To gain an unusual perspective into tobacco use and its surrounding health issues, full-time employer of Philip Morris international, Abdul Aziz Purnama Adi (2019, pers. Comm., 14 January), was interviewed. Aziz, as he prefers, distributes tobacco products throughout Indonesia and considers himself a casual smoker. Aziz argues for tobacco, asserting the product is harmless, and all health-issues said to surround cigarettes are merely the act of a conspiracy. Despite his positive views on smoking, further analysis and investigation could reveal several discrepancies in Aziz’s statements.
Aziz outlines tobacco as a form of “good medicine which helps to clear the mind.” He reinforces its positive qualities asserting that he is yet to meet anyone who’s health or wellbeing has been negatively affected by smoking. Although studies reveal “Tobacco kills 225,720 people each year” in Indonesia (World Health Organization 2018). His outlook is heavily influenced by the novel Membunuh Indonesia Konspirasi Global Penghancuran Kretek, Aziz explaining “I do not believe the graphic imagery on cigarette packets” nor that “health issues exist or are a direct cause of smoking full-time. Perhaps his fixed perspective is somewhat due to lack of knowledge, Aziz also mentioning that he does not remember receiving education in school about the impacts of smoking.
Conversely, Aziz recognizes tobaccos potential to be somewhat “harmful.” He explains that smoking ten cigarettes a day is the suitable amount, however, if someone was to consume any greater than this quantity, that is when it can become damaging. With regards to smoking more than ten a day, Aziz believes: “this is when it begins to control you, you become addicted” but cigarettes “are okay when you can control the tobacco, and it’s regulated.” He was quick to reinforce however that “the problem here is not the tobacco itself but the over and uncontrolled usage of it.” While he blatantly disregards tobacco as the cause of any health issues, it is odd that he opposes to smoking around children: “I’ll never smoke around children.” Why must he refrain himself from doing so if cigarettes do not cause any direct harm? Unable to admit the dangerous consequences associated with smoking, Aziz’s employer ironically can, their website promoting smoking as harmful: “We are dedicated to doing something very dramatic – we want to replace cigarettes with smoke-free products as fast as possible… we have more than 400 scientists, engineers, and technicians developing less harmful alternatives to cigarettes” (Philip Morris 2019). And while Aziz could aim to emulate his employer, recognizing the harm and moving towards a smoke-free future, perhaps the Philip Morris company could have the courtesy of completely eradicating themselves.
Tobacco advertisements are known to saturate Indonesia’s environment (Danardono 2008). Research continues to validate this statement, sources asserting “tobacco advertising is everywhere –at roadside stalls, on billboards, music concerts, even sporting events” (The Guardian 2018). While this proved correct within the city centre of Ambon, and lower-economic areas, it was wondered if this followed suit within regions considered to be more upper-class.
The initial exploration of central Ambon and the lower-class areas established the inescapability of tobacco advertisements. From main streets to alleyways, houses to moving cars, the exposure to these adverts were inevitable (refer to figure 1). Shockingly situated outside of homes, hospitals and down the streets of schools, statements made by The Jakarta Post were reinforced: “[they] can be found anywhere, including near schools and hospitals” (The Jakarta Post 2017). While evident within the city centre, the ads were also prominent when driving through somewhat more impoverished areas located further out. This was confirmed through the 187 tobacco advertisements spotted from point A to point B (refer to figure 2).
To investigate further and to draw comparisons, another exploration was undertaken moving more towards the suburbs of Ambon and houses of greater wealth. This additional ethnography allowed for better interpretation of Ambon’s tobacco culture, and insights into the cigarette advertisements’ presence concerning the ‘upper-class’ areas. Motioning uphill east, buried deep in the plantation, more luxurious houses came to into view (refer to Figure 3). Once out of the city’s centre and immersed within this new ‘lusher’ region, the once-inescapable ads almost felt as though they had become escapable. The ads appeared much less prominently, only witnessing a mere 5 (refer to figure 4). In comparison to the city centre inundated with tobacco advertisements, five seemed somewhat more tolerable. The littering of cigarette packets, while still evident, had also reduced immensely.
Figure 3: Houses of greater wealth
Exposure to these two different areas provoked many questions and speculations. Perhaps there were fewer ads in this higher socio-economic region purely because there was lesser foot traffic. The vocational education and government buildings situated within the area could also be contributing factors (refer to Figure 4). Educational facilities are to be considered smoke-free zones (The Tobacco Atlas 2018) while the Mayor of Ambon has enforced rules of his own to eradicate smoking from government premises’. Regardless of these assumptions, it is feasible that this insight found could be attributable to strategic purposes. Advertising in the lower socio-economic areas would prove of much more value to tobacco companies, studies demonstrating that Indonesian “males and older adolescents, from poorer wealth… and living in certain provinces” have much “higher odds of smoking” than those of higher wealth (Kusumawardani et al. 2018). A study outside of Indonesia also asserts that “low-income people smoke more than higher-income people” (World Health Organization 2011), while evidence specific to Indonesia reveals “people with low incomes are more responsive to tobacco price increases” (Adioetomo et al. 2008) — hence the high-volume adverts within the city centre. The lowest income group in Indonesia spends “15% of their total expenses on tobacco” (World Health Organization 2004), perhaps validating the assumption of as to why tobacco companies exploit the lower socio-economic areas. In response to these findings, however, throughout the exploration of Ambon, it is important to note that the presence of cigarettes was not eliminated in the higher-class areas, ads, and packaging still somewhat evident.
Adioetomo, S.M., Ahsan, A., Barber, S., Setyonaluri, D. 2008, Tobacco economics in Indonesia,International Union Against Tuberculosis and Lung Disease, Paris.
In 2012, the US Centers for Disease Control and Prevention (CDC) launched the first-ever paid national tobacco education campaign named ‘Tips From Former Smokers’ (Tips) (Centers for Disease Control and Prevention 2018). The advertisements contained and profiled real people, showcasing graphic imagery which illustrated the life-long consequences of smoking. The top-down approach aimed to create awareness of the health issues associated with smoking, with the main motive of encouraging individuals to quit and refrain from smoking around others (Centers for Disease Control and Prevention 2018). The numerous videos apart of the campaign all implement a variety of different, yet effective design approaches. ‘Terrie’s Story’, one of the first videos to kick-start the campaign, is just one of many successful infomercials included in the expedition.
‘Terrie’s Story’ advantageously implements shock value and fear to play on people’s emotions (Skubisz 2016). The audience is introduced to a beautiful, young version of Terrie, suddenly contrasted with a worn and ill Terrie. The abrupt juxtaposition between the two frames shocks viewers, further instilling fear as Terrie continues to talk about the life-long consequences she suffers as a result. Terrie’s outcome makes viewers feel “susceptible” to her consequences, therefore motivating one to quit to remove the shock or fear felt (Skubisz 2016). The approach ultimately “elicit[s] a particular emotion” in hopes of provoking “a related motivational action tendency” (Skubisz 2016). Research validates the success of this particular method, Truth Initiative stating: “Tips has motivated more than 5 million smokers to attempt to quit, and an estimated 500,000 of those smokers have quit for good” (Truth Initiative 2017), whilst an evaluation of the campaign by Alice Miller reads “we found evidence of its continued and significant impact on cessation-related behaviours…[and] these campaigns continue to have… impact, even after multiyear implementations” (Neff 2016). In addition, CDC asserts: “Smokers who have seen ‘Tips’ ads report greater intentions to quit,” with those who have seen the ads multiple times having “even greater intentions” (Centers for Disease Control and Prevention 2018). While intentions are a great starting point, is this enough? Other sources disagree, challenging the ‘negative impact’ approach.
Numerous campaigns, similar to ‘Tips,’ implement negative, fearful and shock value methods. However, the research argues the importance and effectiveness of a positive and encouraging approach. Gareth Iacobucci in ‘New anti-smoking campaign adopts shock tatics’ states: “Public experts said the shock tactics will benefit some more than others and called for other initiatives… Positive images of non-smoking… are needed” (Iacobucci 2012). He argues: “many believe wrongly that the harm is already done” or they believe “the health risks associated with smoking are greatly exaggerated” (Iacobucci 2012). Another source claims: “positive campaigns were most effective at increasing quit-line calls,” while harmful emotive content only proves useful if exposed to at higher levels (Richardson 2014).
Research outlines the effectiveness of ‘Tips,’ and the ways in which it has provoked viewers to quit smoking. On the contrary, however, its success could be questioned, one arguing its failure to cater for those who would benefit from a positive approach.
The public’s perception often outlines design as ‘a plan or drawing’ which ‘shows the look and function… of a building, garment, or other object’ (Google Dictionary 2019). They may also refer to it as the act of ‘conceiving a plan of something before it is made’ (English Oxford Dictionary 2019), commonly associating it with “glossy magazines, elaborate advertising campaigns, or fancy book covers” (Shea 2011). These definitions however only merely scratch the surface, both design and the designers themselves holding the ability to influence and initiate social change (Shea 2011). This act of human-centered design, or design activism, while able to combat various complex social challenges (Shea 2011), recurrently faces social, political, behavioural and industry barriers. Complicated by companies’ destructive advertising objectives, paired with designers who uphold unethical approaches, design activism proves difficult. Both Indonesia’s tobacco and Australia’s alcohol industries are pertinent to this.
The Indonesian tobacco industry demonstrates how a group may implement barriers, abuse and thrive from design. Indonesia, “the only country in Asia that has not signed…the World Health Organization’s Framework Convention on Tobacco Control” is undeniably suffocating from toxic tobacco culture (Tjandra 2018). Both political and economic elements appear as the two “driving forces” behind this addiction (Stories 2015), their relaxed regulations accompanied with aggressive industry advertising allowing for cigarette-smoking to become socially acceptable (Hui-Peng & Tze-li 2009). As a result, culture and behaviours are influenced, Indonesia’s leniency ultimately allowing the industry to target a younger audience (as seen in the video below).
Tobacco advertisement intended for a younger audience. This is evident through the young actors, music integrated, and activities portrayed (e.g., street dancing, mo-peds, guitar/rock scene).
Individuals are exposed continuously through “billboards, stalls, events,… [the] internet, [and] advertise[ments]” (Tjandra 2018), all of which are designed with consideration and purpose. Adding to these roadblocks, the tobacco industry boasts the extensive amount of jobs it provides Indonesia, whilst companies such as Sampoerna and Djarum have charmingly developed “educational pathway[s]…which distributes scholarships [and] supports underprivileged schools” (Tjandra 2018), or have “established sports academies for young talents” (Tjandra 2018). These high-volume challenges band together, ultimately intervening with and making human-centered design extremely problematic. Not only specific to Indonesia, this abuse of advertising and the various barriers put forward prove similar within Australia’s alcohol industry.
While design has been used positively with regards to tobacco within Australia (refer to the anti-smoking video below), the stance has not followed suit for alcohol consumption.
Australian tobacco advertisement intended to shock, educate and encourage people to quit (or refrain from taking up smoking).
Alcohol is known “to be the cause of significant physical, emotional and social harm” (Jones & Gregory 2007), and continues to be encouraged and often “designed deliberately to appeal to those under… age” (Jones & Gregory 2007). It seems political and economic barriers (as seen in Indonesia), are too perhaps to blame. US expert on alcohol policy, David Jernigan, states: “the Australian government is failing to… regulate the alcohol industry to stop its advertisements reaching children” (Davey 2017). Proof of this became evident when a report revealed the 2018 NRL grand final exposed children “to more than three cases of alcohol advertising every minute,” while AFL promoted alcohol once a minute (SBS News 2018). Equal to Indonesia’s tobacco industry, destructive barriers are evident. The lax laws, advertising, and their design yet again play a negative role contributing to and complicating the practice of human-centered design.
Research demonstrates the difficulties of design activism, its barriers and how design is used for darker motives. Those designers whom do uphold ethical values are too often presented with various complex and intricate challenges, which dominate and complicate their practice and/or working environments. Although confronted with these issues, the ability to initiate social change is still very much attainable. To gain greater insight into this uplifting realm and the successes of human-centered design, the following post (B) will explore and investigate an effective design initiative of tobacco control.
Shea, A 2011, Designing for Social Change : Strategies for Community-Based Graphic Design, Princeton Architectural Press, New York.