POST A: Designing in the Tobacco Landscape

Having visited Yogyakarta, it is evident that the culture of the city is fostered through the soul of creative art which can be seen all around. From street art, independent boutique stalls for designers and numerous galleries, Jogja is a place where creativity comes to life. “Central to the island’s artistic and intellectual heritage, Yogyakartais where the Javanese language is at its purest, the arts at their brightest and its traditions at their most visible.” (Lonely Planet, 2019). 

Street Art in Jogja, a glimpse into the creative landscape. Photograph by Aisling Rudge, 2019.

The first time I thought about the link between tobacco companies and the power that designers have, was when I was on a tour in Kali Code. My tour guide, Bayu, stopped to show us some art produced by students in the area. He said that each year the students are able to exhibit their work near Kali Code at an event sponsored by tobacco companies. This made me think of other ways that the tobacco industry has crept into the scenes of events, disguising itself as a friendly sponsor. 

My visit to Kali Code. Photograph by Aisling Rudge, 2019.

Such examples in the past have included the event Java Rockin’ Land, sponsored by Gudang Garam, an Indonesian cigarette company. The event also targeted school children, who “…are enticed to attend the event through special discounted ticket prices”. (SEATCA, 2010). The role of designers in helping to bring these sponsored events to life often include the creation of posters and advertisements that further the agenda of the tobacco companies. 

Still not having signed the WHO FCTC, Indonesia does not need to enforce measures for tobacco control. These measures for control include: “…ban on tobacco advertising, promotion, and sponsorship”. (Kin, Lian & Yoon, 2010). As a result, advertising and sponsorship by tobacco companies runs rampant throughout Indonesia, having a detrimental effect towards the tobacco cessation movement. A study on smoking behaviour showed that: “cigarette ads were perceived as encouraging youths to smoke”. (Dewi & Prabandari, 2016).

As designers, we can choose if we want to partake in furthering the power of the tobacco industry, or take a stand and say ‘no’.  American designer, Victor Papanek, notes that “social good and moral values are very important in a designer’s practice…”. (Savvina, 2016).

Whether it be through refusing roles that are associated with tobacco industries or through our own forms of self-expression such as street art, designers can choose how they want to influence the world around them.

‘Stop Smoking’. Photograph by Aisling Rudge, 2019.

References:

Dewi, A. & Prabandari Y. 2016, How do Indonesian youth perceive cigarette advertising? A cross-sectional study among Indonesian high school students, Global Health Action, vol. 9, viewed 23 December 2019, 

https://www.tandfonline.com/doi/full/10.3402/gha.v9.30914

Java Rocking Land, 2010, Java Rockin’ Land, viewed 22 December 2019,

http://www.javarockingland.com/2010/

Kin, F., Lian, T. & Yoon, Y. 2010, How the Tobacco industry circumvented ban on tobacco advertising, promotion and sponsorship: Observations from selected ASEAN countries, Asian Journal of WTO and International Health Law and Policy, vol. 5, no. 2, pp. 449 – 466.

Lonely Planet, 2019, Yogyakarta, viewed 22 December 2019,

https://www.lonelyplanet.com/indonesia/java/yogyakarta

Savvina, O. 2016, Proceedings of the 2016 International Conference on Arts, Design and Contemporary Education, Advances in Social Science, Education and Humanities Research, vol. 2, viewed 23 December 2019,

https://www.atlantis-press.com/proceedings/icadce-16/25858269 

Southeast Asia Tobacco Control Alliance, 2016, ASEAN Tobacco Control Resource Center, viewed 23 December 2019,

https://seatca.org/international-artists-performing-at-indonesian-tobacco-sponsored-rock-festival-despite-protest

Post C: Smoking and Health Campaigns

Like many men in Indonesia, Bayu Topan, faced constant pressure to take up smoking throughout his youth. Having grown up around his grandfather and uncle, who were regular smokers, Bayu was exposed to cigarettes from a young age. Unlike the men in his family, however, Bayu never picked up the habit. He tried smoking for one week at University but it never caught on.  

“I tried one week with my friends, my friend was also the first time with me. We try one week smoking, but I cannot stand for that, but my friend’s until now, are still smoking.”

Photo of Bayu pointing at a banner for a cigarette company, Kali Code. Photograph taken by me.

These kinds of stories are not uncommon and reflect the current statistics within Indonesia. 

According to the survey on Basic Health Research (RISKESDAS) 2018, approximately 62.9% of the male population in Indonesia smoke daily (WHO Report, 2019). This stems from a societal pressure for men to smoke, something which Bayu often experienced. 

“Because I don’t smoke, people say to me like, yeah you are not a man”. 

The problem also lies with the younger generations taking up smoking. In an article about smoking in Indonesia, Tjandra Aditama notes that smoking habits can start quite young: “Other problem is a fact that smoking habit start quite in early age in Indonesia.” (Aditama, 2002)

Ashamed of the prevalence of smoking in Indonesia, especially among younger children, Bayu commented on the common sights he would see in his home town in East Java. 

“I saw children like 5 years old, like holding smoke just like expert, smoking. Yeah, so embarrassing… So many, not only just one. Parents are so proud that kids can smoke.”

With smoking being such a large-scale issue in Indonesia, it’s hard to know where to start in trying to help those with tobacco addictions. 

One approach, backed by doctors and healthcare professionals at Puskesmas Berbah in Yogyakarta is to use anti-smoking and health campaigns to educate the public on the detrimental effects of smoking. Dr. Evy Diana Apriliani said in her presentation to students from the University of Technology Sydney that: “Smoking is a complex and global problem. Its impact to health is undeniable.” (Apriliani, 2019). Dr. Apriliani also showed examples of health campaigns being used in Indonesia:

Bayu mentioned that he also believes educating the public about smoking, is important.  

“I think, make awareness about smoking to the people, that’s more important, education to the people.”

References:

Aditama, T. 2002, Smoking problem in Indonesia, Medical Journal of Indonesia, vol. 11, no. 56, pp. 56 – 65.

Apriliani, E. 2019, ‘Health Effects of Cigarette Smoking’, Puskesmas Berbah Presentation, PowerPoint Presentation, Puskesmas Berbah, Yogyakarta, presented 7 December 2019.

Kementerian Kesehatan Republik Indonesia 2018, Hasil Utama RISKESDAS, viewed 17 December 2019, 

http://www.kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf

Puskesmas Berbah, 2019, Puskesmas Berbah, Yogyakarta, viewed 19 December 2019,

http://www.pkmberbah.slemankab.go.id

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

World Health Organization, 2019, WHO Report on the global tobacco epidemic 2019, WHO, viewed 5 December 2019, 

https://www.who.int/tobacco/surveillance/policy/country_profile/idn.pdf

PROJECT: The Future of Jalan Malioboro

The following is a recount and documentation of the process that Adeel, Serena, Stella and Aisling, underwent to produce a response to their Design Project, Group C: Jalan Malioboro (Malioboro Street) and surrounding areas. 

Our group began their design project by coming together and discussing the research that we had gathered prior to the trip as well as the many ideas that we had been brainstorming. We posted a response to questions asked by our teachers on the 3rdof December 2019, into our private slack group, Group Pala:

“As a group we held many assumptions about the prevalence of smoking; we were surprised to see that there weren’t as many people smoking as often as we had assumed. Some of us were also expecting to see children smoking due to the exposure of media before the studio.

The tobacco advertisements were more impactful and shocking despite reading about them beforehand and we were especially surprised to see how many there were and how targeted they were.

We think some of the biggest challenges that we may face designing in this context are going to be cultural and language barriers. Socially speaking as well, we think deconstructing or challenging the entrenched gender roles and cultural significance of smoking will be very challenging. Besides the strong ties between masculinity and smoking, we believe the national patriotism tied to the tobacco industry in the general public will also be difficult to overcome. We are hoping to combat this through research and first-hand cultural immersion.”

Next we continued to do our own further research, both first hand and online, looking to gather as much information as possible before the commencement of our brief. 

A few days later, we had another meeting with our teachers where we discussed the three rules in which we would follow as a group, working together over the next week:

“Everyone should be heard and open to ideas but uniform in decision making. Keep up with deadlines and group goals. Have a place for everyone to shine.”

Following on from this, we were later given our official brief:

“*LOCATION C: Jalan Malioboro (Malioboro street) and surrounding areas* (Smoke free Yogya campaign, working with public spaces in Yogyakarta which fall under the Provincial government, not the city government. This links to the first focus of the public health campaign we discussed at Puskesmas Berbah. You might like to look into advertising contracts, visit Kali Code, or think about different ways of mapping the area.)”

We then continued our research, brain stormed ideas to present to the teachers in our next meeting, visited Malioboro and took observational notes and decided on our style of approach, through the lens of a comic book. 

After our first official meeting with our teachers at our hotel, we had a clear vision of where we were heading. We had our comic book idea approved and decided that our next steps would involve some more first-hand research as well as researching visual comic book styles. 

Here is a written recount of what the we did, following our first meeting: 

“Yesterday we had a busy day which primarily consisted of first hand research:

We looked at visual styles for comics by conducting our own research as well as visiting Achong. He showed us many of the comics that he has and talked to us about Riso printing. Through looking at different visual styles, we decided that we’d like to incorporate both hand drawn and photographic media into our comic. Here are some examples:

The photographic media will showcase textures from both Kali Code and Malioboro to reflect the histories of the locations in our future scenario, juxtaposing the old against the new to show how far Malioboro has come since its past in “2019”.
Next we walked around the streets, observing and photographing street art, looking at the various forms of self expression in the area. 

We then went on a 4 hour walking tour of Kali Code where we immersed ourselves in the rich history of the area by talking to locals as well as meeting the hard working families who specialise in different crafts, many of which end up at the markets in Malioboro. We told our tour guide that we were looking into the Tobbacco industry in Indonesia and he gave us some wonderful insights as he used to work in The House of Sampoerna, a Tobacco Museum, in Surabaya, East Java. We had many questions for the locals regarding cigarette advertisement in the area, which our tour guide was able to translate for us. for example, an elderly couple had cigarette advertisement banners hanging up in the front of their house which we were told they were given for free from the convenience store “to block the sun coming into their home”, because they have lots of them just lying around. 

Our tour guide, Bayu, in Kali Code – Photograph taken by Group Pala

We also spoke to a lady on the street who sold cigarettes in her store. She had giant banners to promote cigarettes at the front of her store and we asked her if she got paid to have them there, she said “no”, but that it lets people know that there are cigarettes there and helps her with business. At the end of the tour, we conducted a formal interview with the tour guide as a subject, his name is Bayu Topan. We found him interesting because he does not smoke but always felt a great deal of pressure to do so and he used to struggle because people would say ‘he is not a man’ if he does not smoke. Many male members of his family also gave up smoking cigarettes in their later life due to poor health. 

Then after the tour, some of us went to Malioboro to observe our surroundings as well as to enjoy the car free day/night and festival. It was a very different atmosphere this time around and we recorded key sensory observations such as colours, noise, smell, weather and the actions of people around us. We also used mixed tools to record our surroundings such as photography, videography, writing and sound mapping. 
Then our last task of the night was to watch Into the Spiderverse, a comic book style movie about Spider-Man which uses various visual symbols and styles to link the movie to its comic book background.



And then we reconvened and brought together our many ideas for our future scenario and decided and what we wanted to do. We also drew up some sketches of what we want our comic to look like.”

Over the next few days, we continued to work together as a group, meeting up each day with the teachers and continuing our research as well as the development of our project and visuals for our comic through both photography and drawing.

Here are further written recounts from what we were able to achieve over those few days:

“Yesterday we contacted Bayu and got his permission to use him as a main character in our comic, as well as permission to keep his name the same.

Then, we gathered as a group and put together a storyboard while working on creating different scenes visually and decided how we would go about it. While the illustrators were working on their drawings, I put together scripts, titles for the comic and conducted further research. We have decided that we will only have two pages with a comic illustration, printed in Riso, the cover and the first page. The remainder of the comic will be presented as a scroll comic while we communicate the information for our scenario to the audience. This is more achievable for us. 

We also re-visited Malioboro but this time during the day to gain a new perspective. We took note of sensory observations as well as using photography to document the streets. We later used the photos to help aid our research and drawings of the Malioboro area.

Next we went and chose paper stock that we would like to use for our Riso printing. After successfully choosing a size, colour and texture, we went to another shop and got all the pages cut to size. 

In the afternoon, we went and visited Anagard’s home in Bantul. Anagard is a famous street artist in Indonesia who has his own studio and produces work throughout the town of Bantul as well as abroad. Anagard is currently in Cambodia doing work for people so he could not be at his home but he thanked us for coming to visit and had his student give us a tour of the work in the local village that Anagard and other artists have contributed to. We found the work of the artists interesting because the street art in the village is being used to convey important messages and themes such as recognising the work of farmers and how vital they are to the country, control of the citizens, particularly children, through media as well as looking into health issues such as excess sugar consumption. It was also interesting to see the variety of visual styles used. 

We continued to work on the visuals for the comics and developed our scenario for the year 2040 which the teachers had approved.

We also had a look at the comic book section and children’s book section at Milas Vegetarian Resto.”

Finally, our project was close to being complete and we were beginning to tie up any loose ends that we still had to finish, including printing our Riso work and rehearsing our script for the scenario presentation.

We decided on riso printing as it would be most effective in displaying our dystopian view. The three colours used to print were red, black and blue. This way, we were able to use the red to draw attention to the abundance of cigarette advertising, contrasted against the blue of the streets and buildings. The smoke was printed in black to also show the toxicity of the environment. Also, though each were individually illustrated with different styles, the limitation of colours ensured visual cohesion. 

We printed three poster designs for the presentation: the first was the cover of the comic, in which Bayu, the protagonist and hero is given the spotlight. The other poster was a dystopian view of Maliaboro St, in which dark clouds of smoke overwhelm the environment, cigarette butts are littered everywhere and Marlboro advertising has taken over the street. The last poster is a scene from the comic that showcases the only smoke-free zone, the Marlboro Mall.

Here is a copy of the speech that we gave in our presentation:

“Before we start, we would just like to say hello and thank you to a special guest in the audience, Bayu. Without whom, we would not have been able to learn all we have about our area of research. He has also been our inspiration for our hero character in our comic book!

The date is May 31st2040, World no Tobacco Day, and Indonesia has still not signed the WHO FCTC. This comes despite the efforts of many organizations to direct Indonesia towards a ‘smoke-free’ future. Indonesia’s failure to implement harsher anti-smoking laws has led to the demise of specific ‘smoke-free’ areas across the city and has seen an increase in active smokers of all ages, specifically boys between the ages of 12 to 15 years old. 

The city streets and village landscapes are littered with red, black and white banners, more so than ever, often sporting the age-old slogan “Pro Never Quit”. Like propaganda, cigarette advertisement drape across the surroundings, poisoning the minds of the people. Where once there stood ‘smoke free areas’ in restaurants, hospitals, schools and more, people gather to smoke like never before. The saddest of all is Jalan Malboro, formerly known as Jalan Malioboro. Celebrating the street’s love of cigarettes, despite it once being a ‘smoke free zone’, the area was officially renamed to ‘Marlboro’. Its vibrancy, culture and bustling nature has been swept away like the fresh air that once was, and standing in its place is the stench of burning tobacco as it sweeps through the streets, like a dark grey cloud, choking us all.

Everywhere you look, children are made to wear face masks, their little eyes peeping out from the cloth that protects their lungs trying not to breathe in the harsh chemicals that reside in the air. What once was a city loved, is now an area where people only gather to smoke, a soulless void that sucks your life away. Moving swiftly off the streets, the plaza is the only escape for people wanting to get away from the smoke. 

The most popular items sold in Marlboro are face masks and cigarettes, an unlikely combination that has cemented its way into the streets among the discarded cigarette butts that litter the ground like leaves after a heavy storm. Whispers among locals say that the ghosts of the past that once had Marlboro dancing and singing into the night, now haunt the hollow lanes, desolate and black. Street vending carts lie dormant like wounded skeletons, tossed to the side, but no one bats an eye. 

This is the Malioboro that you once loved. Is this the future that you want for it?

This is how we envision the future to be if nothing changes. As a group, we have brought to life, a series of visuals in the form of a comic in the hopes that we may prevent such things from happening. By seeing the dim prospects of what lies in store, our comic aims to scare people into action. 

Through extensive research, we have been able to create a realistic landscape of what the future may hold. Let’s talk about how tobacco continued to take over despite the solutions that Indonesia has tried to put in place, particularly amongst the younger generations. Back in 2018, the National Health Research Data (Riskesdas) noted that “the prevalence of smoking teenagers aged 10-18 years old rose from 7.2% in 2013, to 9.1% in 2018. This shows a clear increase of new smokers over the time period in which new policies have been implemented. According to Andrew Rosser from the School of Social Sciences at the University of Adelaide, the inconsistency of the government in locking down a stricter tobacco-control policy regime has had a negative impact on the country’s worsening tobacco epidemic. Thus, tobacco control in Indonesia will likely not move forward until the government strengthens existing laws, makes new improved laws or “develops protocols for enforcing all laws”.

Rosser also notes, that advertising is also a key player in the worsening of the tobacco crisis in Indonesia with statistics showing that over 90% of young students in one month during 2015 had actively noticed advertisements on billboards for cigarettes, magazines and newspapers. 

In an article ‘Linking global youth tobacco survey data to the WHO framework convention on tobacco control: The case for Indonesia’, inconsistencies within the tax administration on cigarettes has allowed for loopholes to form between point of sale and consumers. “Tired tax rates by production scale allows firms to evade paying the highest tax brackets legally, thereby increasing profit margins while reducing the prices at point of sale”. According to a 2009 article on tobacco control for health by Sarah Barber and Abdillah Ahsan, Indonesia has been implementing tobacco regulations since 1999, but the reality of tobacco use goes in the opposite direction according to the survey data report. Other contributing factors that have shaped our future scenario include a lax control over tobacco in Indonesia, the social normality of smoking, the powerful lobby of the tobacco industry against tobacco control and the continued profit maximization behaviour and sustainability of the tobacco industry. 

The possible impacts of thinking about this scenario now include early prevention where we can see the extremes that Indonesia is heading towards if harsher control of tobacco is not implemented. With this, early strategies can be put into place, spurring the people of Jogja into action. It allows time for a campaign to arise brought about by the shock factor created from this scenario. After becoming aware of what the future may hold, we can work together to avoid such an outcome. 

What can be implemented now is the spreading of awareness of what the future may look like if nothing is done. We would like this comic to be in print form and readily available to anyone who wishes to read it, by making it affordable to people of all ages with no restrictions. We want people to look at the tobacco industry from a new perspective. Our comic is thought provoking and can spur changes such as the removal of advertising from Malioboro street, the implementation of smoke free zones that are monitored and adhered to, as well as signage to remind people that no smoking is permitted. Through our comic, we believe community action can form with added pressure from the public to see changes that will improve the future prospects of the area.  

Our scenario can help our stakeholders imagine different ways of doing things. It can help them to investigate new ways of approaching the topic. In our case, through a medium that is quite popular, especially among young audiences in which we could have the biggest impact, therefore preventing children and teenagers from taking up smoking. It also has an element of fun and thought provocation through the act of reading a comic, something which can be a cause for discussion. Our comic is also new and visually appealing, grabbing the attention of those who may want to read it. Alongside our comic there is potential for expansion into other forms of campaigning such as interactive murals or street art where people are invited to leave their messages for others to see. 

Over time, in our scenario, we anticipate the social context, global tobacco industry and stakeholders to change. In the future, more countries will place tighter restrictions on tobacco as part of the signing of the WHO FCTC. As a result, the industry will put added pressure on Indonesia to continue to increase its production and demand for the consumption of tobacco products. In a social context, it will become more widely acceptable to smoke as a result of the pressure and a doubling on the production of advertisements that are placed in public areas. While stakeholders are still campaigning against the tobacco industry, it will be no match for the tobacco takeover. 

COMIC BEGINS 

Our hero Bayu takes a group of tourists on a tour,

Welcome to Jalan Marlboro! Sorry there is a lot of smoke, there’s nothing stopping people from smoking here. 

The smoke begins to take over. 

Bayu explains to the group, 

Many years ago, before being overtaken by the smoke, this street was lined with beautiful and vibrant stores selling lovely handmade crafts. Now all that remains are abandoned stalls with cigarette butts lying around the streets. 

No longer able to withstand the smoke, they exclaim ‘lets get away from all this smoke!’ 

They spot the only smoke free zone, the mall, and rush towards it, thwarted by the line snaking out and around the street as everyone is driven there for some relief from the smoke. The End.

Here’s some of our other printed materials we’d like to share.”

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

Aditama, T., Asma, S., Jones, N., Lee, J., Pradono, J., Rahman, Q. & Warren, C. 2008, Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control: the case for Indonesia, Preventive medicine, vol. 47, viewed 12 December 2019,

https://www.researchgate.net/publication/5269770_Linking_Global_Youth_Tobacco_Survey_GYTS_data_to_the_WHO_Framework_Convention_on_Tobacco_Control_the_case_for_Indonesia

Ahsan, A. & Barber, S. 2009, The tobacco excise system in Indonesia: Hindering effective tobacco control for health, Journal of Public Health Policy, vol. 30, no. 2, pp. 208 – 225.

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

Luetge, C. & Tandilittin, H. 2013, Civil Society and Tobacco Control in Indonesia: The Last Resort, The Open Ethics Journal, vol. 7, viewed 10 December 2019,

https://benthamopen.com/ABSTRACT/TOJ-7-11

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

Rosser, A. 2015, Contesting Tobacco-Control Policy in Indonesia, Critical Asian Studies, vol. 47, no. 1, pp. 69 – 93.

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

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 photograph taken by me during my visit to Central Java. In the photo there are 4 signs in a row for cigarette companies and ‘Pro Never Quit’ slogans.

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.  

________________________________

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

Post B: Success in Plain Packaging

On 29 April 2010, the Australian Government made an important decision to introduce mandatory plain packaging of all tobacco products by 2012. I was only 15 at the time, but I welcomed this change. I had lost my grandmother 6 months prior to complications brought about by emphysema. For years, I watched her suffer as she continued to puff away on her packs of ‘Peter Stuyvesant’s’. With each inhale, the false promise of glamour and beauty once paraded about by the ads on television, scattered away into the distance. Instead, I watched the damaging effects of cigarettes as they slowly took the life of my grandmother.

Packaging

‘Before and after photos of cigarette packs from Australia, where plain packaging was introduced in 2012’ (Hammond, 2016)

Since the introduction of plain packaging, all tobacco products now come with a confronting health warning in the form of a graphic image, as part of the campaign to reduce the rate of smoking within Australia. Funded by the government, the method behind the campaign is to ‘shock’ viewers. A study on the effectiveness of ‘shock tactics’ in advertisement, determined that the use of shocking imagery by organisations was “…deemed successful at capturing the audience’s attention”. (Jones, Parry, Robinson, Stern, 2013) Click for article.

Furthermore, the Australian Bureau of Statistics show the successful impact of plain packaging in Australia: “…Since 1995, the proportion of adults who are daily smokers has decreased from 23.8% to 13.8% in 2017-18.” (ABS, 2019)  Click to visit website.

Another study carried out, looked at links between the introduction of plain packaging in Australia and Quitline calls. Results showed that there was a “78% increase in the number of calls to the Quitline, associated with the introduction of plain packaging”. (Currow, Dessaix, Dobbins, Dunlop, Stacey, Young, 2014) Click for article.

In the early stages and still today, the government has been met with strong opposition, from Big Tobacco, members of the World Trade Organization and Australian retailers. Those opposed, were concerned that other countries would see the success of the plain packaging campaign, and would want to implement their own, thus industry profits would suffer. “Once even one country with a population of 23 million showed that plain packaging could be implemented, others would see it as something feasible”. (Chapman, Freeman, 2014)

The success of the plain packaging campaign in Australia shows a method that could be applied universally through a transdisciplinary approach.

Although my grandmother did not live long enough to see the changes brought about by the introduction of plain packaging, she would have been happy to see its success.

________________________________________

References

Australian Bureau of Statistics 2019, National Health Survey: First Results, Australia, February 2019, cat. no. 4364.0.55.001, ABS, Canberra, viewed 16 November 2019,

https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001~2017-18~Main%20Features~Smoking~85

Australian Government Department of Health, 2019, Tobacco plain packaging, Canberra, viewed 16 November 2019,

https://www.health.gov.au/health-topics/smoking-and-tobacco/tobacco-control/tobacco-plain-packaging

Brenna, E., Coomber, K., Durkin, S., Scollo, M., Wakefielf, M. & Zacher, M. 2019, Tobacco Control, BMJ Journals, vol. 24, no. 2, viewed 17 November 2019,

https://tobaccocontrol.bmj.com/content/24/Suppl_2/ii17

Chapman, S. & Freeman, B. 2014, Removing the Emperors Clothes: Australia and tobacco plain packaging, 1stedn, Sydney University Press, Sydney.

Hammond, D. 2016, Before and after photos of cigarette packs from Australia, where plain packaging was introduced in 2012, Vox, viewed 18 November 2019,

https://www.vox.com/2016/6/2/11818692/plain-packaging-policy-us-australia

Jones, R., S., Robinson, M. & Stern, P. 2013, ‘Shockvertising’: An exploratory investigation into attitudinal variations and emotional reactions to shock advertising, Journal of Consumer Behaviour, vol. 12, no. 2, viewed 17 November 2019,

https://onlinelibrary.wiley.com/doi/abs/10.1002/cb.1430

Pursuit, 2018, Big tobacco vs Australia’s plain packaging, The University of Melbourne, Melbourne, viewed 15 November 2019,

https://pursuit.unimelb.edu.au/articles/big-tobacco-vs-australia-s-plain-packaging

WHO Framework Convention on Tobacco Control, 2019, Protocol, Geneva, viewed 16 November 2019,

https://www.who.int/fctc/en/

Young, J., Stacey, I., Dobbins, T., Dunlop, S., Dessaix, A. & Currow, D. 2014, Association between tobacco plain packaging and Quitline calls: a population-based, interrupted time-series analysis, The Medical Journal of Australia, vol. 200, no. 1, viewed 17 November 2019,

https://onlinelibrary.wiley.com/doi/abs/10.5694/mja13.11070