This pilot study utilized cross-sectional data and adhered to the The Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE) guidelines for study design and reporting. ¹⁸ The study protocol and research questionnaire were registered on protocol.io ( dx.doi.org/10.17504/protocols.io.36wgq3r45lk5/v1) to ensure transparency and replicability. Additionally, we followed the The Sex and Gender Equity in Research ( SAGER) guidelines relevant to this study. ¹⁹ As a pilot study, a small number of participants or observations were included, and the calculation of sample size was not deemed necessary. ²⁰ However, it was important to ensure that the sample in the pilot study was representative of the intended main study. ²¹ Thus, inclusion and exclusion criteria were established for participant recruitment.

The present study specifically targeted students residing in Palembang, the capital of South Sumatra Province, Indonesia. Statistics Indonesia’s report indicated that young individuals from this province were among the highest consumers of cigarettes in the country. ²² Non-probability sampling was employed, specifically convenience sampling, to select the schools and participants for the study. Data collection was carried out through an online self-administered survey conducted during two pilot studies conducted from 2021 to 2022. The data collection process involved the participation of the homeroom teachers, who assisted in distributing the online questionnaire link to the students. Study I aimed to provide insights into specific interactions within the classroom and explore the potential for peer support among students. Meanwhile, Study II focused on understanding how individual factors impact peer support within the classroom environment. For the purpose of this study, the term ‘classroom setting’ was defined to encompass the range of daily interactions between students and their classmates.

Participants in this study had to meet the following inclusion criteria: 1) registered as grade 11 students, 2) male or female students, and 3) between the ages of 15 and 17. This pilot study is designed and will be implemented as a school-based program for students in Grade 11 who are between the ages of 15 and 17. We did not address the issue of gender differences in this study because we allowed participants of both genders (male and female). The SAGER guidelines are only implicit in the study’s relevance (how sex and gender are accounted for in the study design). Our exclusion criteria were a non-grade 11 high school student or an individual aged 18 and up. Participants were drawn from state and non-state high schools in the area where the study was conducted.

Participants in this study were provided with a Google Form link by their homeroom teacher and were asked to complete the questionnaire online. The questionnaire survey took approximately 10-15 minutes to complete. Informed consent was obtained from all participants, and the consent process was included at the beginning of the questionnaire. For more information on the study procedures, including the steps, guidelines, and materials used, please refer to the protocol available at protocol.io with the DOI: https://doi.org/10.17504/protocols.io.36wgq3r45lk5/v1.

Two primary independent variables were used in this study: empathic concern and altruistic motivation. The measurement of empathic concern and altruistic motivation was adapted from Batson’s empathic-altruism hypothesis. ^{23 , 24} Empathic concern refers to emotions that are focused on others and congruent with their perceived well-being when they are in need. On the other hand, altruistic motivation refers to a state of motivation that aims to enhance the well-being of others. ²⁵ This form of motivation can drive individuals to provide peer support or engage in prosocial actions. The criterion variable in this study is peer support, which refers to the provision of emotional, appraisal, and informational assistance by a member of the social network who possesses experiential knowledge of a specific behavior or stressor and shares similar characteristics with the target population ²⁶ We measured empathic concern and altruistic motivation using well-validated scales, ^{27 – 29} using a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). On the other hand, we measured peer support using a dichotomous scale (willingness to help). Logistic regression was used to predict the group membership for the question “Are you willing to help your friend stay away from cigarette products?” with two possible answers: “0” for “no, that is not my business” and “1” for “yes, of course.”

This study was approved by the Institutional Review Board at Universitas Gadjah Mada (Ethical clearance ref. KE/UGM/037/EC/2022).

All individual participants in this study provided informed consent. All procedures involving human participants were approved by the Universitas Gadjah Mada Institutional Review Board and were in accordance with the 1964 Helsinki Declaration and its subsequent amendments or comparable ethical standards.

Before using the data for further analysis, we performed dataset validation to ensure its integrity, accuracy, and structure. All of the data collection, recoding, and analysis procedures were meticulously carried out. To maintain the validity of the data source, we enlisted the assistance of homeroom teachers in distributing questionnaires. Furthermore, construct validity was assessed using confirmatory factor analysis (CFA) to ensure the convergence of the construct (e.g., construct of empathic concern, altruistic motivation, and peer support). We determined that there is no potential bias because the study was exploratory and the data collection medium was transparent (see published research protocol and data availability). In addition, the researchers had no control over how the questionnaire was distributed.

The dataset used in this study consists of two files with the SPSS *.sav extension that describe and define the sample and variables. The first dataset contains demographic information about participants, as well as their knowledge and opinions about cigarettes. The second dataset contains main variables and their measurements (for example, empathy variable and its item measurement). Table 1 contains information about the characteristics and data description of data in datasets.

The data was processed using Microsoft Excel and SPSS version 23. The raw data from a Google Form (.xls extension) was then re-encoded for further processing (e.g., string data is converted to numeric data). Each question (column) in the raw Excel data was then coded (e.g., male=1, female=2, and so on). The data was carefully transferred to the SPSS dataset after it had been recoded. To accommodate the research purpose, two SPSS datasets were created for each study. To accommodate the wide range of student opinions in Study I, we allowed participants to provide more than one answer (multiple answers). Figures 1 and 2 were graphically processed in Microsoft Excel.

Overall, the findings from these datasets suggest that we should pay more attention to popular opinion about cigarettes and smoking behavior. According to the findings, popular opinion may describe the majority of adolescent beliefs in the classroom setting. As expected, ‘cigarette as a tobacco product’ and ‘cigarette as a dangerous product’ are the most popular views on the cigarette product. Furthermore, most participants perceived smoking as a harmful activity to their health. Furthermore, our findings suggest that influencing student emotion (e.g., empathy) and motivation (e.g., altruistic motivation) may contribute to increased peer support. Non-responsive peer support, on the other hand, is caused by a lack of empathy and motivation to help. This finding lends support to the idea of using emotional and motivational elements to foster more effective collaboration and shared responsibility among adolescents. ^{15 , 33}

The dataset has some key limitations, primarily stemming from the small number of participants. It is important to interpret the results of this pilot study with caution due to these limitations. The findings cannot be generalized to a larger population but can still provide valuable insights for the development of school-based programs within the specific context. Descriptive statistics and association tests can be helpful in informing program development within this limited scope. Additionally, it should be noted that this pilot study did not address sex differences, while other studies on emotions have examined this aspect. ^{34 – 36} Exploring participant reactions based on sex differences could be beneficial for developing specific interventions to promote peer support. ²⁶

The significant findings of this study have important implications for the successful implementation of evidence-based policies and prevention activities, particularly within a classroom setting. The empirical results offer valuable insights for health practitioners, as well as professionals in health marketing or social marketing. The study has shown that students with high levels of empathy and altruistic motivation are more likely to engage in helping behaviors compared to those with lower levels. Based on these findings, it is recommended to develop school-based adolescent smoking cessation programs that incorporate empathy and altruism training for students, aiming to encourage them to provide peer support.