a low
level of participation and 83.3% had a high level of
participation. The statistical analysis using Chi
square test obtained p = 0.024 (p <0.050), which
means that there is a relationship between
knowledge and the level of participation to do with
the implementation of SFA.
In this study, the attitude variable has not been
calculated because the result is constant. All of the
respondents have a good attitude, so it cannot be
analysed by way of bivariate analysis.
4 DISCUSSION
Most of the respondents have a high level of
knowledge about SFA (75.8%), especially in terms
of understanding SFA and areas included in SFA.
Only a few had knowledge about the implementation
of SFA regulations. Most of the students do not
know about government regulations and local
regulations about Smoke Free Areas. The Chi square
test result obtained a value of significance at 0,024
so it can be concluded there is a relationship
between knowledge with the level of participation.
Some previous research results have illustrated
the existence of a negative influence between
cigarette consumption and health status, both self-
health status and national health status. Cigarette
illnesses such as lung infections, coronary heart
disease and chronic obstructive pulmonary disease
have become one of the leading causes of death in
the world. Both for active smokers and second-hand
smokers, the health problems that appear because
the toxic substances in cigarettes are endangering
them. Therefore, it can be predicted that decreasing
cigarette purchasing patterns after increasing
cigarettes taxes will reduce the risk of smoking-
related diseases in Indonesia.
This study shows similar results with Renaldi’s
research in 2013 on Students at the Health Science
High School of Hang Tuah Pekanbaru, which states
that there is a significant relationship between
SFAknowledge with the implementation of SFA
(p=0,000). However, this is different to the results
from Saptorini’s research in 2013 at the University
of Dian Nuswantoro Semarang which states that
there is no relationship between knowledge and
participation (p = 0.065). Many previous studies
have reported on the association between knowledge
and participation in policy implementation. In
theory, the knowledge base that is possessed will
affect the whole environment of society. This makes
the community understand or not understand the
stages and forms of participation that exist (Yulianti,
2012). Knowledge of a policy is needed to
understand how the implementation of a policy
works, and that understanding can support a person
in their participation with a policy. The community's
knowledge of the participation process will
determine the nature and direction of a decision that
is to be taken (Ramla, 1992). One way to increase
public participation, especially for students, is to
have knowledge of SFA policy, and knowledge of
how the course will increase with the information
received. Therefore, socialisation is needed
regarding the policy and application of SFA as a
form of information that can increase knowledge
about the implementation of SFA.
5 CONCLUSIONS
This research study has concluded that 75.8% of the
respondents have a high level of knowledge about
Smoke Free Areas, 100% of the respondents have
good attitude about SFA and 77.9% of the
Factors Affecting Participation Levels among College Student in the Implementation of Smoke Free Area (SFA) in Universitas Airlangga
Surabaya
211

respondents have a high rate of participation towards
SFA implementation. There is a correlation between
knowledge of SFA with SFA participation with a
significance value of 0.024. The attitude about SFA
cannot be analysed because all of the respondents
have a good attitude toward SFA implementation.
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