Predicting Tobacco Smoking among Adolescents Using Social Capital and Media Exposure with Theory of Planned Behavior:

Tobacco smoking remains an ongoing and dire public health threat globally. Identifying factors that influence individuals’ smoking behavior is critical especially among adolescents. This study aimed to determine the effects of media exposure to tobacco advertisement, social capital, and other factors, on tobacco smoking among adolescents using Theory of Planned Behavior (TPB). This cross-sectional study was conducted in KulonProgo District, Yogyakarta Province, Indonesia, in April 2018. The dependent variable was smoking behavior. The independent variables were intention to smoke, attitude toward smoking, knowledge about tobacco use, subjective norm toward smoking, perceived behavior control not to smoke, media exposure to cigarette advertisement, and social capital among peer adolescents. The data were collected by questionnaire and analyzed by path analysis run on Stata 13. The TPB constructs including attitude toward smoking (b = 0.90; 95% CI = 0.29 to 1.51; p = 0.004), subjective norm toward smoking (b = 1.59; 95% CI = 0.99 to 2.19; p < 0.001), and perceived behavior control not to smoke (b = -2.07; 95% CI = -2.68 to -1.45; p < 0.001), had impact on intention to smoke and smoking behavior. Exposure to tobacco advertisement had indirect impact on smoking behavior through attitude toward smoking and intention to smoke. Weak social capital had indirect impact on smoking behavior through subjective norm toward smoking and intention to smoke. It concludes thatTPB can be used to explain smoking behavior among adolescents.