The Increased Interaction of Parents can Prevent Smoking Behavior

and Alcohol Consumption of Adolescents in Indonesia

Iqlima Dwi Kurnia, Ilya Krisnana, Praba Diyan Rachmawati, Kristiawati, Yuni Sufyanti Arief,

Hary Budiarto and M. Sayid J.R

Faculty of Nursing Universitas Airlangga, Kampus C Mulyorejo, Surabaya, Indonesia

Keywords: Interaction, Parents, Adolescents, Smoking Behavior, Alcohol Consumption Behavior

Abstract: A problem that often occurs in adolescents is their relationship with their parents. When the quality of

interaction with parents is reduced, adolescents tend to prefer smoking behavior and consumption of

alcohol. Cigarette and alcohol consumption can cause addiction and affect development in adolescent

health. The aim of this study is to analyze the relationship between parents’ interaction with smoking

behavior and alcohol consumption among adolescents. The design in this study was cross-sectional with

simple random sampling. The result of sample calculation with power analysis obtained a sample equal to

744. Data collection was carried out with online questionnaires using Google Forms. PACHIQ-R was used

for the parent interaction variable, and for smoking behavior and alcohol consumption questionnaires were

used that had been tested for validity and reliability and analyzed used by a chi-square test. Independent and

dependent variables are parent interaction, smoking behavior, and alcohol consumption. The results showed

a significant relation between parent interaction and smoking behavior (p = 0.044). Existence of parent

interaction relation with alcohol consumption behavior (p = 0.00.). Improvement of parent interaction with

children can increase the intensity of time children spend with parents and parents’ love, and improve their

relationship, and teen sex will affect the quality of relationship between parents and adolescents.

1 BACKGROUND

The interaction of parents and adolescents is very

important in fostering good emotional intelligence in

adolescents (Joan S. Tucker, Phyllis L. Ellickson,

Maria Orlando and Klein, 2005). The purpose of the

interaction of parents with adolescents is to build a

fit between the characteristics and abilities of

adolescents in adapting to the environment

(Santrock, 2014). However, based on the results of

previous research, if adolescents feel the acceptance

of parents through the interaction of parents and

children, this can improve the ability of adolescents

to know and manage emotions and can solve their

problems (Todd Q. Miller, 2002). The impact of lack

of parental interaction on children can lead to

negative behavior in children, such as risk behavior.

Risk behavior encompasses various aspects of

aggressive behavior, free sex, alcohol and drugs, and

smoking behavior (Todd Q. Miller, 2002).

Factors that cause smoking and alcohol

consumption behavior in adolescents are the

environment, peers, family’s economic status,

perceptions of smoking, cigarette advertising,

psychological factors, and lack of parental

interaction with children (Joung, 2014).

Cigarettes and alcohol consumption are among

the world’s leading causes of death. The World

Health Organization (WHO) predicts by 2030 deaths

from smoking and consuming alcoholic drinks will

reach 12.5 million people per year. Based on data

from WHO in 2012, the order of most cigarette

consumption at age 15 years and above is Europe

39%, Southeast Asia 32.1%, Africa 24.2%, and

America 22.8% (WHO, 2012). According to Basic

Health Research Data (RISKESDAS, 2013) in

Indonesia in 2013, the incidence of smoking was

34.6%, consisting of 64.4% men and 2.1% women.

With regard to age ranges of first smoking, for 5-9

years, it was 1.7%, for 10-14 years 17.5%, and for

15-19 years 43.3%. The average number of

cigarettes smoked was about 12.3 cigarettes per day

(RISKESDAS, 2013). Regarding age ranges of first

consumption of alcoholic beverages, for 5-9 years it

was 3.05%, for 10-14 years 8.73%, and for 15-19

274

Kurnia, I., Krisnana, I., Rachmawati, P., Kristiawati, ., Arief, Y., Budiarto, H. and J.R, M.

The Increased Interaction of Parents can Prevent Smoking Behavior and Alcohol Consumption of Adolescents in Indonesia.

DOI: 10.5220/0008323802740279

In Proceedings of the 9th International Nursing Conference (INC 2018), pages 274-279

ISBN: 978-989-758-336-0

years 5.59%. The National Narcotics Agency (BNN)

conducted a survey in 2016, and it was found that

the number of teenagers who smoke in the province

of East Java was 27.5% while the number of teens

who drink alcohol was 5% (BNN, 2016). Data from

the Surabaya City Health Office stated that the

number of smokers in Surabaya up to 2014 was

63.7% and those who consumed alcohol was 20.3%

(Guillermo Prado, José Szapocznik, Mildred M.

Maldonado-Molina and Schwartz, 2008).

Adolescents are more vulnerable to smoking and

drinking alcohol caused by psychosocial influences,

i.e, limited ability to think logically, weak emotional

regulatory ability, and peer influences. Being an

individual who is considered an out-group by peers

is an unpleasant experience for teenagers.

Consequently, adolescents perform behavior that can

be accepted by peers; this is where adolescents adopt

the value of peers (Temcheff, C. E., Dery, M., St-Pierre,

R. A., Laventure, M. and Lemelin, J. P., 2016). Parents

shape the child’s behavior through daily nurturing

called parenting (Wang et al., 2016).

Parent–teen interaction is very influential on

aspects of adolescent life. The active role of the

parents also greatly aids the emotional process of the

child. This can be seen from the form of support

related to the formation and emotional development

of children; namely, it releases the creative power

and imagination of children who have positive

impact and, of course, the child is always directed.

Attitude and attention is the key to creating a

harmonious relationship between parents, children,

and other family members.

It is important for parents to intensely communicate

with their children. Through the results of this study,

it is expected to know whether there is correlation

between interaction of parents and the behavior of

smoking and drinking alcohol in adolescents (Ross

and Mirowsky, 2011).

2 METHODS

The design of this study was cross-sectional, and it

was conducted in Indonesia in September-December

2017. The population of this study were adolescents

aged 12-19 years in Indonesia. The sampling method

used was simple random sampling. The results of

power analysis calculation obtained 744 samples.

Data collection was carried out using online

questionnaires using Google Forms that contained

the purpose of the study, informed consent sheet,

demographic data questionnaire, PACHIQ-R

questionnaire, smoking behavior questionnaire, and

questionnaire about alcoholic beverage consumption

behavior. Inside the questionnaires, there was a

description of how to fill it in. The completion of the

informed consent sheet was done by the teenagers

themselves. They filled out the informed consent

sheet first, after the researchers obtained their

approval to fill in demographic data and the

questionnaires in Google Forms. Filling out the

questionnaire took approximately 20 minutes. After

the questionnaires were filled out, respondents

submitted the questionnaires so that data that had

been supplied could be directly entered into

researchers’ e-mail. The independent variable was

parent interaction with adolescent.

The dependent variable of smoking behavior and

alcohol consumption in adolescents was measured

using PACHIQ-R questionnaire, a smoking behavior

questionnaire, and a questionnaire about alcoholic

beverage consumption behavior and analyzed using

the chi square statistical test. This study has passed

the review and certification of the Ethical

Agreement with no. 548 - KEPK 6 November 2017

issued by the Faculty of Nursing Universitas

Airlangga.

3 RESULTS

Respondents in this study were mostly in the age

range of 15-17 years, as many as 374 people

(50.2%). The majority of respondents had high

school education, as many as 606 people (81.3%).

The majority of respondents’ parents had a senior

high school education; there were 328 people

(44,1%) with fathers who had a senior high school

education and 314 people (42.2%) with mothers who

had a senior high school education.The majority of

respondents, 672 people (90.3%), live with their

parents. Most respondents used a motorcycle as a

medium of transportation to school, as many as 462

people (62.1%), and the majority of respondents

were given pocket money by their parents, as much

as less than Rp 50,000 and as many as 626 people

(84.1%).

Respondents in this study were mostly in the

category of not smoking, as many as 533 people.

The majority of respondents in the category, 671

people (90.2%) did not consume alcoholic drinks.

The majority of respondents who live with parents

are in the high interaction category, 566 people

(76%). Mostly respondents who live with parents do

not smoke cigarettes, as many as 489 respondents

(65.7%). The majority of respondents who live with

The Increased Interaction of Parents can Prevent Smoking Behavior and Alcohol Consumption of Adolescents in Indonesia

275

parents do not consume alcoholic beverages, as

many as 610 respondents (82.1%).

For most respondents in this study, those who

had high parent interaction also had non-smoking

behavior, that is, 458 people (61.8%). Still, it was

found that the respondents who exhibit smoking

behavior had high parent interaction, that is, 168

people (22.4%).

From the results of statistical analysis of the

relationship of parent interaction with smoking

behavior in adolescents based on the statistical test

of the chi square with significant value p = 0,044, it

can be concluded there is relationship between

parent interaction with behavior of smoking in

adolescents.

For most respondents in this study, those who

had high parent interaction also did not consume

alcoholic beverages, that is, 575 people (77.3%).

Still, it was found that the respondents who did

consume alcoholic had high parent interaction, that

is, 51 people (6.9%).

The results of statistical analysis of the

relationship of parent interaction with alcoholic

beverage consumption behavior of adolescents were

based on chi square statistical test with significant

value p = 0,000; hence can be concluded there is

relation between parent interaction and alcohol

consumption behavior of adolescents.

4 DISCUSSION

4.1 The Correlation of Parent

Interactions with Smoking

Behavior in Adolescents

The result of statistical analysis using chi square

showed that there is relationship between parent

interactions with behavior of smoking in

adolescents.

The results of this study are in line with the

proposed theory of Joung (2014) that children who

have emotional closeness embodied in interactions

with good parents will grow into children with

higher self-esteem and better emotional well-being.

One of the contributing factors to being a smoker is

the unstable emotions of a person (Arnett, J.J.,

2007). Parental interactions are important in

fostering good emotional intelligence in adolescents

(Santrock, 2014). The results of this study are in line

with the results of previous research that mentions

that adolescents will feel the acceptance of parents

through the interaction of parents with adolescents

and that this can improve the ability of teenagers to

know and manage emotions, and solve problems

faced (Kim, I. J., Ge, X., Conger, R. D., Brody, G

.H., and Gibson, 2003). If the need for interaction

between parents and children can be well

established, teenagers will find it easier to get

through the crises in their development. Fulfillment

of needs during adolescence will create a positive

climate so that adolescents have stable emotional

well-being. This will not make teenagers fall into

risky smoking behavior during times of crisis

(Calvert, W. J., Bucholz, K. K and Steger-May, K.,

2010).

The process of interaction starts with the family,

that is, the relationship between parent and child,

and the interaction of parents has a very strong

relationship with behavioral changes in children.

This is in accordance with the theory of Kathryn E.

Barnard (1994), which states that a person’s

behavior change is influenced by interaction; the

interaction itself involves parent-to-child interaction,

child-to-parent interaction, and interaction with the

environment (Guarnieri, Ponti and Tani, 2010).

Gender according to Scalici and Schulz (2017) is

also one of the factors that can influence smoking

behavior. Men are usually more interested in trying

new things such as smoking than women, but some

research suggests that men consume more cigarettes

than women because men prefer to join a peer group

and try to do things like that that are beyond their

ability to reason about. In teenagers, especially

males, gender has the greatest impact and influence

on smoking behavior because adolescence is the

stage of a person where they are between the phases

of child and adult characterized by physical and

psychological changes. Teenagers sometimes

question the values that exist during this time;

consequently teenagers experience various conflicts

related to themselves, and they begin to question

their self-concept. Other than that, teenagers also

start thinking about the ideal characteristics for

themselves and compare themselves with the ideal

standards of others (Rioux C, Castellanos-Ryan

N, Parent S, Vitaro F, Tremblay RE, Séguin JR,

2010).

It is not impossible for adolescent girls to try to

smoke cigarettes. The data showed there are teenage

girls who smoke cigarettes. Factors that encourage

young women to start smoking are very diverse,

both in the form of factors from within oneself

(personal), sociocultural factors, and the strong

influence of the environment (Lacey et al., 2016).

Cigarettes also have a bad impact on the health of

young women as they can lead to heart and lung

disease, reproductive health problems, cancer, and

also social diseases (Green et al., 2017).

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4.2 The Correlation of Parent

Interaction with Alcoholic

Consumption Behavior in

Adolescents

The results of statistical analysis show that there is

relation between parent interaction and alcohol

consumption behavior of adolescents. According to

Gross and John (2003), one of the findings on the

consumption of alcoholic beverages in adolescents is

that young people from households who do not have

harmonious relationships, causing parent–child

interaction to be low and where parents are not too

concerned about who children associate with and are

happy giving hard physical punishment, it is easier

to be a deviant child than it is for young people from

a harmonious shome environment.

The distribution tables of parents’ interaction

with adolescents are divided into three categories:

low, medium, and high with acceptance and conflict

resolution parameters. This is shown based on the

distribution data of the parent interaction category,

which indicates that the majority of parent

interactions are in the high category. This can be

caused by several demographic factors of

respondents, such as respondent education,

respondent age, parents’ education, living with

whom, school transportation, and pocket money per

respondent.

Interaction is very important for families because

if there is a good relationship in the family, then the

hope of becoming a happy family will be easier to

fulfill. Thus in a family there must be

communication, interaction, flexibility, attachment,

personality suitability, and cooperation in conflict

that occurs (Guarnieri, Ponti, and Tani, 2010).

Interaction of teenagers with parents declines

because teenagers prefer to interact with peers; early

adolescents consider relationships with peers to be

very important. Peers meet their needs to be part of

the group, the need for social interaction, and

support their personal identity. Friendship at this

time is more intimate and reciprocal. Decreased

interaction between parents and adolescents is also

caused by several other factors: the lack of intensity

of time spent with the parents, the quality of parent

interaction with the child, parental affection, the

importance of the relationship, and the sex of the

adolescent will affect the quality of the overall

relationship between the older person and teenager

(Parna, K. Rahu, K., Fischer, K., Mussalo-

Rauhamaa, H., Zhuravleva, I., Umbleja., T., and

Rahu, M., 2003). Emotional problems often

experienced by adolescents are usually associated

with the transition period they undergo from

childhood into adulthood. Lack of parental

interaction with children is one factor that can cause

negative changes in children, such as the risk

behavior of alcohol consumption.

According to Scragg et al. (2010), in adolescence

people have problems such as adjustment problems,

religious issues, health problems, economic

problems, and other problems that cause them to

seek solutions outside the home by trying to

consume alcohol. The majority of teenagers who

consume alcoholic beverages are male because

males prefer interaction with their peer groups.

Adolescents learn to make their own decisions and

do everything independently while learning the

patterns of behavior received and performed by

friends or groups. This is done in order to gain

recognition and acceptance from friends or groups.

Peer groups are important to teenagers so they tend

to follow the behaviors that the group receives (Ross

and Mirowsky, 2011).

The behavior of consumption of alcoholic

beverages can be due to predisposing factors that

cause antisocial personality disorder, intelligence

and depression. Non-intact families allow children to

seek satisfaction outside the home. In adolescence,

the individual is more concerned with the views of

his group’s friends than his parents’. Often, alcohol

is used for reasons of showing group solidarity. Peer

dependence, social interaction that occurs in groups,

and competition among friends aims to gain status

and self-esteem in groups so as to encourage

adolescents to take action and gain new experiences

(Chaplin et al., 2012). Individuals who consume

alcoholic drinks usually do so as a result of

conscious processes, but not in all cases (Chaplin et

al., 2012). Sociocultural factors have a very diverse

role in the consumption of alcoholic beverages many

individuals are influenced by those who consume

alcohol around them to start using alcoholic

beverages. Those with parents who consume alcohol

are likely to consume it; with this model as an

example, the individual will have a greater tendency

to consume alcoholic beverages than if there is no

consumption model (Sieving et al., 2000).

When exposed to others drinking alcohol, it is

commonly observed that consumption of alcoholic

beverages can alter mood; this is a distinct

reinforcement for consuming alcoholic beverages. It

can be seen that individuals start consuming

alcoholic beverages due to their lifetime experience

with the consumption of alcoholic beverages, that is,

the environmental conditions surrounding alcoholic

beverages including genetic and cultural factors. It

then affects the personality and cognitive

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277

functioning of individuals, so they do not take a

stand regarding alcohol consumption Calvert, W. J.,

Bucholz, K. K and Steger-May, K., 2010).

Distribution data shows there is a relationship

between smoking behavior and alcohol consumption

in adolescents. Teenagers usually consume alcohol

at the same time as smoking cigarettes. Smoking

habits and alcohol consumption in adolescents can

be influenced by various factors, among others,

because developing children seek identity and

always want to try new things in the environment

(Griesler, Kandel, and Davies, 2002). Family and

peers are the ones that will greatly affect teenagers’

habits. In addition, the media show that airs a teen

idol figure who smokes cigarettes will encourage

teenagers to follow him (Scalici and Schulz, 2017).

Behavioral consumption of cigarettes and alcoholic

beverages is not good for adolescent health because

cigarettes and alcoholic beverages have substances

in them that are harmful to the human body and

cause side effects such as addiction (Barmpagianni

E, Travlos A, Kalokairinou A, and Sachlas A, 2014).

Smoking and consuming alcoholic beverages is seen

by some people, including among teenagers, as an

activity that can be stressful (Temcheff, C. E., Dery,

M., St-Pierre, R. A., Laventure, M. and Lemelin, J. P.,

2016). Peers can influence a teenager’s judgment

and decisions about his behavior. Research in New

York shows that the role and consent of peers affects

smoking intentions and the consumption of alcoholic

beverages in the future in adolescents (Trucco, Elisa

M, 2011). Teens usually consume cigarettes side by

side with alcoholic drinks. Because cigarettes and

alcoholic beverages are very easy to find/get in a

stall, by pooling their resources in a joint venture,

teenagers can buy cigarettes and alcoholic

beverages. The development of technology has

affected teenagers in obtaining a pleasant picture

when smoking cigarettes and consuming alcoholic

beverages; almost every television station shows a

movie that gives an idea of how good it is to smoke

and consume alcohol, as if smoking and consuming

alcohol as a teenager would make one look more

slick, cool, and professional, and make stress

disappear (Mcgee CE, Trigwell J, Fairclough SJ,

Murphy R, Porcellato L, and Ussher M, 2015).

Smoking behavior and alcoholic drink

consumption behavior are usually interconnected.

Researchers argue when teenagers are gathered with

peers who consume alcoholic beverages, these are

usually accompanied by cigarettes that complement

their alcohol consumption. This is because smoking

and alcohol consumption can make the mind calm,

make stress disappear, and make one feel

comfortable (Lacey et al., 2016).

Parent interaction is very influential in the

development of children. The giving of love and

affection must be improved if parents are to avoid

teenagers pursuing deviant behavior such as

smoking and consumption of alcoholic beverages.

The higher the quality and intensity of interaction

given by parents to adolescents, the lower the

smoking behavior and consumption of alcoholic

beverages in adolescents, and also the lower the

quality and quantity of interaction that parents give

to adolescents, the higher the smoking behavior and

consumption of alcoholic beverages in adolescents.

5 CONCLUSIONS

Parent interaction has a relationship with smoking

behavior and alcohol consumption in adolescents.

The higher the parent’s interaction with the child,

the more the smoking behavior and alcohol

consumption behavior of adolescents can be

prevented. Parent interaction is one of the factors

that influence and shape the behavior of respondents

and can cause behavioral changes regarding risk

behaviors such as smoking and alcohol

consumption.

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