Keywords

Knowledge, Experiential Marketing, Smoking Decision, Medical Students

Introduction

Indonesia is a developing country that has many social problems, one of which is smoking. The cigarette problem is still difficult to stop even though the government has made efforts to increase cigarette excise and warnings on the dangers of smoking on cigarette packs (Ahmed, 2020).

Indonesia is the country with the highest adolescent smoking rate in the world, where most of the men first smoked at the age of 12-13 years, and most of the women tried smoking at the age of ≤ 7 years and 14-15 years. Based on data from the 2014 Global Youth Tobacco Survey (GYTS) survey, 19.4 percent of teenagers were smoking tobacco over the past 30 days. Among the adolescents in the survey found 35.3 percent of boys and 3.4 percent of girls. Meanwhile, of the total adolescents surveyed, it was found that 18.3 percent of adolescents smoked cigarettes during the last 30 days, as many as 33.9 percent for boys and 2.5 percent for girls. Furthermore, it was found that a total of 32.1 percent of the adolescents surveyed had smoked, even though only 1-2 puffs, and in these teens it was found that 54.1 percent of boys and 9.1 percent of girls (Atmojo, 2017).

Smoking is one of the main risk factors for various non-communicable diseases (Azmi, Istiarti & Cahyo, 2016). According to GYTS, data on the number of cigarettes consumed in Indonesia in 2013 had reached 302 billion cigarettes per year (Atmojo, 2017). The dangers of smoking are well understood by people in Indonesia. Information about the dangers of smoking is very easy to obtain. Knowledge of the dangers of smoking is the extent to which a person is able to know and understand about the dangers that can result from smoking. Good knowledge about the dangers of smoking will have different smoking behavior than those with less knowledge (Braun, 2018). Knowledge about the dangers of smoking is information that a person has about the adverse health effects caused by cigarette content, and diseases caused by smoking, such as: stroke, heart disease and lung cancer (Hemant & Palki, 2016). There have been many media and scientific articles that provide information about the dangers of smoking. However, there are still many people who ignore. Smoking behavior is currently carried out from various groups and from various different educational backgrounds (Chen, Jia & Xiang, 2020).

The phenomenon of smoking also occurs among medical students (such as at Universitas Jenderal Achmad Yani/UNJANI). This may rarely be heard, because as medical students, they know more about the health and negative effects of smoking than ordinary people. However, medical students are also human beings who have the freedom to choose whether they want to smoke or not. They realize that smoking is dangerous, but for several reasons smoking is one of the best ways. So, even though they understand and have been reminded, they still do not stop their smoking habits (Fyall, et al., 2019). From the results of a pre-survey conducted on 30 medical students, it was found that some of them had experienced illness caused by smoking. Sore throat, cough, and other diseases were some of the illnesses experienced by these students due to smoking. In addition, they have also experienced bad events such as pants and clothes that were perforated by cigarette ash, car carpets were about to catch fire, and many more. But still it doesn't stop them from smoking.

This study aims to determine how much influence knowledge and experiential marketing have on the decision to smoke among medical students of the Faculty of Medicine UNJANI either partially or simultaneously. This research needs to be done to find solutions in suppressing or reducing smoking habits. Of course the benefits of this research are not only devoted to medical students but also the whole community because the problem of smoking has become one of the nation's problems.

Literature Review

Knowledge

According to Giansoldati & Rotaris (2020), knowledge is a treasure trove of mental wealth which directly or indirectly enriches life. The knowledge of a person with other people varies, so that knowledge is a mental wealth that directly or indirectly enriches human life (Kartika & Rudiatno, 2020). In another sense, knowledge is a variety of symptoms that humans encounter and acquire through the observation of reason (Kiruti & Sreeya, n.d.). Knowledge arises when a person uses their intellect to recognize certain objects or events that have never been seen or felt before.

Changes in the subject's behavior towards smoking began with the subject knowing and knowing cigarettes first, then the subject began to be interested in smoking, after that the subject began to weigh the advantages and disadvantages of smoking against him, then the subject began to try smoking behavior, and finally the subject had a new behavior in the form of smoking that has been adjusted to his knowledge, awareness and attitude towards smoking (Philip & Kevin, 2017). According to Atmojo (Surya, Putri & Rizanda, 2015) there are six level domains in knowledge, namely: knowledge, understanding, application, analysis, synthesis, and evaluation.

Knowledge is also information that is known by someone (Lestari & Haryani, 2019). In another sense, knowledge is a variety of symptoms that humans encounter and acquire through the observation of reason. Knowledge arises when a person uses their intellect to recognize certain objects or events that have never been seen or felt before. According to Chen, Jia & Xiang (2015), there are four dimensions in explaining knowledge variables, namely: 1). factual knowledge, 2). conceptual knowledge; 3). procedural knowledge; 4). metacognitive knowledge.

Experimental Marketing

Widiyanti & Retnowulan (2019) argues that experiential marketing is an approach to providing information that is more than just information about a product or service. Kartika & Rudiatno (2019) argue that experiential marketing is the marketing of experiences to consumers as an effort to attract consumers to use products or services, even motivating consumers to make repeat purchases. Yeh, Chen & Chen (2015) divided experiential marketing into four key characteristics, including: focus on consumer experience, analyzing consumers, driven by emotion, and methods. In forming a perspective based on experiential marketing, the application of experiential marketing must be preceded by identifying with a two-element matrix, namely Strategic Experiential Modules (SEMs) which are the basic form of Experiential Marketing and Experience Provides (ExPros) as a tactical tool for implementing Experiential Marketing.

Strategic Experiential Modules (SEMs) are modules that can be used to create various types of experiences for consumers (Schiffman, Kanuk & Hansen, 2012). SEMs include five main dimensional elements, namely: senses, feelings, thoughts, actions and relationships. In this era of increasingly fierce competition, the success of creating positive perceptions in the minds of consumers is an important factor in the success of a product/brand, perhaps even more than technological excellence.

Purchasing Decision

Purchasing decisions are consumer decisions regarding preferences for brands in the choice set (Sidiq, Jalil & Achmad, 2021). Schiffman & Kanuk (2019) define a purchasing decision as a person's decision where he chooses one of several available alternative options (Wiwik & Julia, 2018). In this study, the purchase decision is defined as a process by which medical students will determine whether to smoke or not (smoking decision). Kotler & Keller (2014) state that there are five stages in explaining the process by which the purchase decision is made, namely: 1) problem recognition, 2) information search, 3) evaluation of alternatives, 4) purchasing decisions, and 5) post-purchase behavior. As for the factors that can influence a smoking decision action are individual differences that include resources, knowledge, attitudes, and environmental influences including culture, social class, family, and situation.

Correlation between Knowledge and Smoking Decisions

Knowledge is a person's ability that can directly or indirectly enrich someone. In determining the decision-making process, a person will not be separated from the knowledge he has. Santy & Antika (23) state that there is an influence between knowledge and cigarette purchasing decisions. Likewise with Van der Werf (9) who stated that knowledge influences purchasing decisions. In this study, knowledge is the result of sensing that has been experienced either directly or indirectly with smoking and its dangers.

H1: Knowledge influences smoking decisions.

Correlation between Experiential Marketing on Smoking Decisions

Experiential marketing is someone's experience and is usually used as one of the considerations in decision making. Apart from knowledge about the dangers of smoking, a factor that can influence the decision to smoke is experiential marketing. Widiyanti (2020) states that experiential marketing has an influence on purchasing decisions. In this study, experiential marketing is a bad experience that is experienced as a result of smoking, especially students of the Medical Faculty.

H2: Experiential marketing influence smoking decisions.

Correlation between Knowledge and Experiential Marketing on Smoking Decisions

The purchase decision is an action in which the consumer chooses one of various alternatives based on the consumer's own ability. This ability includes knowledge (Lestari & Haryani, 2019) and experience. Knowledge about the dangers of smoking and bad experiences are often related to the decision to smoke. In this study, the purchase decision is a process in which students decide to smoke or not to smoke.

H3: Knowledge and experiential marketing influence smoking decision.

Methodology

The research data were obtained using observation, interviews and questionnaires to medical students who were smokers. The pilot study was did to first 30 respondents and the result showed that the questionnaire were valid and reliable.

The population in this study was students at the medical student who were smokers. The population size in this study is unknown. For this research, iteration method is used so that the minimum number of representative samples is 115. In practice, the samples obtained were 122 students. For the data collection, purposive sampling is used.

Result and Discussion

Medical students in this study were 20-25 years old because they were active students in the Faculty of Medicine up to the Clinical Clerkship stage. All respondents were male, most of who were medical students. While the rest are students at the Clinical Clerkship stage.

Table 1 Descriptive Analysis
Variables	Average %	Categories
Knowledge	79.80%	Know Well
Experiential Marketing	75.79%	Positive Experience
Decision	76.39%	Keep Smoking

The descriptive analysis performed (Table 1) shows that students are well aware of the dangers of smoking both to personal health and to those around them. They know clearly that the content in cigarettes is not only debilitating but can also damage the body itself. In addition to being harmful to themselves, students also know about the impact of smoking on passive smokers, who are at three times the risk of active smokers because the toxins inhaled through cigarette smoke from active smokers are not filtered.

Students also have positive experiences related to smoking. They have never or rarely had a bad experience with smoking such as illness caused by smoking. Clothing that is damaged by smoking is also less frequent. Instead, they feel the benefits of smoking, namely an increase in self-confidence when faced with a difficult task. Smoking also maintains concentration while they are studying. In addition, smoking can also relieve feelings of anxiety or stress and release fatigue when facing a busy lecture schedule and a lot of college assignments. Thus, students feel that the benefits obtained from smoking are more than the harm or bad experiences they have experienced.

But psychologically they feel less comfortable when smoking in public places because their status as medical students should provide a good example to society by not displaying smoking behavior in public. So that they rarely spend cigarettes when in public areas.

Smoking restrictions in public areas which are intensively carried out recently are supported by respondents as an effort to reduce smoking and its impact on society. The bad image as a smoker is also a concern for them. In addition, as medical students, they should promote a healthy lifestyle to society.

Respondents stated that they will continue to smoke because they get the positive things they need. Although they will not smoke every time. Smoking is needed when experiencing anxiety so that it requires cigarettes to relieve anxiety and increase self-confidence and increase concentration in completing lecture tasks that are deemed heavy. In addition, the influence of fellow smokers can also increase smoking intensity. From the results of calculations using Lisrel 9.30 (student version), the path diagrams showed at Figure 1.

Discussion

Table 2 Hypothesis Test
Simultaneous Test
Null Hypothesis	Fcount	Ftable	Result	Conclusion
Knowledge about the dangers of smoking and experiential marketing did not have a significant effect on the decision to smoke	15,567	3,07	Fcount>Ftable H0 rejected	Knowledge about the dangers of smoking and experiential marketing have significant effect on the decision to smoke
Partial Test
Null Hypothesis	Tcount	Ttable	Result	Conclusion
Knowledge about the dangers of smoking did not have a significant effect on the decision to smoke	5,573	2,62	tcount>ttable H0 rejected	Knowledge about the dangers of smoking have significant effect on the decision to smoke
Experiential marketing did not have a significant effect on the decision to smoke	0,799	2,62	tcount<ttable H0 accepted	Experiential marketing did not have significant effect on the decision to smoke

The impact of variable (Table 3) shows that knowledge has a strong influence on the decision to smoke. This shows that the respondents' knowledge of smoking has a strong enough impact on the decision to smoke. The knowledge referred to is not only related to the dangers of smoking, but as medical students they also certainly know how to reduce the impact of smoking.

Table 3 Variable Impact
Correlations	Coefficient	Impact	Residual
Knowledge about the dangers of smoking toward decision to smoke	0,452	20,43%	79,67%

Although restrictions on smoking areas have been implemented, there are still many canteens around the campus that sell cigarettes and provide smoking areas. The price of cigarettes is also still relatively affordable, so this does little to support them to keep smoking. In addition, they have also been addicted to smoking for a long time. On campus there are also no posters explaining the dangers of smoking, as in general, in clinics or hospitals. So that the dangers of smoking will not cross their minds, even though the students have knowledge of the dangers of smoking.

Conclusion

Knowledge about the dangers of smoking has a strong impact on the decision to smoke. Meanwhile, experiential marketing does not have a significant impact on smoking decisions because the smoking impact that they have experienced is not bad and can still be tolerated by them. As medical students, they also know and understand the things that can reduce the impact of smoking. Exercising regularly, drinking lots of water, and consuming fruits and vegetables, are things they have done to reduce the impact of the dangers of smoking.

Enforcement of the no-smoking rule accompanied by sanctions can reduce smoking habits of students. In addition, the non-smoking area has also been expanded to the canteens around the campus, thereby narrowing the smoking area for students. Canteens in campus are also advised not to sell cigarettes to students.

Placing posters of the dangers of smoking to health in the campus area can arouse student awareness to reduce smoking habits. Apart from that, the posters also need to be conveyed in relation to their image as medical students who should set an example and promote a healthy lifestyle.

Acknowledgement

We would like to express our sincere gratitude to Mr. Ajat Sudrajat for allowing us to develop the research. This study has been supported by Faculty of Medicine, UNJANI.
Conflicts of interest: is none.

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Received: 18-Jan-2022, Manuscript No. ASMJ-21-10465; Editor assigned: 20-Jan-2022; PreQC No. ASMJ-21-10465(PQ); Reviewed: 08-Feb-2022, QC No. ASMJ-21-10465; Revised: 12-Feb-2022, Manuscript No. ASMJ-21-10465(R); Published: 22-Feb-2022