Proses Perubahan Perilaku Berhenti Merokok: Studi Kualitatif Mengenai Motif, Dukungan Sosial dan Mekanisme Coping

La Ode Reskiaddin, Supriyati Supriyati

Abstract

Latar Belakang. Tingginya jumlah perokok sebenarnya juga diiringi dengan tingginya keinginan untuk berhenti merokok, namun tidak semua berhasil berhenti merokok.Tujuan. untuk menggali peran motivasi, dukungan sosial, mekanisme coping dalam upaya berhenti merokok.Metode. Penelitian kualitatif dengan rancangan penelitian fenomonologi. Teknik snowball sampling dan rekrutmen via whatsapp digunakan untuk mendapatkan informan, dan dipilih menggunakan purposive sampling. Data dikumpulkan melalui wawancara mendalam kapada 18 orang yang terdiri dari 5 orang (1 perempuan 4 laki-laki) yang sudah berhenti merokok 6 bulan sampai 2 tahun, 4 orang yang sedang berhenti merokok (<6 bulan) dan 9 orang sebagai significant others. Keabsahan data melalui triangulasi, member checking dan peer debrieving.   Hasil. Faktor sosial merupakan penyebab yang mendominasi untuk merokok. Motif kesehatan adalah motif utama untuk berhenti merokok. Dukungan untuk berhenti merokok diantaranya dukungan secara emosional dan instrumental.Kesimpulan. Perokok berhenti merokok karena motif kesehatan seperti ingin lebih sehat.  Motif non kesehatan diantaranya haram dan pengeluaran membeli rokok lebih banyak dari kebutuhan untuk makan. Coping kognitif seperti mensugesti diri melalui perubahan mindset sebagai salah satu strategi yang dapat dilakukan untuk mengendalikan perilaku merokok. Dukungan sosial hanya sebagai penguat atau moderator. Coping merupakan pengendali utama dalam berhenti merokok. Dukungan sosial sebagai moderator dalam proses berhenti merokok. ABSTRACTIntroduction. A high number of smokers aligned with smoking cessation eagerness, but not all succeed.Objective. to explore the motive, social support and coping mechanism for smoking cessationMethods. Qualitative research with phenomenology research design. We did the snowball sampling technique and participants’ recruitment via WhatsApp and Purposive sampling. 18 in-depth interviews consisted of 5 participants (1 woman and 4 men) who quit smoking within the past 6 months to 2 years, 4 participants who are quitting smoking (<6 months) and 9 people as significant others. Data validation was through triangulation, member checking and peer debriefing.Results. Social factors are the dominant cause of smoking. Health motives are the main motives for quitting smoking. Support for quitting smoking includes emotional and instrumental support Conclusion. Smokers’ motivations to quit due to health reasons such as a better level of health. Non-health reasons are religious prohibition (haram) and cigarette expenses higher than primary (food) expenditure. Research also found cognitive coping such as personal suggestion through mindset change, is one of the strategies to control smoking behavior. Social support as a booster or moderator. Coping is the primary controller in smoking cessation. It’s strengthened by personal willingness. Social support acted a moderator.  

Keywords

Berhenti merokok, dukungan sosial, mekanisme coping, usia produktif

Full Text:

pdf

References

Eriksen M, Mackay J, Schlunger N, Gomeshtapeh FI, Drop J. The Tobacco Atlas. Fifth. Vol. 80, The Quarterly Review of Biology. Georgia: American Cancer Society; 2015.

Kemenkes RI. Perilaku Merokok Masyarakat Indonesia Berdasarkan Riskesdas 2007 dan 2013. Infodatin Pusat Data Informasi Kementerian Kesehatan RI. 2015. p. 1–12.

Dinas Kesehatan DIY. Laporan Rekapitulasi Cakupan PHBS. Dinas Kesehatan DIY: Yogyakarta; 2017.

Syafiie RM, Frieda N, Kahija Y La. Stop Smoking! : Studi Kualitatif Terhadap Pengalaman Mantan Pecandu Rokok dalam Menghentikan Kebiasaannya. 2009;1–21.

World Health Organization. Global Adult Tobacco Survey: Indonesia Report 2011. 2012. 1–182 p.

RSRespira. Kunjungan konseling berhenti merokok. Rumah Sakit Paru Respira Bantul ; DIY; 2016.

Brose LS, West R, Michie S, McEwen A. Changes in success rates of smoking cessation treatment associated with of a national evidence-based training programme. Prev Med (Baltim). 2014;69:1–4.

Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: Toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–5.

Glanz K, Rimer BK, Viswanath K. Health Behavior and Health Education: Theory, Research and Practice. San Fransisco: Jossey-Bass; 2008.

Breslau N, Peterson EL. Smoking cessation in young adults: Age at initiation of cigarette smoking and other suspected influences. Am J Public Health. 1996;86(2):214–20.

Wang IJ, Gjengedal E, Larsen T. “Passed and cleared” - former tobacco smokers’ experience in quitting smoking. Glob Health Promot. 2014;21(2):57–65.

Smith AL, Carter SM, Chapman S, Dunlop SM, Freeman B. Why do smokers try to quit without medication or counselling? A qualitative study with ex-smokers. BMJ Open. 2015;5(4):e007301.

Donev D, Pavlekovic G, Zaletel-Kragelj L. Social Networks and Social Support in Health Promotion Programmes. 2008;(January 2015).

Guo Q, Unger J, Palmer P, Chou C-P, Johnson A. The Role of Cognitive Attributions for Smoking in Subsequent Smoking Progression and Regression among Adolescents in China. Addict Behav. 2013;13(2):83–96.

Portnoy DB, Wu CC, Tworek C, Chen J, Borek N. Youth curiosity about cigarettes, smokeless tobacco, and cigars: Prevalence and associations with advertising. Am J Prev Med. 2014;47(2 SUPPL. 1):S76–86.

Hitchman SC, Fong GT, Zanna MP, Thrasher JF, Laux FL. The relation between number of smoking friends, and quit intentions, attempts, and success: Findings from the international tobacco control (ITC) four country survey. Psychol Addict Behav. 2014;28(4):1144–52.

Bellatorre A, Choi K, Bernat D. The Influence of the Social Environment on Youth Smoking Status. Prev Med. 2015;

Courtenay WH. Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Soc Sci Med. 2000;50(10):1385–401.

Ng N, Weinehall L, Öhman A. “If I don’t smoke, I’m not a real man” - Indonesian teenage boys’ views about smoking. Health Educ Res. 2007;22(6):794–804.

Tsourtos G, Ward PR, Muller R. Smoking and stress: The double-edged sword of living in a disadvantaged area. Australas Med J. 2008;1(1).

Shuaib F, Foushee HR, Ehiri J, Bagchi S, Baumann A, Kohler C. Smoking, sociodemographic determinants, and stress in the Alabama Black Belt. J Rural Heal. 2010;27(1):50–9.

Advani PS, Reitzel LR, Nguyen NT, Fisher FD, Savoy EJ, Cuevas AG, et al. Financial Strain and Cancer Risk Behaviors among African Americans. Cancer Epidemiol Biomarkers Prev. 2014;23:967–75.

Hernandez DC, Reesor L, Reitzel LR, Businelle MS, Wetter DW, Kendzor DE. Smoking, Financial Strain, and Food Insecurity. Heal Behav Policy Rev. 2017;4 (2):182-188 (7).

Siahpush M, Borland R, Scollo M. Smoking and financial stress. Tob Control. 2003;12(1):60–6.

McKenna CS, Law C, Pearce A. Financial Strain, Parental Smoking, and the Great Recession: An Analysis of the UK Millennium Cohort Study. Nicotine Tob Res. 2016;(April):ntw269.

Perelman J, Alves J, Pfoertner T-K, Moor I, Federico B, Kuipers MAG, et al. The association between personal income and smoking among adolescents: a study in six European cities. Addiction. 2017;

Widome R, Joseph AM, Hammett P, Van Ryn M, Nelson DB, Nyman JA, et al. Associations between smoking behaviors and financial stress among low-income smokers. Prev Med Reports. 2015;2:911–5.

Leung LWS, Davies GA. Smoking Cessation Strategies in Pregnancy. J Obstet Gynaecol Canada. 2015;37(9):791–7.

Jones A. Diagnosis on Smoking Cessation. Br J Nurs. 2017;26(14).

Turner L, Mermelstein R, Flay B. Individual and contextual influences on adolescent smoking. Ann N Y Acad Sci. 2004;1021:175–97.

Sensussiana T. Studi Fenomenologi; Pengalaman Perubahan Perilaku Berhenti Merokok Tahap Action dan Manitenance Berdasarkan Transtheortical Theory pada Remaja di SMAN 1 Cawas. Tesisi. Yogyakarta: Universitas Gadjah Mada; 2016.

West R, McEwen A, Bolling K, Owen L. Smoking cessation and smoking patterns in the general population: a 1- year follow-up. Addiction. 2001;96(6):891-902.

Surat Keputusan Pimpinan Pusat Muhammadiyah. Fatwa Majelis Tarjih dan Tajdid Pimpinan Pusat Muhammadiyah No.6/SM/MTT/III/2010 Tentang Hukun Merokok. 2010;(6):1–8.

Koenig HG. Spirituality and Health Research; Methods, Measurement, Statistics, and Resources. West Conshohocken, PA: Templeton Press; 2011.

Busch SH, Jofre-Bonet M, Falba TA, Sindelar JL. Burning a hole in the budget: Tobacco spending and its crowd-out of other goods. Appl Health Econ Health Policy. 2004;3(4):263–72.

Wang H, Sindelar JL, Busch SH. The impact of tobacco expenditure on household consumption patterns in rural China. Soc Sci Med. 2006;62(6):1414–26.

Guillaumier A, Bonevski B, Paul C. “Cigarettes are priority”: A qualitative study of how Australian socioeconomically disadvantaged smokers respond to rising cigarette prices. Health Educ Res. 2014;30(4):599–608.

Yao T, Huang J, Sung H-Y, Ong MK, Mao Z, Jiang Y, et al. Determinants of smoking-induced deprivation in China Tingting. Tob Control. 2015;24 (4):iv35–iv39.

Kendzor DE, Businelle MS, Waters AF, Frank SG, Hébert ET. Financial strain indirectly influences smoking cessation through withdrawal symptom severity. Drug Alcohol Depend. 2018;183(June 2017):55–61.

Fawzani N, Triratnawati A. Terapi Berhenti Merokok: Studi Kasus Tiga Perokok Berat. J Kesehat. 2005;9 (I); 15-.

Torre G La. Smoking Prevention and Cessation. Rome, Italy: Spinger; 2013.

Kahler CW, LaChance HR, Strong DR, Ramsey SE, Monti PM, Brown RA. The commitment to quitting smoking scale: Initial validation in a smoking cessation trial for heavy social drinkers. Addict Behav. 2007;32(10):2420–4.

Chandola T, Head J, Bartley M. Socio-demographic predictors of quitting smoking: How important are household factors? Addiction. 2004;99(6):770–7.

Ghouri N, Atcha M, Sheikh A. Influence of Islam on smoking among Muslims. Br Med J. 2006;332(7536):291–4.

Mahroof R, Syed R, El-Sharkawy A, Hasan T, Ahmed S, Hussain F. Ramadan health guide. 2007;30.

Aveyard P, Begh R, Sheikh A, Amos A. Promoting smoking cessation through smoking reduction during Ramadan. Addiction. 2011;106(8):1379–80.

Asropi. Efikasi Diri Mantan Perokok Dalam Mempertahankan Perilaku Tidak Merokok (Studi Kualitatif Mantan Perokok di Kabupaten Bengkulu Utara). Tesis. Yogyakarta: Universitas Gadjah Mada; 2016.

Siriwong S. Exploring Quitting Smoking Behavior Among Royal Thai Navy Personnel With the Transtheoretical Model. Procedia - Soc Behav Sci. 2015;191:1062–8.

Rimer BK, Orleans CT, Keintz MK, Cristinzio S, Fleisher L. The older smoker. Status, challenges and opportunities for intervention. Chest. 1990;97(3):547–53.

Kerr SM, Watson H, Tolson D, Lough M, Brown M. Other Developing evidence-based smoking cessation training/education initiatives in partnership with older people and health professionals. Glasgow, Scotland: Caledonian Nursing & Midwifery Research Centre; 2004.

Schofield I, Tolson D. An exploration of the smoking-related health beliefs of older people with chronic obstructive pulmonary disease. J Clin Nurs. 2007;16:1726–35.

Childs E, de Wit H. Effects of acute psychosocial stress on cigarette craving and smoking. Nicotine Tob Res. 2010;12(4):449–53.

Skov-Ettrup LS, Egan KK, Dalum P, Tolstrup JS. Stress-related expectations about smoking cessation and future quit attempts and abstinence - a prospective study in daily smokers who wish to quit. Prev Med Reports. 2017;6:187–90.

Porritt D. Social support in crisis: Quantity or quality? Soc Sci Med Part A Med Psychol Med. 1979;13(C):715–21.

Rausa BA. Social Support. Encycl Aging Public Heal. 2008;751–4.

Mermelstein R, Cohen S. Social support and smoking cessation and manteinance. J Consult Clin Psychol. 1986;(4):447–53.

Burns RJ, Rothman AJ, Fu SS, Lindgren B, Joseph AM. The Relation between Social Support and Smoking Cessation: Revisiting an Established Measure to Improve Prediction. 2014;47(3):369–75.

De Jesus MCP, Da Silva MH, Cordeiro SM, Kortchmar E, De Barros Zampier VS, Merighi MAB. Understanding unsuccessful attempts to quit smoking: A social phenomenology approach. Rev da Esc Enferm. 2016;50(1):71–8.

Van Der Rijt GAJ, Westerik H. Social and cognitive factors contributing to the intention to undergo a smoking cessation treatment. Addict Behav. 2004;29(1):191–8.

Bigsby E, Hovick SR. Understanding Associations between Information Seeking and Scanning and Health Risk Behaviors: An Early Test of the Structural Influence Model. Health Commun. 2017;33(3):315–25.

Niven N. Psikologi Kesehatan Keperawatan Pengantar untuk Perawat dan Profesional Kesehatan Lain. Jakarta: EGC; 2002.

Taylor SE, Stanton AL. Coping Resources, Coping Processes, and Mental Health. Annu Rev Clin Psychol. 2007;3(1):377–401.

Jannone L, O’Connell KA. Coping strategies used by adolescents during smoking cessation. J Sch Nurs. 2007;23(3):177–84.

Covino N a, Bottari M. Hypnosis, behavioral theory, and smoking cessation. J Dent Educ. 2001;65(4):340–7.

Sugito. Stop Merokok. Jakarta: Penebar Swadaya; 2009.

Brodbeck J, Bachmann MS, Znoj H. Distinct coping strategies differentially predict urge levels and lapses in a smoking cessation attempt. Addict Behav. 2013;38(6):2224–9.

Apriyani T, Evi AH. Mengapa Late Chilhood Merokok? J Hum vol2. 2011;

DOI: http://dx.doi.org/10.47034/ppk.v3i1.4142

Refbacks

  • There are currently no refbacks.