BackgroundPrevious studies have reported an association between cigarette advertising and smoking behavior. Although this has been reported extensively in the West, it has been reported less in Sou...

Background: For more than ten years, Indonesia has health law, one of which states that local governments are mandated to establish Smoke Free Area (SFA). The results of 2018 National Basic Health Research shows tobacco consumption is still quite high and increasing compared to the results of 2007 and 2013 National Basic Health Research. The burden of disease in Indonesia is increasing every year. Methods: This study aims to describe SFA regulation and analyze the relationship between the percentage of smokers and the prevalence of smoking attributable morbidity. Data from the 2018 Basic Health Research in Indonesia with the number of units of analysis were 514 districts and cities level. The design of the study was cross-sectional study. The variables analyzed were the percentage of smokers, the prevalence of diabetes, hypertension, upper respiratory tract infections (URTI), pneumonia, lung tuberculosis, asthma, and mental emotional disorders. Geographical mapping of the distribution of District/City with Smoking-Free Areas was made using QGIS 3·16. Results: Around 72% of districts/cities in Indonesia already had local regulations of SFA after more than ten years implementation of the regulation of the health law. There was a significant relationship between the high percentage of smokers and the high prevalence of diabetes (p value: 0·000, PR: 1·342, 95%CI 1·135 to 1·587), hypertension (p value: 0·000, PR 1·631, 95%CI 1·252 to 2·124), and lung tuberculosis (p value: 0·008, PR 1·219, 95%CI 1·049 to 1·417) at the District/City level. However, there was no significant association between URTI, pneumonia, asthma, and mental emotional disorders. Conclusion: The percentage of smokers in an area was associated with diabetes, hypertension, and lung tuberculosis. The implementation of Smoke Free Area should be evaluated.

Summary: Objectives  To document the prevalence of tobacco use among male diabetes patients in a clinic based population of Yogyakarta Province, Indonesia; to examine patient’s perceptions of smoking as a risk factor for diabetes complications; and to investigate whether patients had received cessation messages from their doctors.Method  Twelve in‐depth interviews and five focus groups (n = 21) with diabetic patients in 2004–2005, followed by a cross‐sectional survey of 778 male diabetic patients in diabetes clinics in 2006–2007.Results  65% of male diabetes patients smoked before being diagnosed, and 32% smoked in the last 30 days. Most patients incorrectly perceived low level smoking safe for diabetics (mean of 3.6 cigarettes). The median range of cigarettes smoked per day was in excess of this ‘safe’ amount (4–10 cigarettes). Most respondents did not associate smoking with diabetes and its complications. Only 35% of all patients recalled being asked whether they smoked by their doctors, and there were no differences between smokers and non‐smokers. Quit messages received by patients were seen as general health advice and not diabetes specific.Conclusions  Many diabetic patients continue to smoke despite the hazard of smoking on diabetes complications and mortality. Smoking cessation is not commonly encouraged by health‐care providers in Indonesia, and is not a routine part of diabetes counselling despite the risk of smoking to those with diabetes. Project Quit Tobacco International is currently developing cessation services for patients with diabetes and encouraging medical and nursing schools to incorporate disease specific tobacco education in its curriculum and skill based classes in tobacco cessation counselling.

Limited research exists exploring the experience of living with advanced breast cancer in Indonesia. We sought to explore the narratives of women with breast cancer across the illness trajectory to understand their experiences from diagnosis to accessing and undergoing cancer treatments to inform the development of cancer care. A nested, exploratory study adopting a qualitative approach. We conducted in-depth face-to-face interviews with women living with advanced breast cancer in Yogyakarta, Indonesia. We purposively sampled participants by age, education and marital status. All interviews were transcribed verbatim with thematic analysis used to identify, analyse and report patterns and themes within the data. Four main themes were derived: 1) Early experiences, prior to accessing health care; 2) Navigating the system to access treatment; 3) Enduring chemotherapy and advancing disease, with crucial family support; 4) Seeking normalcy and belief in treatment. From initial symptoms through to undergoing treatments, the experience of participants was punctuated by barriers and challenges. Presentation delays were driven by dismissing initial symptoms, seeking alternative medicines, and fear of surgery. Access to healthcare required participants to contend with long-distance travel to facilities, tiered and convoluted referral processes, and adverse effects and financial impact of treatments. Individual determination, belief in God, and the role of families were critical throughout the disease trajectory. Adopting a focus across the disease trajectory facilitated the identification of enduring and persistent challenges to care delivery that can inform targeted development and optimisation of care delivery for women with breast cancer.

Background: Bonding is an emotional bond between a mother and a baby that develops gradually and immediately after birth until it is formed into an attachment. Bonding is considered important to ensure the baby’s protection. However, bonding remains challenging for mothers with spontaneous childbirth because they are most likely to focus on themselves. Objective: To explore the bonding and attachment experience among postpartum mothers with spontaneous childbirth. Methods: This was a qualitative study with a phenomenological approach. Data were collected from nine participants using semi-structured interviews and observations. Data were analyzed using Colaizzi’s analysis method. Results: Five themes emerged, namely 1) feeling relieved and happy with the birth of the baby, 2) bonding and attachments are important, 3) stimulating the baby’s sense, 4) the need of social supports in bonding and attachment, and 5) internal and external factors of bonding and attachment. Conclusion: Bonding and attachment are very important that should be done by the mothers to the baby. However, it takes time and needs the supports from the husbands, parents, relatives, and health workers. Therefore, nurses or midwives should pay attention to this process to create the better bonding and attachment between the mothers and the babies.