ROLE OF INFORMATION MODALITIES TO ACTIVE SMOKERS INTEREST IN

SMOKING CESSATION

Mariatul Fadilah1, Muhammad Yufimar Riza Fadilah2

1
Program Studi Profesi Fakultas Kedokteran, Universitas Sriwijaya
2
Department Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Sriwijaya

Jln. Dr. Moh. Ali Komp. RSMH Km 3.5, Palembang 30126, Indonesia

E-mail : yopirf@gmail.com

Abstract
Background : Smokers around the world is approximately now about 1,2 billion and 800 million among them on
development country. Based on WHO data, Indonesia is the biggest third country by smokers in the worldwide after
China and India. Indonesian Health Ministry shows increasing on smokers prevalence from 27% on 1995 to 36,3% on
2013. Some policies is already done by government to decrease amount of smokers, but it useless unless those smokers
realize the benefits. Modality is divided into 3 based on book “Quantum Learning”, there are visual, auditory, and
kinesthetic. This research goal is to analyze how 3 different modality could effect on smoking cessation.
Methods :This research is quantitative analysis research with cross sectional design through questioners in form of
google form to all smokers around Palembang. Questioners consist of questions list which categorized based on the
main theory of Lawrence Green. 475 samples have been successfully collected.
Result : In this research we found that among smokers in Palembang were dominated by man, age around 22-23 years
old, melayunese, colleger, and there was 290 of them interests in smoking cessation. Based on analyze using linear
regression we found that kinesthetic became the most related modalities to smokers interest in cessation.
Summary: In this research, we knew the modality and factors that effects in smoking cessation.

Keywords : Information modalities, active smokers

1. Preliminary to 6,7% on 2013. We can assume that 20

Use of tobacco (as cigarette) is one of the
serious health threat around the world, it
because these thing currently is the main actor
of preventable cause of death. About 6
millions people died every single year and we
predict this number increasing to 20% on
2020.1 Smokers around the world now about
1,2 billion peoples and 800 millions among
them are on development countries. Based on
WHO (World Health Organization), Indonesia
is the third highest country by smokers after
China and India.
Data of Indonesian Health Ministry
showed inreasing number of smokers from
27% on 1995 to 36,3% on 2013. So, this
mean, if 20 years ago from 3 peoples 1 of
them is smoker, this years from 3 peoples 2of
them are smoker.6
Sad things about this, the women smokers
prevalence also inreasing from 4,2% on 1995
years ago comparison of women smokers
4:100, nowadays it becoming 7:100. Another
sad thing we found that the prevalence of
young smokers also increase. Indonesian
Health Ministry data proved it. Smokers age
of 16-19 years old increaed 3 times from
7,1% on 1995 to 20,5% on 2014.
Government already put some strategies to
decrease smokers around the world, smoking
bans on public places, increasing tobacco tax,
warning labels on cigarette pack. The WHO’s
Framework Convention on Tobacco Control
state that “those warning labels should put
50% or more on cigarette pack, and there are
pictorial warning on it too”. In fact,
implementaion of pictorial warning is a great
educational strategy. Not only decrease
number of tobacco using, but also increase
number of smoking cessation.1
 All of those strategies are meaningless study there are 5 predispotition, 5 support and
unless each individu realize how important it 5 motivational factors.
is. Modalities based on book “Quantum
Learning” divided into 3. They are visual,
auditory, and kinesthetic. Visual modality is
somekind of way to process information that
dominated by seeing, auditory dominated by Distribution Description
listening, and kinesthetic is a learning process This research was done in Palembang with
dominated by moving/acting. 375 samples.
Through this research, researcher want to
analyze how different modalities could effect Table 1. Respondents’ Distribution based
and play important role on someone’s act, on Age
especially on smoking cessation. Based on the following data, the youngest
respondents were 15 years old with
2. Research Method percentage of 0,3% from 375 samples.
This is a quantitative analytic research with
corss-sectional design. This Research goal is
to gain the information about modalities
around smokers in Palembang relate to their
interest in smoking cessation and held in
Palembang through questionnaire by google
form who filled by smokers.
Data collected by questionnaire in this
research are primary data. Dependent variable
is active smokers interest in smoking
cessation and independent variable is
information modalities. Univariat, bivariat,
and multivariat analysis are used in this
research by SPSS software.

3. Result
This study aimed to determine the role of
information modalities of Palembang
community as active smokers in influencing
their interest to smoking cessation. There
were 3 modalities of information examined,
namely kinesthetic, auditory, and visual
modalities. The profiles seen in this study
were in 9 forms: respondent age, gender,
ethnicity, occupation, smoking age, smoking
cessation experience, and interest in cessation.
In addition there were also factors that could
affect a person's response. This study used the
basic theory of behavior of Lawrence Green While the eldest respondents were 55 years
theory that reveals three factors that can affect old with a percentage of 0.3% as well. The
a person's behavior, such as predisposing, highest age of respondents was 22 years old
supporting, and motivating factors. In this (73 persons) with 19.5% and 23 years old (79
persons) with 21.1%.
Table 2. Respondents’ Distribution by Sex
From the data above, it can be seen that
375 respondents were dominated by men with
the number of 318 (84.8%), while female
respondents were 57 people (15.2%).
Table 3.
Respondents’ Distribution by Ethnicity
The data shows that most of respondents
came from Malay (46,1%), followed by Java
(27,2%). While the rest are relatively even
among other tribes.
Table 4. Distribution of Respondents by
Job
From the data above, it can be seen that
the majority of respondent's main job are 234
students (62,4%), followed by private
employee 49 people (13%), respondent with
other job 43 people (11,5%) , respondents
with doctor job as many as 18 people (4.8%),
and respondents with self-employment jobs of
15 people (4%)
Table 5. Distribution of Respondents by
Age of Smoking
Based on the above data, it is seen that
the majority of respondents aged the first time
smoked in this study was dominated by
respondents with segments aged 16 to 20
years (61.6%), followed by segments aged 11
to 15 years (19.7%), age 21 up to 25 (17.6%),
and ages 25 to 30 years (1.1%).
Table 6. Distribution of Respondents
Based on the Experience of Smoking
Cessation

From
the
following data, it is found that out of a total of
375 respondents who had experienced
smoking cessation as many as 207 people
(55.2%) and who never had the experience of
smoking cessation as many as 168 people
(44.8%).
Table 7. Respondents’ Distribution by
Smoking Cessation Interest
Based on the following data, it can be seen
that most respondents have interest in
smoking cessation (77.3%) and respondents
who have no interest in smoking cessation
(22.7%).
The role of information modality with
predisposition factors on smoking cessation
interest
Table 8.
Modality of information with trust
Based on the table above, we can know
that of the three modalities of information, the
only visual role of predisposing factors of
trust. The p value is 0.000. This is because the
two other modalities are not eligible for a
multivariate test because of the p value of no
significance.
Table 9. Modality of information with
knowledge of cigarettes
According to the following table, the three
most significant modalities of significance are
kinesthetic modalities with p values of 0.000
and followed by auditory modality (p value
0.375) then visual modality (p value 0.430).
Table 10. Modality of information with
social norms
From the table above, kinesthetic
modalities show the most significance /
relationship with p value of 0.001, then visual
modalities with a score of 0.464. In the table
is not listed auditory modality due to auditory
modality is not eligible for multivariate tested
by linear regression.
 Table 11. Information modality with
perceptions of cigarettes
Of the three modalities of information
above, the most significant/ relationship with
perceptual predisposing factor is auditory
modality with p value of 0.009, followed by
visual modalities (p value 0.011) and
kinesthetic modalities (p value 0.631).
Table 12. Information modality with
financial / finance
Furthermore, in financial factor,
kinesthetic modality showed significantly
more p value / correlation to finance factor /
finance with score 0,001 compared to visual
modalities with p value equal to 0,067.
The Role of Information Modality with
Supporting Factors to Smoking Cessation
Interest
Table 13. Information modality with
government policy
Based on the table we can know that of the
two modalities of information above, visual
modalities most related to the supporting
factor in the form of government policy, it is
proved through the p value of 0.016 compared
to kinesthetic modalities with p value of
0.023.
Table 14. Modality of information with
smoking sanctions in the workplace
From the data below we can know that
visual modality is most related to the
supporting factor is the existence of sanctions
(p value of 0.005), followed by kinesthetic
modalities (p value 0.159), then p value
0.689.
Table 15. Modality of information by
means of cigarette provider
Based on the data we know that visual
modality is the most related modality and
influence to cigarette provider factors (p value
equal to 0,131) followed by kinesthetic
modality with p value 0,669, then p value
0,859.
 Table 18. Modality of information with
Table 16. lack of information from health workers
Modality of information with regulation of
prohibition to smoke in public places

Based on the data above we can see that

From the data above we know that
kinesthetic modalities are the most influential
and associated with supporting factors in the
form of smoking-prohibited regulations in
public places (p value of 0,000), followed by
auditory modalities with p value 0.722 and
visual modality 0.875.
between the visual modalities (p value 0.639)
and auditory modality (p value 0.684) nothing
related to the reinforcing factors of lack of
information about cigarettes. But when
compared, between the two modalities, visual
modalities are more influential.
Table 19. Modality of information with
family support

Table 17. Information modality with

warnings on cigarette packaging

Based on the following table we can see

that among the three modalities, the
kinesthetic modalities (p value of 0.002) and
visual modalities (p value of 0.002) have the
same p value, so both modalities are related to
Based on the data it can be seen that
the motivational factors of family support.
kinesthetic modalities have the most influence
over supporting factors in the form of
Table 20. Modality of information with
warning on cigarette packaging (p value
history of smoking diseases on family /
0,008), then visual modalities with p value
friends
0,040 followed by auditory modality with p
value 0,871.

The Role of Information Modality with

Factors Strengthening Interest in Smoking
Cessation

Based on the above table we know that
visual modality is the most important
modality to the driving factor, the family /
friends who suffer from cigarette disease (p
value equal to 0.001) than kinesthetic
modalities (p value 0.041) and auditory
modality (p value 0.934 ).
Table 21. Modality of information with
doctor's advice
Based on the table below we can know that
kinesthetic modalities play a role (0.006) to
the supporting factors in the form of
suggestions from doctors that affect his
interest to quit smoking. While the other
modalities are visual (p value of 0.010) and
auditory modality (p value of 0.453).
Table 22. Modality of information with
family / friends who quit smoking
Based on the table above we can see that
visual modalities have the most influence and
contribute to the supporting factors in the
form of family / friends who quit smoking so
as to influence the respondent's interest to quit
smoking (p value 0.000), compared with
kinesthetic modalities (p value 0,004) and
auditory modality (p value of 0.936).
Discussion
Role of Information Modalities Related by
Predispose Factor to Smoking Cessation
Interest.
a. faith27
Based on multivariat data, only visual
modalities has relation with faith to smoking
cessation interest. While the others modalities
(auditory and kinesthetic) got no role and no
relation to smoking cessation interest. It
showed on visual p value 0,000 (p<α 0,005).
Research of Pawiono (2008) showed the same
result.
b. knowing about cigarette/smoke
What researcher means about this is
respondent knowledge about own
cigarette/smoke. What is contents, effects of
it, what is the hazard, etc. Based on table 54,
after regression test, we found among those 3
modalities, kinesthetic with p 0,000 becoming
most related to smoking cessation interest.
c. social norm28
What researcher mean of this factor is how
community think about smokers. They tend
feeling smoker is a bad habit. This thing also
effect smoking cessation. In this observation,
table 55, kinesthetic is a modality that most
related to smoking cessation. Probably some
respondents have experienced and felt how
discrimination of community.
This thing also agree with research of
Karasek et al (2011) state that a community
with no desire of smoking related with rate of
smoking cessation.
d. perception about cigarette29
Some people think smoking is a symbol
of gentlemen, maturity level, glamour, and as
a stress reliever. In this research, auditory (p
0,009) is most related modality to compared
to visual (p0,011) and kinesthetic (p 0,631).
Cui et al (2012) also state the same result,
workers with higher level of stress has 45%
bigger chance to start smoking.
e.financial30
Data based on CDC (2014) showed
67,5% of US citizens who put on lower level
of socialeconomic status more tend to stop
smoking. In this research, we found that
kinesthetic is most related than others (p
0,001).
Role of Information Modalities Related by
Enabling Factor to Smoking Cessation
Interest.
a. government policies31
Some of government policies such as,
increasing cigarette prices, build much no-
smoking area, increasing tobacco tax also
effect smoking cessation. Table 58 showed
visual is the most related modality among
others (p 0,016). According research of Ross
et al (2011), state that higher cigarette prices
increased probability of smoking cessation, in
the other hand, respondents who lived at high
tax area also related to smoking cessation.
b. punishment for workers who smoked at
workplace32
In this research, it means for workers
who got caught smoking while working but
their workplace applied no smoking policy. In
this research we found that visual modality is
most related than others to smoking cessation
(p 0,005). Lee & Kahende (2007) also found
no smoking policy at work place increasing
smoking cessation interests.
c. cigarette provider33
Place that provide cigarette also effect on
smoking cessation, such as store, minimart,
etc. But, how if those provider location far
away from smoker home? In this research, we
found that all three (3) modalities has no
relation to smoking cessation. P score of
kinesthetic 0,669, auditory : 0,859, and
visual : 0,131.
Different with this research, Halonen et al
(2013) found there is a relation to smoking
cessation. More near respondents home to
store, probability to stop smoking also
decrease.
d. no-smoking ban at public area34
Based on table 61, we knew that
kinesthetic modality is most related to
smoking cessation than others (p 0,000)
compare to auditory (p 0,722) and visual (p
0,875). It could be because respondents
already felt how no-smoking ban at public
area policy.
A research in China by Luo et al (2015),
state there is a relation between that policy
and smoking cessation.
e. warning label on cigarette pack35
We all clearly knew on cigarette pack
there is warning label, it could be pictorial
label or sentence lebel. In this research we
found that kinesthetic is most related modality
among others (p 0,008), visual in the other
hand (0,040) and auditory (p 0,871).
Azagba & Sharaf (2013) also found same
result. They found warning label on cigarette
pack, especially pictorial warning has
significant effect on smoking cessation.
Role of Information Modalities Related by
Reinforcement Factor to Smoking
Cessation Interest.
a. insufficient Information by Medical
Staff36
For low educational level person, they
probably didn’t know negative effects of
smoking. Here what medical staff should did,
they should give information for those kind of
person. In this research, we found that among
visual (p 0,639) & auditory (p 0,684), there is
no relation to smoking cessation.
 But Li et al (2014) found that a
counselling needed for smoking cessation.
b. family Support37
In this research, we knew visual modality
(p 0,002) and kinesthetic modality (p 0,002)
has same role and relation to smoking
cessation. But on the other hand, Park et al
(2012) found family support has significant
role to smoking cessation.
c. history of disease caused by smoking on
family or friends
Family or friends also has significant role
on smoking cessation. In this research, we
found that visual modality (p 0,001). It
means, seeing this directly could effect
smoking cessation.
d. doctor’s suggestion38
Doctor as communicator and care
provider surely know about negative effects
of smoking. Here how doctor’s suggestion
could effect smoking cessation. In this
research, we knew kinesthetic is the most
related modality among others (p 0,006).
According to Ng et al (2010) we found the
same thing, doctor’s suggestion about
smoking increasing the smoking cessation of
patients.
e. there is friend/s or family stop smoking
earlier
In this research we found that visual is
most related modality among others (p 0,000)
compare to kinesthetic (p 0,004) and auditory
(p 0,936). It means if we seeing those person
directly it could effects on our smoking
cessation interest.
Conclusion
1. In this study obtained a total sample of 375
respondents. Based on that number, 290
respondents (77.3%) are interested to stop
smoking. So the distribution of Palembang
city residents who are interested to stop
smoking is 290 people.
2. Factors that affect the interest in smoking
cessation in active smokers consist of 3
factors, namely predisposing factors,
enabling factors, and reinforcing factors.
a) Predisposing factors in this study were
faith, knowledge about cigarettes, social
norms, perceptions about cigarettes, and
financial.
b) Enabling factors are factors that enable or
facilitate behavior or action. The
supporting factors in this study are
government policy, punishment for
smokers at work, cigarette providers,
smoking prohibition regulations in public
places, and warnings on cigarette
packaging.
c) Faktor penguat adalah faktor-faktor yang
mendorong atau memperkuat terjadinya
perilaku. Faktor penguat pada penelitian
ini adalah 1) konseling, 2) dukungan
keluarga, 3) riwayat penyakit akibat rokok
pada teman/keluarga, 4) saran dokter, dan
5) ada keluarga/teman yang berhenti
merokok terlebih dahulu.
3. The most dominant and related modalities
of information to smoking cessation is
kinesthetic. We proved this by linear
regression test, kinesthetic modality gets p
value 0,000, followed by visual modality
with p value 0,003, then auditory modality
with p value 0,796.
Advice
1. Build or plan some policies that effects on
smoking cessation, one of them by
increasing cigarette prices. In researcher
opinion, this gonna be an effective way to
significantly increasing smoking cessation
interest, especially for those who on lower
socioeconomic status.
2. Perform Health Promotion using
interesting media, such as short movie or
animation, so it significantly increasing
smoking cessation interest.
3. Please do re-research with the number of
samples more, so the answer from this
study can be more representative and
describe actual conditions.

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