While Indonesia’s recovery from the Asian Economic Crisis was commendable, 26.6% of Indonesians are still living in poverty (Hartati, 2018). The most disadvantaged Javanese per capita are those living in the Special Region of Yogyakarta, due to its extreme population density (1138 people/square kilometre) (World Bank 2010), as well as families in rural villages such as those in Central Java.
Despite Indonesia being in the bottom 50% of wealthiest countries in the world (IMF, 2019), tobacco consumption is on the rise, increasing almost 7 times between 1970 and 2000 (WHO, 2000). Globally, 84% of smokers live in developing and transitional economies reflecting the global epidemic of tobacco use in poorer regions. WHO states that tobacco kills 225720 Indonesians per year – that’s 14.7% of all deaths and the top cause of premature death. Furthermore, cardiovascular diseases in adolescents are more likely to be caused by tobacco use, reflecting the strengthening tobacco culture. For the 9% of the youth population who smoke (WHO, 2018), socio-economic factors can be largely attributed. Bigwanto (2015) reported that youths having mothers with a lower level of education or employment were more likely to smoke. This is due to the malleability of young minds and a child’s search for empowerment in a parental figure.
Poor Indonesian families place tobacco as a necessity, spending 12.4% of their incomes on it, only second to rice (19%) (National Socio-Economic Surveys, Indonesia, 2003-2005). Furthermore, populations in the most socioeconomically deprived groups have higher lung cancer risk than those in the most affluent groups (Singh, 2011). These healthcare costs of smoking reinforce Indonesia’s poverty, direct costs including medicine and hospital visits, and indirect costs referring to productivity and caregiving. The government is burdened with most of this cost, which in turn drains and represses the economy. (Ross, 2015).
On a regional scale, a direct correlation between poverty and tobacco use can be seen on the island of Java, where regions with the highest Purchasing Power Parity experience the lowest rates of smoking. Exceptions are made for Jakarta, where income levels are high enough to purchase tobacco as a luxury and for Jogjakarta where residents may be too poor to afford tobacco. From these trends it can be seen that smoking and poverty are interrelated and self-reinforcing.
The solution to reducing consumption, especially in the youth and poor demographics, is price and taxation intervention (Barber, 2008). This would additionally generate government revenue, offsetting the debt caused by medical bills and premature mortality, and stabilise Indonesia’s economy as the nation grows and emerges.
Aditama 2002, ‘Smoking Problem in Indonesia’, vol 11, no. 1, pp. 56-65.
Badan Pusat Statistik 2016, Statistik Indonesia 2016, Jakarta, accessed November 25, < https://www.bps.go.id/index.php/publikasi/4238>.
Ganiwijaya 1995, ‘Prevalence of Cigarette Smoking in a Rural Area of West Java, Indonesia,’ Tobacco Control, vol. 4, no. 4, 1995, pp. 335–337.
IMF 2019, World Economic Outlook, accessed 25 November, <https://www.imf.org/en/Publications/WEO>.
Nugraha 2018, Indonesia’s Poverty Rate Lowest in History, Australia-Indonesia Centre, Melbourne, accessed 25 November, <https://australiaindonesia.com/digital-economy/indonesian-media-in-brief-indonesias-poverty-rate-lowest-in-history/>.
Ross 2015, ‘Tobacco and Poverty in South East Asia’, International Tobacco Control Research, vol. 2, pp. 1-11.
Singh 2011, ‘Socioeconomic, Rural-Urban, and Racial Inequalities in US Cancer Mortality’, Journal of Cancer Mortality, vol. 10, no. 11, pp. 107-197.
WHO 2018, Factsheet 2018 Indonesia, accessed 25 November, < https://apps.who.int/iris/bitstream/handle/10665/272673/wntd_2018_indonesia_fs.pdf?sequence=1>