Background:
Although Indonesia has not ratified the WHO Framework Convention on Tobacco Control, it has developed a series of tobacco control policies at the local level. Strong presence of tobacco industry is marked with intensive marketing towards young people. This study assessed the impact of local smoke-free policy (SFP) on prevalence of daily and non-daily smoking among youth living in 33 provinces, 98 municipalities, and 412 regencies in Indonesia in 2007 and 2013.

Methods:
Data on 239,170 adolescents (12-17 years old) was derived from the 2007 and 2013 basic health survey (RISKESDAS) performed by Indonesia Ministry of Health. Information on local tobacco control policies was derived from official documents from 84 districts and 8 provinces. District SFP and provincial SFP were distinguished. A multilevel logistic regression analysis compared the odds of daily and non-daily smoking between areas with and without SFP.

Results:
Respondents who reported smoked daily was 4.6 % and non-daily was 4.4% in 2007. Smoking prevalence rates were high among males, in older adolescents, areas with high GDP per-capita, and rural areas. Different models consistently observed significantly reduction of daily smoking (OR:0.85; CI95%:0.79-0.90) and non-daily smoking (OR:0.92; CI95%:0.86-0.98) prevalence between 2007 and 2013. No difference in daily smoking and non-daily smoking was observed between districts with and without SFP. Intermediate compared with no provincial SFP was significantly associated to reduce the odds of non-daily (OR:0.82; CI95%:0.69-0.98) smoking, while no association was found between no provincial SFP and high group.

Conclusions:
Smoke-free policies at the municipal level seemed to have no effect to reduce smoking among youth in local settings of Indonesia while policies at the provincial level were associated with lower smoking rates. To have better result of the smoking prevention among youth in the future, we suggest enhancing provincial SFP and strengthening the implementation of local SFP as well.