Journal of Preventive Medicine and Public Health

Original Articles

Determinants of Smoking Relapse Among Indonesian Children: A National Cross-sectional Analysis Using Global Youth Tobacco Surveillance Data: Risky Kusuma Hartono, Muhammad Abdul Rohman, Renny Nurhasana, Aryana Satrya, Salsabila Nadya, Ni Made Shellasih, Fadhilah Rizky Ningtyas, Astri Hanna Waruwu; J Prev Med Public Health. 2026;59(2):162-173. Published online December 12, 2025; DOI: https://doi.org/10.3961/jpmph.25.703

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Abstract Summary PDF: Objectives
This study aimed to identify the determinants associated with 4 smoking trajectories (never smoking, current smoking, consistently quitting smoking, and smoking relapse) among Indonesian children using pooled national data.
Methods
This study analyzed children’s smoking trajectories using pooled data from the Indonesian Global Youth Tobacco Survey (2006, 2009, 2014, and 2019). Multinomial logistic regression was applied to examine 4 categories of smoking behavior, and propensity score matching (PSM) was used to address potential selection bias related to advertising exposure.
Results
Higher prices (>IDR31 000/USD1.87) (relative risk ratio [RRR], 0.527) were protective against relapse. This policy effect was systematically undermined by single-stick purchasing, which increased relapse risk by 57.41 times (p<0.01). Peer smoking (RRR, 3.696) and exposure to advertisements in sports events (RRR, 1.477) were also significant risk factors for relapse. Free cigarette distribution demonstrated the strongest association, corresponding to a 23.1 percentage-point increase in relapse probability.
Conclusions
The findings indicate that children’s smoking relapse in Indonesia is shaped by distinct behavioral trajectories. Relapse was influenced by the widespread availability of single-stick cigarettes, pervasive marketing, peer dynamics, and relatively affordable prices. These results underscore the urgent need for a comprehensive strategy that includes substantially increasing excise taxes, eliminating single-stick sales, and fully banning tobacco advertising. Simultaneous implementation of these measures is crucial to prevent relapse and interrupt the progression toward lifelong nicotine addiction.; Summary

Key Message
- To examine factors associated with smoking relapse among Indonesian children, including price, affordability, and advertising exposure. - Pooled Global Youth Tobacco Survey data (2006–2019) were analyzed using multinomial logistic regression and propensity score matching. - Higher cigarette prices (>IDR31,000) reduced relapse risk (RRR 0.527), while single-stick purchases (>57-fold), peer smoking (RRR 3.696), sports advertising exposure (RRR 1.477), and receiving free cigarettes (+23.1 percentage points) significantly increased relapse. - Relapse is driven by accessibility, social influence, and marketing, requiring comprehensive tobacco control policies.

Psychometric Characteristics of the Fear of Cancer Recurrence Inventory-Severity Subscale Among Korean Cancer Survivors: So-Young Park; J Prev Med Public Health. 2024;57(4):319-326. Published online May 16, 2024; DOI: https://doi.org/10.3961/jpmph.24.096

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2 Web of Science
3 Crossref

Objectives
Despite the importance of choosing and using a valid assessment tool for fear of cancer recurrence (FCR) for early detection and interventions, the validity of the FCR inventory has yet to be thoroughly investigated in Korea. This study explored the psychometric properties of the Fear of Cancer Recurrence Inventory-Severity (FCRI-S) subscale and assessed its applicability to cancer survivors in Korea.
Methods
The survey involved 93 Korean individuals who had survived cancer. The reliability of the FCRI-S subscale was assessed using Cronbach’s α and composite reliability (CR). Confirmatory factor analysis (CFA), along with tests for discriminant and convergent validity, was conducted to evaluate the construct validity of the FCRI-S subscale.
Results
The FCRI-S subscale showed excellent internal consistency (Cronbach’s α=0.88; CR=0.89). CFA showed a good factor structure for the FCRI-S subscale, and the correlations of the FCRI-S subscale with FCR-related measures (r=0.69 to 0.80) and other psychosocial measures (r=-0.23 to 0.37) confirmed both the convergent and discriminant validity of the FCRI-S subscale.
Conclusions
This study confirmed the robust psychometric characteristics of the FCRI-S subscale among cancer survivors in Korea. The use of the FCRI-S subscale would be helpful for health professionals to rapidly screen FCR levels in clinical settings.

Summary

Korean summary
암 재발 두려움은 암 생존자들이 흔히 호소하는 심리사회적 어려움 중의 하나이다. 한국 성인 암 생존자들을 대상으로 암 재발 두려움-심각성 하위척도의 심리계량적 속성을 평가한 결과, 해당 하위척도가 좋은 타당도와 신뢰도를 보인 것으로 나타났다. 본 연구 결과는 임상 현장에서 암 재발 두려움에 대한 조기 발견과 적극적인 개입의 중요성을 강조한다.

Key Message
Fear of cancer recurrence (FCR) has emerged as a significant and common concern among cancer survivors. This study evaluated the psychometric properties of FCRI-S subscale among Korean adult cancer survivors and confirmed its good validity and reliability. Findings of this research emphasize the importance of early detection and active interventions for FCR in clinical settings.

Citations

Citations to this article as recorded by

Validation of the Czech version of the nine-item Fear of Cancer Recurrence Inventory in differentiated thyroid cancer survivors
Petra Nemcikova, Alena Javurkova, Jaroslava Raudenska, Samuel Srobar, Vladimir Musil, Sebastien Simard, Ludmila Brunerova
Endocrine.2026;[Epub] CrossRef
Validation of Two Shortened Versions of the State-Trait Anxiety Inventory-State Subcategory in Cancer Patients
Hyeri Kim, Mohd. Ashik Shahrier, Sumin Hong, Junseok Ahn
Journal of Clinical Psychooncology.2026; 12(1): 28. CrossRef
Fear of cancer recurrence in oncohematological patients: assessment instruments and evidence-based psychological interventions — a systematic review
Ana Sancho-Martínez, María Rueda-Extremera, Sergio Alejandre-Carmona, María Cantero-García
Frontiers in Psychology.2025;[Epub] CrossRef

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