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The Role of Biomarkers in Early Detection of Chronic Disease Risk and Smoking Cessation Efforts among Students, Indonesia

Halid, M.; Susilo, B. B. B.; Pauzan, P.

2026-02-22 public and global health
10.64898/2026.02.19.26346603 medRxiv
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ObjectiveThe study aimed to analyze factors associated with cotinine levels as an early risk indicator for chronic diseases and students readiness to quit smoking in Praya Barat District. MethodsThis study used a cross-sectional design involving 563 high school students in Praya Barat District. Data analysis was performed using the Chi-square test and multiple logistic regression to identify determinants of high cotinine levels. ResultsA total of 67% of subjects had high cotinine levels, indicating high levels of nicotine exposure among students. The results of the analysis showed that the main determinants of high cotinine levels were cigarette consumption of [&ge;]5 cigarettes/day (AOR=2.426; 95% CI=1.534-3.838; p<0.001), male gender (AOR=2.100; 95% CI=1.358-3.250; p=0.001), family members who smoke (AOR=2.149; 95% CI=1.359-3.399; p=0.001), rarely of exercise (AOR=2.155; 95% CI=1.350-3.440; p=0.001), and personal history of chronic disease (AOR=2.646; 95% CI=1.653-4.234; p<0.001). Meanwhile, willingness to participate in a smoking cessation program did not show a significant relationship (p=0.093). ConclusionsMost students showed high cotinine levels, indicating significant exposure to nicotine and a potential risk of chronic disease in the future. The most influential factors were active smoking behavior, a family environment of smokers, and low levels of physical activity.

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