POST C: Religion and smoking in Ambon?

In order to get a better understanding of Ambonese culture and the effects of smoking had on Ambon, I interviewed Arif, a small family restaurant owner in Ambon whose venue is one of the few that is strictly smoke-free.

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Figure 1. Arif standing in front of his smoke-free restaurant. Photographer: Yllianna Maneze.

 

I was interested in gaining an insight into Ambonese culture as well as history and whether there was a connection between religion and smoking culture, as Arif claimed the reason he didn’t allow smoking in his restaurant because it was the ‘House of the Lord’. A study done claims that those who participate in a high amount of religious activities have a higher chance of be a non-smoker (Widyaningrum & Yu 2018; U.S Department of State 2010). As we were conversing about Ambonese culture, he stated that the people were very communal and there were many mixed races and religions which is true for most of Indonesia. He also brought up the riots that occurred in Ambon during 1999. These riots were an ethnopolitical conflict triggered by a relatively minor fight between a Christian bus driver and a Muslim youth. The real reason is still unclear, but Arif states that there was a looming ethnoreligious tension in the city, predominately between the Christian and Muslim. The neighbourhoods used to be a mixing pot of ethnicities and religion, but post-war Arif described it like a ‘shadow’ dividing the city.

It was interesting how Arif brought up the darker past of Ambon when I asked him about smoking. Thinking in a wider context, Indonesia unites over 200 million people with over 300 ethnicities, 250 languages and 6,000 islands. One would believe that with such a wide range of cultures there would be many different types of faiths however, only 6 religions are officially recognised by the government (U.S Department of State 2010).

Some groups have turned to religion to stop smoking which has become portrayed as rooted into Indonesian culture and tradition. For example, Islamic groups have tried to ban smoking as forbidden under Islam and united with anti-smoking lobbies to stop tobacco sponsored events. Arif states that the bibles teachings preach that smoking is bad for you, he also knows passive smoking has harmful effects and because of his strong family values he chooses not to smoke. Religion could possibly be an overlooked aspect to incorporate into a non-smoking campaign.

 

References

Bebas Bernapas 2019, “Meet Arif”, Instagram post, 23 January, viewed 24 January 2019, <https://www.instagram.com/p/Bs9dwxsB47f/&gt;.

U.S Department of State 2010, International Religious Freedom Report 2010, viewed 30 January 2019, <https://www.state.gov/j/drl/rls/irf/2010/148869.htm>.

Widyaningrum, N. & Yu, J. 2018, ‘Tobacco Use Among the Adult Muslim Population in Indonesia: A Preliminary Study on Religion, Cultural, and Socioeconomic Factors’, Journal of Drug Issues,   vol. 48, no. 4, pp. 676-88.

 

POST C: Assiz from Ambon

Interviewer: Madison Chan
Interviewee: Assiz Mahu

Time: 40min
20 Jan 2019
2:00pm

The aim of the task was to get insight into the daily life of an Ambonese resident and their perspective on tobacco. Interviewing as a research design method was chosen not only because it enables us to inquire about one’s social world, but is actually a significant constituent of the kind of society one lives in (Brooks & Horrocks & King 2019).

Assiz Mahu is a 22-year-old male who was born and raised in Ambon, Indonesia. As neutrality is the byword of interviews (Gubrium & Holstein 2001), I lead with the unbiased and open-ended question,

‘What are your thoughts on smoking?’

Mahu’s immediate response was,

‘I do not smoke…it is bad for you and not good for your body.’

How did he come to this confident conclusion? Not only did Mahu witness anti-tobacco campaigns on the street but he also conducted his own independent research on YouTube. I found it interesting that when I mentioned emphysema and COPDs, he was not aware of these terms. The only impacts of smoking Mahu knew about was that it made you ‘sick’ and ‘cough a lot’. However, despite not knowing this terminology, it seemed Mahu’s association of tobacco with ‘being sick’ was powerful enough for him to not risk even trying a cigarette.

It is suggested, that people are motivated to form accurate perceptions of reality and react accordingly – to comply and conform – in order to develop and preserve meaningful social relationships, and to maintain a favourable self-concept (Cialdini & Goldstein 2004). Mahu’s friends have all complied to smoking because they believe it makes them strong. They have called Mahu a ‘sissy’ and ‘not a man’ for not smoking but he did not care because he understood the impacts. It was admirable that Mahu valued his health over social conformity considering Ambon was largely based on community and unity.

As the respondent is someone who can provide detailed descriptions of his or her thoughts, feelings, and activities (Gubrium & Holstein 2001), I was intrigued about Mahu’s personal experiences with tobacco. It was clear smoking was a sign of masculinity. His dad was a former smoker, his two older brothers smoked and so did his male friends. Yet, when I asked ‘why is this?’, Mahu struggled to go beyond the reasoning of ‘it’s our culture…it’s habit…you’re a bad and shameful woman if you do…why?…just because,’ which supports my argument of smoking as an unquestionable and normal behaviour in my previous blog Smoke, Eat, Drink, Repeat.

Although Mahu was aware of smoking impacts, he has accepted it as a norm. The following stories were unfamiliar and shocking to me, but for Mahu, this was his everyday life. Mahu’s job was security in the women’s prison Lapas Perempuan Kelas III, and claimed that there was ‘rarely a case of tobacco’. The exception: when prisoners had a headache or blocked sinuses, the doctor would prescribe them with one cigarette a day for relief. At the high school that Mahu attended, there was a no smoking policy. Students would hide behind the walls and if they were caught, the punishment from the teachers involved smoking five cigarettes at the same time. Mahu admitted, ‘sometimes it worked and sometimes it didn’t.’

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Madison Chan (right), Assix Mahu (left) (Mahu 2019)

 

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References

Brooks, J. & Horrocks, C. & King, N. 2019, Interviews in Quality Research, SAGE Publications, London.

Cialdini, J. & Goldstein, N. 2004, ‘Social Influence: Compliance and Conformity’, Annual Review of Psychology, vol. 55, no. 1, pp. 591-621.

Gubrium, J. & Holstein, J. 2001, The Handbook of Interview Research, SAGE Publications, London.

Mahu, A. 2019, Photograph, Ambon.

POST C: Ninik’s perspective

Ninik, 25 years-old is a general practitioner in Ambon, who agrees that a significant portion of the Ambonese population are habitual smokers (2019, pers. comm., 21 January). Although, an insufficient amount of time in the 4 years of medical college in Indonesia is devoted to the harms of tobacco (Prabandari 2015), Ninik is fully aware of the effects and actively persuades the people around her to refrain from smoking. Ninik believes that the reason why Ambonese men smoke is to release stress, especially while they are working, causing it to become an addictive and detrimental habit.

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Figure 1: men smoking in Ambon

She suggests that people often start smoking in junior high school, around the age of 14 and continue to the practice for their whole lives. In Australia, a customer must be at least 18 years of age with valid identification to purchase cigarettes (Youth Law Australia 2018). I therefore asked if there was a similar age limit imposed on buying cigarettes in Indonesia. Ninik responded with no, as children frequently buy cigarettes for their parents, shopkeepers thus do not question children of their motives for purchasing cigarettes. Prabandari concurs, stating that the initiation of smoking in Indonesia begins at a young age, with 18% even reporting to have begun between the ages of 10 and 14 (Prabandari 2015).

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Figure 2: young boys smoking in a park in Ambon

Although most smokers in Indonesia are male and it is commonly held that females do not smoke, a few women do take up the practice (Barraclough 1999). When questioned whether women smoke, Ninik however answered “not really” and “not at all” (2019, pers. comm., 21 January). This is because Ninik believes that Muslims see smoking as a “useless thing” that they should not attempt (2019, pers. comm., 21 January). After subsequent research, I discovered that the use of tobacco for Islamic believers is haram, forbidden (Huda 2018). Despite that, many Muslims still smoke as the opinion that smoking is haram is still moderately new and thus not all Muslims have adopted it as a cultural norm (Huda 2018).

Furthermore, Ninik also stressed the detrimental effects of second-hand smoking, which is worse than primary smoking. This is a serious issue as the harm of second-hand smoke is little recognised within Indonesia (Permitasari 2018), resulting in men regularly smoking in enclosed spaces, such as mini-buses and trains (Barraclough 1999). Furthermore, 85% of male smokers also smoke within the home daily, exposing their family members to harmful consequences (Prabandari 2015). The interview with Ninik and research allowed me to gain deeper insights into the tobacco situation in Ambon and Indonesia.

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Figure 3: photo with Ninik (second from left)

 

REFERENCE LIST

Barraclough, S. 1999, ‘Women and tobacco in Indonesia’, Tobacco Control, vol. 8, no. 3, pp. 327-332.

Huda 2018, Is Smoking Allowed in Islam?, ThoughtCo, viewed 29 Janurary 2019, <https://www.thoughtco.com/is-smoking-allowed-in-islam-2004327&gt;.

Permitasari A.L., Satibi S. & Kristina, S.A. 2018, ‘National burden of cancer attributable to secondhand smoking in Indonesia’, Asian Pacific Journal of Cancer Prevention, vol. 19, no. 7, pp. 1951-1955.

Prabandari Y., Nichter M., Nichter M., Padmawathi R. & Muramoto M. 2015, ‘Laying the groundwork for Tobacco Cessation Education in medical colleges in Indonesia’, Education for Health, vol. 28, no. 3, p. 169.

Youth Law Australia 2018, Cigarettes, Australia, viewed 30th January 2019, <https://yla.org.au/nsw/topics/teen-issues/cigarettes/&gt;.

 

 

POST C: Looking through the lens of Ambonese Puskesmas

For the sake of primary research and getting to know the health situation amongst the local population, I chose to interview someone who works from a Puskesmas, a government-mandated community health centre, which can often provide some of the services a hospital might as well. Having gone to a boarding school with strict rules, she and her friends didn’t smoke throughout their teenage years and has never smoked a cigarette to this day. In her opinion, it’s a bad habit that can be easily eradicated from Ambonese culture.

51007071_2289563254606683_8324944717678641152_nHeidy Nivaan (middle)

In my interview with Puskesmas Karang Pajang’s general practitioner, H. Nivaan (2019, pers. comm., 18 January), we spoke about her experience with patients who smoke or breathe in second-hand smoke frequently. Nivaan says that Ambon faces problems with diseases such as tuberculosis, one of the most common lung diseases there, with studies (Boon et al. 2007) suggesting that passive smoking may increase the risk of acquiring tuberculosis, especially for those within the same household as someone afflicted. Older patients will often say they have smoked since they were young and it hasn’t done them any harm, but will come to the Puskesmas with significant signs of COPD such as shortness of breath and coughing, and won’t know they have something like emphysema until they get to a hospital. In cases such as these, people who are diagnosed with TB do not stop smoking, and they do not believe that smoking was the cause of harm.  

Perhaps the most surprising discovery I heard from Nivaan is that most people are not aware of the harm second-hand smoke can cause (Nichter et al. 2009). According to an article in the Jakarta Post (2001), Indonesia is believed to be a hazardous area for second-hand smoke due to the number of smokers, which is believed to have reached 141.44. million. Nivaan says that people will smoke even near babies or their pregnant spouse, and mothers will come to the clinic with sick children not knowing that it is their husband’s smoking that is causing them harm. For such vulnerable groups, raising awareness seems to be the first step to eradicating tobacco-related diseases, but for those who do not want to quit after being educated about such dangers, there is nothing more that can be done from the side of medical health professionals in Ambon.

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Boon, D. S., Verver, S., Marais, B. J., Enarson, D. A., Lombard, C. J., Bateman, E. D., Irusen, E., Jithoo, A., Gie, R. P., Borgdorff, M. W. & Beyers, N. 2007, ‘Association between passive smoking and infection with Mycobacterium tuberculosis in children’, Pediatrics, vol. 199, no. 4, pp. 734-739.

‘Firms urged to help smoke-free campaign’ 2001, The Jakarta Post, 26 May, p. 2.

Nichter, M., Padmawati, S., Danardono, M., Ng, N., Pradanbari, Y. & Nichter, M. 2009, ‘Reading culture from tobacco advertisements in Indonesia’, Tobacco Control, vol. 18, viewed 17 January 2019, <https://tobaccocontrol.bmj.com/content/18/2/98.abstract>.

POST A: Design activism challenges. A comparison of tobacco advertising between Indonesia and the USA.

The tobacco industry has had great success in Indonesia now being the 2nd largest tobacco market in the world (Campaign for Tobacco-Free Kids 2017). Designers play a major role in this by shaping the identity of the tobacco branding through packaging and promotion to mislead consumers away from its negative health effects. Current trends in the market advertise cigarettes as mild or low-tar, for example since 2002 the major brand Gudang Guram in Indonesia has the GG mild brand to cater to changing consumer preferences. This demonstrates some of the strategies designers utilise to keep their consumers loyal to the brand.

The big Indonesian tobacco company Sampoerna hosted a ‘Go Ahead Challenge’ competition which involved designing a limited edition A Mild cigarette package (Astuti, Assunta & Freeman 2018). The winning design was a red fingerprint with the tag “Go Ahead, be yourself and be brave!”. Through their website over a million people voted for the design indicating the large community of active users. These tactics allow the tobacco industry to be heavily rooted in Indonesian youth culture, the economy and politics.

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Figure 1. Sampoerna website displaying the winning design of a competition to design a cigarette packet. The middle image is the designed packet. To the right is the inside of the packet with a description of the design and the tagline.

 

In the case of tobacco control, Indonesia is one of the few countries that is not WHO Framework Convention on Tobacco Control (WFTC) compliant, on the other hand, the USA is WFTC compliant. When the toxicity of tobacco was unclear in the past, many people in the USA were sold by the idea of smoking through revolutionary tobacco companies’ advertisements. The American cigarette brand Marlboro was the company to utilise ‘lifestyle advertising’, a type of advertisement that ties the product to an aspect of life. The tv advertisement depicts Marlboro man, a fictional persona became the archetype of manliness and freedom and it was a highly successful. This kind of powerful lifestyle advertising is still seen today in Indonesian cigarette ads. The difference is that in the USA, nicotine advertisements like Marlboro Man were banned from television and radio in 1970 (White, Oliffe & Bottorff 2012), however in Indonesia advertisements are still allowed to be played on television after prime time.

Designers face the challenge of not only fighting the constructed image of tobacco but also all the stakeholders, such as smokers, the tobacco industry, sellers, buyers, etc. Julier puts forward that design activism is something that begins in social, environmental and political issues and the designer’s role is to ‘intervene funtionally’ in them (Julier 2013). The US national campaign, ‘truth’ is dedicated to empowering youth to become more knowledgeable about big tobacco and helping them quit. They focus on pop culture, community and the environment, through events and utilising social media to make an engaging site for youth to access is something to learn from.

 

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Figure 2. Screenshot of the ‘truth’ site. #IDRATHERBUY is highlighted.

References

Astuti, P.A.S., Assunta, M. & Freeman, B. 2018, ‘Raising generation ‘A’: a case study of millennial tobacco company marketing in Indonesia’, Tobacco Control, vol. 27, no. e1, pp. e49.

Campaign for Tobacco-Free Kids 2017, The Toll of Tobacco in Indonesia, viewed 30 January 2019, <https://www.tobaccofreekids.org/problem/toll-global/asia/indonesia&gt;.

Julier, G. 2013, ‘From Design Culture to Design Activism’, Design and Culture, vol. 5, no. 2, pp. 215-36.

truth Take Action, viewed 30 January 2019, <https://www.thetruth.com/take-action&gt;.

White, C., Oliffe, J.L. & Bottorff, J.L. 2012, ‘From the Physician to the Marlboro Man’, Men and Masculinities, vol. 15, no. 5, pp. 526-47.