A Reason Action Theory: Factors Impacting Male Students' Motivation to Quit Smoking

Background: Smoking behavior is often found in our society. Based on the results Basic Health Research of Indonesia, it is reported that the proportion of male and female smokers in Indonesia is 64.9% and 2.1%, respectively. Smoking has been shown to cause various health problems and increase risk factors for death. This study uses a quantitative method with a cross-sectional approach. The population was male students of the Faculty of Engineering and Science at Universitas Muhammadiyah. The samples were 300 students. Afterward, they filled out questionnaire adopted from Istifaizah that have been distributed using the WhatsApp group. The data were analyzed using the Chi-Square test. The result showed that the significance value of the relationship between attitudes and motivation to quit smoking was 0.000≤0.05. Meanwhile, the significance value of the relationship between subjective norms and motivation to quit smoking was 0.000≤0.05. Afterward, the significance value of the relationship between perception and motivation to quit smoking was 0.000≤0.05. Respondents attitudes, subjective norms and perceptions toward smoking cessation showed that the percentage of positive attitudes was lower than the percentage of negative attitudes. The respondents' motivation to quit smoking showed that the percentage of motivation to quit smoking was low more than the high motivation to quit.


INTRODUCTION
Theory Reasoned Action (TRA) is prepared using assumptions the basis that humans behave consciously and consider everything available information. This theory connects between attitudes, beliefs, and intentions. a person can act based on intention (intention) only when the individual have control over their behavior (Soedarmadji, 2011).
Smoking behavior is often found in our society. The results of Riskesdas report that the proportion of smokers in Indonesia is 64.9% male and 2.1% female for the average number of cigarettes smoked per day is 12.3 cigarettes (equivalent to one pack). The proportion of age at starting smoking in Indonesia is increasing every year. The proportion of smoking age aged 15-19 years is 55.4% (1) . In the Banyumas area, the percentage of smokers aged 15-24 years is 19.722% (BPS Jawa Tengah, 2019).
Smoking can cause various health problems and increase risk factors for death. The prevalence of disease, one of which is caused by smoking, is increasing, but this does not make people stop smoking behavior (Soedarmadji, 2011). The bad impact of smoking on health has taken many victims, thousands of people have ISSN: 2808-1021 Proceedings homepage: https://conferenceproceedings.ump.ac.id/index.php/pshms/issue/view/18 52 died from smoking, millions of people are affected by various diseases such as cancer, coronary heart disease, lung disease, and other diseases (Kemenkes, 2011). This is because cigarettes contain approximately 4000 chemical compounds and at least 200 of them are toxic and declared harmful to health, while 43 other chemicals can trigger cancer (Satiti, 2009). Some smokers stated that active smokers definitely want to quit smoking behavior, but they still have difficulty quitting. One of the things that can affect quitting smoking is motivation (Nainggolan, 2006). A person's desire to quit smoking arises due to a person's knowledge of the dangers of smoking accompanied by a strong desire to implement it (Samijatun, 2006). Based on the Theory of Reasoned Action (TRA) developed by Ajzen & Fishbein that attitude is influenced by intention or intention as a reason or determinant of behavior where this is determined by attitude, subjective norms and behavioral control (Setyawaty, 2017).

RESEARCH METHOD
This type of quantitative research with Cross Sectional approach. The research sample was male students with a sample of 300 respondents from the Faculty of Engineering and Science at Private Universities with inclusion criteria. Samples were taken by consecutive sampling technique. Then respondents who met the inclusion criteria filled out the questionnaire from Istifaizah (2017) link that had been distributed using the whatsapp group. Data analysis with univariate and bivariate. The statistical data test used was the Chi Square test. Based on table 1 above, there are 5 study programs that participate in this research. The batches that are involved in this research are from 2017-2021. The characteristics of the ages included in this study are the ages of 18-24 years. On the characteristics of the weekly allowance, it is divided into two categories with the weekly allowance of <200,000 and >200,000. In the early age characteristics, smoking is divided into four categories with a frequency of elementary school age, junior high school age and the college age. In terms of duration of smoking, it is categorized into three with a frequency of 1-4 years, 5-9 years and 10 years. Based on table 3, shows that the P value is 0.000≤0.05, which means that there is a relationship between attitude and motivation to quit smoking in students of the Faculty of Engineering and Science. The results of the odds ratio in table 9.796 which means that students with a negative attitude will have a low risk of having a low motivation to quit smoking 9.7 times compared to students with a positive attitude. In this study, the respondents' negative attitudes towards smoking cessation motivation were influenced by peer association, lack of intention to quit smoking, government recommendations to stop smoking that were not paid attention to by respondents and respondents felt that quitting smoking could interfere with concentration. This study explains that the attitudes of respondents affect the motivation to quit smoking. Tabel 3.3 shows that the P value is 0.000≤0.05, which means that there is a relationship between subjective norms and motivation to quit smoking in students of the Faculty of Engineering and Science. The results of the odds ratio in table 9.812 which means that students who have negative norms are at risk of having low motivation to quit smoking by 9.8 times compared to students who have positive norms. This study suggests that respondents' subjective norms tend to be negative towards the motivation to quit smoking, one of which is influenced by the lack of parental control and also the punishment they don't get when smoking on campus. In this study subjective norms are influenced by the surrounding environment which indirectly makes respondents more free to smoke. Tabel 3.4 shows that the P value is 0.000≤0.05, which means that there is a relationship between perception and motivation to quit smoking in students of the Faculty of Engineering and Science. The results of the odds ratio in the table are 7.306, which means that students with negative perceptions are at risk of having low motivation to quit smoking by 7.3 times compared to students who have positive perceptions. Perceptions of respondents in this study tend to have negative perceptions of motivation to quit smoking. This is because respondents feel that quitting smoking will not make them productive and respondents do not realize that smoking has a negative impact on themselves. In this study, respondents' perceptions tend to be negative about the negative impact of cigarettes on health, even though there have been many advertisements about the dangers of cigarettes, both digital advertisements and in cigarette packs.

CONCLUSION
Respondents' attitudes toward smoking cessation showed that the percentage of positive attitudes was lower than the percentage of negative attitudes. Respondent's subjective norm of smoking cessation showed that the percentage of positive norms was lower than the percentage of negative norms. Respondents' perceptions of quitting smoking indicate that the percentage of positive perceptions was lower than the percentage of negative ones. The respondents' motivation to quit smoking showed that the percentage of motivation to quit smoking was low more than the high motivation to quit. If students can adopt a healthy lifestyle with no smoking, they can live a healthy life and create smoke-free air. The suggestions for the campus environment, parents and the government to better implement a stop smoking.