Effectiveness of Digital Peer Education in Supporting Adolescent Smoking Cessation: A Systematic Review
DOI:
https://doi.org/10.25311/keskom.Vol11.Iss3.2372Keywords:
Berhenti Merokok, Pendidikan Sebaya Digital, RemajaAbstract
Smoking behavior among adolescents in Indonesia is increasingly alarming, with the number of active smokers reaching 70 million and a significant rise observed in the 13–15 age group. Early initiation of smoking increases the risk of nicotine addiction, non-communicable diseases, and the economic burden on both families and the nation. This study aims to evaluate the effectiveness of digital peer education in enhancing adolescents’ motivation to quit smoking.
Methods: This systematic review was conducted following the PRISMA 2020 guidelines. Article searches were performed in Scopus, ScienceDirect, and ProQuest databases between March and April 2025. Inclusion criteria were developed based on the PICO framework and focused on quantitative studies involving adolescents aged 10–19 years who participated in digital peer education interventions. A total of 10 studies (4 randomized controlled trials, 2 quasi-experimental studies, 2 cohort studies, and 2 cross-sectional studies) met the inclusion criteria and were critically appraised using the JBI Critical Appraisal Checklist.
Results: The review revealed that digital peer-based interventions significantly improved adolescents’ self-efficacy, knowledge, and intention to quit smoking. The interventions included online peer education, digital games, social media messaging, and school-based modules. Most studies demonstrated positive outcomes, although variations in evidence strength were noted due to methodological differences, limited follow-up, and reliance on self-reported data.
Conclusion: Digital peer education has strong potential as an effective strategy to enhance adolescents’ motivation to quit smoking. Further studies with more rigorous designs and longer follow-up periods are recommended to strengthen the generalizability of these findings.
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References
Kementerian Kesehatan Republik Indonesia. Laporan Akuntabilitas Kinerja Kementerian Kesehatan Tahun 2023 [Internet]. Jakarta: Kementerian Kesehatan RI; 2024 [diunduh 10 Okt 2025]. Available from: https://www.kemkes.go.id.
2. WHO global report on trends in prevalence of tobacco use 2000-2030 [Internet]. 2024. Available from: https://iris.who.int/.
3. Sharapova S, Reyes-Guzman C, Singh T, Phillips E, Marynak KL, Agaku I. Age of tobacco use initiation and association with current use and nicotine dependence among US middle and high school students, 2014-2016. Tob Control. 2020;29(1):49–54.
4. Ye BZ, Wang XY, Wang YF, Liu NN, Xie M, Gao X, et al. Impact of Tobacco Smoking on Health Care Utilization and Medical Costs in Chronic Obstructive Pulmonary Disease, Coronary Heart Disease and Diabetes. Curr Med Sci. 2022;42(2):304–16.
5. Agarwal A, Lubet A, Chen S, Khoury A, Bloom DE. Non-communicable Diseases and Their Macroeconomic Impact in India. Econ Polit Wkly. 2021;56(51):56–63.
6. Rajbanshi M, Rajbanshi R, Aryal R. Smokeless tobacco use and its associated factors among secondary school students of Rangeli Municipality of Morang district, Nepal. PLoS One. 2024;19(11 Novembe).
7. Do EK, Bradley KC, Fugate-Laus K, Kaur K, Halquist MS, Ray L, et al. An examination of social and environmental determinants of secondhand smoke exposure among non-smoking adolescents. Tob Prev Cessat. 2021;7:1–12.
8. Reitsma MB, Kendrick PJ, Ababneh E, Abbafati C, Abbasi-Kangevari M, Abdoli A, et al. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. The Lancet [Internet]. 2021 Jun;397(10292):2337–60. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0140673621011697
9. Meilissa Y, Nugroho D, Luntungan NNHW, Dartanto T. The 2019 economic cost of smoking-attributable diseases in Indonesia. Tob Control. 2022;
10. Swarnata A, Kamilah FZ, Melinda G, Adrison V. The Impoverishing Effect of Tobacco Use in Indonesia. Nicotine and Tobacco Research. 2024;26(10):1331–8.
11. Tahlil T, Woodman RJ, Coveney J, Ward PR. The impact of education programs on smoking prevention: a randomized controlled trial among 11 to 14 year olds in Aceh, Indonesia [Internet]. 2013. Available from: http://www.biomedcentral.com/1471-2458/13/367
12. Chung OK, Li WHC, Ho KY, Kwong ACS, Lai VWY, Wang MP, et al. A descriptive study of a Smoke-free Teens Programme to promote smoke-free culture in schools and the community in Hong Kong. BMC Public Health. 2019;19(1).
13. Plaisime M, Robertson-James C, Mejia L, Núñez A, Wolf J, Reels S. Social Media and Teens: A Needs Assessment Exploring the Potential Role of Social Media in Promoting Health. Social Media and Society. 2020;6(1).
14. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Vol. 372, The BMJ. BMJ Publishing Group; 2021.
15. Munn Z, Stone JC, Aromataris E, Klugar M, Sears K, Leonardi-Bee J, et al. Assessing the risk of bias of quantitative analytical studies: introducing the vision for critical appraisal within JBI systematic reviews. JBI Evid Synth. 2023 Dec 8;21(3):467–71.
16. Orsal O, Ergun A. The effect of peer education on decision-making, smoking-promoting factors, self-efficacy, addiction, and behavior change in the process of quitting smoking of young people. Risk Manag Healthc Policy. 2021;14:925–45.
17. Rachmat M, Arif NA, Anwar SA, Asrianti T, Awaru AT. Effect of peer promoters on changes in adolescent smoking knowledge and attitudes: A school-based intervention study. Open Access Maced J Med Sci. 2021 Jan 10;9:1169–74.
18. Mermer G, Nurcan Bilgic, Keskin S, Gunay T. Effect of peer education on knowledge and frequency of smoking among high school students in disadvantaged districts: a quasi-experimental study. J Pak Med Assoc [Internet]. 2024 May 24;74(6):1089–93. Available from: https://jpma.org.pk/index.php/public_html/article/view/10129
19. Lareyre O, Cousson-Gélie F, Pereira B, Stoebner-Delbarre A, Lambert C, Gourlan M. 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. 2024 Sep 1;119(9):1616–28.
20. Nyman J, Salanterä S, Pasanen M, Parisod H. Effectiveness of a Digital Health Game Intervention on Early Adolescent Smoking Refusal Self-Efficacy. Health Education and Behavior. 2024 Aug 1;51(4):562–72.
21. Khalil GE, Khan M, Kim J. Social influence and advocacy pathways during a web-based program for adolescent smoking prevention. Addictive Behaviors Reports. 2024 Jun 1;19.
22. Lazard AJ. Social Media Message Designs to Educate Adolescents About E-Cigarettes. Journal of Adolescent Health. 2021 Jan 1;68(1):130–7.
23. Megatsari H, Damayanti R, Kusuma D, Warouw TS, Nadhiroh SR, Astutik E, et al. The influence of anti-smoking messages to Indonesian youth smoking behavior: the Indonesian 2019 Global Youth Tobacco Survey (GYTS). BMC Public Health. 2023 Dec 1;23(1).
24. Khalil GE, Khan M, Kim J. Social influence and advocacy pathways during a web-based program for adolescent smoking prevention. Addictive Behaviors Reports. 2024 Jun 1;19.
25. Kelly BC, Vuolo M, Maggs J, Staff J. E-cigarette use among early adolescent tobacco cigarette smokers: testing the disruption and entrenchment hypotheses in two longitudinal cohorts. Tob Control. 2024 Jun 20;33(4):497–502.
26. de Andrés-Sánchez J, Belzunegui-Eraso A, Pastor Gosálbez I, Sánchez-Aragón A. A cross-sectional assessment of the influence of information sources about substance use in adolescents’ tobacco prevalence. Heliyon. 2024 Oct 15;10(19).
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