Background Research

Nicotine (C₁₀H₁₄N₂)

According to the National Cancer Institute, a tobacco cigarette is a product that is mainly created from tobacco. It is shaped in a cylindrical shape, and inside it, there are cut and cured tobacco leaves. It is all wrapped in thin paper, mostly rolling paper. According to the American Lung Association (2020), tobacco cigarettes contain more than 600 substances, and when it is burned, they produce more than 7000 substances. More than 69 substances from tobacco cigarettes are carcinogens or substances that can cause cancer.

The three main components of all 7000 substances are nicotine, tar, and carbon monoxide. Nicotine is the substance found in tobacco that causes addiction and pleasure. The pleasing effects are temporary. Thus it makes the smoker reach for another cigarette and never stops smoking. Next is tar. Tar is a substance that creates stains in the smoker's teeth and fingers. It contains carcinogens or substances that can cause cancer. Besides that, it can damage the bronchioles, the small tubes in our lungs, and cilia, the tiny hair in our lungs. If we keep consuming tar, it can lead to chronic obstructive pulmonary disease (COPD) and emphysema. The last substance is carbon monoxide. Carbon monoxide is a toxic gas, usually found in vehicles, which replaces the oxygen in the blood. It makes the heart and lungs work harder, and the cells in our body do not receive the oxygen needed. Inhaling carbon monoxide will lead to diseases like stroke and baby miscarriage.

Nicotine (C₁₀H₁₄N₂)

According to Medical News Today, an electronic cigarette is a device that produces a vaporized solution, mostly nicotine, to be inhaled. It stimulates the sensation of smoking tobacco cigarettes but without the smoke.

Electronic cigarettes have three main components: battery, atomizer, and e-liquid or e-juice. There are three common types of batteries for electronic cigarettes. The first is disposable. Some electronic cigarettes, mostly the old ones, have a limited lifespan. Thus, they need to be thrown away after being used, and they are not rechargeable. The second one is integrated. The cigarettes that use this battery cannot be replaced or removed, but different from disposable, integrated batteries can be recharged even though they can only be recharged at certain times. The last type is removable. This type of battery can be recharged and replaced or removed after they no longer recharged. The second component of electronic cigarettes is the atomizer. An atomizer is a device to heat the e-liquid and convert it into a gas. The atomizer consists of a metal coil and a wick. The process of how it works is such: the battery heats the metal coil, and the e-liquid gets absorbed into the wick and gets heated. After being heated, the e-liquid will turn into a gas through evaporation. The last component is e-liquid. E-liquid is the liquid that gets heated and converted into aerosol or gas. The main ingredients of e-liquid are water, nicotine, flavorings, and propylene glycol or vegetable glycerin base.

There are several differences between tobacco and electronic cigarettes. The first difference is how they work. Tobacco cigarettes produce smoke by burning tobacco. On the other hand, electronic cigarettes produce aerosol or gas by heating the e-liquid inside the cigarette. The second difference is the toxins in both cigarettes. According to Scott Roberts Law (2021), tobacco cigarettes are way more toxic than electronic cigarettes. The tobacco itself is toxic when burnt. It contains hundreds of toxic chemicals and several carcinogenic chemicals. Meanwhile, electronic cigarettes are healthier than tobacco cigarettes, even though they are still harmful. The e-liquid does not contain any harmful chemicals like tobacco, and all of the ingredients are not toxic when vaporized. The other difference is the cost of cigarettes. Tobacco cigarettes are generally cheaper than electronic cigarettes. Besides that, electronic cigarettes need more cleaning and maintenance than tobacco cigarettes.

According to the Centers for Diseases Control and Prevention (2020), smoking can lead to several severe diseases in almost all organs in our body. It can cause cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary diseases (COPD), like emphysema and chronic bronchitis. Besides that, smoking cigarettes can increase the risk of tuberculosis, several eye diseases, problems in the immune system, and rheumatoid arthritis. Passive smoking can also affect health. About 41,000 people died due to passive smoking or secondhand smoking. In addition, there are 400 deaths of infants (babies) every year. Besides causing diseases, smoking can cause addiction. Addiction is caused by nicotine. When we consume nicotine, our brain releases dopamine. It is the chemical that gives pleasure. When the effect of nicotine starts to disappear, the brain will release more dopamine. The more we smoke, our sensitivity will decrease. To feel good, we need more dopamine than before. This situation will make us hard to stop smoking.

According to Badan Pusat Statistik (BPS), 3.69% of the teenagers in Indonesia (age below 18) smoked both tobacco and electronic cigarettes in 2021. From 2015 to 2021, the trend line of smokers is stable, except for 2018. In 2018, there was a big blast, at 9.65%. According to analysis, this blast can happen because the Indonesian government just legalized vaping. This creates a trend about vaping, thus increasing the number of teenagers smokers in Indonesia. 16-18 have the highest percentage when classified into several age groups, at 9.59%, followed by 13-15, at 1.44%. Last is 10-12 at 0.07%. We think that this number is a lot. According to Badan Pusat Statistik (BPS), the number of people below 18 is 88400000. If 3.69% of them smoked, there would be 3261960 people smoking. Even though the percentage is small, it does not mean that the result will be small either.

According to FAKTOR-FAKTOR PENYEBAB PERILAKU MEROKOK PADA REMAJA (Komasari & Helmi, 2015), there are 3 main reasons why teenagers in Indonesia smoke. The first reason is psychological satisfaction. When first trying to smoke, they usually experience unpleasant symptoms like coughs, tongue tastes bitter, and stomachache. However, they tend to ignore them and continue building up this habit, which later becomes an addiction. This addiction is perceived as comfort and pleasure, which creates psychological satisfaction. From a fun thing to do, smoking has become an obsessive activity. This addiction can happen because of nicotine. The second reason is family. If one family member smokes, they will be a good imitation agent for teenagers to smoke. On the other hand, if none of the family members smoke and there are permissive parents, their kids will tend to smoke. The last reason is friends. Friends, especially those of the same age, have an essential role in teenagers' development. They will usually do anything to join their friends' group or gang. Besides that, smoking is one of the symbols of masculinity and strength. Thus, if one of the friends does not smoke, they will be effeminate and sissy. Lastly, friends are one of the agents that first introduce what smoking is to teenagers.

Survey Result

These charts illustrate the result of a survey in which Santa Laurensia students were asked whether they are passive smokers or not, including the sex of the passive smokers, the grade the passive smokers at, the age of the passive smokers, the frequency of them inhaling smoke, and what they do when someone is smoking near them.

From 80 students participating in the survey, it is clear that most Santa Laurensia students do not become passive smokers, at 72.5%. The rest, at 22.5%, are passive smokers. The majority of the passive smokers are female, at 81.8%, and the rest are male. They are primarily seventh-graders, at 50%. Eighth grade has the second-highest students, at 36.4%. The grade with the minor students is senior high schoolers, at 13.6%. The majority age of the passive smokers in Santa Laurensia is 13 years, at 54.6%. The 12 years group represents 22.7% of the total. The 16-18 years group shares the third-highest number of students, at 13.6%. The age group with the minor students is 14 years, at 9.1%. The frequency of inhaling cigarette smoke by passive smokers is dominated by sometimes, at 45.5%. The seldom group has the second-highest percentage, at 31.8%, followed by often, at 18.2%. The smallest frequency group with the least student is always at 4.5%. Lastly, if the students are near a person smoking, the majority will avoid them, at 77.3%. The rest of them will ignore them and stay there.

These charts illustrate the result of a survey in which Santa Laurensia students were asked whether they are ever smoked or not, including sex of the smokers, the grade the smokers at, the age of the smokers, the type of cigarettes they smoked, the reason why they smoked, the number of cigarettes smoked in their entire life, and the last time they smoked.

From 80 students participating in the survey, it is clear that most Santa Laurensia students never smoked, at 96.3%. The rest, at 3.7%, are ever smoked. The majority of the smokers are male, two-thirds of the total and the rest are male, a third of the total. They are primarily senior high schoolers, two-thirds of the total. The grade with the minor students in seventh grade, a third of the total. The majority age of the passive smokers in Santa Laurensia is 16-18 years, two-thirds of the total. The age group with the most negligible student contribution is 12 years, one-third of the total. All the smokers have ever tried smoking using electronic cigarettes, but only two-thirds of the total ever tried smoking using tobacco cigarettes. Two-thirds of the smokers smoked because of curiosity, while the rest smoked because smoking is a fun activity to do with friends. The majority of the smokers, two-thirds of the total, smoked 1-10 cigarettes in their entire life. On the other hand, the other third smoked 11-100 cigarettes in his entire life. Two-thirds of the smokers last smoked over one year ago, while the other one-third last smoked within this month.

Analysis

From the analysis of the charts, Alam Sutera, the area in which most of the students live, is clean and free from smokers. This is because most of the survey participants do not passively smoke. It indicates that their environment is free from smokers and cigarettes. After that, they are primarily female because, in general, active smokers are male. Females and males are inseparable; thus, some females might be passive smokers. Next, most passive smokers are seventh graders because they are too young to smoke actively. Then, most seventh graders have older siblings, which probably smoke since they are mature enough. The majority of the passive smokers are 13 years old because the seventh graders are mostly 13 now. Besides that, the frequency of passive smokers inhaling the smoke is sometimes. This indicates that the place where passive smokers live contains a lot of active smokers. In addition, if someone is smoking near them, most of them will avoid that person. This shows that most of them are educated and know the effects of passive smoking.

In the other charts, most students are not active smokers, which means that they are well educated about the dangers of active smoking. Then, they are primarily male because smoking is a symbol of masculinity. After that, they are primarily senior high schoolers. This is because their parents already trust them and know that they understand the effects of smoking. Besides that, most smokers are 16-18 years old because they are mostly senior high schoolers. Furthermore, when smoking, they mostly use electronic cigarettes. This indicates that they are well educated and understand that electronic cigarettes are healthier than tobacco cigarettes. As well as that, the reason why they smoked is mostly curiosity. This may happen because they are imitating other people who smoke. Moreover, most of the number of cigarettes they consume in their entire life is 1-10 cigarettes. This further supports the reason why they smoked, which is curiosity. If they were serious about smoking, they would smoke more than 50 cigarettes in their entire life. Lastly, the majority of smokers last smoked over 12 months ago. This indicates that they may be curious about smoking or have already stopped smoking.

From the charts and analysis, it can be concluded that the place where the majority of the survey participants live, Alam Sutera, is free from smoking. In the place where the passive smokers live, there are quite a lot of active smokers there. The school and its environment have well-educated Santa Laurensia students. They can understand the effects of smoking, like causing diseases and addiction, as well as, trying either not to smoke or passively smoke. Besides that, they also know which type of cigarettes is better and healthier, which is electronic cigarettes.

Advice to Teens

It is recommended to stop and avoid smoking. Never try smoking. Once you try smoking, the nicotine in the cigarette will react and cause addiction. You will struggle to stop and remove that habit. If you smoke and try to stop, you can start reducing the number of cigarettes you consume every day. If you continue this every day, you can stop smoking entirely. If you are smoking tobacco cigarettes and you struggle to stop that, doctors recommend it to switch to electronic cigarettes. This is because electronic cigarettes are way healthier than tobacco cigarettes since they do not have any toxic substances.

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