Post D: Targeting the youth – Tobacco culture in Indonesia

It was a few years ago now when a video of an Indonesian toddler, smoking up to 40 cigarettes a day, went viral. The video showed a young boy from Sumatra, puffing away on a cigarette, a habit which he took up at only 18 months old. Although this is an extreme case, it is not uncommon for children to begin smoking from a young age in Indonesia. 

‘Indonesian baby smokes 40 cigarettes a day’, (On Demand News, 2019)

Around 66.6% of men and 2.1% of women, are daily smokers in Indonesia. While nearly 4% of children between the ages of 10 – 14 years old use tobacco daily. (The Tobacco Atlas, 2015). Click for more information.

Without looking too far, it is easy to see why tobacco culture is rife in Indonesia. “Tobacco advertising in Indonesia is among the most aggressive and innovative in the world, and tobacco advertisements saturate the environment” (Danardono, Ng, Nichter, Padmawati, Prabandari, 2009). Click for full article. After conducting my own research, several key factors seem to be playing a contributing role to the issues surrounding smoking in Indonesia. These include, persistent and widespread advertising with few restrictions, tobacco companies as a large source of government revenue, a lack of cessation strategies being put into place, a societal pressure for men to smoke, and a lack of health care providers being at the forefront of tobacco reduction efforts. 

A 6 year old boy smoking a cigarette in Indonesia, (Broadhurst, 2019)

A survey carried out in East Java, studied the smoking behaviours of teenagers in the City of Surabaya and found that the “prevalence rate among youth in Indonesia is much higher than in neighbouring countries” (Martini, Sulistyowati, 2005). Part of this is a result of youth having easy access to tobacco in stores and from street vendors. Further results showed that the youth in Surabaya usually begin smoking between the ages of 10 and 17 years old. Shockingly, some begin as early as 3 years old. As East Java is one of the major raw tobacco, cigarette and kretek producing provinces in Indonesia, it is no surprise that such a high proportion of youths take up smoking. 

Hand drawn map of a section of Indonesia, showing key areas discussed in this blog post

A sad reality of the smoking epidemic are the health problems that come with it. “Indonesia is a significant contributor to the global burden of disease from tobacco-related illnesses” (Hidayat, Thabrany, 2010). Click for more. Cardiovascular diseases are one of the major causes of death in Indonesia, with over 26% being directly caused by tobacco. “Tobacco control is essential for preventing and controlling deaths…caused by CVDs” (World Health Organization, 2018). Further information.

Looking to the future, it is clear that there needs to be some changes made, knowing where to begin and how to go about making these changes are the first steps towards tackling the tobacco industry in Indonesia.  

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References

Achadi, A., Croghan, I., Ebbert, J. & Hurt, R. 2012, Roadmap to a tobacco epidemic: transnational tobacco companies invade Indonesia, BMJ Journals, vol. 21, no. 3, viewed 21 November 2019,

https://tobaccocontrol.bmj.com/content/21/3/306.short

Broadhurst, C. 2019, Dihan, 6, has cut down to just four cigarettes a day from his usual two packs a day. And his parents are proud, PRI, viewed 25 November 2019,

https://www.pri.org/stories/number-children-smoking-indonesia-getting-out-control

Danardono, M., Ng, N., Nichter, M., Padmawati, S. & Prabandari, Y. 2009, Reading culture from tobacco advertisements in Indonesia, BMJ Journals, vol. 18, no. 2, viewed 24 November 2019,

https://tobaccocontrol.bmj.com/content/18/2/98.short

Dhumieres, M. 2019, The number of children smoking in Indonesia is getting out of control, Public Radio International, unknown date, viewed 23 November 2019,  

https://www.pri.org/stories/number-children-smoking-indonesia-getting-out-control

Hidayat, B. & Thabrany, H. 2010, Cigarette Smoking in Indonesia: Examination of a Myopic Model of Addictive Behaviour, International Journal of Environmental Research and Public Health, vol. 7, no. 6, viewed 22 November 2019,

https://www.mdpi.com/1660-4601/7/6/2473/htm

Hull, T., McDonald, P., Reimondos, A., Suparno, H., Utomo, A. & Utomo, I. 2012, Smoking and young adults in Indonesia, Australian Demographic and Social Research Institute, vol. 1, no. 2, viewed 25 November 2019,

https://chr.ui.ac.id/wp-content/uploads/downloads/2013/06/policy_background_2_smoking.pdf

Lando, H. 2016, Promoting tobacco cessation in low- and middle-income countries, Cambridge Core, vol. 11, no. 2, viewed 22 November 2019,

https://www.cambridge.org/core/journals/journal-of-smoking-cessation/article/promoting-tobacco-cessation-in-low-and-middleincome-countries/841A7ADD6DB9A77EA7BD3BE8DB871F46/core-reader

Martini, S. & Sulistyowati, M. 2005, The determinants of smoking behaviour among teenagers in East Java Province, Indonesia, Economics of Tobacco Control Paper No. 32, vol. 1, no. 1, viewed 25 November 2019,

https://openknowledge.worldbank.org/bitstream/handle/10986/13781/347660IND0YouthSmoking0HNP0Tobacco032.pdf;sequence=1

McCall, C. 2014, Tobacco advertising still rife in southeast Asia, The Lancet, vol. 384, no. 9951, viewed 20 November 2019,

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61804-3/fulltext

Ng, N., Ohman, A. & Weinehall, L. 2007, ‘If I don’t smoke, I’m not a real man’—Indonesian teenage boys’ views about smoking, Health Education Research, vol. 22, no. 6, viewed 22 November 2019,

https://academic.oup.com/her/article/22/6/794/640787

The Tobacco Atlas, 2015, Indonesia, American Cancer Society, viewed 26 November 2019,

https://tobaccoatlas.org/country/indonesia/

World Health Organization, 2018, Factsheet 2018 Indonesia, Regional Office for South-East Asia, viewed 24 November 2019,

https://apps.who.int/iris/bitstream/handle/10665/272673/wntd_2018_indonesia_fs.pdf?sequence=1

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