Smoking habits within Indonesian culture starts from a very young age. With primary research showing the direct correlation to smoking and peer pressure in schools, I was interested to see how education plays a role in the tobacco epidemic. Sreeramareddy et al. (2014), speaks of tobacco use being associated with lower education and poverty, showing over 70% of Indonesian tobacco users having only received equivalent of a primary education. Complementary to this report, Sohn (2013), conducted a study which showed the beneficial effects high school education levels had on smoking behaviour. The effects in this study correlate to the cognitive skills, risk aversion and patience taught during this time in school that are mediating factors to smoking behaviours. To develop on this research, I decided to speak with a UNAIR (Airlangga University) student, Indra about his personal experience with tobacco.

Indra is a university student studying health at Airlangga University. Indra suffers from Asthma and therefore chooses not to smoke. His friends are extremely supportive of his decision and if they’re smokers themselves, they always make sure they don’t smoke around him. Indra’s father was a heavy smoker for a large part of his life. He quit last year as he was diagnosed with a lung disease which made him realise how this habit was effecting his health. When I spoke with Indra about his family’s support and understanding of the health issues associated with tobacco use, he told me that if he were to partake in smoking, he believes he would be kicked out of home. Indra told me that his school was of high calibre and therefore he believes his education has made a direct contribution to his choice of not smoking. From speaking with Indra, I realised how education and family/community support was a driving factor in the choices made towards tobacco consumption. Being educated in a school and home environment has made a direct effect on Indra’s view of smoking.

A study conducted by Hiscock et al. (2017), in Indonesia, shows that uptake of smoking is higher among those of a low socioeconomic status and that quit attempts are less likely to be successful. This study shows that from reduced social support, low motivation to quit and stronger addictions, this income bracket has a higher prevalence of smoking culture. Although education isn’t the only factor at play to help prevent smoking, my experience within Surabaya showed me that public awareness of the adverse effects of smoking is limited. In order to start making a change to a behaviour so ingrained in the culture of this country, we must look at informing the public of the risks associated to tobacco use across all socioeconomic levels, especially those of low income and low education. 

 

References

Sohn, K. (2013). A note on the effects of education on youth smoking in a developing country. Journal of the Asia Pacific Economy, [online] 19(1), pp.66-73. Available at: https://www.researchgate.net/profile/Kitae_Sohn2/publication/263607895_A_note_on_the_effects_of_education_on_youth_smoking_in_a_developing_country/links/5b422d8baca2728a0d62bd76/A-note-on-the-effects-of-education-on-youth-smoking-in-a-developing-country.pdf [Accessed 19 Dec. 2018].

Sreeramareddy, C., Pradhan, P., Mir, I. and Sin, S. (2014). Smoking and smokeless tobacco use in nine South and Southeast Asian countries: prevalence estimates and social determinants from Demographic and Health Surveys. Population Health Metrics, [online] 12(1). Available at: https://pophealthmetrics.biomedcentral.com/articles/10.1186/s12963-014-0022-0#Sec9  [Accessed 19 Dec. 2018].

Hiscock, R., Bauld, L., Amos, A., Fidler, J. and Manufo, M. (2017). Socioeconomic status and smoking: a review. Addiction Reviews. [online] Annals of the New York Academy of Sciences, pp.107-123. Available at: https://s3.amazonaws.com/academia.edu.documents/41157251/ [Accessed 19 Dec. 2018]. 

Design to me means problem solving in a way which shapes the world. Whether we are communicating an idea, belief or opinion, the tools and skills we have give us the ability to promote action in individuals. Having this skillset is beneficial not only to our professional careers, but our personal lives as well. However being able to influence a particular audience through design brings in to question certain morals, ethics and values which we employ on a day-to-day basis. A Study conducted by Allen & Davis, (1993) shows how individual values positively correlate to professional ethics. This study highlights how the way in which you conduct yourself personally, carries through to your professional careers. Understanding your personal morals of what is good and bad, and employing them in your professional lives is a way designers can create positive change through design activism. 

Throughout my experience in Surabaya, I was bombarded with advertising which supported the smoking culture of Indonesia. These ads were seen across product packages, billboards and posters. Seeing this made me realise that specific design choices were made to entice the responder to partake in behaviours which were detrimental to their health. After realising the power of design in these instances, I questioned my own moral and ethical standards in a professional light. Our role as designers, is to create a message for an audience. However it’s naive of us to believe that it’s up to personal choice whether the individuals viewing our message will partake in the behaviours I’m representing (Wolowicz, 2011). Designers, must be aware that through good design comes subliminal messages which work on the subconscious mind to create a pattern of behaviour over time (Wolowicz, 2011). If a designer isn’t aware of the long-term effects of their creations, then they will purely be working to make things look good, versus making things good (Hardt, 2009).

Through design activism, we can create a human-centred approach to navigating the ethical dilemma’s that arise in our careers (Brown, 2009). From my primary research in Surabaya, the tobacco advertisements depict a lifestyle of adventure and professionalism, however the environmental, economical and social impacts were far from this ‘truth’. With the World Health Organisation (2017) showing that the socio-economic context of smokers in Indonesia are from a middle-low income household, we can see that these professional and extravagant lives that are depicted in the advertisements are fabrications designed to encourage behaviours that aren’t beneficial to the health and environment of humans. Design is a powerful tool and one which we mustn’t take lightly. As designers we must understand that what we do solidifies and naturalises opinions, stories, behaviours and traditions (Rock, 2016). Maintaining personal values in a professional environment will help us forge a career with positive influence and change on the general population.

SIDE NOTE: Here’s a great example of design which I found along my travels. A paint mural advertising MIXONE Outdoor Paint, located just outside the Kampung Warna Warni Jodipan (The Coloured Village in Malang).

 

 

References

Allen, J. and Davis, D. (1993). Assessing some determinant effects of ethical consulting behavior: The case of personal and professional values. Journal of Business Ethics, [online] 12(6), pp.449-458. Available at: https://link.springer.com/article/10.1007/BF01666559 [Accessed 18 Dec. 2018].

Brown, T. (2009). Change by Design. 1st ed. [ebook] Canada: HarperBusiness. Available at: http://bsili.3csn.org/files/2013/06/change-by-design-brown-e.pdf [Accessed 18 Dec. 2018].

Hardt, M. (2009). Design & Ethics: Good, bad, innocent or ignorant?. [online] International Council of Design. Available at: http://www.ico-d.org/connect/features/post/353.php [Accessed 18 Dec. 2018].

Rock, M. (2016). The Accidental Power of Design. [online] NY Times. Available at: https://www.nytimes.com/2016/09/15/t-magazine/design/bathroom-debate-accidental-power-of-design.html?mcubz=0 [Accessed 18 Dec. 2018].

Wolowicz, M. (2011). Ethical Issues in the Graphic Design Business. [Blog] The Design, Photo and Apple Geek. Available at: https://dpageek.wordpress.com/2011/09/07/ethical-issues-in-the-graphic-design-business/ [Accessed 18 Dec. 2018].

World Health Organisation (2017). WHO report on the global tobacco epidemic. [online] Available at: https://www.who.int/tobacco/surveillance/policy/country_profile/idn.pdf [Accessed 18 Dec. 2018].

Indonesia is a major consumer and producer of tobacco, ranking third among countries globally (Achadi et al., 2005). With over 62% of Indonesian adult males smoking regularly (Achadi et al., 2005), I was interested to find out what practices created such high statistics. Through my limited yet immersive experience in Surabaya, Indonesia so far, I have noticed a vast array of practices associated around Tobacco consumption. One interesting association with the use of tobacco within Surabaya is how smoking is strongly tied to drinking coffee.

I was recently taken on a walking tour of Surabaya, where I was able to see how smoking is so ingrained within Indonesian culture, with communal cigarette cans being placed at all the local cafes. Within Surabaya Warung Kopis (coffee shops), customers are able to purchase their coffee as well as single cigarettes. Smoking has strong social ties within the community in Indonesia, where you can find individuals smoking more often with friends than alone (Smet et al., 1999).

This social tie can be seen not only in the street coffee shops, but also in the large malls such as Tunjungan Plaza, where majority of the coffee shops have smoking rooms out the back of the cafe. Giving individuals the ability to enjoy their coffee and cigarette with friends, while still in the comforts of the mall.

Smoking is a culturally internalised habit in Indonesia, with cigarettes being shared at celebratory events and festivals (Nawi et al., 2007). This social smoking culture is only enhanced with local cafe’s and restaurants feeling the pressures to remain a welcoming environment for smokers. Not only do the local cafes sell cigarettes as well as their own goods, but they also display large signs outside their shops of favourited cigarette brands in order to further entice clientele.

With cigarette smoking being shown to increase the consumption of coffee (Treur et al., 2016) one can see how Warung Kopis and Tobacco brands accompany one another to create a pleasant sensory experience. Although this business partnership is idealistic for economic growth, smoking practices not only effect the smokers themselves, but it also effects the passive, involuntary smokers who don’t choose to directly smoke, but are simply being impacted by their environment. From my experience in Surabaya so far, these individuals are the true victims of the Tobacco epidemic.

References

Treur, J. L., Taylor, A. E., Ware, J. J., McMahon, G., Hottenga, J. J., Baselmans, B. M., Willemsen, G., Boomsma, D. I., Munafò, M. R., … Vink, J. M. (2016). Associations between smoking and caffeine consumption in two European cohorts. Addiction (Abingdon, England), 111(6), 1059-68

Nawi Ng, L. Weinehall, A. Öhman; ‘If I don’t smoke, I’m not a real man’—Indonesian teenage boys’ views about smoking, Health Education Research, Volume 22, Issue 6, 1 December 2007, Pages 794–804, https://doi.org/10.1093/her/cyl104, (Accessed 6 Dec. 2018)

Smet, B., Maes, L., De Clercq, L., Haryanti, K. and Winarno, R. (1999). Determinants of smoking behaviour among adolescents in Semarang, Indonesia. Tobacco Control, [online] 8(2), pp.186-191. Available at: https://tobaccocontrol.bmj.com/content/tobaccocontrol/8/2/186.full.pdf, (Accessed 5 Dec. 2018)

Achadi, A., Soerojo, W. and Barber, S. (2005). The relevance and prospects of advancing tobacco control in Indonesia. Health Policy, [online] 72(3), pp.333-349. Available at: https://www.sciencedirect.com/science/article/pii/S016885100400209Xl, (Accessed 6 Dec. 2018)

Hon Lik, Captured by Wang Zhao, n.d.

The use of electronic cigarettes, better known as “vaping”, mimics the look and feel of smoking through heating up chemicals in a cartridge which is then inhaled by the user (Fairchild, A. et al, 2014). These devices were designed by 52 year old pharmacist, inventor and smoker, Hon Lik from Beijing, China in 2003 (CASAA, 2016) after his father who was a heavy smoker died of lung cancer. Hon Lik wanted to minimise the use of tobacco by creating a tobacco-less product which still gave the user a nicotine hit. Hon Lik’s invention was the seed which sprouted a billion dollar industry, which now sees tobacco companies owning all of the top e-cigarette brands (Greenhalgh, E., & Scollo, M. 2016). 

Now… without a critical eye as of yet, and assuming the intentions were pure, the e-cigarette initiative was a transdisciplinary design which created conversation around alternatives to tobacco smoking. But with heavy investment now made by the tobacco industry, are we merely consuming the harmful collateral of marketing extraordinaries, giving more money to tobacco tycoons (Cheney, M. et al, 2015)?

Hon Lik graduated from a Traditional Chinese Medicine college, where he majored in Pharmarcy. Post graduation, Lik spent over ten years working in plant agriculture, while developing a system which used food additives as solvents vaporised by ultrasound to help combat his smoking habits (Blu UK,2016). Lik’s initial design used a transdisciplinary approach to create a well informed product with good intentions. This bottom-up approach started from one individuals experimentation into dealing with tobacco issues.

Tobacco Fields, Keith Taylor, 2013

Once patenting the product, the commercial use become fanatical before enough research was conducted to know if this design was a solution to an issue, or if it became part of the issue itself. In 2015, an estimated 35 million people were recorded as regular users of vapour products and the market was estimated to be worth 7.1 billion US dollars (Greenhalgh, E., & Scollo, M. 2016). 

The tobacco industry is heavily investing in this product which shows a projected increase in popularity, highlighting the possibility of reliance and addiction (Cheney, M. et al, 2015). There is definitely a path that can be taken with this design to help combat the tobacco issues we have, however with the more momentum this fad gains, the more open it is to being morally and ethically questioned. 

Research such as the one conducted by (Caponnetto P, et al. 2014) shows that we can definitely adapt Hon Lik’s design to help combat the issue and see preferential changes, however we must develop this product to make it a healthier alternative. We must remain aware of the companies and industries that are supporting the evolution of such products to assure that the general population are making educated and informed decisions rather than buying in to new-age marketing tactics. 

Is Vaping Healthier?, WIRED, Youtube, 2016

 

REFERENCES:

1. blu UK. (2016). Hon Lik: The Man Who Invented Vaping. [online] Available at: https://www.blu.com/en/GB/blog/about/hon-lik–the-man-who-invented-vaping/hon-lik-man-invented-vaping-2.html?countryselect=true (Accessed 27 Nov. 2018)
2. Caponnetto P, Campagna D, Cibella F, Morjaria JB, Caruso M, Russo C, et al. (2014) Correction: EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as Tobacco Cigarettes Substitute: A Prospective 12-Month Randomized Control Design Study. PLoS ONE 9(1): https://doi.org/10.1371/annotation/e12c22d3-a42b-455d-9100-6c7ee45d58d0
3. CASAA. (2016). Historical Timeline of Electronic Cigarettes. [online] Available at: http://www.casaa.org/historical-timeline-of-electronic-cigarettes (Accessed 27 Nov. 2018)
4. Cheney, M., Gowin, M., & Wann, T. F. (2015). Marketing practices of vapor store owners. American journal of public health, 105(6), e16-21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4431105/ 
5. Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS). (2016). In: Conference of the Parties to the WHO Framework Convention on Tobacco Control. [online] Delhi, India: WHO Framework Convention, pp.1-7. Available at: https://www.who.int/fctc/cop/cop7/FCTC_COP_7_11_EN.pdf (Accessed 27 Nov. 2018)
6. Fairchild, A., Bayer, R. and Colgrove, J. (2014). The Renormalization of Smoking? E-Cigarettes and the Tobacco “Endgame”. New England Journal of Medicine, 370(4), pp.293-295 https://www.nejm.org/doi/full/10.1056/NEJMp1313940
7. Greenhalgh, E., & Scollo, M. (2016) InDepth 18B: Electronic cigarettes (e-cigarettes). In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2016. Available from: http://www.tobaccoinaustralia.org.au/chapter-18-harm-reduction/indepth-18b-e-cigarettes
8. NSW Health. (2018). Ban the use of e-cigarettes in smoke-free public places – Tobacco and Smoking. [online] Available at: https://www.health.nsw.gov.au/tobacco/Pages/use-ecigs-in-public-places.aspx (Accessed 27 Nov. 2018)
9. Taylor, K. (2013). Tobacco Fields. [image] Available at: http://www.keithtaylorphotography.com/landscape-photography-southern-living-tobacco-fields-morris-west-and-life-perspective (Accessed 27 Nov. 2018)
10. WIRED (2016). Is Vaping Healthier than Smoking?. Available at: https://www.youtube.com/watch?v=PFSuRu5zZNc (Accessed 27 Nov. 2018)
11. Zhao, W. (2016). Hon Lik enjoying a vape. [image] Available at: https://motherboard.vice.com/en_us/article/kb7gey/we-asked-the-inventor-of-the-e-cigarette-what-he-thinks-about-vape-regulations-5886b747f672c2456363054c (Accessed 27 Nov. 2018)