Journal of Education and Health Promotion

Abstract BACKGROUND: Before the COVID-19 pandemic, medical students had reported experiencing high
rates of distress, burnout, anxiety, and depression. The psychological impact of the COVID-19 in the
general population suggested that the mental health impact was increased anxiety, depression, and
stress. There were no exceptions if medical students also experience the same psychological impact.
The aimed to this study is analyze the mental and emotional effects of the COVID-19 pandemic
among medical students.
MATERIALS AND METHODS: An observational analytic study was used with a cross-sectional
approach. Data were obtained with questionnaires distributed through social media platforms from
July 14, 2020, to July 21, 2020. This study using the Fear of COVID-19 (FCV-19) Scale and the
Depression, Anxiety, and Stress Scale-21 to assess FCV-19, anxiety, stress, and depression.
statistical analysis used IBM SPSS Statistics 24 was used to analyze the two-tailed Chi-square test,
the Mann–Whitney test, and the Kruskal–Wallis test, which were used with statistical significance
as P < 0.05 for all tests.
RESULTS: Out of 1027 samples, 44.6% had stressed, 47.8% had anxiety, and 18.6% had depression.
The gender (P = 0.000), educational stage (P = 0.000), and the comorbidity factor (P = 0.001 for
stress and anxiety, P = 0.036 for depression, and P = 0.000 for FCV-19) had a significant association
with stress, anxiety, depression, and FCV-19 in medical students. The hometown that showed zone
risk of infection only showed significant differences in FCV-19 (P = 0.026).
CONCLUSIONS: Protection and psychological support for a medical student is extremely high
importance given that COVID-19 is now a well-established pandemic and there will be other
pandemics in the future.

Abstract INTRODUCTION: Smoking is a significant health problem among Indonesian adolescents and adults.
The Indonesian government had issued several policies to alleviate this problem, including placement
of pictorial health warning (PHW) on cigarette package. There had been several evaluation studies
regarding the effectivity of PHW in urban areas but none in rural areas. This study aims to evaluate
the effectivity of PHW in motivating smoking cessation in a rural area in Indonesia.
MATERIALS AND METHODS: This was a descriptive cross‑sectional study conducted in August
2017 in Losari village, Indonesia. Respondents of this study were villagers aged 18–60 years who
were active smokers and purchased cigarette with PHW on the package. The research instruments
for this study were questionnaire and printout pictures of each PHW approved by the Indonesian
government.
RESULTS: There were 94 respondents recruited in this study. Among them, only 26 (27.7%) stated
that PHW motivated them to stop smoking. From the five figures of PHW, a picture of lung cancer
was the most effective PHW to motivate smoking cessation. Eighty‑one of 94 respondents affirm
that there are other factors besides PHW that might motivate them to stop smoking. Most of them
agreed that an increase in cigarette price will force them to stop smoking.
CONCLUSIONS: Current PHW used on cigarette package might be ineffective in motivating smoking
cessation at Losari village. Further study with larger samples needs to be done to confirm this finding.