Sobat KTR: A Peer Support Group Program  To Increase Adolescents' Awareness of The Dangers of Smoking and Smoke-Free Areas

Leni Dwi Utami; Denny Ayu Safitri; Nadia Yolanda; Zulfia Rahmih; Icha Khaerunnisa; Katharina Maria Tredi Saka

doi:10.30994/jceh.v9i2.832

Authors

Leni Dwi Utami Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
Denny Ayu Safitri Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
Nadia Yolanda Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
Zulfia Rahmih Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
Icha Khaerunnisa Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
Katharina Maria Tredi Saka Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia

DOI:

https://doi.org/10.30994/jceh.v9i2.832

Keywords:

Adolescent, Peer Support Group, Smoking Prevention, SOBAT KTR, Smoke-Free Area, Health Promotion

Abstract

Adolescent smoking remains a significant public health challenge, with peer influence being one of the strongest determinants of smoking initiation and continuation. The SOBAT KTR (Sosial Berdaya Tanpa Asap Rokok) program was developed to empower adolescents through peer support in promoting smoke-free lifestyles and strengthening awareness of Smoke-Free Areas (SFA). This study aimed to describe the implementation of the SOBAT KTR program based on a Peer Support Group approach to improve adolescents’ awareness of the dangers of smoking and their commitment to supporting Smoke-Free Areas. A community-based descriptive evaluative design was conducted among 21 adolescents in RW 06, Klampis Ngasem, Surabaya. Participants were divided into five peer groups facilitated by students. Program activities included peer sharing, group discussions, experience exchange, and commitment building. Data were collected through structured observation, facilitator notes, group discussion outcomes, and participant commitments, and analyzed descriptively. Results: Participants actively identified peer influence, curiosity, and social acceptance as major factors contributing to smoking behavior. They proposed positive peer support strategies, including reminding friends about smoking hazards, encouraging healthy activities, motivating smoke-free lifestyles, and discouraging smoking behavior. The program also strengthened participants’ commitment to becoming peer role models and promoting Smoke-Free Areas within their schools and communities. The SOBAT KTR program successfully utilized peer support to enhance adolescents’ awareness of smoking prevention and foster positive social norms supporting smoke-free environments. This approach has strong potential as a sustainable community-based health promotion strategy for adolescent smoking prevention.

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References

Alsahli, F., Alruwais, N., Alsultan, L., Abojalid, B. S., Nughays, R. O., Humedi, A., Alosaimi, A., Alrubaian, M. T., Almuteri, D., & Alkhunizan, M. A. (2025). Interventions for Prevention of Tobacco Smoking in School-Aged Children and Adolescents: A Systematic Review and Meta-Analysis. Cureus, 17. https://doi.org/https://doi.org/10.7759/cureus.77008

Bantwal, P., Kulkarni, M. M., Kamath, V. G., Jay, R., Jois, G. S., Sekar, N., Shankar, M. V., Bajwa, D. S., Bhagawath, R., & Naik, A. K. (2025). Interventions for Preventing Tobacco Uptake among Adolescents within School Setting in South-East Asia region: A Systematic Review. Child & Youth Care Forum, 54, 545–569. https://doi.org/10.1007/s10566-024-09830-8

Claramita, M., Fitriyani, N., Syah, N. A., Hilman, O., Ekawati, F. M., Mahmudah, N. A., & Riskiyana, R. (2021). Empowering adolescents as peer-educators for early prevention of non-communicable diseases: Through existing ‘POSBINDU’ program in Indonesia. Journal of Family Medicine and Primary Care, 10(6), 2202–2208. https://doi.org/10.4103/jfmpc.jfmpc_2613_20

Claramita, M., Fitriyani, N., Syah, N., Hilman, O., Ekawati, F. M., Mahmudah, N. A., & Riskiyana, R. (2021). Empowering adolescents as peer-educators for early prevention of non-communicable diseases: Through existing ‘POSBINDU’ program in Indonesia. Journal of Family Medicine and Primary Care, 10, 2202–2208. https://doi.org/https://doi.org/10.4103/jfmpc.jfmpc_2613_20

Dinas Kesehatan Kota Surabaya. (2025). Laporan tahunan Dinas Kesehatan Kota Surabaya tahun 2024.

Dodd, S., Widnall, E., Russell, A. E., Curtin, E. L., Simmonds, R., Limmer, M., & Kidger, J. (2022). School-based peer education interventions to improve health: a global systematic review of effectiveness. BMC Public Health, 22, 2247. https://doi.org/10.1186/s12889-022-14688-3

Fithria, F., Hartaty, N., & Susanti, S. S. (2023a). The effectiveness of self-help group intervention on smoking prevention among adolescents in Aceh, Indonesia: A controlled field trial. Asian Pacific Journal of Cancer Prevention, 24(3), 991–997. https://doi.org/https://doi.org/10.31557/APJCP.2023.24.3.991

Fithria, Hartaty, N., & Susanti, S. S. (2023b). The Effectiveness of Self-Help Group (SHG) Intervention on Smoking Prevention of Adolescents in Aceh, Indonesia: A Controlled Field Trial. Asian Pacific Journal of Cancer Prevention, 24(3), 991–997. https://doi.org/10.31557/APJCP.2023.24.3.991

Go, M.-H., Green, H. D., Kennedy, D. P., Pollard, M., & Tucker, J. S. (2010). Peer influence and selection effects on adolescent smoking. Drug and Alcohol Dependence, 109(1–3), 239–242. https://doi.org/10.1016/j.drugalcdep.2009.12.017

Harakeh, Z. (2014). Experimental, observational design as an important method to identify the underlying mechanisms of the impact of peer influence on smoking. In Advances in Psychological Research on Health Behavior (pp. 59–70). Nova Science Publishers, Inc.

Iacobini, V., Mazza, E., Rinaldi, M., & Galletti, C. (2025). The Development of Adolescent Empowerment for Health Promotion : A Scoping Review. 37(6), 765–775. https://doi.org/10.7416/ai.2025.2705

Inkiriwang, D. H., & Triwahyuni, P. (2025). Phenomenon of Smoking Behavior Among Adolescents Aged 10 to 18 Years in Parongpong District. Jurnal Biologi Tropis. https://doi.org/https://doi.org/10.29303/jbt.v25i4a.10906

Kemenkes. (2024). Survei Kesehatan Indonesia (SKI) 2023. Badan Kebijakan Pembangunan Kesehatan.

Kemenkes. (2025). Laporan kinerja Kementerian Kesehatan tahun 2024.

Khalil, G. E., Jones, E. C., & Fujimoto, K. (2021). Examining proximity exposure in a social network as a mechanism driving peer influence of adolescent smoking. Addictive Behaviors, 117. https://doi.org/10.1016/j.addbeh.2021.106853

Kobus, K. (2003). Peers and adolescent smoking. Addiction, 98(SUPPL. 1), 37–55. https://doi.org/10.1046/j.1360-0443.98.s1.4.x

Lakon, C. M., & Valente, T. W. (2012). Social integration in friendship networks: The synergy of network structure and peer influence in relation to cigarette smoking among high risk adolescents. Social Science and Medicine, 74(9), 1407–1417. https://doi.org/10.1016/j.socscimed.2012.01.011

Lakon, C. M., Wang, C., Hipp, J. R., & Butts, C. T. (2025). Simulating social network-based interventions for adolescent cigarette smoking. Social Science and Medicine, 380. https://doi.org/10.1016/j.socscimed.2025.118196

Lareyre, O., & Cousson-Gélie, F. (2024). Effect of a peer-led prevention program (P2P) on smoking in vocational high school students: Results from a two-school-year cluster-randomized trial. Addiction, 119(12). https://doi.org/10.1111/add.16528

Li, M., Huang, Y., & Sun, M. (2025). Exploring the structural links between peer support, psychological resilience, and exercise adherence in adolescents: a multigroup model across gender and educational stages. BMC Public Health, 25. https://doi.org/https://doi.org/10.1186/s12889-025-23308-9

Littlecott, H. J., Moore, G. F., Evans, R. E., Melendez-Torres, G. J., McCann, M., Reed, H., Mann, M. K., Dobbie, F., Jennings, S., Donaldson, C., & Hawkins, J. (2023). Perceptions of friendship, peers and influence on adolescent smoking according to tobacco control context: A systematic review and meta-ethnography of qualitative research. BMC Public Health, 23, 424. https://doi.org/https://doi.org/10.1186/s12889-022-14727-z

MacArthur, G. J., Campbell, R., Coppo, A., Murphy, S., & Moore, G. (2024). Peer-led interventions to prevent tobacco, alcohol and drug use among young people: An updated evidence review. Health Education Research, 39(1), 1–15.

Murray, J. M., Sánchez-Franco, S. C., Sarmiento, O. L., Kimbrough, E. O., Tate, C., Montgomery, S. C., Kumar, R., Dunne, L., Ramalingam, A., Krupka, E. L., Montes, F., Zhou, H., Moore, L., Bauld, L., Llorente, B., Kee, F., & Hunter, R. (2025). Moderators of peer influence effects for adolescents’ smoking and vaping norms and outcomes in high and middle-income settings. Frontiers in Psychology, 16. https://doi.org/https://doi.org/10.3389/fpsyg.2025.1655761

Ragan, D. T. (2016). Peer beliefs and smoking in adolescence: A longitudinal social network analysis. American Journal of Drug and Alcohol Abuse, 42(2), 222–230. https://doi.org/10.3109/00952990.2015.1119157

Simons-Morton, B. G., & Farhat, T. (2010). Recent findings on peer group influences on adolescent smoking. Journal of Primary Prevention, 31(4), 191–208. https://doi.org/10.1007/s10935-010-0220-x

Vaihekoski, A., Lagström, H., Eloranta, S., Bäärs, S., Hannula, A., Lehvikkö, M., & Salakari, M. (2022). Influencing adolescents’ attitudes towards nicotine products: A systematic review. Nordic Studies on Alcohol and Drugs, 39(5), 568–584. https://doi.org/https://doi.org/10.1177/14550725221096908

Veenstra, R. (2025). Harnessing peer influence: A summary and synthesis of social network and peer-led intervention research. International Journal of Behavioral Development, 50, 272–283. https://doi.org/https://doi.org/10.1177/01650254251331201

WHO. (2024). Hooking the next generation: How the tobacco industry captures young customers. World Health Organization.