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.

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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.

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