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"ABSTRAK Latar Belakang : Kotinin merupakan hasil metabolit utama nikotin dankadarnya pada urin merupakan indikator pajanan asap rokok. Penlitian ini untukmengetahui kadar kotinin urin pada anak yang terpajan dan tidak terpajan asaprokok di lingkungan rumah. Metode : Penelitian potong lintang pada anak usia sekolah dasar yang tidakmerokok. Subjek dikelompokkan menjadi kelompok terpajan dan tidak terpajanberdasarkan status pajanannya. Data yang diperoleh dari kuesioner dan sampelurin sewaktu yang diukur dengan metode ELISA. Hasil : Total subjek 128 anak usia 6-12 tahun yang terdiri dari 64 anak padakelompok terpajan dan 64 anak yang tidak terpajan. Kadar kotinin urin padakelompok terpajan lebih tinggi dibandingkan kelompok tidak terpajan (median30,1 vs 8,45 ng/ml; p<0.05). Terdapat perbedaan kadar kotinin pada anak yangterpajan asap rokok dengan jumlah batang rokok yang dihisap oleh perokok dirumah (p<0.05). Status pajanan asap rokok berhubungan dengan keluhan batuk,infeksi saluran napas atas dan rawat inap karena keluhan respirasi pada anak. Nilaititik potong optimal kadar kotinin urin pada anak untuk menilai pajanan asaprokok yaitu 17,95 ng/ml (sensitifitas 81%, spesifisitas 81%, AUC 91,2%, p<0.05).Kesimpulan: Kadar kotinin urin dapat digunakan sebagai biomarker yang tidak invasif untuk evaluasi pajanan asap rokok pada anak.ABSTRACT Introduction : The cotinine is major metabolite of nicotine and the level ofurinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smokeat home.Method : A Cross sectional study that enrolled elementary school nonsmokerschildren classified into exposed group and unexposed group based on tobaccosmoke sexposure status. The questionnaire and spot urinary samples werecollected and urinary cotinine levels were measured by ELISA.Results : A total 128 nonsmokers children age 6-12 years divided into 64 childrenin exposed group and 64 children in unexposed group. The urinary cotinine levelsin exposed group significantly higher than unexposed group (median 30,1 ng/m;vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine levelin exposed group with number of cigarettes (p<0.05). Tobacco smoke exposurestatus associated with frequent cough symptom, upper respiratory infection andhospitalization because of respiratory symptoms in subjects. The optimal cut offpoint urinary cotinine in children to distinguish unexposed children with exposedto tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%,p<0.05).Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children. ;Introduction : The cotinine is major metabolite of nicotine and the level ofurinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smokeat home.Method : A Cross sectional study that enrolled elementary school nonsmokerschildren classified into exposed group and unexposed group based on tobaccosmoke sexposure status. The questionnaire and spot urinary samples werecollected and urinary cotinine levels were measured by ELISA.Results : A total 128 nonsmokers children age 6-12 years divided into 64 childrenin exposed group and 64 children in unexposed group. The urinary cotinine levelsin exposed group significantly higher than unexposed group (median 30,1 ng/m;vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine levelin exposed group with number of cigarettes (p<0.05). Tobacco smoke exposurestatus associated with frequent cough symptom, upper respiratory infection andhospitalization because of respiratory symptoms in subjects. The optimal cut offpoint urinary cotinine in children to distinguish unexposed children with exposedto tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%,p<0.05).Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children. ;Introduction : The cotinine is major metabolite of nicotine and the level ofurinary cotinine is an indicator of tobacco smoke exposure. This study investigate role of urinary cotinine level in children exposed and unexposed to tobacco smokeat home.Method : A Cross sectional study that enrolled elementary school nonsmokerschildren classified into exposed group and unexposed group based on tobaccosmoke sexposure status. The questionnaire and spot urinary samples werecollected and urinary cotinine levels were measured by ELISA.Results : A total 128 nonsmokers children age 6-12 years divided into 64 childrenin exposed group and 64 children in unexposed group. The urinary cotinine levelsin exposed group significantly higher than unexposed group (median 30,1 ng/m;vs 8,45 ng/ml; p<0.05). There was significant difference of urinary cotinine levelin exposed group with number of cigarettes (p<0.05). Tobacco smoke exposurestatus associated with frequent cough symptom, upper respiratory infection andhospitalization because of respiratory symptoms in subjects. The optimal cut offpoint urinary cotinine in children to distinguish unexposed children with exposedto tobacco smoke at home was 17,95 ng/ml (sensitivity 81%, spesificity 81%,p<0.05).Conclusion : The urinary cotinine level is useful and noninvasive biomarker for evaluating tobacco smoke exposure in children. "

"Otitis Media Akut (OMA) adalah penyakit multifaktorial. Penelitian ini bertujuan mengetahui prevalensi OMA dan hubungannya dengan status gizi, Infeksi Saluran Pernapasan Atas (ISPA), dan perokok pasif pada anak usia 0-5 tahun di lingkungan padat penduduk di Jakarta Timur. Penelitian menggunakan desain cross-sectional dan data diperoleh melalui wawancara terpimpin, pemeriksaan fisik umum, dan pemeriksaan THT pada seluruh anak usia 0-5 tahun yang rumahnya terpilih berdasarkan spatial random sampling di Kelurahan Cawang yang terpilih berdasarkan multistage random sampling. Data diolah menggunakan program SPSS versi 20.0 dan dianalisis dengan uji chi square. Hasil penelitian menunjukkan prevalensi OMA 17,54%. Uji Fisher Exact menunjukkan perbedaan tidak bermakna pada prevalensi OMA berdasarkan status gizi (p>0,05), ISPA (p>0,05), dan perokok pasif (p>0,05). Disimpulkan prevalensi OMA pada anak usia 0-5 tahun di lingkungan padat penduduk di Jakarta Timur adalah 17,54% dan tidak berhubungan dengan status gizi, ISPA, dan perokok pasif.

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Acute Otitis Media (AOM) is a multifactorial disease. The purpose of this study was to determine the prevalence of AOM and its association with nutritional status, Upper Respiratory Tract Infection (URTI), and passive smoker of 0-5 years old children in high-density population in East Jakarta. This cross sectional study was conducted by performing guided interview, physical examination, and ear, nose, and throat examination to all 0-5 years old children whose house is chosen based on spatial random sampling in Cawang, chosen district based on multistage random sampling. Data are managed with SPSS version 20.0 and analyzed with chi square test. The results showed that the prevalence of AOM was 17,54%. Fisher exact test has shown no significant difference between prevalence of AOM with nutritional status (p>0,05), URTI (p>0,05), and passive smoker (p>0,05). In conclusion, prevalence of AOM of 0-5 years old children in high density population in East Jakarta is 17,54% and there is no association between the prevalence of AOM with nutritional status, URTI, and passive smoker"

"Prevalensi paparan asap rokok yang tinggi di rumah di Indonesia semakin mengancam anak-anak sebagai pihak mayoritas yang secara sukarela terpapar. Studi ini menyelidiki hubungan antara paparan asap rokok pada masa prenatal dan usia dini dan hasil kognitif anak-anak berusia 7-12 tahun, menggunakan data dari Survei Aspek Kehidupan Rumah Tangga Indonesia (SAKERTI) 2014. Dengan model regresi probit, hasilnya menunjukkan bahwa paparan asap rokok sangat penting dalam mempengaruhi hasil kognitif anak bahkan setelah dikendalikan oleh karakteristik keturunan, karakteristik anak-anak, dan karakteristik sosial ekonomi ibu. Status merokok ibu memiliki dampak negatif yang signifikan terhadap hasil kognitif anak.

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The high prevalence of secondhand smoke at home in Indonesia is increasingly threatening children as the majority party who voluntarily exposed. The study investigated the relation between exposure to secondhand smoke on prenatal and early childhood development and cognitive outcome of children aged 7-12 years, using data from Indonesia Family Life Survey (IFLS) 2014. With probit regression model, the result indicates that exposure to secondhand smoke is significant in affecting children cognitive outcome even after controlled by heredity characteristic, children characteristics, and socioeconomic characteristics. Maternal smoking status has negatively significant impact on children cognitive outcome."

"Mulai tahun 2010, Pemerintah Kota Bogor menerbitkan Peraturan Daerah No. 12 tentang Kawasan Tanpa Rokok (KTR) tahun 2009. Namun setelah 2 tahun berjalan hasil pengamatan menunjukan, masih banyak perokok di kawasan yang ditetapkan dalam peraturan daerah. Studi berjenis kuantitatif dengan pendekatan cross-sectional. Sampel adalah rumah tangga di seluruh wilayah Kota Bogor, diambil dengan metode multistage cluster random sampling. Jumlah sampel sebanyak 300 rumah tangga. Hasilnya, masyarakat Kota Bogor menilai implementasi KTR di tatanan tempat-tempat umum belum efektif. Analisis menunjukkan banyaknya perokok di tempat-tempat umum berhubungan dengan pajanan penyuluhan KTR, tiadanya teguran dari orang lain, pengawasan petugas, keberadaan iklan rokok, dan keberadaan penjual rokok (p <0,05).Untuk lebih mengefektifkan Peraturan daerah tersebut dibutuhkan prioritas berbeda dalam implementasinya di setiap tempat yang menjadi KTR.

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In 2009, the Government published the Bogor Area Regulations No. 12 about the area Without Smoking (KTR). Based on observations, there are still many smokers in the area set out in the regulatory area. Study of a quantitative approach with cross-sectional. The samples are households in the whole area of the city, which was taken by the method of multistage cluster random sampling. The number of samples as much as 300 households. As a result, society Bogor City looked at the implementation of KTR at public places order has not been effective. Analysis showed the number of smokers in public places associated with exposure illumination KTR, lack of rebuke from others, supervision officers, the presence of advertising cigarettes, and the existence of a seller of cigarettes (p <0,05). To be more makes effective regional regulation would require priorities different in its implementations in every place into KTR."

"Latar Belakang: Menurut Global Youth Tobacco Survey GYTS Indonesia 2014, 57,3 siswa terpajan asap rokok. Pajanan asap rokok menyebabkan inflamasi saluran nafas dan paru, serta penurunan fungsi paru. Kotinin sebagai metabolisme nikotin dapat digunakan sebagai biomarker pajanan asap rokok.Tujuan: Mengetahui efek pajanan asap rokok lingkungan terhadap kadar kotinin urin dan uji fungsi paru pada anak.Metode: Penelitian teknik potong lintang dengan subyek siswa berusia 11-16 tahun di Jakarta. Data didapat dari kuesioner, spirometri, dan penghitungan kadar kotinin urin dengan metode ELISA.Hasil: Terdapat 92 subyek, terdiri dari 46 kelompok kasus dan 46 kelompok kontrol. Kadar kotinin urin >10 ng/ml ditemukan pada 37,0 kelompok kasus dan 4,3 kelompok kontrol; p=0,000; OR=8,50 95 IK 2,08-34,71 . Terdapat perbedaan bermakna kadar kotinin urin terhadap jumlah perokok p=0,027 dan jumlah batang rokok per hari p=0,037 . Tidak ditemukan hubungan pajanan asap rokok dengan uji fungsi paru. Terdapat perbedaan bermakna absensi anak pada kelompok kasus dibandingkan kelompok kontrol; p=0,004; OR=6,00 95 IK 1,42-25,33 .Kesimpulan: Anak yang terpajan asap rokok memiliki kadar kotinin urin lebih tinggi dibandingkan yang tidak terpajan, yang dapat dipengaruhi oleh jumlah perokok dan jumlah batang rokok per hari.

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Background Global Youth Tobacco Survey GYTS 2014 in Indonesia showed that 57,3 of students are exposed to enviromental tobacco smoke, which causes inflammation of respiratory tracts and decrease of lung function. Urinary cotinine can be used as biomarker for cigarette smoke exposure.Objectives To examine effects of enviromental tobacco smoke exposure on urinary cotinine level and lung function test in children.Methods Subjects were students aged 11 16 years old in Jakarta. Data were obtained from questionnaire, spirometry, and urinary cotinine test using ELISA method.Results There were 92 subjects, consisted of 46 case group and 46 control group. Urinary cotinine level 10 ng ml was found in 37,0 of case group and 4,3 of control group p 0,000 OR 8,50 CI 95 2,08 34,71 . There were significant differences between urinary cotinine level with number of smokers p 0,027 and number of cigarettes per day p 0,037 . No association was found between cigarette smoke exposure and lung function test. There was a significant difference in school abscence between case group and control group p 0,004 OR 6,00 CI 95 1,42 25,33 .Conclusions Children exposed to enviromental tobacco smoke have higher urinary cotinine level than non exposed children. Factor such as number of smokers and number of cigarettes per day may affect urinary cotinine level. "

"Berat badan lahir rendah (BBLR) BBLR merupakan hal yang sangat penting dalam bidang Kesehatan Masyarakat karena hubungannya yang sangat erat dengan kematian dan morbiditas neonatal dan penyakit tidak menular seperti hipertensi, penyakit jantung iskemik, diabetes, dan lain-lain. BBLR adalah bayi dengan berat lahir < 2500 gram. BBLR masih cukup serius di Indonesia dengan prevalensi 11,1% pada tahun 2010. Merokok pasif merupakan isu kesehatan yang cukup penting dan di beberapa penelitian dapat mengakibatkan luaran buruk seperti BBLR. Tujuan umum penelitian ini adalah mengetahui hubungan antara Merokok pasif pada ibu usia 15-54 tahun dengan kejadian BBLR di Indonesia setelah dikontrol dengan variabel potensial confounder lainnya. Penelitian ini merupakan penelitian cross-sectional study dengan menggunakan data Riskesdas 2013. Variabel dependen dalam penelitian ini adalah BBLR, dan variabel independen utama adalah Merokok pasif, variabel potensial perancu yakni usia ibu saat melahirkan, status sosial ekonomi, pendidikan ibu, keinginan untuk hamil dan paritas. Hasil analisis menunjukan merokok pasif pada ibu usia 15-54 tahun berhubungan lemah dengan BBLR. Anak yang lahir dari ibu merokok pasif memiliki resiko 1,14 (95% CI: 0,94 - 1,38) kali untuk BBLR dibandingkan anak yang lahir dari ibu tidak merokok pasif.

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Low is birth weight (LBW) is an important issue in Public Health because of its relevance with neonatal mortality and morbidity and future health risk, such as Hypertension, Ischaemic Heart Disease, Diabetes Mellitus, etc. Low birth weight is baby born with birth weight less than 2500 grams. Low birth weight is still an important problem in Indonesia and its prevalence is 11,1 % in 2010. Passive smoking is also a threat and may cause detrimental outcome such as Low birth weight. The main purpose of this study was to investigate the relationship between passive smoking in mothers aged 15-54 years and low birth weight in Indonesia after controlling of potential confounders. The design of this study was cross-sectional using data from National Basic Health Research 2013. The dependent variable was Low Birth Weight, and the main Independent Variable was mothers aged 15-54 years who passively smoke, potential confunders were maternal age, socioeconomic status, maternal education, pregnancy intention, and Parity. The result was passive smoking in mothers aged 15-54 years was weakly associated with low birth weight. Children born from mothers who passively smoke have 1,14 risk of being low birth weight baby (95% CI: 0,94 - 1,38) compared to their non passive smoker mothers counterpart."

"ABSTRAKLatar Belakang : Benzo(a)pyrene (BaP) adalah hidrokarbon aromatik polisiklik sangat karsinogenik yang terdapat dalam asap rokok. Tidak hanya perokok yang perlu menjadi perhatian, namun bahaya yang ditimbulkan akibat asap rokok pada orang yang tidak merokok juga perlu diperhatikan.Metode : Penelitian ini berjenis potong lintang pada 26 perempuan dewasa bukan perokok yang terpajan asap rokok dan 15 perempuan tidak terpajan asap rokok di rumahnya di kelurahan Palmeriam Kecamatan Matraman, Jakarta. Kadar BPDE-protein adducts diukur menggunakan metode ELISA. Kadar CO ekspirasi, informasi kebiasaan merokok anggota keluarga di rumah pada subjek penelitian dikumpulkan melalui kuesioner.Hasil : Nilai BPDE-protein adducts <40 ng/ml sebanyak 16 orang (61,5%) dan nilai BPDE-protein adducts >40 ng/ml sebanyak 10 orang (38,5%), sedangkan pada kelompok perempuan tidak terpajan asap rokok di rumah, nilai BPDE-protein adducts <40 ng/ml sebanyak 11 orang (73,3%) dan nilai BPDE-protein adducts >40 ng/ml sebanyak 4 orang (26,7%), hasil analisis menunjukkan perbedaan yang tidak bermakna (p=0,443). Pengukuran kadar CO ekspirasi pada penelitian ini memperoleh nilai tengah kadar CO ekspirasi pada kelompok perempuan yang terpajan asap rokok sebesar 5,5 ppm. Pada kelompok perempuan yang tidak terpajan asap rokok, rerata kadar CO ekspirasi sebesar 6 ppm, hasil analisis tidak menunjukkan adanya perbedaan yang bermakna (p=0,398). Lama pajanan, jenis rokok, banyaknya jumlah rokok yang dihisap serta banyaknya jumlah perokok aktif dirumah tidak mempengaruhi kadar BPDE-protein adducts.Kesimpulan : Nilai BPDE-protein adducts >40 ng/ml pada perempuan terpajan asap rokok lebih tinggi dibandingkan dengan perempuan yang tidak terpajan asap rokok di lingkungan rumah.

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ABSTRACTBackground: Benzo(a)pyrene (BaP) is a polycyclic aromatic hydrocarbon contained in cigarette smoke. This highly carcinogenic substance is also found in Environmental Tobacco Smoke (ETS) which equally dangerous to the health of population and equally require attentions as much as cigarette smoke. This study observes level of BaP among those in risk of ETS exposure.Methods: A cross-sectional study was performed involving 26 women exposed to ETS and 15 women unexposed to ETS in Palmeriam Matraman area, Jakarta, Indonesia. The BPDE (Benzo(a)pyrene Diol Epoxide) protein levels of adducts were measured using ELISA method. In addition, exhaled carbon-monoxide (CO) level during expiration was measured and family members smoking habits at home was obtained using questionnaire.Results: The mean age of women exposed to ETS was 35.8 ± 6.5 years and women unexposed to ETS was 41.7±7.5 years. In the ETS exposed women, the BPDE level of <40 ng/mL was found in 16 people (61.5%) and the BPDE level of >40 ng/mL was found in 10 people (38.5%). In the ETS unexposed women, the BPDE level of <40 ng/mL was found in 11 people (73.3%) and the BPDE level of >40 ng/mL was found in 4 people (26.7%). None of these results were significantly different (p=0.443). The median exhaled CO level of ETS exposed women was 5.5 ppm and of ETS unexposed women was 6.0 ppm. None of these results were significantly different (p=0.398). No correlation was found between length of ETS exposure, types of cigarettes, number of cigarettes smoked and number of active smokers at home and BPDE-protein adducts level.Conclusion: The BPDE level of ETS exposed women was higher than of ETS unexposed women (>40 ng/mL and <40 ng/mL, respectively). The median exhaled CO level of ETS exposed women was lower than of ETS unexposed women (5.5 ppm and 6.0 ppm). However, none of these results were statistically significant."

"Street children are vulnerable groups of risky behavior like smoking behavior. This study aims to describe smoking andrelation with education, living with parents, family, peer influence, and religiosity. Study design was cross sectionalstudy. The population was 990 street children with the sample of 277 street children. Sample selection in accidentalsampling with criteria of respondents aged 10-19 years and Muslims. Data were analyzed with chi square test withconfidence interval of 95% (α=0.05). Results show that 48% of street children have ever smoked and 37.2% of streetchildren were still smoking in the last 30 days. Then, there is a relationship between living with parents (p=0.002) andlevels of religiosity (p=0.023). However, there was no relationship with school status (p=0613), family history(p=0.874), and peer influence (p=0.157) with the smoking behavior of street children. This research suggests to giveeducation about the dangers of smoking, provide religious values for them and involve them in religious socialactivities, family empowerment approach to parents to guide their children not to smoke, and optimize function ofNGOs or shelters for street children.Perilaku Merokok Anak Jalanan di Kota Makassar 2013. Anak jalanan merupakan kelompok yang rentan akanberbagai perilaku berisiko, salah satunya adalah perilaku merokok. Penelitian ini bertujuan untuk mengetahui gambaranperilaku merokok anak jalanan di Kota Makassar serta hubungannya dengan status sekolah, tinggal bersama orang tua,riwayat keluarga yang merokok, pengaruh teman sebaya, dan tingkat religiusitas. Penelitian ini menggunakan desainstudi cross sectional. Dari populasi sebanyak 990 anak jalanan di Makassar, jumlah sampel studi ini adalah 277 anakjalanan. Teknik penarikan sampel menggunakan accidental sampling dengan kriteria inklusi responden berusia 10-19tahun dan beragama Islam. Analisis data menggunakan uji chi square dengan tingkat kepercayaan 95% (α=0,05). Hasilpenelitian memperlihatkan bahwa 48% anak jalanan pernah merokok dan 37,2% dari anak jalanan masih merokok.Hasil uji statistik dengan uji chi square menunjukkan adanya hubungan antara variabel tinggal bersama orang tua(p=0,002) dan tingkat religiusitas (p=0,023). Namun, status sekolah (p=0,613), riwayat keluarga (p=0,874), danpengaruh teman sebaya (p=0,157) tidak berhubungan dengan perilaku merokok anak jalanan. Penelitian inimenyarankan adanya edukasi mengenai bahaya rokok untuk anak jalanan dan membekali nilai-nilai keagamaan didalamnya serta melibatkan anak jalanan dalam kegiatan sosial keagamaan. Selain itu perlu dilakukan jugapemberdayaan keluarga melalui pendekatan kepada orangtua agar dapat membimbing anak mereka untuk tidakmerokok dan perlunya mengoptimalkan fungsi LSM atau rumah singgah untuk anak jalanan."

"ABSTRAKPerilaku merokok masyarakat Indonesia meningkat dan dapat mengakibatkan masalah kesehatan bagi pengguna rokok bahkan menyerang kematian. Perilaku merokok saat ini mengalami pergeseran usia lebih muda bahkan cenderung anak-anak. Hal ini menjadi prihatin pada kondisi kesehatan anak usia sekolah yang sudah berperilaku merokok. tujuan dari penelitian ini adalah mengetahui hubungan faktor risiko dengan perilaku dan persepsi merokok pada anak usia sekolah dasar di Kabupaten Karawang. Metode penelitian deskriptif korelatif dengan desain cross-sectional. Sampel sebanyak 356 responden rentang usia 9-12 tahun menggunakan teknik random sampling. Data dianalisis menggunakan korelasi, ada hubungan faktor risiko usia pertama kali merokok, ajakan teman sebaya, keluarga perokok, dan ekonomi dengan perilaku merokok anak usia sekolah dasar, dan terdapat hubungan faktor risiko mengikuti tren dan ingin keren, keluarga perokok dengan persepsi merokok anak usia sekolah dasar. Analisis multivariat regresi linier ganda menunjukan faktor paling dominan berhubungan dengan perilaku merokok yaitu usia pertama kali merokok. sedangkan faktor paling dominan berhubungan dengan persepsi merokok yaitu keluarga perokok. Temuan dalam penelitian ini menyarankan pemberian pendidikan kesehatan pada anak usia sekolah tentang bahaya merokok.

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ABSTRACTSmoking behavior of Indonesians is increasing and can lead to health problems for cigarette users and even death. Smoking behavior is currently experiencing a shift in younger age even tends to children. This becomes concerned with the health condition of school aged children who have already behaved in smoking. the purpose of this study is to know the relationship of risk factors with smoking behavior and perception in elementary school age children in Kabupaten Karawang. The research method is descriptive correlative with cross sectional design. The sample of 356 respondents ranged from 9 12 years old using random sampling technique. The data were analyzed using correlation, there were correlation of age first risk factor of smoking, invitation of peers, family of smoker, and economy with smoking behavior of elementary school age children, and there was correlation of risk factor following trend and wanted cool, smoker family with smoker perception basic. Multiple linear regression multivariate analysis showed the most dominant factor related to smoking behavior that is first age of smoking. while the most dominant factor is related to smoking perception that is family of smoker. The findings in this study suggest providing health education to school aged children about the dangers of smoking."