The Impact of Spiritual Emotional Freedom Technique (SEFT) on Adolescent Nicotine Dependence: A Quasi-Experimental Study
https://doi.org/10.33860/jik.v19i3.4289
Keywords:
Adolescent Smokers, Nicotine Dependence, Spiritual Emotional Freedom Technique, Smoking Cessations, adolescent Health, Behavioural TherapyAbstract
Background: Adolescent smoking remains a major public health concern in Indonesia, with increasing rates of nicotine dependence and limited effectiveness of existing cessation strategies. Culturally relevant, low-cost, and non-pharmacological interventions are needed, particularly for adolescents with strong religious backgrounds. The Spiritual Emotional Freedom Technique (SEFT), which integrates emotional regulation, acupressure tapping, and spiritual affirmation, may offer a holistic approach to smoking cessation. This study aimed to evaluate the effectiveness of SEFT in reducing nicotine dependence among adolescent smokers.
Methods: A quasi-experimental pretest–posttest control group study was conducted in Bengkulu City, Indonesia, involving 60 Muslim adolescent smokers aged 18–25 years who intended to quit smoking. Participants were consecutively recruited and allocated to an intervention group (SEFT; n=30) or a control group (hypnotherapy without tapping; n=30). SEFT was delivered individually for approximately 10 minutes per session over three consecutive days. Nicotine dependence was assessed using the Fagerström Test for Nicotine Dependence (FTND) at baseline and one week post-intervention. Data were analysed using the Wilcoxon signed-rank test and Mann–Whitney U test.
Results: The intervention group showed a significant reduction in FTND scores from pretest to posttest (p=0.001), whereas no significant change was observed in the control group (p=0.177). Post-intervention FTND scores differed significantly between groups (p<0.001), indicating a substantial effect of SEFT in reducing nicotine dependence.
Conclusion: SEFT was effective in reducing nicotine dependence among adolescent smokers and demonstrated greater benefits than hypnotherapy alone. SEFT represents a culturally congruent, low-cost complementary intervention with potential for integration into school- and community-based smoking cessation programs in Indonesia.
References
Andrade, R. C. C. de, Ferreira, A. D., Ramos, D., Ramos, E. M. C., Scarabottolo, C. C., Saraiva, B. T. C., … Christofaro, D. G. D. (2017). Smoking among adolescents is associated with their own characteristics and with parental smoking: cross-sectional study. Sao Paulo Medical Journal, 135(6), 561–567. https://doi.org/10.1590/1516-3180.2017.0154220717
Aras, A., & Bayraktar, M. (2024). Third-hand smoke perception and awareness among medical students: a survey study. Scientific Reports, 14(1), 13355. https://doi.org/10.1038/s41598-024-61636-9
Asmawati, Ikhlasia, M., & Panduragan, S. L. (2020). The effect of Spiritual Emotional Freedom Technique (SEFT) therapy on the anxiety of NAPZA (narcotics, psychotropic, and other addictive substances) residents. Enfermería Clínica, 30, 206–208. https://doi.org/10.1016/j.enfcli.2019.11.055
Batra, A., Eck, S., Riegel, B., Friedrich, S., Fuhr, K., Torchalla, I., & Tönnies, S. (2024). Hypnotherapy compared to cognitive-behavioral therapy for smoking cessation in a randomized controlled trial. Frontiers in Psychology, 15. https://doi.org/10.3389/fpsyg.2024.1330362
Celik, Z. H., & Sevi, O. M. (2020). Effectiveness of Cognitive Behavioral Therapy for Smoking Cessation : A Systematic Review. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry, 12(1), 54–71. https://doi.org/10.18863/pgy.534638
Chen, S., Nita, A., Coble, C., Ortiz, R., & Leong, C. D. (2024). Parent Education and Adolescent Health Outcomes: The Potential Role of Adolescent Academic Intention. Journal of Health Care for the Poor and Underserved, 35(2), 619–635. https://doi.org/10.1353/hpu.2024.a928636
Defoe, I. N., Semon Dubas, J., Somerville, L. H., Lugtig, P., & van Aken, M. A. G. (2016). The unique roles of intrapersonal and social factors in adolescent smoking development. Developmental Psychology, 52(12), 2044–2056. https://doi.org/10.1037/dev0000198
Friedson, A., Li, M., Meckel, K., Rees, D. I., & Sacks, D. W. (2024). Exposure to cigarette taxes as a teenager and the persistence of smoking into adulthood. Health Economics (United Kingdom), (March), 1962–1988. https://doi.org/10.1002/hec.4859
Giulietti, F., Filipponi, A., Rosettani, G., Giordano, P., Iacoacci, C., Spannella, F., & Sarzani, R. (2020). Pharmacological Approach to Smoking Cessation : An Updated Review for Daily Clinical Practice. High Blood Pressure & Cardiovascular Prevention, 27, 349–362. https://doi.org/https://doi.org/10.1007/s40292-020-00396-9
Hastuti, D., Kulsum, D. U., Pustiana, M. N., & Ropei, O. (2022). The Effect of Spiritual Emotional Freedom Technique on Decreasing the Intensity of Smoking Among Adolescent in Indonesia. In Malaysian Journal of Medicine and Health Sciences (Vol. 18, pp. 68–72). Retrieved from https://medic.upm.edu.my/upload/dokumen/2023010416260611_2021_1658.pdf
Ifazatul, N. A. (2016). Spiritual Emotional Freedom Technique Sebagai Terapi dalam Konseling. Jurnal Madaniyah, 2, 317–327.
Jackson, S. E., West, R., & Brown, J. (2020). If at first you don’t succeed, when should you try again? A prospective study of failed quit attempts and subsequent smoking cessation. Addictive Behaviors, 106(January), 106366. https://doi.org/10.1016/j.addbeh.2020.106366
Le, M., Pereira Pedrosa, R., & Murdock, E. (2024). Social Smoking – an Observational Study. Human Arenas, 42087. https://doi.org/10.1007/s42087-024-00434-1
Liang, Y.-C., Liao, J.-Y., Lee, C. T.-C., & Liu, C.-M. (2022). Influence of Personal, Environmental, and Community Factors on Cigarette Smoking in Adolescents: A Population-Based Study from Taiwan. Healthcare, 10(3), 534. https://doi.org/10.3390/healthcare10030534
Nian, T., Guo, K., Liu, W., Deng, X., Hu, X., Xu, M., … Wang, Z. (2023). Non‑pharmacological interventions for smoking cessation: analysis of systematic reviews and meta-analyses. BMC Medicine, 21(378), 1–17. https://doi.org/10.1186/s12916-023-03087-z
Nurmansyah, M. I., Umniyatun, Y., Jannah, M., Syiroj, A. T. R., Purnama, T. B., & Koire, I. I. (2021). Peer, family and teachers’ role on smoking behaviour among Islamic high school students in Depok, Indonesia. Vulnerable Children and Youth Studies, 16(2), 189–194. https://doi.org/10.1080/17450128.2020.1861398
Perski, O., Theodoraki, M., Cox, S., Kock, L., Shahab, L., & Brown, J. (2022). Associations between smoking to relieve stress, motivation to stop and quit attempts across the social spectrum: A population survey in England. PLOS ONE, 17(5), e0268447. https://doi.org/10.1371/journal.pone.0268447
Rosilawati, Y., Rafique, Z., & Sudiwijaya, E. (2024). Tobacco use among in-school young adolescents in Indonesia: Exploring availability, affordability, and accessibility. PLoS ONE, 19(3 March), 1–13. https://doi.org/10.1371/journal.pone.0301291
Sulifan, Y., Suroso, & Muhid, A. (2014). Efektifitas Terapi SEFT (Spiritual Emotional Freedom Technique). Jurnal Psikologi Tabularasa, 9(1), 86–95. https://doi.org/DOI : https://doi.org/10.26905/jpt.v9i1.237
Tania, B. N., Mardjan Mardjan, & Elly Trisnawati. (2025). EFT (Emotional Freedom Technique) Method Intervention in Reducing the Risk of Work Stress in Female Health Workers. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 8(1), 11–19. https://doi.org/10.56338/mppki.v8i1.6407
Vázquez-Otero, C., Bekalu, M. A., Dhawan, D., & Viswanath, K. (2023). Tobacco-control policy support among people from low socioeconomic positions in Massachusetts. Preventive Medicine Reports, 35(July), 102336. https://doi.org/10.1016/j.pmedr.2023.102336
WHO. (2019). WHO global report on trends in prevalence of tobacco use third edition. In World Health Organisation. Retrieved from https://www.who.int/publications/i/item/who-global-report-on-trends-in-prevalence-of-tobacco-use-2000-2025-third-edition
Wilkinson, A. V., Shete, S., & Prokhorov, A. V. (2016). The Moderating Roleof Parental Smoking on their Children’s Attitudes Toward Smoking among a Predominantly Minority Sample: A Cross-Sectional Analysis. In Social Work in Mental Health and Substance Abuse (pp. 185–199). Apple Academic Press. https://doi.org/10.1201/b13136-12
Winarti, R., Nurkhastana, I., & Rohana, N. (2022). The Effevt Spiritual Emotional Freedom Technique (SEFT) Therapy Methods on Changes in Adolescent Smoking Behavior. Jurnal Ilmu Dan Teknologi Kesehatan, 13(2), 46–53. https://doi.org/10.33666/jitk.v13i2.435
Wojnar, M., Wierzbiński, P., Samochowiec, J., Rymaszewska, J., Filipiak, K. J., Wichniak, A., … Dudek, D. (2024). Management of nicotine dependence in patients with psychiatric disorders – recommendations of the Polish Psychiatric Association – part I. Psychiatria Polska, 58(3), 403–418. https://doi.org/10.12740/PP/OnlineFirst/161773
World Health Organization. (2021). Gats|Global Adult Tobacco Survey. In Fact Sheet Indonesia 2021. Retrieved from https://cdn.who.int/media/docs/default-source/ncds/ncd-surveillance/data-reporting/indonesia/indonesia-national-2021-factsheet.pdf?sfvrsn=53eac4fd_1
World Health Organization (WHO). (2019). WHO report on the global tobacco epidemic, 2019. Offer help to quit tobacco use. In Geneva: World Health Organization. Retrieved from https://www.who.int/teams/health-promotion/tobacco-control/who-report-on-the-global-tobacco-epidemic-2019
Zhang, Y., Yu, Z., Lan, H., Liang, S., Fang, M., Robinson, N., & Liu, J. (2021). European Journal of Integrative Medicine Non-traditional acupuncture therapies for smoking cessation : a systematic review of randomized controlled trials. European Journal of Integrative Medicine, 47(2021), 101390. https://doi.org/https://doi.org/10.1016/j.eujim.2021.101390
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with Poltekita : Jurnal Ilmu Kesehatan agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY-SA 4.0) that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.

This work is licensed under a Creative Commons Attribution-ShareAlike 2.0 Generic License.
Poltekita : Jurnal Ilmu Kesehatan is licensed under a Creative Commons Attribution-Share Alike 4.0 International License
You are free to:
- Share, copy and redistribute the material in any medium or format
- Adapt, remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.



