The study was conducted by Made Rangga Dwinanta Putra, Pande Ayu Naya Kasih Permatananda, Desak Putu Citra Udiyani, Anak Agung Sri Agung Aryastuti, and Putu Nita Cahyawati. Their findings were published in the Asian Journal of Healthcare Analytics and focused on the growing relationship between smoking habits and sleep disturbances among young people in Bali’s capital city.
The researchers highlighted that sleep problems among adolescents have become a significant public health issue globally and in Indonesia. Previous data cited in the study showed that around 73.4 percent of Indonesian adolescents experience sleep disorders. At the same time, smoking rates among teenagers continue to rise, including in Bali and Denpasar City.
According to the researchers, nicotine acts as a stimulant that directly affects the central nervous system. The substance can delay the onset of sleep, reduce sleep efficiency, and interfere with deep sleep cycles. Teen smokers may also experience nicotine dependence, which can trigger repeated cravings during the night and further disrupt healthy sleeping patterns.
“Smokers generally take longer to fall asleep and experience lighter, less restorative sleep compared to non-smokers,” the researchers explained in the study.
The research used a descriptive observational design with a cross-sectional approach. A total of 66 respondents participated in the study, all of whom were active smoking students at Warmadewa University. Participants were between 18 and 24 years old and had been smoking actively for at least six months.
To assess sleep quality, the team used the Indonesian version of the Pittsburgh Sleep Quality Index (PSQI), a widely used questionnaire that evaluates sleep duration, sleep latency, sleep disturbances, sleep efficiency, and daytime dysfunction over the previous month.
The study produced several major findings:
- 80.3 percent of respondents were male.
- All respondents were aged 18–24 years.
- 47 percent primarily used electronic cigarettes or vape devices.
- 40.9 percent used both conventional and electronic cigarettes.
- 56.1 percent were classified as having poor sleep quality.
The results indicate that vaping has become highly popular among adolescents in Denpasar. Researchers believe the trend is driven by perceptions that e-cigarettes are safer than traditional tobacco products, combined with attractive flavors, modern branding, and aggressive promotion on social media platforms.
However, the researchers warned that electronic cigarettes still contain nicotine and may significantly affect sleep health. Nicotine stimulates brain activity and can prevent the body from entering deep restorative sleep phases.
The comparison above illustrates that adolescents with poor sleep quality outnumbered those with healthy sleep patterns in the study population.
The researchers also found that male adolescents were much more likely to smoke than females. Social and cultural factors were considered important contributors. In many communities, smoking is still associated with masculinity, maturity, and social acceptance among peers.
The age group of 18–24 years was identified as a particularly vulnerable stage. During late adolescence, young people are often exploring their identity and social role, making them more susceptible to peer influence, experimentation, and lifestyle trends promoted through digital media.
Poor sleep quality among adolescents may have serious long-term consequences. The researchers noted that inadequate sleep is linked to decreased concentration, mood instability, fatigue, reduced academic performance, and higher risks of mental health problems.
Nicotine can also interfere with REM (Rapid Eye Movement) sleep, a critical stage associated with brain recovery, emotional regulation, and memory consolidation. Even when adolescents sleep for several hours, nicotine-related sleep disruption may prevent the body from achieving optimal rest.
According to Pande Ayu Naya Kasih Permatananda and the research team, the findings should encourage stronger preventive and educational programs targeting adolescent smoking behavior and sleep health.
The researchers recommended more intensive public health campaigns in schools, universities, and social media environments to increase awareness about the risks of smoking and vaping. They also emphasized the importance of correcting the misconception that electronic cigarettes are harmless alternatives to conventional tobacco products.
Further studies are expected to explore the relationship between nicotine dependence levels, smoking duration, and the severity of sleep disturbances among adolescents.
Author Profiles
Made Rangga Dwinanta Putra is a health researcher affiliated with the University of Warmadewa.
Pande Ayu Naya Kasih Permatananda is a lecturer and researcher from University of Warmadewa whose work focuses on sleep health, mental health, and adolescent behavioral health.
Desak Putu Citra Udiyani, Anak Agung Sri Agung Aryastuti, and Putu Nita Cahyawati are also researchers at the University of Warmadewa, specializing in public health and adolescent health studies.
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