Students' Perceptions of the Prohibition of Smoking in Public Middle Schools

Introduction: The smoking ban policy in Indonesia has not been fully complied with by the community, one of which is the policy of prohibiting smoking in schools. Smoking behavior at school is influenced by several factors such as knowledge, environmental influences, experience


Introduction
Indonesia is the fifth largest tobacco producer and the third largest cigarette user in the world.Based on Riskesdas in 2018, reported that children aged 15 years and over can consume as many as 12 cigarettes per day.Sourced on Global Youth Tobacco Survey (GYTS) in 2019, school-age children who smoked 39.6% of them boys 67.7% and girls 12.8%.On the other hand, school children aged 13-15 years are exposed to secondhand smoke at home as much as 57.5% and exposed to secondhand smoke in public places as much as 66.2% (Balitbangkes RI, 2018) (Purnamasari, Smoking, & Smoking, 2023).According to the results of Riskesdas in 2018, the age of first smoking is at the age of 5-9 years (0.9%), at the age of 10-15 years 10.6% and at the age of 15-19 years 48.2%v (Balitbangkes RI, 2018).
Meanwhile, according to the National Socioeconomic Survey (Susenas) of the Central Statistics Agency (BPS), the proportion of Indonesians aged ≥ 15 years who smoke is 28.26% in 2022, down slightly from the previous year of 28.96%.Based on the province, the most smokers in Indonesia are occupied by Lampung Province with a percentage of smokers as much as 33.81%.Based on BPS data, South Sumatra Province is ranked third active smoker on the island of Sumatra with the number of smokers of 30.49%.Smokers in South Sumatra consume cigarettes with an average of 12 cigarettes per day.The highest percentage of the initial age of smoking is in the age group of 15-19 years, which is 34.1% and the age of 10-14 years is 10.6% (Hidayati, Pujiana, &;Fadillah, 2019).
According to smoker data in Banyuasin Regency in 2022, the prevalence of smokers is 24.0% and Rantau Bayur District is the highest percentage, namely in the Semuntul Health Center work area with a smoking prevalence of 54.0%, with an adolescent age group of 3.94%.
Security of substances containing addictive substances is regulated in Government Regulation Number 109 of 2012 article 49, namely the implementation of security of substances containing addictive substances and tobacco for health, the Government and local governments are obliged to realize areas without smoking.Indonesia enforces a ban on smoking in public places consisting of health facilities; teaching and learning process; The implementation of non-smoking areas has been implemented by education units in the Banyuasin Regency area, especially in JHS Negeri 6 Rantau Bayur.Smoking ban for JHS Negeri 6 Rantau Bayur students is in accordance with the principal's policy stated in the school rules.Students who violate these rules will be sanctioned.Based on the observations that researchers found that there were 5 students who violated the rules of conduct by smoking in the school environment in 2022, the purpose of this study was to find out how students perceived the smoking ban in the school environment.It is expected to find out what dominant factors can influence students' perceptions of smoking bans.

Method
This research uses qualitative research with a case study approach.Data collection through in-depth interviews, Focus Group Discussion (FGD), document review, and direct observation in the field as primary data sources for research, and notes or documents in schools are used as secondary data sources.The informants in this study were 43 people consisting of 13 in-depth interview informants, namely 5 students, 1 school principal, 1 counseling guidance teacher, 6 parents of students and 3 Focus Group Discussion (FGD) groups of 10 people each, in the selection of informants, researchers used purposive sampling.This research is located at JHS Negeri 6 Rantau Bayur, Talang Kemang Village, Rantau Bayur District, Banyuasin Regency.Data management in this study uses Nvivo 12 Pro Software.This research has received ethical clearance No.LB.02.06/2/54/2023Jambi Poltekes.

Age
Based on the results of in-depth interviews and FGDs that have been conducted, it shows that students are aware of the smoking ban and the adverse effects of smoking.In accordance with the results of research obtained on class IX informants with an age range of 14-15 years conveyed about the dangers of smoking, smoking can cause many diseases, and there are places where smoking is prohibited such as transportation, health facilities, as expressed as follows: "cigarettes cause lung cancer, the lungs turn black and perforated" (TY) "can stunt growth for children" (A-Z) "The smoking ban is usually in public places that are not allowed to smoke, such as places of worship, public transportation, and schools" (NR) Annisa Indah Zhafirah, M Ridwan, Vinna Rahayu Ningsih, Willia Novita Eka Rini, Puspita Sari/KESANS Students' Perceptions of the Prohibition of Smoking in Public Middle Schools Based on the results of in-depth interviews and FGDs that have been conducted, it shows that class VIII and VII informants, namely those with an age range of 12-14, have decreased, namely not more understanding of the dangers of cigarettes and smoking prohibitions with an age range of 14-15 who have more understanding, as expressed as follows: "True, cigarettes endanger health, can make coughing" (SE)

"Smoking can cause diseases such as cancer" (SI)
"The smoking ban is usually installed in places where it is not permissible to smoke, such as schools and school environments" (DW)

Information
Students have known about the smoking ban information by looking at the media in the form of banners, posters, rules of conduct posted on school walls, and also with health socialization carried out by the puskesmas and police, this socialization is carried out once a year, this is in accordance with the statement expressed as follows: "socialization from puskesmas mothers was once from the police" (EP) "With the police, health authorities or pukesmas in increasing discipline and health of students so that they instill discipline and they apply according to the rules of conduct to hold socialization held once a year to strengthen the character of students as well as remind the dangers of smoking for students.For 2023 this has not been held again but has been conveyed continuously from the school during the coaching ceremony" (KS) This is also supported by the results of observations made, that there are indeed banners installed near the school gate, posters pasted on the walls and school madding and also the rules posted in each classroom.

Social Rules
Social rules applied in the JHS Negeri 6 Rantau Bayur environment are rules prohibiting smoking in the school environment which have been written in school rules such as not being allowed to smoke in the school environment and outside school by wearing school uniforms, this is in accordance with the statement expressed as follows: "No smoking is allowed in the school environment and outside the school while wearing school uniform" (GS) In addition to the prohibition not to smoke in the school environment and outside school while wearing school uniforms, JHS Negeri 6 Rantau Bayur has also set a ban on buying "It is not possible, and in JHS Negeri 6 Rantau Bayur prohibits the sale of cigarette products, either in the school canteen or still in the school circle" (KS) Furthermore, the sanctions and penalties applied if students violate the rules that have been set, such as being reprimanded, calling parents, making a letter of agreement and being suspended, this is in accordance with the statement expressed as follows: "The sanction is reprimanded by the teacher, then called by the parents, filling out a letter of agreement that they will not repeat the violation again" (AM) "... Students are scouted three times, after which they call the parents of the students, and if they repeat the violation, they will be returned to their parents or on the screen."(KS)

Experience
The experience experienced by students shows that they have only known about the ban on meroko in the school environment since the beginning of entering JHS, this shows that students have not previously known about the ban, in accordance with the statement expressed as follows: "If it's about the smoking ban in schools, I only know when I enter JHS here" (FH) Students who have a record of violations have the experience of being caught smoking while in the upper canteen wearing school uniforms, this is in accordance with the statement expressed as follows: "Caught when I came home from school, in front of the school there was a canteen, caught smoking by a friend while behind the canteen" (DM) Learners also revealed that they usually get cigarettes by asking with friends or bringing their own from home and buying them at stalls.This is in accordance with the statement expressed as follows: "Bring from home or buy at a stall" (AM) "Buy from a stall or ask a friend" (DM) Students who smoke have a good taste experience when smoking which begins with curiosity to try which ends up being smokers, this is in accordance with the statement expressed as follows:

Milieu
The environment owned by students shows that almost all parents smoke, namely their fathers, and the habit of parents smoking is seen by students, this is in accordance with the statement expressed as follows: "Never, I've seen my father smoke at home" (SE) "Usually dad smokes at home, so I see him a lot" (TY) Students who have a record of violations have a parental environment that does not prohibit and does not get angry when their children smoke, this is in accordance with the statement expressed as follows: "Not scolded, my father never got angry, at that time I was called because I was caught smoking, my father was not angry at all" (DM) "I can't be angry or forbid either, I've been young" (ND) This is in contrast to the statement of students who have never had a record of violations because they have a parental environment that strictly prohibits and is angry if they smoke, this is in accordance with the statement expressed as follows: "Not allowed, definitely going to be scolded too, I've seen my brother get caught smoking, he's been scolded" (AP) "Mother is strict if the problem (smoking), but if the father is not angry, the child if he has started smoking usually likes to be fierce and resist, therefore the mother forbids it (smoking)" (RH) Students who have a record of violations reveal that when they see their parents smoking, have the desire to try, it is inversely proportional to the statement of students who do not have a record that reveals that they do not have the desire to smoke, this is in accordance with the statement expressed as follows: "There is a desire, because it looks like a good activity, when you see you smoking again, it feels like trying" (SE) "Because it is common to see the father smoking, but there is no desire to try (cigarettes)" (MR) Annisa Indah Zhafirah, M Ridwan, Vinna Rahayu Ningsih, Willia Novita Eka Rini, Puspita Sari/KESANS Students' Perceptions of the Prohibition of Smoking in Public Middle Schools

Age
The understanding of each student varies according to their age level.Students aged 14-15 years, namely class IX, have a better understanding of what are the adverse effects of smoking such as diseases caused by smoking and non-smoking areas consisting of schools, hospitals, public transportation, and so on.Students with an age range of 12-14 years, namely grade VIII and grade VII, experienced a decrease in understanding, namely not more understanding of the dangers of cigarettes and smoking prohibitions.This is because the adolescent phase aged 11-14 years is early adolescence, which is where adolescents are still adapting to their replacement, adolescents aged 14-17 years are middle adolescents characterized by the development of new thinking skills and learning to make their own decisions (Benjamin J. Sadock, Virginia A. Sadock, 2009).
According to Alizamar & Nasbahry (2016), age differences can distinguish each person's understanding of perceiving something, age can affect a person's comprehension and mindset, because the older a person is, the more they know (Alizamar Nasbahry Couto, 2016).This is in accordance with research conducted by Indah Istiyarini, et al ( 2019) the older the student, the more reasonable the smoking ban is (Istyarini & Sartika, 2020).Each of the learners has an independent perception related to his knowledge.Knowledge about smoking prohibitions and the dangers of smoking can be obtained not only from the school but can be from social media, electronic media, which can increase students' knowledge of smoking bans in the school environment.

Information
Learners pay attention to the information they see and hear through the five senses who eventually understand the meaning conveyed.The information conveyed has gone well with socialization from the puskesmas and the police.For media such as banners and posters, it is optimal with the installation of large information and pasted on several school walls that can be clearly seen by students and school residents, but for school rules posted in each classroom is not optimal enough because the size is very small and difficult to see from a distance by students which makes information not conveyed optimally.Information media is a means or effort to display messages or information to be conveyed through print, electronic and room media.The media serves to help health counseling so that the target of counseling gets material and information clearly and purposefully (Kurniati Nawangwulan, S.M., M.Kes; Dr.Ady Purwoto, S. Kep., Ners., M.Kep., 2022).
According to Alizamar &Nasbahry that information enters through the sensory devices that a person has such as hearing and vision, namely in the form of colors, images.A person's sensory capacity to perceive something will vary according to what they see and hear (Alizamar Nasbahry Couto, 2016).This is in line with research conducted by Effendy et al (2022) on the results of indicators audience reponse Considered positive because it obtained a frequency value of 62 percentage of 77% which means students understand the message and meaning of pictures that have a ban on smoking, students Annisa Indah Zhafirah, M Ridwan, Vinna Rahayu Ningsih, Willia Novita Eka Rini, Puspita Sari/KESANS Students' Perceptions of the Prohibition of Smoking in Public Middle Schools know that the cross indicates wrong and students understand the purpose of the picture about the dangers of smoking (Effendy & Rafii, 2010).
Research conducted by M. Ridwan, et al (2023) on the No Smoking Area Policy in Indonesian Schools, is not in line with the results of the research conducted, which shows obstacles and challenges in implementing smoke-free areas in educational facilities in Muaro Jambi Regency.The main obstacle is the lack of widespread socialization of local regulations on no-smoking areas (Ridwan, Syukri, Solida, Kalsum, & Ahsan, 2023).Information if conveyed by the right communicator and the right media and interesting to see, it can have an impact on students, especially when students perceive the prohibition of smoking in the school environment.

Social Rules
The smoking ban policy at JHS Negeri 6 Rantau Bayur is quite clear with the rules of conduct and sanctions given from the school and the absence of sales of cigarette products.All students are aware of the smoking ban that has been written in the school rules and regulations that have been made by the school, but this smoking ban has not run optimally because there are still students who are caught smoking in the school environment, due to the lack of compliance of students regarding the smoking ban.Students who are caught smoking will receive guidance, this is in accordance and in line with the Regulation of the Minister of Education No. 65 of 2015 article 7 paragraph 3, namely schools are required to provide guidance to students who smoke inside and outside the school environment in accordance with applicable regulations.In addition to coaching students who violate will get strict sanctions, and this has been done by JHS Negeri 6 Rantau Bayur in accordance with the Minister of Education Regulation No.65 of 2015 Article 5 paragraphs 3 and 4.
The implementation of policies regarding the sale and purchase of cigarette products, from the statement of students that in JHS Negeri 6 Rantau Bayur there is no sale of cigarette products, this shows that JHS Negeri 6 Rantau Bayur has implemented regulations in accordance with the Minister of Education Regulation No. 65 of 2015 article 5 paragraph (1).The results of research conducted by Rika, 2018 are in line with showing that the implementation of non-smoking areas has not been effective and maximal because there are still students, teachers and employees who smoke in the school environment, this happens because of the low level of compliance (Marchel, 2019).
However, research conducted by M. Ridwan, et al (2023) is not in line, namely on the Policy Study of School No Smoking Areas in Indonesia, showing that the implementation of local government regulations has not been carried out according to the provisions set by the regent, resulting in low compliance with smoke-free zones in educational institutions (Ridwan et al., 2023).This is because JHS Negeri 6 Rantau Bayur has implemented policies in accordance with the regulations of the Minister of Education and Banyuasin Regency Government.

Experience
Annisa Indah Zhafirah, M Ridwan, Vinna Rahayu Ningsih, Willia Novita Eka Rini, Puspita Sari/KESANS Students' Perceptions of the Prohibition of Smoking in Public Middle Schools Previous experience of students shows that they only know about the smoking ban when they first enter JHS which makes students from those who do not know the smoking ban in school finally know.Research conducted by Dimitra Mpousiou, et al (2021) on Could adolescents be the vehicle that transfers a no-smoking rule from school to home shows that experiential learning programs have succeeded in increasing adolescent students' knowledge about smoking (Mpousiou et al., 2021).
Students have experience of being caught smoking in the school environment, namely in the school cafeteria and making cigarettes commonplace and showing that there are smoking activities that are still in the school environment, this is in line with research conducted by Mua, Sudirman & Kadri (2018) concerning the Implementation of Regional Regulation of Sigi Regency No. 8 of 2016 concerning Non-Smoking Areas (KTR) at the Kulawi Health Center.This study concludes that the implementation of the No Smoking Area Policy at the Kulawi Health Center has not been carried out because there are still smoking activities both inside the building and outside the Kulawi Health Center (Front, Sudiudiudi, & Kadri, 2018).
From the results of in-depth interviews also obtained statements from students who stated that they smoked because of curiosity which over time caused a sense of pleasure and addiction, students also got cigarettes from asking with friends, buying them at stalls or directly bringing them from home.Research conducted by Ida Suryawati, et al (2022) is also in line, namely it was found that peers who smoke the majority will become smokers because adolescents see and are curious about the sensations and tastes released from cigarettes so as to imitate these habits (Suryawati and Gani, 2022).
The experiences possessed by students, whether positive or negative will give their own impression and are well stored in their memory.A person's experience may come from different sources, but ultimately it has an impact on the way they perceive cigarettes.Several alternative efforts can be made to minimize the increase in the prevalence of adolescent smoking according to Yuyun, et al (2019) by bringing them closer to positive things, such as being active in social organizations and organizations at school, participating in extracurricular activities that can develop talent interests and invite them to improve their religious attitudes as religious people (Umniyatun, Nurmansyah, Maisya, & Al Aufa, 2019).It is hoped that this effort and supported by school policies can optimize the implementation of smoke-free clean schools and become a deterrent effect for students.

Milieu
The environment influences students' perceptions of smoking bans, informants who have smoker parents and smoker friends tend to have a perception that smoking is normal and want to smoke and violate smoking in the school environment.The attitude of parents who allow or prohibit students to smoke affects students' perceptions of smoking bans, parents who allow, make students have the perception that smoking bans are normal and there is no fear in them to smoke, while parents who prohibit, make students' perceptions of cigarettes are not good and have a fear of smoking and violate smoking prohibition  Mpousiou, et al (2021) the results of this study show that children from homes with smoking restrictions are less likely to have the intention to smoke in the next 12 months (Mpousiou et al., 2021).
Research conducted by Devy Riyanti Adi Wijaya, et al (2022) is in line with the results of research that has been conducted, stating that the most influential social environment of adolescents is family or parents and peers.There needs to be special assistance to adolescents in order to reduce the prevalence of smoking in adolescents (Wijaya, Gayatri, & Handayani, 2022).
Research conducted by Rokiah Abu Bakar, et al ( 2013) on a Pioneering Study of Children's Views on the Marketing Strategy of Anti-Smoking Campaign in Pantai Dalam Kuala Lumpur shows that most respondents' families cannot set a good example for children, as many as 40% of respondents said that their families often smoke in front of them in person and only 63.3% of respondents stated that their mothers and fathers advised not to smoke (Abu Bakr, Abu Bakr Ah, &;Zachariah, 2013).

Conclusion
Students aged 14-15 years, namely grade IX, have a better understanding than those aged 12-14 years, namely grade VIII and grade VII.Information has run optimally with the existence of information media and socialization.In terms of social rules, the school has implemented the rules firmly, but it is not optimal enough because there are still students who do not obey.In terms of experience, students only know about the smoking ban in the school environment when they first enter JHS, have curiosity and pleasure when consuming cigarettes.The environment of students shows that parents and friends of students are very influential

Reference
Annisa Indah Zhafirah, M Ridwan, Vinna Rahayu Ningsih, Willia Novita Eka Rini, Puspita Sari/KESANS Students' Perceptions of the Prohibition of Smoking in Public Middle Schools children's playground; embat worship; public transport; workplace; and public squares and other designated places.This is explained in Government Regulation Number 109 of 2012 article 50 ("Government Regulation of the Republic of Indonesia Number 109 of 2012 concerning Safeguarding Substances Containing Addictive Substances in the Form of Tobacco Products for Health," 2012).School Policy Regulations Related to Non-Smoking Areas (KTR) refer to the Regulation of the Minister of Education and Culture of the Republic of Indonesia No. 64 of 2015 concerning non-smoking areas in school environments.The goal is to make the school environment a clean and healthy place without cigarette smoke.Regulation of the Minister of Education and Culture of the Republic of Indonesia, Decree No. 64 of 2015, Article 7 Paragraph (3) students who smoke during school or outside school will receive guidance from the school in accordance with applicable regulations ("Regulation of the Minister of Education and Culture of the Republic of Indonesia Number 64 of 2015 concerning Non-Smoking Areas in School Environments," 2015).

' Perceptions of the Prohibition of Smoking in Public Middle Schools KESANS, Vol. 3, No. 3, 2023 260
Annisa Indah Zhafirah, M Ridwan, Vinna Rahayu Ningsih, Willia Novita Eka Rini, Puspita Sari/KESANS Students"At first I was curious, it turned out to be delicious, when smoking it tastes very good, especially when you are with friends" (SE)