%X Acute respiratory distress syndrome (ARDS) is one of the main causes of high mortality among coronavirus disease 2019 (COVID-19) patients. This study aimed at determining the association between presence of chronic diseases and smoking behaviors with the development of ARDS among hospitalized COVID-19 patients in Indonesia. This study was carried outin 15 Muhammadiyah-‘Aisyiyah–affiliated COVID-19 referral hospitals in Indonesia. Four hundred ninety participants who tested positive for the COVID-19 were recruited in this study. Demographic data, history of chronic diseases, and the development of ARDS were retrieved from hospital patient records. Information about the smoking behavior was collected after respondents were discharged from the hospital. Presence of chronic diseases such as diabetes, chronic heart disease, hypertension, and chronic liver diseases were significantly associated with the development of ARDS. In a similar regard, patients who currently smoked had a 5 times greater risk of developing ARDS compared with those who never smoked. %L repository9886 %I Sage Journals %J Asia Pacific Journal of Public Health %D 2021 %A Emma Rachmawati %A Ekorini Listiowati %A Deni Wahyu Kurniawan %A Izza Suraya %A Abdillah Ahsan %A Mochamad Iqbal Nurmansyah %V 33 %P 427-430 %T Significance of Chronic Diseases and Smoking Behavior in the Development of Acute Respiratory Distress Syndrome Among Hospitalized COVID-19 Patients in Indonesia %N 4