Blog D: The Forth largest market in the world!

The five largest cigarette consuming nations are China, Indonesia, Russa, US and Japan. (Tobacco-Free Kids, 2018) Cigarettes manufactured in Indonesia are unique to the sales market being a blend of tobacco and cloves, made from a spice that makes a smooth blend and aroma of cigarette. The city called Bandung, Southwest of Java Indonesia, places second in the tobacco industry of “prevalence’s” of familiarity/acceptance in Southeast Asia.  

Photo: BAT 2014

In the early ’90s, households were spending more money on tobacco then they were in household goods, such as food, clothing, footwear, most importantly, medical and education. In the early ’70s study shows that a population of 49% or males and %5 of females within the Java area show that smoking starts from – 15 years of a younger age, 50% of men doubled to 80% by the ’90s, the rates were likely to increase by another 63% due to the population of smokers being brought up within these areas of young smoking families. (CATHERINE REYNOLDS 1999)

The age standard is stating at 15years of age which is made up of 39.5% In 1985 a Jakarta study found that 49% of boys and 9% of girls aged 10–14 were daily smokers. World Health Organisation. While the legal minimum age for smoking in Indonesia is 18 years old, the industry remains mostly unregulated, particularly in more remote parts of the county. (ABC, Tasha Wibawa, 2019) Among these studies, it shows that smoking was inversely related to education. Those who had completed high school or college training were less likely to smoke. 

Photo: Ranumata Aziz
https://www.abc.net.au/news/2019-09-01/indonesian-child-smoking-1/11450792

About 80% of the world’s smokers live in low – middle-income countries. Tobacco in Indonesia’s government is the largest source of revenue it has not only fueled by affordability which plays a crucial role in its economy, In 2018 cigarettes brought 153 trillion rupiah, nearly 96% of the national excise total, Being 10% of the government’s revenue. (ABC, Tasha Wibawa, 2019) 

The Indonesian political cycle has made it difficult to see the long-term effects and economic cost of cigarettes, instead it priorities the yearly economic gains, Mr Ahsan said. 

The highest tax revenue is obtained in Bandung, West Java which is the highest smoking prevalence in Indonesia. While smoking is a leading cause of death in Indonesia, Tobacco consumption can kill more than 7 million people every year; at least 214,00 people die each year in Indonesia, approximately 19% male and &% Male. 

Bandung, Wast Java

Unless effective tobacco control measures are implemented in low- and middle-income countries, the burden of tobacco-related death and disease in those countries will continue to increase (tobaccocontrol, 1995)

Indonesia has introduced a concept on cigarette tax called Earmarking Tax, and this can be a beneficial government tax where the revenue from a particular tax is kept separate from general revenue, Tobacco tax is one of the efforts to control tobacco use. (Robert Carling 2007) The study states it has a favourable impact taxes are used to control tobacco, health promotion and health-related activities. ( Jurnal Ilmu Sosial dan Ilmu Politik, 2019) 

Australia, Brazil, and other countries that have implemented the most advanced tobacco control laws globally are almost entirely offset by the increasing consumption in many countries with weaker tobacco control regulations. The Tobacco Atlas 2019, Drope J, Schluger N, Cahn Z, Drope J, Hamill S, Islami F, Liber A, Nargis N, Stoklosa M. 2018. The Tobacco Atlas. Atlanta: American Cancer Society and Vital Strategies https://tobaccoatlas.org/topic/consumption/ 
The study states 'to reduce worldwide smoking prevalence by 30 per cent in 2025, countries are exhorted to fully implement the Framework Convention on Tobacco Control (FCTC).' The World Health Organization's first public health treaty calls on countries to implement proven strategies to reduce tobacco use, including higher tobacco taxes, 100 per cent smoke-free laws, ample, graphic health warnings, and comprehensive bans on tobacco advertising, promotion and sponsorships. (Southeast Asia Tobacco Control Alliance 2016)

World Health Organisation. Tobacco or health: a global status report—Indonesia. Geneva: WHO, 1998. 

Tobacco-Free Kids 2018, THE GLOBAL CIGARETTE INDUSTRY, view online 27 November, 
https://www.tobaccofreekids.org/assets/global/pdfs/en/Global_Cigarette_Industry_pdf.pdf

ABC, Tasha Wibawa 2019, Tackling Indonesia’s smoking addiction a ‘double-edged sword, online article, viewed 20 November https://www.abc.net.au/news/2019-09-01/tackling-indonesias-smoking-addiction-harder-than-it-seems/11430638

Tabacco Control 1995, Prevalence of cigarette smoking in rural area of West Jave, Indonesia, online publication, Viewed on 27 November https://tobaccocontrol.bmj.com/content/tobaccocontrol/4/4/335.full.pdf

Jurnal Ilmu Sosial dan Ilmu Politi, Volume 23, Issue 1, July 2019 (45-58), The Implementation of Earmarking Tax policy on Cigarette Tax in West Jave Province, Online article, Viewed online 27 November, https://jurnal.ugm.ac.id/jsp/article/view/41485/pdf 

Robert Carling 2007, Tax Earmarking Is It Good Practice? online booklet, viewed on 20 November, https://www.cis.org.au/app/uploads/2015/07/pm75.pdf

The Tobacco Atlas 2019, Drope J, Schluger N, Cahn Z, Drope J, Hamill S, Islami F, Liber A, Nargis N, Stoklosa M. 2018. The Tobacco Atlas. Atlanta: American Cancer Society and Vital Strategies https://tobaccoatlas.org/topic/consumption/ 

Southeast Asia Tobacco Control Alliance 2016, Online article, Viewed on 23 November, https://seatca.org/ctfk-worlds-largest-tobacco-use-study-shows-vast-scope-of-tobacco-epidemic/ 

Click to access 89.full.pdf

http://www.healthdata.org/research-article/global-burden-diseases-injuries-and-risk-factors-young-people%E2%80%99s-health-during-1990

Blog D: Smoking – a Culturally Ingrained Habit?

Approximately one third of the world’s population partakes in smoking, with the top 3 countries being China, India and Indonesia. Surveys have shown that 62% of men and 1-3% of women are smokers nationwide (Nichter et al. 2009) and this high number is often the cause of highly aggressive advertisements from tobacco companies targeting Indonesia. The Government of Republic of Indonesia is one of the few countries who have still not sanctioned the Framework Convention on Tobacco Control (FCTC) despite encouragement from the World Health Organisation (WHO) (Sumartono et al. 2011). The government reaps the economic benefits from the selling of cigarettes so there is little incentive for them to discourage tobacco use (Ganiwijaya 1995), thus the lack of tobacco regulation at a national level. Therefore, as a highly diverse country made up of many cultures and subcultures, further research into specific areas is required to tackle the tobacco issues and its stems.

 
A tobacco cessation initiative called Project QTI has been working on developing messages which denormalise a smoking society. This initiative is concentrated in Java, a politically and economically dominant island of Indonesia containing more than half of the nation’s population. In a cross-sectional study of 15 to 17-year-old students in Java, 55.6% of the male students were current smokers (Skulberg, Hamid & Vaktskjold 2019). The study has found that the probability of active smokers was 7.4 times higher in public rural schools than public schools in town (Skulberg, Hamid & Vaktskjold 2019).

 
In group discussions conducted with 50 teenage boys in the Purworejo District in Central Java, representing rural villages and urban settlements, the non-smokers perceived there to be few smokers around them, whilst the smokers felt that ‘everybody smokes’ (Ng, Weinehall & Ohman 2008). Moreover, tobacco was tied into their traditional ceremonies and gifted during such events. They were also smoked during social gatherings – and this is a case of the tobacco industry reading and working with Javanese culture as a means to sell cigarettes.

Untitled_Artwork 42.png
The boys used words such as ‘a steady life’, ‘pleasure’, ‘good taste’, ‘feel so rich’ and ‘impressive’ to describe smoking. Also, depending on the cigarette brand, they felt that they could increase their social status to feel more confident, mature and richer amongst their peers (Ng, Weinehall & Ohman 2008). This focus on popularity is in contrast to adult males, who often rely on cigarettes to demonstrate responsibility and willpower (Nichter et al. 2009).

 
Going back to Project QTI, the anti-tobacco intervention, Javanese ideals of strength and moral identity are tapped into, to encourage men to have the strength to part with the harmful habit of smoking. This is most similar to Ramadan, in which one challenges oneself to control desires such as hunger, thirst and sleep. These cases demonstrate the importance of gender-specific intervention when it comes to tobacco regulation. A relatively young population compounded by the high prevalence of smoking among males (Sumartono et al. 2011) provides further reason for Indonesia to avoid economic health care consequences by ratifying the FCTC to implement measures for a smoke-free society as the norm.

References

Ganiwijaya, T., Sjukrudin, E., De Backer, G., Suhana, D., Brotoprawiro, S. & Sukandar, H. 1995, ‘Prevalence of cigarette smoking in a rural area of West Java, Indonesia’, Tobacco Control, vol. 4, no. 4.

Ng, N., Weinehall, L. & Ohman, A. 2008, ‘If I don’t smoke, I’m not a real man’- Indonesian teenage boys’ views about smoking’, Health education research, vol. 22.

Nichter, M., Padmawati, S., Danardono, M., Ng, N., Prabandari, Y. & Nichter, M. 2009, ‘Reading culture from tobacco advertisements in Indonesia’, Tobacco Control, vol. 18.

Skulberg, K.R., Hamid, S. & Vaktskjold, A. 2019, ‘Smoking Among Adolescent Males at Pulau Weh, Indonesia’, Public Health of Indonesia, vol. 5, no. 3.
Sumartono, W., Sirait, A.M., Holy, M. and Thabrany, H. 2011, ‘Smoking and Socio-Demographic Determinant of Cardiovascular Diseases among Males 45+ Years in Indonesia’, International Journal of Environmental Research and Public Health, vol. 8.

Post D: Mental Health Implementation

Based on the results done in 2010, Java is the province with higher rates of an active smoker (Barkina, T., Dewi, V. K., Isnaniah. & Kirana, R. 2014). A survey conducted in East Java’s Surabaya – Indonesia’s second largest city, found that there was a significantly higher prevalence of depression in women in comparison to other cities (Byles, J., Christiani, Y., Dugdale, P. & Tavener, M. 2015). Women have turned to smoking as a form of a quiet self-medication, with the odds of a depressed woman being a smoker being twice that of a depressed man (Liew, H.P. & Gardner, S. 2016). In the same research study, the results of Indonesia was compared to the results attained in USA, South Africa, and Glasgow (UK), and it was found that the common aspects to the co-morbidity of depression and smoking is due to lack of strong social support networks caused by stigmas with mental health.

Statistical analysis showed that with better knowledge about mental health, the lower the tendency to have negative attitudes towards mental disorders. This recommends psychoeducational programs through a variety of methods to improve the understanding of mental health and the resources available to treat it (Ariana, A.D., Fardana, N.A., Hartini, N. & Wardana, N.D. 2018). In Surabaya, the highest concentration of Puskesmas (Community Health Centres) are greatly concentrated in the city centre. However, it is found that “current smoking behaviour was more frequent among the poor.” (Byles, J., Christiani, Y., Dugdale, P. & Tavener, M. 2015). 

The support needed for these women and the community as a whole is greatly lacking. Indonesia possesses a Mental Health Law established in 2014, but its implementation is not yet optimal (WHO in Ayuningtyas, D., Maulidya, A.N., Misnaniarti, M. & Rayhani, M. 2018), with the causes being mainly due to limited resources and prevailing stigma against mental health. Although services in the field are increasing with 48 Mental Hospital and Drug Addiction Hospitals established in 26 of 34 provinces, there is still a low priority in the national budget for this area with only 1% dedicated to the cause (WHO in Ayuningtyas, D., Maulidya, A.N., Misnaniarti, M. & Rayhani, M. 2018). Where the mental health is low in exposure, a different industry is thriving with its voice in the community.

Indonesia ranks fifth highest in cigarette consumption, and “is the only country in the region that have not signed the WHO Framework Convention on Tobacco Control” (Barber et al. in Barkina, T., Dewi, V. K., Isnaniah. & Kirana, R. 2014 ). The tobacco industry has begun to feature more young women in cigarette advertisements. With 87% of the female population being Muslim in Surabaya, advertisements are marketing cigarette-use with female independence, portraying “young women in sleeveless tank tops in a country where many women dress modestly and wear hijabs.” (Cohen, J.E., Hardesty, J.J., Kaplan, S., Kennedy, R.D. et. al 2019 p. 42). This has resulted in a steady increase in female smokers in Surabaya since 2012 (Cohen, J.E., Hardesty, J.J., Kaplan, S., Kennedy, R.D. et. al 2019).

The battle now is between the efficacy of public health awareness and the aggressive advertising campaigns of the tobacco industry. With the rates of female smokers rising, it’s important to recognise that more power must be given to the support of mental health programs.


References

Ariana, A.D., Fardana, N.A., Hartini, N. & Wardana, N.D. 2018, ‘Stigma toward people with mental health problems in Indonesia’, Psychology Research and Behaviour Management, vol. 11, pp. 535-41.

Ayuningtyas, D., Maulidya, A.N., Misnaniarti, M. & Rayhani, M. 2018, ‘Implementation of mental health policies toward Indonesia free restraint’, Policy & Governance Review, vol. 2, no. 2, pp. 161-173.

Barkina, T., Dewi, V. K., Isnaniah. & Kirana, R. 2014, ‘ Smoking behavior and attitude towards cigarette warning labels among informal workers in Surabaya city – East Java, Indonesia’, Advances in Life Science and Technology, vol. 21, pp.1-2.

Byles, J., Christiani, Y., Dugdale, P. & Tavener, M. 2015, ‘Socioeconomic related inequality in depression among young and middle-adult women in Indonesia’s major cities’, Journal of Affective Disorders, vol. 182, pp. 76-81.

Cohen, J.E., Hardesty, J.J., Kaplan, S., Kennedy, R.D. et. al 2019, ‘Smoking among female daily smokers in Surabaya, Indonesia,’ Public Health, vol. 172, pp.40-42.

Liew, H.P. & Gardner, S. 2016, ‘The interrelationship between smoking and depression in Indonesia’, Health Policy and Technology, vol. 5, no. 1, pp. 26-31.

POST D: Is the Indonesian tobacco industry killing or giving?

I remember watching ABC News’ ‘Children smoking in Indonesia’ (ABC, 2012) in high school years back. The video depicted Indonesian toddlers in which majority were boys as young as two year olds smoking, sparking high controversy.

‘Children smoking in Indonesia (2012)’ by ABC News
Youtube, 2012, Children smoking in Indonesia, ABC, viewed 26 November 2019, https://www.youtube.com/watch?v=qcsdt468C_0.

Local tobacco company, Gudang Garam’s ‘GG Mild brand’ is rumoured to be notorious for targeting the youth in their trendy smoking advertisements (refer to video). They’ve used this to their advantage as cigarettes are accessible to the underage as there are no laws of restriction in buying (GYTYS). Further, tobacco is also sold cheaply at around $1.55USD for a Malboro 20 pack.

‘Iklan GG Mild 2017’
Youtube, 2017, Iklan GG Mild 2017 style of new generation, viewed 26 November 2019, https://www.youtube.com/watch?time_continue=7&v=_ulaZYgXzdM&feature=emb_title.

In 2012, Indonesia was said to have the most male smokers in the world according to the ‘Global Adult Tobacco Survey’ (GATS, 2012). Almost 72% of Indonesian men over the age of 15 years have smoked and more than half (54.2%) of their male population are daily smokers (WHO, 2019). Tobacco has been intentionally developed to integrate with Indonesian culture through ‘kretek’. Kretek is a clove scented cigarette which is inspired by Indonesian natural herbs and is said to be smoother but more toxic than the average commercial cigarette. Cigarette companies were aware of how Kretek played on Indonesian culture and thus, saw further opportunities with it. These companies invested greatly into marketing strategies, sponsoring national sporting events and even educational scholarships (Muhammad Zulfikar Rakhmat, University of Manchester, 2018). They were successful with using mainstream marketing as a strategy because unlike Australia, Indonesia does not have a cigarette advertising ban. In a GATS survey, 82.5% Indonesians reported seeing a cigarette promotion (GATS, 2012).

Indonesian boys smoking.
Muhammad Zulfikar Rakhmat and Dikanaya Tarahita, 2018, As the Rest of the World Quits, Indonesia’s Smokers Increase, asia sentinel, viewed 26 November 2019, https://www.asiasentinel.com/econ-business/indonesia-smokers-increase/.

Cheap and easy access to cigarettes go hand in hand with Indonesia’s poverty rate. Over ‘30 million’ Indonesians live in poverty and ’43.4 million’ youths are unemployed, West Java having the highest unemployment rate of 60%. When there is no employment, education is neglected which results in the population being un-educated to the consequence of smoking. This can be particularly dangerous in a place like Java as more than half of the nation’s tobacco is produced in East Java (Santi Martíni and Muji Sulistyowati, 2005). Perhaps, Java’s cultural hub Yogyakarta could also play a factoring role in the tobacco market there too as it is known for its island culture. Similarly, Surabaya, a city in East Java known for its organised youth gangs and homelessness could also add to the popularity of tobacco usage.

Hand drawn map of Indonesia highlighting Java island cities by Brandon Siow, 2019.

With tobacco having such a big part of their culture and high unemployment rates, it is no surprise the government sees no interest in promoting tobacco use less as it is profiting for them and employment in the tobacco industry.

References:

Matteo Carlo Alcano, 2014, Youth Gangs and Streets in Surabaya, East Java: Growth, Movement and Places in the Context of Urban Transformations, viewed 25 November 2019, https://www.researchgate.net/publication/307744782_Youth_Gangs_and_Streets_in_Surabaya_East_Java_Growth_Movement_and_Places_in_the_Context_of_Urban_Transformations.


Muhammad Zulfikar Rakhmat and Dikanaya Tarahita, 2018, As the Rest of the World Quits, Indonesia’s Smokers Increase, asia sentinel, viewed 26 November 2019, https://www.asiasentinel.com/econ-business/indonesia-smokers-increase/.

Nathalia Tjandra, 2018, Indonesia’s lax smoking laws are helping next generation to get hooked, viewed 26 November 2019, https://www.thejakartapost.com/academia/2018/06/04/indonesias-lax-smoking-laws-are-helping-next-generation-to-get-hooked.html.

Tobacco free kids, 2012, Survey: Indonesia Has Highest Male Smoking Rate in the World, viewed 23 November 2019, https://www.tobaccofreekids.org/blog/2012_09_12_indonesia.

Santi Martini and Muji Sulistyowati, 2005, The Determinants of Smoking Behavior among Teenagers in East Java Province, Indonesia, viewed 24 November 2019, https://openknowledge.worldbank.org/bitstream/handle/10986/13781/347660IND0YouthSmoking0HNP0Tobacco032.pdf;sequence=1

WHO, 2019, WHO report on the global tobacco epidemic, viewed 24 November 2019, https://www.who.int/tobacco/surveillance/policy/country_profile/idn.pdf.

Youth Hub Indonesia, 2019, Challenge, Emotive, viewed 26 November 2019, https://www.emotiveprogram.org/challenge/rural-hub/youth-hub-indonesia/

Youtube, 2012, Children smoking in Indonesia, ABC, viewed 26 November 2019, https://www.youtube.com/watch?v=qcsdt468C_0.

Youtube, 2017, Iklan GG Mild 2017 style of new generation, viewed 26 November 2019, https://www.youtube.com/watch?time_continue=7&v=_ulaZYgXzdM&feature=emb_title.

POST D: Youth advertising in Yogyakarta

Advertising is the key to selling any product and the indonesia tobacco industry is no exception, a range of mediums are used over the archipelago in an effort to coerce consumers into purchasing a product. Kedaulatan Rakyat is a daily newspaper publication based in Yogyakarta with a circulation of 125,000 copies split between print and digital form. Dyna Herlina Suwarto Nurhidayati Kusumaningtyas analysed and conducted research deconstructing the advertising and the messages appearing in the publication.. This research was produced in an effort to aid efforts in counter cigarette advertising. It’s important to note that tobacco companies in Indonesia do not compete in price per unit but rather but rather rely on a bombardment of emotional advertising.

It found that 45% of advertisements depicted models and of these the majority were middle class Javanese males, the main approach used by companies was transformational advertising – consuming the product will result in a positive increase of physiological characteristics (Christopher, 1984). Young people ages 10-19 in Yogyakarta make up a massive 17.6% of the population, many of whom are at risk from these advertisements. But this is not just specific to the region, rather occurs all over the archipelago.

Yayi Suryo Prabandari and Arika Dewi’s cross section in youth cigarette advertising found that “cigarette advertising and promotional messages are targeted at youths”. Leading me to believe that youth advertising is a crucial way to create customers for tobacco. But this is not just in Yogyakarta; “In Jakarta. 99.7 % of teenagers see cigarette ads on television; 86.7% of all teenagers see cigarette advertising in outdoor media space; 76.2 % of all teenagers see cigarette ads in newspapers and magazines and 81% of teenagers have attended events sponsored cigarettes” (Kusumaningtyas, 2015) . 

So the youth are heavily targeted in this advertising, this led me to investigate an example of one of these billboards that are heavily discussed in my research. This Advertisement was seen in Jakarta in 2012 by blogger Luke Regler and depicts a prominent english footballer Rio Ferdinand. Sports team sponsorship is a critical way for companies to engage a young audience.

Rio Ferdinand promoting Gudang Garam Tobacco in Jakarta

Sebayang, S., Rosemary, R., Widiatmoko, D., Mohamad, K. and Trisnantoro, L. 2012, Better to die than to leave a friend behind: industry strategy to reach the young, Tobacco Control 2012, pp.370-372, viewed 24 November 2019, <http://ezproxy.lib.uts.edu.au/login?url=https://search-proquest-com.ezproxy.lib.uts.edu.au/docview/1781954926?accountid=17095&gt;.

Rus’an Nasrudin & Ledi Trialdi & Djoni Hartono & Abdillah Ahsan, 2013. “Tobacco Economic of Indonesia: Poor Households’ Spending Pattern, Tax Regressivity and Economic Wide Impact of Cigarette Excise Tax Simplification,” Working Papers in Economics and Business 201302, Faculty of Economics and Business, University of Indonesia, revised Mar 2013.

Christopher P. Puto and William D. Wells. 1988,”Informational and Transformational Advertising: the Differential Effects of Time”, in NA – Advances in Consumer Research Volume 11, eds. Thomas C. Kinnear, Provo, UT : Association for Consumer Research, Pages: 638-643.

Regler, Luke. 2012. Rio Ferdinand promotes smoking in Indonesia! Personal Blog (WordPress)

http://al-terity.blogspot.com/2012/04/rio-ferdinand-promotes-smoking-in.html