The Role of Health Literacy in Quitting Tobacco in Indonesia

Nicole Johnson, Sri Handayani, John Parrish-Sprowl

Introduction: Within the past few years, Indonesia Ministry of Health and government have begun to push toward more anti-tobacco initiatives by sponsoring mass media campaigns and advertising policy changes. Smoking is considered a way of life in Indonesia where most smokers never consider quitting. Indonesia is home to the third highest number of smokers in the world. Currently, almost 60% of Indonesian men, the highest rate in the world, and 30% of all Indonesians smoke. Tobacco is the leading preventable cause of death worldwide, yet Indonesia remains a hotbed for the tobacco industry.

RQ1) Among current smokers in Indonesia, is there a difference in health literacy scores among gender, age, education, residence location, marital status and health status?

RQ2) Is there a significant difference in health literacy scores among current smokers, ever and never smokers in Indonesia?

RQ3) Among current smokers in Indonesia, is there a difference in health literacy scores between those who intend to quit and those who do not?

RQ4) Among current smokers in Indonesia, what are the predictors of intent to quit smoking?

Methods: Adults in a large city in Indonesia were recruited online and at a public university to complete a survey (n = 304). 63% (n = 174) of respondents ranged from 18 to 34 years old. 55% (n= 152) of respondents were current smokers. We measured health literacy using a 3-item measure. Smoking status and intent to quit smoking were measured by single items. T-tests, ANOVAs and a multiple regression analysis were conducted to answer the research questions.

Results: RQ 1: There is a significant difference in health literacy scores based on gender (p=.015, r=.43), residence location (p<.001, r=.48), education (p<.001, r=.15), marital status (p=.011, r=.22), and health status (p<.001, r=.097). RQ 2: There is a significant difference in health literacy scores among current smokers, ever smokers, and never smokers (p = .011, r=.192). RQ 3: There is a significant difference in health literacy scores between smokers who intend to quit and those who do not (p<.001, r=.37). RQ 4: Health literacy was the only significant predictor of intent to quit (p=.004).

Conclusion: As Indonesia seeks to reduce its number of deaths related to tobacco, understanding health literacy provides data for message development and dissemination for smoking cessation. Findings from this preliminary research contribute insight about how health literacy is associated with intent to quit smoking, and provide a foundation for future research examining relationships between health literacy and readiness for change for smoking cessation as a global health initiative.

This abstract was submitted to the 2017 Society for Prevention Research Annual Meeting.