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Background: This study aimed to investigate gender differences in social environmental factors of psychological distress among Indonesian adolescents.Methods: This was a cross-sectional study using the data from the 2015 Indonesia Global School-based Student Health Survey. Binary logistic regression was used to assess the influences of main independent variables - social environmental factors (i.e., peer support, having close friends, bullying victimisation, physical fight, physical attack, parental supervision, connectedness, bonding), demographic characteristics, and health-related behaviours on the measures of psychological distress (loneliness, anxiety-induced sleep disturbance, and a combination of both measures as psychological distress).Results: The prevalence of psychological distress measured as loneliness, anxiety-induced sleep disturbance, and combined psychological distress was 6.12%, 4.52%, and 8.04%, respectively. Findings from multivariate analyses indicated that bullying victimisation, physical attack, experience of hunger (a proxy of socioeconomic status), and sedentary behaviour were associated with all measures of psychological distress. Meanwhile, age, gender, drug use, parental connectedness and bonding, and having no close friends were correlates of one or two measures of psychological distress. Based on gender-stratified analyses, experience of hunger, sedentary behaviour, bullying victimisation, and having no close friends were consistently associated with measures of psychological distress among both girls and boys. In addition, the influence of some social environmental factors, such as parental connectedness, peer support, and physical attack, were more salient among girls.Conclusions: The findings suggest that social environmental factors, demographic characteristics, and health-related behaviours were associated with psychological distress, and the associations appeared to differ by gender. Interventions that include improving positive social environmental factors (e.g., reducing interpersonal violence, encouraging positive relationships with parents and peers) and promoting healthy behaviours (e.g., less sedentary behaviour, preventing substance use) might help reduce the risk of psychological distress among Indonesian adolescents. [ABSTRACT FROM AUTHOR]

Introduction: The city of Denpasar has implemented the smoke-free law for five years. However, the compliance remains low. Smoking remains highly accepted in society, and the provision of cigarettes in several religious and customary events. Hence, this study aims to assess how social smoking norms affect compliance with smoke-free laws. Methods: This was a cross-sectional study located in Denpasar, Bali, Indonesia. This study was conducted from December 2019 until February 2020. The sample size was 192 and was selected using multistage random sampling. Data were collected through interviews using a structured questionnaire then analyzed using multiple linear regression. Results: Descriptive norms of smoking affected the compliance in worship places (standardized coefficient beta of 0.175 and p=0.01). Moreover, the effect of descriptive norms to compliance was significantly moderated by perceived of injunctive norms (standardized coefficient beta of 0.216; p<0.01); benefits to one-self (standardized coefficient beta of 0.199; p<0.01); benefits to others (standardized coefficient beta of 0.164; p=0.02); anticipatory socialization (standardized coefficient beta of 0.146; p=0.03); similarity (standardized coefficient beta of 0.141; p=0.04); aspiration (standardized coefficient beta of 0.131; p=0.06); and local leader role (standardized coefficient beta of 0.129; p=0.06). Conclusion: The social norms of smoking remain an important predictor of compliance with the smoke-free law, particularly in countries with strong cultural characteristics. However, its effect could be moderated using appropriate culture-sensitive strategies. [ABSTRACT FROM AUTHOR]

Background: In 2017, Indonesia initiated the amendment of its 11-year-old tobacco control regulation (PP 109/2012) to reduce smoking among youth, but the process was stalled. The proposed changes in the regulation include a full ban on tobacco advertising, promotion and sponsorship (TAPS), increasing health warning label (HWL) size and regulating electronic cigarettes (e-cigarettes). This study analysed the arguments and actors for and against the PP 109/2012 amendment in online media articles., Method: Content analysis of 326 online articles reporting on the PP 109/2012 amendment published from 2018 to 2023, retrieved from the Tobacco Watcher platform. We coded articles for statements supporting or opposing the amendment (position statement), content of the arguments used to support (supporting argument) and oppose (opposing argument) the amendment, actors presenting the arguments and tobacco control measures. We iteratively reviewed and coded data and presented the frequency of categories., Results: Of 332 position statements, 53.3% were against the amendment. The main categories of supporting arguments (N=1448) included smoking trends (21.1%), health implications (16.6%), science-based evidence (9.6%) and protecting the population (9.2%). Opposing arguments (N=1413) emphasised the tobacco farmers' welfare (16.6%), impact on the industry (16.4%) and current regulation is sufficient (11.0%). Supporting actors were predominantly health-related entities and government officials (89.3%), while 62.1% of opposing actors included trade and Islamic groups, the tobacco industry and front groups. HWLs, e-cigarette/heated tobacco product regulation and TAPS were the main (77.8%) tobacco control measures mentioned in the proamendment arguments, while HWLs, TAPS and cigarette sale restrictions were the dominant (79.3%) tobacco control measures in anti-amendment arguments., Conclusion: Indonesia's tobacco control reform faced opposition by false claims primarily from industry allies, resulting in a 5-year delay in enactment. Future tobacco control media advocacy must address these claims and emphasise the alignment of economic interests with public health goals., Competing Interests: Competing interests: JEC is a paid consultant in litigation against a tobacco company., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: The aim of the study was to assess the Sudanese tobacco advertising, promotion and sponsorship (TAPS) legislative environment and the challenges characterising it. We formulated three research questions: What is the TAPS policy context in Sudan? What circumstances led to the development of the current legislative text? Finally, what was the involvement of the different actors in these events?, Design: We conducted a qualitative analysis using the Health Policy Triangle model to frame the collection and extraction of publicly available information from academic literature search engines, news media databases or websites of national and international organisations, as published by February 2021. The thematic framework approach was employed to code and analyse the textual data and the generated themes were used to map connections across the data and to explore relationships among the generated subthemes and themes., Setting: Sudan., Data: Using a combination of the keywords "Sudan" and "tobacco advertising" (or "tobacco marketing" or "tobacco promotion"), we collected publicly available documents in the English language. We included 29 documents in the analysis., Results: Three themes underpin the Sudanese legislative environment on TAPS: (1) limited and outdated TAPS data, (2) stakeholder involvement and tobacco industry interference and (3) TAPS legislation not aligned with the WHO Framework Convention on Tobacco Control Secretariat recommendations., Conclusions: Findings from this qualitative analysis suggest that recommendations to move forward in Sudan should include the systematic and periodic collection of TAPS surveillance data, addressing any remaining legislative content loopholes and protecting policy-making from tobacco industry interference. In addition, best practices from other low-income and middle-income countries with good TAPS monitoring systems, such as Egypt, Bangladesh and Indonesia, or with protective provisions against tobacco industry interference, such as Thailand and the Philippines, could be considered for adaptation and implementation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

A smoke-free workplace is important to reduce secondhand smoke exposure, raise awareness, encourage smoking cessation, and increase productivity. This study aimed to assess indoor smoking in the workplace as part of a smoke-free policy implementation and the factors associated. This was a cross-sectional study at workplaces in Indonesia from October 2019 to January 2020. The workplaces were divided into private workplaces owned by a company for business and government workplaces that run for public services. Samples were selected using stratified random sampling. Data collection follows time and area observation guidelines, starting in the indoor area and then outdoor. The observation was conducted for at least 20 min for each workplace in 41 districts/cities. Of the 2900 observed workplaces, 1097 (37.8%) were private and 1803 (62.92%) were government workplaces. The proportion of indoor smoking at government workplaces was 34.7%, higher compared to private (14.4%). The results were consistent for each indicator such as people smoking (14.7% vs. 4.5%), electronic cigarette use (0.7% vs. 0.4%), cigarette butts presence (25.8% vs. 9.5%), and smell of cigarette smoke (23.0% vs. 8.6%). The factors associated with indoor smoking were indoor ashtray availability (adjusted odds ratio [AOR] =13.7; 95% confidence interval [CI]: 10.6-17.5), indoor designated smoking area (AOR = 2.4; 95% CI: 1.4-4.0), presence of indoor tobacco advertising, promotion and sponsorships (AOR: 3.3; 95% CI: 1.3-8.89), whereas the presence of no smoking sign was a preventive factor (AOR = 0.6; 95% CI: 0.5-0.8). Indoor smoking remains high, particularly in government workplaces in Indonesia., Competing Interests: None

Prevalence of depression in Indonesia was 6.1% in 2018, while disability was doubled from 11% in 2013 to 22% in 2018. Pre-elderlies are susceptible to experience both disability and depression. We conducted secondary data analysis of nationally representative data to measure the association between disability and depression among pre-elderlies, age 45 to 59 years old. This analysis involved 70,301 pre-elderlies with normal body mass index, and 70,090 with complete data for further analysis with multilevel logistic regression. We found 1.6% pre-elderlies experience depression, 19.1% have disability, while 3.3% of those with disability were depressed. We found likelihood of depression almost three time among pre-elderly with disability (AOR = 2.81). Other variables with independent association are residential area, sex, history of chronic illness, socio-economic, and education level. Preventive measures are needed to improve awareness and to screen for both disability and depression among these age-group, as well as rehabilitative programs to improve their wellbeing.