POST C: Finding the truth of this non-smoking campus

Our group’s project is to study the tobacco problem in UMY. So, we did observations and interviews in the UMY campus. I picked up some details when I was making observations on the campus. For example, there are many non-smoking signs on the campus. I found many no-smoking signs on the walls and pillars. No-smoking signs were also found in the student activity area behind the main building. This is a smoke-free campus. Through research, we learned that national policies of Indonesia include: Prohibit smoking on public transit and in healthcare facilities, educational facilities, and places of worship (The Union, 2019). The Faculty of Sociology and Politics, University of Indonesia (UI) has announced that the UI has become a 100% smoke-free campus (SEATCA, 2019). The policy of banning smoking in universities can effectively educate students about the dangers of smoking and protect the health of non-smokers. It’s a very good rule. But I still have a question, will the students strictly abide by the smoking rules? So, I interviewed three kinds of people: a female student, two male students, and a tutor.

UMY CAMPUS, 2019

That girl, Ayu, is a non-smoker. She said there is no smoker in her family, so neither she nor her brother is a smoker. This reminds me of the previous research on children’s smoking. Most children and teenagers’ smokers are influenced by their families. At the same time, she says, many of her peers started smoking at age 8. This just shows the serious problem of underage smoking in Indonesia. When I asked Ayu is the smoking signs in her school are working well, she hesitated for a moment before replying: “These smoking signs are not useful.” She was resigned to the situation.

The second interviewer is two boys who often smoking. They were coming merrily down the corridor. I quickly stopped them to ask about the smoking problem on campus. They said they had just finished smoking and were ready to return to class. I was very surprised. They say many classmates will smoke on campus and few will ban smoking. “Because there is no punishment for smoking at all.” said one of the boys. Another boy said his reason for smoking was to fit in with classmates and friends. In Indonesia, smoking is a social tool among boys. If you can’t smoke, you’re not a ‘cool guy’. That reason brings us to a solution. Perhaps, through the design, we can change the way that people think about smoking, and provide these students with an alternative to smoking?

The third interviewer was a tutor. We told him gently that there was smoking on campus. However, he was not surprised at all. He said that he tried to stop it yet, but he can’t change anything. The school doesn’t have any punishment for smoking. The education bureau does not allow them to take any form of punishment. And that gives us a little bit of inspiration. Designers can ‘reward’ students for choosing not to smoke.

I think these three interviews are very important, they help us to know more about the truth of the smoking status on campus and combine these realities to design. In order to change the long-term smoking status in Indonesia and protect the health of non-smokers, society and universities must implement smoke-free policies (Kaufman, Merritt, Rimbatmaja and Cohen, 2014). So, we decided to combine this information to design a truly smoke-free campus.

Reflection:

Dhumieres, M. 2013, The number of children smoking in Indonesia is getting out of control, Public Radio International. viewed 18 December 2019, <https://www.pri.org/stories/number-children-smoking-indonesia-getting-out-control&gt;.

Kaufman, M., Merritt, A., Rimbatmaja, R. and Cohen, J. 2014, ‘Excuse me, sir. Please don’t smoke here’. A qualitative study of social enforcement of smoke-free policies in Indonesia, Health Policy and Planning, vol 30, no 8, pp.995-1002, viewed <https://doi.org/10.1093/heapol/czu103&gt;.

SEATCA 2019, University of Indonesia has become a 100% smoke-free campus – Southeast Asia Tobacco Control Alliance, Seatca.org. viewed 18 December 2019, <https://seatca.org/university-indonesia-become-100-smoke-free-campus/&gt;.

The Union 2019, Indonesia, Tobaccofreeunion.org. viewed 18 December 2019, <https://www.tobaccofreeunion.org/index.php/where-we-work/priority-countries/indonesia&gt;.

Post D: Do not let your children play in the “Tobacco Industry’s Disneyland”.

Indonesia is facing very serious tobacco problem. With a population of 260 million, Indonesia has become the biggest economy in South-East Asia. However, more than 225700 people were killed by tobacco-caused disease every year. And more than 469000 children (10-14 years old) and 64027000 adults (15+ years old) continue to use tobacco each day. (Indonesia – Tobacco Atlas, 2019) What is most striking is the growing prevalence of smoking among children. By age 10, 20% had tried smoking, and by age 13, the figure was closer to 90%. (Tjandra, 2018)

Indonesia or is the only country in Asia that has not signed and ratified the World Health Organization’s Framework Convention of Tobacco Control (FCTC). Indonesia is the World’s second largest Tobacco market, tobacco industry has annual sales of more than $21 billion, accounted for 10% of all taxes, It also provides jobs for 2.5 million workers in agriculture and manufacturing. (Tjandra, 2018) There is no doubt that tobacco is a very important industry that supporting Indonesia’s finances, so tobacco companies have significant political and economic influence in Indonesia. This became an important reason for its failure to join FCTC.

And it brings a very serious problem for Indonesia — children smoking. FCTC convention includes: broad ban on tobacco advertising, higher prices and taxes, the printing of health warning labels on tobacco products, and measures to prevent people from accepting passive tobacco in addition to other tobacco control strategies. (World Health Organization, 2019) However, Indonesia is not bound by these provisions. It means in Indonesia, people can see tobacco advertisements everywhere and teenagers can smoke without restraint. This has given Indonesia the ironic nickname——”Tobacco Industry’s Disneyland”. Indonesia is the only country in south-east Asia that allows tobacco advertising. These tobacco companies say they are not targeting for young people who are under the age of 18, and limit their ads to between 9.30pm and 5am to avoid contact with children. (Indonesia Details | Tobacco Control Laws, 2019)

However, teenagers can still easily see those advertisements through many channels, such as roadside shops and restaurants, concerts, sports events and the Internet. Cigarette companies sponsor almost all the country’s concerts and sports events. (Dhumieres, 2019) Those tobacco advertisements deliver very misleading content — smoking means success, charming, courage and popularity. These contents have great appeal to children and teenagers.

Dihan, 6, has cut down to just four cigarettes a day from his usual two packs a day. And his parents are proud. (Clea Broadhurst)

Other reasons for childhood smoking are the prevalence of adult smoking and poor government regulation. Adult attraction has a serious effect on their children. In Indonesian families, parents do not avoid their children when they are smoking, and sometimes they even use cigarettes as a reward. Because cigarettes are very cheap in Indonesia. A pack of 20 Marlboros costs $1.55. In Australia, a pack of regular cigarettes costs about $20. (Tjandra, 2018) The cheap cigarettes became a source of comfort for many families. On the other hand, the government has little control over children’s smoking. Although the government banned the sale of cigarettes to minors, the law was never enforced. Teenagers can easily buy cigarettes and cigarettes from supermarkets. Some cigarette companies even distribute free cigarettes to children and teenagers at sponsored events. Prabandari and Dewi made a survey in some high schools in Yogyakarta. According to their study (2016) found that ‘cigarette advertising and incense messages indeed are targeted at char and their Perception was strongly associated with smoking status. Regulations to ban TAPS in order to prevent sanctions from smoking should be applied rapidly in Indonesia. ‘

As Jakarta Reuters said (2019), Indonesia will raise the minimum price of cigarettes by more than a third from January next year, a finance ministry spokesman said on Friday, As part of the government’s efforts to reduce smoking rates. Indonesia still has the lowest cigarette tax in the world. Rising the prices could lead consumers to switch to cheaper cigarette brands, where illegal cigarettes are still easily got in Indonesia. The government must strike a balance between cigarette companies and ordinary people, including promoting health, generating income, employment and supporting local small and medium-sized industries. (Negara, 2019) In this way, the government will not be controlled by cigarette companies and compensate ordinary workers who lose their jobs.

The proliferation of cigarettes is a very terrible phenomenon. Cigarettes are rotting away in Indonesia, so protecting the next generation is the most important problem we need to face. We must avoid our children from the ‘good’ world of cigarettes shows, avoid them from physical and mental destruction which cigarettes caused. We should let our kids have fun at the real Disneyland, not die in the ‘Tobacco Industry’s Disneyland.’

Hand-drawn Map, Bingjie

Reference:

Dhumieres, M. 2019, The number of children smoking in Indonesia is getting out of control, Public Radio International. viewed 27 November 2019, <https://www.pri.org/stories/number-children-smoking-indonesia-getting-out-control>.

Indonesia Details | Tobacco Control Laws 2019, Tobaccocontrollaws.org. viewed 27 November 2019, <https://www.tobaccocontrollaws.org/legislation/country/indonesia/summary>.

Indonesia – Tobacco Atlas 2019, Tobaccoatlas.org. viewed 27 November 2019, <https://tobaccoatlas.org/country/indonesia/>.

Jakarta Reuters 2019, Indonesia to raise cigarette prices by more than a third at start of 2020, U.S. viewed 27 November 2019, <https://www.reuters.com/article/us-indonesia-tobacco/indonesia-to-raise-cigarette-prices-by-more-than-a-third-at-start-of-2020-idUSKCN1VY17A>.

Negara, S. 2019, Commentary: The power of Big Tobacco and Indonesia’s massive smoking problem, CNA. viewed 27 November 2019, <https://www.channelnewsasia.com/news/commentary/big-tobacco-indonesia-smoking-problem-cigarettes-tax-raise-11940462>.

Prabandari, Y. and Dewi, A. 2016, How do Indonesian youth perceive cigarette advertising? A cross-sectional study among Indonesian high school students, Taylor & Francis. viewed 27 November 2019, <https://www.tandfonline.com/doi/full/10.3402/gha.v9.30914?scroll=top&needAccess=true>.

Tjandra, N. 2018, ‘Disneyland for Big Tobacco’: how Indonesia’s lax smoking laws are helping next generation to get hooked, The Conversation. viewed 24 November 2019, <http://theconversation.com/disneyland-for-big-tobacco-how-indonesias-lax-smoking-laws-are-helping-next-generation-to-get-hooked-97489>.

World Health Organization 2019, World Health Organization. viewed 27 November 2019, <https://www.who.int/fctc/en/>.

Post D: Tobacco industry dominates Indonesia

Known to have rudimentary tobacco control policies, Indonesia ranks highly among countries with the highest tobacco consumption statistics globally. With rampant and prevalent tobacco advertisement and promotion highly visible in all media, the lax enforcement of legislative policies in Indonesia has resulted in detrimental consequences to their peoples’ health. The only Asia-Pacific country that has not ratified the Framework Convention on Tobacco Control, Indonesia’s public health standards suffer as the country’s government fails to protect its citizens. 

Vital Stategies #SuaraTanpaRokok campaign targeting tobacco promotion in Indonesia (Vital Strategies, 2018).

With tobacco advertising ‘among the most innovative and aggressive in the world’ (Sebayang et al., 2012), Indonesia is evidently dominated by the tobacco industry. As advertisements and promotion for tobacco fill the streets of cities like Yogyakarta, larger companies have relentlessly implemented brand imagery and advertisement on billboards, television, in magazines, sponsorship, events, activities, interactive media and more (Prabandari and Dewi, 2016). With so much focus on advertisement is has undeniably become inevitable that the increase of smoking prevalence among the younger generation in Indonesia has increased rapidly over the years. It is said that in 2007, 99.7% of the Indonesian youth revealed to have seen tobacco promotion on television, 87% on billboards, 76% on print mediums and 81% had attended at least one event sponsored by the tobacco industry within their lifetime (Prabandari and Dewi, 2016).

Map of Yogyakarta, visual representation of tobacco promotion exposure to the youth of Indonesia (Data from Prabandari and Dewi, 2016.)

Intertwined between the legal, political and economic factors and considerations of Indonesia, the power of tobacco production within Indonesia contributes to being one of the largest sources of government revenue after gas and oil (Nichter et al., 2008). Often advertised and claimed to be a part of the culture, the Indonesian tobacco industry is decentralised as the cigarette excise taxes are one of the most important sources of national revenue, generating approximately 28 trillion rupiah ($4.2 billion US dollars) in 2006 (Nichter et al., 2008). A lack of initiative to change policies to better tobacco control within the country, the Minister of Finance stated that he ‘sympathise[s] with the idea of getting people to stop smoking, but for now, the cost is too high’ (Nichter et al., 2008).

A change that will require a strong will power from the country’s leaders, it is now more than ever that Indonesia needs to create and enforce anti-tobacco policies and legislations on a national and international level. A push for behavioural change needs to be implemented in order to save the younger generations from the harmful impacts of nicotine addiction and tobacco dependence.

References

Achadi, A., Soerojo, W. and Barber, S. 2004, The relevance and prospects of advancing tobacco control in Indonesia, Science Direct, pp.333-350, viewed 24 November 2019, <https://reader.elsevier.com/reader/sd/pii/S016885100400209X?token=23E186940EC41147619C6890FF92BBC4DF6E2743C6924063349769EFF7B9FC063DCB1F07AFA4015750A13C624CEC9F86&gt;.

Indonesia – Tobacco Atlas 2019, Tobaccoatlas.org. viewed 24 November 2019, <https://tobaccoatlas.org/country/indonesia/&gt;.

McCall, C. 2014, Tobacco advertising still rife in southeast Asia, The Lancet, vol 384, no 9951, pp.1335-1336, viewed 24 November 2019, <https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61804-3/fulltext&gt;.

Nichter, M., Padmawati, S., Danardono, M., Ng, N., Prabandari, Y. and Nichter, M. 2008, Reading culture from tobacco advertisements in Indonesia, Tobacco Control, vol 18, no 2, pp.98-107, viewed 24 November 2019, <https://tobaccocontrol.bmj.com/content/18/2/98&gt;.

Nichter, M., Padmawati, S., Danardono, M., Ng, N., Prabandari, Y. and Nichter, M. 2008, Reading culture from tobacco advertisements in Indonesia, Tobacco Control, vol 18, no 2, pp.98-107, viewed 24 November 2019, <https://www.ncbi.nlm.nih.gov/pubmed/19033331&gt;.

Prabandari, Y. and Dewi, A. 2016, How do Indonesian youth perceive cigarette advertising? A cross-sectional study among Indonesian high school students, Global Health Action, vol 9, no 1, p.30914, viewed 24 November 2019, <https://www.tandfonline.com/doi/pdf/10.3402/gha.v9.30914?needAccess=true&gt;.

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;.

Vital Strategies 2018, #SuaraTanpaRokok, viewed 24 November 2019, <https://twitter.com/vitalstrat/status/960933916063518721&gt;.

Post D : Young smokers in Yogyakarta

Daerah Ibukota Yogyakarta is Java island’s soul, where the Javanese language is the purest (Lonely Planet, 2019). Yogya or often written as Jogja is one of the most active cultural centers in Indonesia. Behind the beauty of its nature and the exotic culinary, Yogyakarta is a city where young active smokers are often found (Octavia, 2017). Research in 2005 suggests that the percentage of young active smokers in Indonesia is 38% among boys and 5.3% among girls (Ng, Weinehall & Ohman, 2006). Fast forward to 2013, another research done shows that the percentage of daily smokers has grown, and in Yogyakarta itself has reached 21.2% (Octavia, 2017). Based on research, smokers in Yogyakarta consist of two categories, one is the experimental smoker, and the other one is a regular smoker (Marwati, 2011).

The beauty of companionship: School children spend time in a convenience store in Pejaten, Pasar Minggu, South Jakarta. Some of the teens enjoy smoking while chatting.
(thejakartapost.com/Elly Burhaini Faizal)

What are the factors that may lead to a growing number of young smokers?

Indonesia itself is the top fifth tobacco consuming countries in the world (Ng, Weinehall & Ohman, 2006), and is the second-largest cigarette market in Asia (Indonesia Investments, 2016). This may happen as tobacco companies in Indonesia have a huge political and financial impact on the country, and are the government’s top five largest sources of revenue (Reynolds, 1999). The tobacco industry itself is very strong, as it employs more than 11 million workers and is the second-largest employer after the government (Nichter M, Padmawati S, Danardono M, et al, 2009). 

Another article suggests that a study revealed that youths perceived cigarette ads as encouraging them to smoke (Prabandari & Dewi 2016). Cigarette advertising can be found anywhere in Indonesia, starting from television, big billboard over the highway, magazines, and even newspapers. Besides advertisements, movies that show scenes that expose the act of smoking may be one of the encouraging factors for youngsters to smoke (Prabandari & Dewi 2016), just like how children often mimic their parents’ behavior. 

A smoking advertisement on a billboard shared by Sebastian Strangio on Twitter.
(https://twitter.com/sstrangio/status/886872286195613698)

Tarwoto (2010) suggests that some factors that may lead to the habit of smoking are social status, the pressure of colleagues, the influence of parents who smoke, and the belief that smoking will not affect health. Besides all that, Indonesia has a lack of tobacco control, as it is stated that this country is behind in terms of the Framework Convention of Tobacco Control signature and ratification (Ng, Weinehall & Ohman, 2006). 

Is there any effort done to tackle this problem?

Many have been done in order to reduce young smokers in Indonesia. One very good example that was done in Yogyakarta by one researcher, was launching a smoke-free home activity back in 2011 in 9 neighborhoods in Yogyakarta (Marwati, 2011). Smoke-free signs were put on every house, but this doesn’t mean that it forbids people to smoke, but rather to appeal to smokers to provide fresh air for other people (Marwati, 2011).

Map of Central Java, where Yogyakarta, the city where I did my research, is highlighted.

Reference Lists:

Faizal, E. B, 2016, Social media plays role in youth smoking, says expert, viewed 21 November 2019, <https://www.thejakartapost.com/news/2016/03/21/social-media-plays-role-youth-smoking-says-expert.html>.

Indonesia Investments, 2016, Tobacco & Cigarette Industry Indonesia, viewed 21 November 2019, <https://www.indonesia-investments.com/business/industries-sectors/tobacco/item6873>.

Lonely Planet, 2019, Welcome to Yogyakarta, viewed 21 November 2019, <https://www.lonelyplanet.com/indonesia/java/yogyakarta>.

Marwati, 2011, 16 Percent of Junior and Senior High School Students in Yogyakarta City are Smokers, viewed 22 November 2019, <https://ugm.ac.id/en/news/6536-16-percent-of-junior-and-senior-high-school-students-in-yogyakarta-city-are-smokers>.

Nawi Ng, L. Weinehall, A. Öhman, 2006, ‘If I don’t smoke, I’m not a real man’—Indonesian teenage boys’ views about smoking, Health Education Research, vol. 22, no. 6, pp 794–804, viewed 22 November 2019, <https://academic.oup.com/her/article/22/6/794/640787>.

Nichter M, Padmawati S, Danardono M, et al, 2009, ‘Reading culture from tobacco advertisements in Indonesia’, Tobacco Control, vol. 18, no. 02, pp 98-107, viewed 21 November 2019, <https://tobaccocontrol.bmj.com/content/18/2/98>.

Octavia, A. A, 2017, Meningkatnya Perokok Aktif Remaja di Yogyakarta (The increasing number of teenage active smokers in Yogyakarta), Kompasiana, viewed 21 November 2019, <https://www.kompasiana.com/agnessayuu/5a1fe9a72599ec3ccd0e9074/meningkatnya-perokok-aktif-remaja-di-yogyakarta-meski-sudah-banyak-peringatan-bahaya-merokok-bagi-kesehatan>.

Prabandari, Y. S. & Dewi, A. 2016, ‘How do Indonesian youth perceive cigarette advertising? A cross-sectional study among Indonesian high school students’, Global Health Action, vol. 9, no. 01, viewed 21 November 2019, <https://www.tandfonline.com/doi/citedby/10.3402/gha.v9.30914?scroll=top&needAccess=true>.

Reynolds, C. 1999, ‘Tobacco advertising in Indonesia: “the defining characteristics for success”’, Tobacco Control, vol. 8, pp 85-88. viewed 22 November 2019, <https://tobaccocontrol.bmj.com/content/8/1/85>.

Strangio, S. 2017, This cigarette advertisement in #Yogyakarta urges smokers to “never quit” #Indonesia, Twitter, viewed 22 November 2019, <https://twitter.com/sstrangio/status/886872286195613698>.

Tarwoto, 2010. Kesehatan Remaja : Problem dan Solusinya, Salemba Medika, Jakarta, viewed 21 November 2019, <https://kink.onesearch.id/Record/IOS3254.slims-687>.

Post B – Plain Impact: Australian Tobacco Control

Smoking tobacco is one of the most self-inflicted causes of death and disease in Australia to date. Despite having implemented a range of tobacco control policies since 1973 and being one of the first nations to announce the implementation of the tobacco plain packaging laws. 2010 introduced a packaging policy funded by the Australian government, implementing tobacco packaging requirements demanding all tobacco goods to display visual health warning images on 75% of the front surface area and 90% of the back surface area (Freeman, 2019). Specified for no company logos, trademarks or brand colours to be incorporated into packaging design, creative or branded aspects of company branding were replaced by product and brand descriptions identified in a grey standardised typeface and size (Freeman, Chapman and Rimmer, 2008)

Promotional Poster released by the World Health Organisation inspired by the Australian plain packaging requirements. Source: Freeman (2019)

An area of public health where the ultimate intentions and aim of targeted campaigns and policies are not so complex and nuanced like some other areas of public health. The clear intentions of protecting non-smokers, supporting smokers to quit, and reducing the numbers of new smokers, tobacco control in Australia has successfully achieved the desired results. Statistics confirm the decline in daily smokers between 1995 and 2017-18 to have decreased from 23.8% to 13.8% (4364.0.55.001 – National Health Survey: First Results, 2017-18, 2019). Further studies have also proved that connections between the execution of the plain packaging in Australia and smoking Quitline calls, resulted in a 78% increase of calls to Quitline referred to the plain packaging initiative (Magnusson, 2014).

A definite public health campaign success story the initiative holds many positives, however, the unsettling fact that ‘there is simply no other legal product sold openly on the market today that has [the] same devastating human toll’ as smoking tobacco evokes my common sense as raises the question why (Freeman, 2019). Why aren’t we doing more to raise awareness and prevent smokers from choosing to slowly kill themselves?

Today, plain packaging laws have created their impact but it is now time for more action. As society has become accustomed to the unpleasant images and warnings, new campaigns or systems need to be implemented to re-create a new impact and deter smokers. I present this opinion based on my own personal observations and relationship as smoking seems to be even more relevant than not. Whether friends are social smokers or smoke routinely, knowledge of the ugly consequences of smoking is definitely identified, however, excused by the youth factor of being young and invincible or the idea that smoking is a means to socialise. 

Living in the 21st century in Australia the health effects and dangers of smoking are predominantly well known. And although consequences are known, the act of quitting and overcoming tobacco addiction requires a strong will and defiant extra push. However, I am a strong believer in the idea small changes create a larger impact so maybe the change we are waiting for is just around the corner!

References

11A.1 Plain packaging as a solution to the misleading and promotional power of packaging – Tobacco in Australia 2018, Tobaccoinaustralia.org.au. viewed 16 November 2019, <https://www.tobaccoinaustralia.org.au/chapter-11-advertising/indepth-11a-packaging-as-promotion/11a-1-plain-packaging-as-a-solution>.

4364.0.55.001 – National Health Survey: First Results, 2017-18 2019, Abs.gov.au. 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>.

Freeman, B. 2019, Thinking outside the box: Tobacco plain packaging and the demise of smoking, Successful Public Policy: Lessons from Australia and New Zealand, pp.303-326,.

Freeman, B., Chapman, S. and Rimmer, M. 2008, The case for the plain packaging of tobacco products, Addiction, vol 103, no 4, pp.580-590,.

Magnusson, R. 2014, The association between tobacco plain packaging and Quitline calls, Medical Journal of Australia, vol 200, no 6, pp.314-315,.

Voon, P. 2018, Big tobacco vs Australia’s plain packaging, Pursuit. viewed 16 November 2019, <https://pursuit.unimelb.edu.au/articles/big-tobacco-vs-australia-s-plain-packaging>.

POST B: Does media actually influence tobacco consumerism?

Tobacco usage was a symbol of status growing up as it debuted on Malaysian mainstream media, broadcasting on national television. A notable advertisement which stuck with me was the Malboro one where in the advertisement, you were promised a lifestyle like the one portrayed by the rugged men on horses smoking chased by beautiful women. 11-year-old me would find myself in a dilemma as I pondered why smoking became something so attractive despite the fatal consequences.

Although the society we live in now is more educated about tobacco consumerism, smoking related mortality rates are still prevalent. In 2015, it is said that ‘2.5 million Australians smoke daily’ (Australian Bureau of Statistics. Australian Healthy Survery 2014/15). In America, about ‘480,000 people’ die from smoking (Centers for disease control and prevention, 2018).

Smoking rates in America, 2018.
Centers for disease control and prevention, 2018, ‘Morbidity and Mortality Weekly report’, viewed 19 November 2019, <https://www.cdc.gov/mmwr/volumes/67/wr/mm6702a1.htm>.

A decade later from my childhood, instead of glamorising tobacco consumerism, I witnessed mainstream media enter a new age as it is now used to tackle it instead. In 2012, America saw ‘the first-ever paid national tobacco education campaign’ by the Centers of Disease Control and Prevention (CDC). The campaign named ‘Tips’ (Tips from former smokers) funded by Affordable ACT care follows and documents real ex-smokers in their deteriorated state as a result from long term smoking. ‘Tips’ primary goal is to create awareness to the risks that smoking holds. Due to the campaign’s success, it has been continued to date. This year, ‘tips’ went further with their initial theme by also including people who have been affected by second-hand smoke.

Their success is owed to the use of highly graphic material in the campaign, as these ex-smokers being documented are essentially on their death beds in worst case disfigured conditions. This plays on the emotions of viewers, often prompting them to be afraid as they empathise in shock. Explicit graphic ads like ‘tips’ have become more common as they are deemed effective if the target client is human. In fact, an academic study by the Cambridge University research team carried out a shock campaign of their own primarily using fear. They found that using this in advertisements ‘significantly increases attention, benefits memory and influences behaviours among students’ (Cambridge university press, 2003).

A screenshot of a before and after of an ex-smoker Terrie from a ‘Tips’ advertisement.
Centers for Disease Control and Prevention (CDC), 2014, ‘CDC: Tips From Former Smokers – Terrie: Teenager Ad’, Youtube video, viewed 19 November 2019, <https://www.youtube.com/watch?v=_th5U5hRu8k>.

Perhaps ‘shock advertising’ could be endorsed more in locations like Central Java instead where tobacco usage is still promoted as a luxury all over Indonesia.

But despite innovate campaigns like ‘tips’, how much can these advertisements impact addicted smokers? Especially if it is only presented via online/tv media which can often be inaccessible.

References:

CDC, 2019, ‘The Burden of Tobacco Smoking’, viewed 19 November 2019, <https://www.cdc.gov/tobacco/campaign/tips/about/index.html>.


Centers for Disease Control and Prevention (CDC), 2014, ‘CDC: Tips From Former Smokers – Terrie: Teenager Ad’, Youtube video, viewed 19 November 2019, <https://www.youtube.com/watch?v=_th5U5hRu8k>.

DARREN W. DAHLKRISTINA D. FRANKENBERGE and RAJESH V. MANCHANDA, 2003, ‘Does It Pay to Shock? Reactions to Shocking and Nonshocking Advertising Content among University Students’, University of Cambridge, viewed 19 November 2019, <https://www.cambridge.org/core/journals/journal-of-advertising-research/article/does-it-pay-to-shock-reactions-to-shocking-and-nonshocking-advertising-content-among-university-students/9899C853E05CE5ED577F03314E27E01F>.


Heart foundation, 2015, ‘Smoking statistics’, Australian Bureau of Statistics, viewed 19 November 2019 < https://www.heartfoundation.org.au/about-us/what-we-do/heart-disease-in-australia/smoking-statistics&gt;.

Hunter Stuart, 2013, ”Tips From Former Smokers’ Ad Campaign Caused 100,000 Smokers To Quit, CDC Estimates’, Huffington Post, viewed 19 November 2019, <https://www.huffingtonpost.com.au/2013/09/10/tips-from-former-smokers-cdc_n_3901167.html>.

Gilling school of public health, 2017, ‘Study evaluates the CDC’s Tips From Former Smokers campaign, finds it an effective smoking cessation program’, viewed 19 November 2019, <https://sph.unc.edu/sph-news/study-evaluates-the-cdcs-tips-from-former-smokers-campaign-finds-it-an-effective-smoking-cessation-program/>.

POST D: Smoke, Eat, Drink, Repeat

Walking along the streets of Ambon, it appears one aspect of Tobacco culture is its association with positive and pleasurable experiences. This ethnographic study was effective because it encourages participation by the researcher, getting involved, seeing what life is like from the point of view of the subject (Coyne 2006).

Locally, I observed (as recorded in ‘Map My Walk Ambon 2019’ below), mostly sedentary smokers – groups of men sitting in alleyways, shopkeepers minding their market stores and drivers both old and young. They appeared to be enjoying it. Perhaps because deep breathing, even when taking in cigarette smoke, can be physiologically relaxing (as is sitting back, socialising, or having a warm drink). These pleasant things get strongly associated with the effect of the cigarette itself (Quit Tasmania 2013).

 

map my walk 1
(Map My Walk Ambon 2019)

img20190114115216
(Men Smoking 2019)

dsc_0109_2
(Men Smoking 2 2019)

This could also be said for the association of one’s identity with smoking. The cigarette is a symbol of manhood and conveys messages such as, in the words of the tobacco company Philip Morris, “I am no longer my mother’s child,” and “I am tough” (Jarvis 2004). There was not one street I walked down that I did not see a pro-tobacco advertisement using themes that are likely to be very attractive to young people, such as humour, adventure, bravery and success. (Tjandra 2018). It’s interesting to note that the dominant banner colours, red and white, are the colours of the Indonesian flag. They are considered the sacred colours of the nation as they represent the sacrifice and the struggle of the people striving toward their independence. (Asimonoff 2016). Simply through colour, smoking is now associated with freedom and courage which the people of Ambon could value.

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(Young Man Smoking 2019)

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(Go Ahead Banner 2019)

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(Pro We Are Stronger Poster 2019)

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(Pro Never Quit Banner 2019)

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(Pro We Are Stronger Banner 2019)

Nationally, the sponsoring and social marketing of music festivals by tobacco companies targets young people to associate smoking with music, creativity, and self-expression. Even though they are 18+ events, Instagram eliminates the boundary exposing the sponsorship to all social media users worldwide. Philip Morris International created an online social networking community for A brand enthusiasts and future customers. At goaheadpeople.id registrants can click on links and find activities where they can learn, meet, create and sell creative products and get involved in projects or challenges (Astuti & Freeman 2018).

It’s evident that Tobacco companies have successfully carried out Craig Lefebvre’s marketing model of scope – co‐creation, conversations, communities and markets; design – honouring people, radiating value, engaging service and enhancing experiences; and value space – dignity, hope, love and trust (Lefebvre 2013), which has resulted in a tobacco empire. In fact, on a global scale, Indonesia is known as the ‘tobacco’s industry Disneyland’ and is the only Asian country that has not signed the ratified the World Health Organization’s Framework Convention of Tobacco Control (FCTC) (Tjandra 2018).

Strategically, tobacco companies have embedded smoking culture so deeply into society that it has rewired people’s brains to think positively about it and to not even question it. It’s a social norm.

 

_____________

References

Asimonoff 2016, Colours in Indonesia, Transparent Language, weblog, New Hampshire, viewed 17 January 2019, <https://blogs.transparent.com/indonesian/colors-in-indonesian-culture/>.

Astuti, P. & Freeman, B. 2018, Protecting young Indonesian hearts from tobacco, The Conversation, viewed 17 January 2019, <https://theconversation.com/protecting-young-indonesian-hearts-from-tobacco-97554>.

Astuti, P. & Freeman, B. 2018, Tobacco company in Indonesia skirts regulation, uses music concerts and social media for marketing, The Conversation, 17 January 2019, <https://theconversation.com/tobacco-company-in-indonesia-skirts-regulation-uses-music-concerts-and-social-media-for-marketing-93206>.

Chan, M. 2019, Go Ahead Banner, photograph, Ambon, Indonesia.

Chan, M. 2019, Map My Walk Ambon, Sketch, Ambon, Indonesia.

Chan, M. 2019, Men Smoking, photograph, Ambon, Indonesia.

Chan, M. 2019, Men Smoking 2, photograph, Ambon, Indonesia.

Chan, M. 2019, Pro Never Quit Banner, photograph, Ambon, Indonesia.

Chan, M. 2019, Pro We Are Stronger Banner, photograph, Ambon, Indonesia.

Chan, M. 2019, Pro We Are Stronger Poster, photograph, Ambon, Indonesia.

Coyne, R. 2006, Creative practice and design-led research, Research Methods, viewed 17 January 2019,<http://ace.caad.ed.ac.uk/JointGrads/ResearchMethods/resources/triangulation.pdf>.

Jarvis, M. 2004, ‘Why people smoke’, The British Medical Journal, vol 328, viewed 17 January 2019, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC324461/>.

Lefebvre, C. 2012, ‘Transformative social marketing: co‐creating the social marketing discipline and brand’, Journal of Social Marketing, vol. 2 , no. 2, viewed 17 January <https://doi.org/10.1108/20426761211243955>.

Tjandra, N. 2018, ‘Disneyland for Big Tobacco’: how Indonesia’s lax smoking laws are helping next generation to get hooked, The Conversation, viewed 17 January 2019, <https://theconversation.com/disneyland-for-big-tobacco-how-indonesias-lax-smoking-laws-are-helping-next-generation-to-get-hooked-97489>.

Quitline. 2013, Stress and Smoking, Quit Tasmania, viewed 17 January 2019, <https://www.quittas.org.au/understanding-your-smoking/stress-and-smoking>.

 

 

 

Post B: Smoking Cessation Applications

In 2013, the Australian National Preventive Health Agency, a government organisation, created my QuitBuddy; a free personalised app designed to help users quit smoking (Department of Health | National Tobacco Campaign, 2019). The top-down approach is government funded and was created by a large interdisciplinary team composed of innovators, communication directors, strategists, managers, account managers and producers (My QuitBuddy, 2013). They saw an opportunity to create a support tool that would be with the user 24/7. The app targets rational, emotional and social functionality and has even created a gamification aspect (Campaign Brief, 2012).

 

Apps including and similar to my QuitBuddy are limited to simple communication; working on text-based programs. However, it offers many advantages which includes goal setting, daily reminders, progress tracking and self-monitoring. Particularly my QuitBuddy features reasons for quitting, recorded messages and photos from loved ones. It is a platform that shares success stories, distraction tips and celebrates milestones (quitnow, 2015). By presenting the risk factors of health and financial costs and benefits, the app succeeds to accommodate to most users as evidence shows younger smokers are concerned with monetary rewards of quitting whilst older populations care for the health factor (Paay, Kjeldskov, Skov, Lichon, & Rasmussen, 2015).

 

 

my Quit Buddy, Campaign Brief, 2012

 

Findings towards the effectiveness of this particular app is limited however US National Institute of Health undertook a systematic review of smartphone applications for smoking cessation. It is understood that applications such as my QuitBuddy has created a health intervention treatment that is more accessible than ever before (Haskins et al., 2017). Previously, face-to-face communication was the ideal way for treatment, but its scalability is not as wide reached as mobile access (Raw & McNeil, 1994). Through text-based support it alleviates problems such as fees, portability, connectivity, scheduling and time issues (Keoleian, Polcin and Galloway, 2015).

 

Weerakone’s thesis discovered hundreds of apps, in which 82 qualified for review; the few high performing apps were ones like my QuitBuddy who partnered with health or government agencies when critiqued against the Clinical Practice Guidelines (Weerakone, 2016). The most effective apps combined a calendar with a calculator in a colourful format making self-monitoring easy to digest; my QuitBuddy succeeded in this area by using infographics (Weerakone, 2016).

 

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Flow chart of the review process, Weerakone, 2016

 

In 2013, it was calculated that there were 200,000 downloads on iOS and Android devices which amounts to approximately 7% of all Australian smokers but more importantly; it was recorded 39% of smokers who have used my QuitBuddy managed to remain abstinent after six months (My QuitBuddy, 2013). Therefore, it is evident that this particular design intervention has been successful and fulfilled their project brief intention. It is also important to be aware of all the other applications that are available and are not made to the correct standard to achieve a positive outcome for users and communities.

 

Reference List

Department of Health | National Tobacco Campaign 2019, Health.gov.au. viewed 10 January 2019, <http://www.health.gov.au/internet/main/publishing.nsf/Content/tobacco-educat&gt;.

Haskins, B. L., Lesperance, D., Gibbons, P., & Boudreaux, E. D., 2017, A systematic review of smartphone applications for smoking cessation. Translational behavioural medicine7(2), 292-299.

Keoleian, V., Polcin, D. and Galloway, G. 2015, Text Messaging for Addiction: A Review, Journal of Psychoactive Drugs, vol 47, no 2, pp.158-176.

My QuitBuddy aims to help people quit smoking 2012, Campaign Brief Australia. viewed 11 January 2019, <http://www.campaignbrief.com/2012/06/anpha-um-develop-and-launch-my.html&gt;.

My QuitBuddy 2013, DRIVENxDESIGN. viewed 11 January 2019, <https://drivenxdesign.com/MA2013/project.asp?ID=11754&gt;.

Paay, J., Kjeldskov, J., Skov., M.B., Lichon, L., & Rasmussen, S. 2015, Understanding individual differences for tailored smoking cessation apps. Retrieved from http://people.cs.aau.dk/~jeni/jeni_homepage/publications_files/CHI2015.pdf

quitnow – My QuitBuddy 2015, Quitnow.gov.au. viewed 11 January 2019, <http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/quit-buddy&gt;.

Raw, M. and McNeillL, A. 1994, The prevention of tobacco-related disease, Addiction, vol 89, no 11, pp.1505-1509.

Weerakone, S. 2016, Examining the effects of an online intervention promoting isometric exercise in smokers, University of London, vol. 1, p47-56.

Post C: Interview with University Student Haitami

As soon as we entered Lambung Mangkurat University’s campus in Banjarmasin I instantly began to compare the differences between the serenity of the wetlands that dot the campus with start and serious nature of the UTS tower. It’s always exciting to explore another university campus and to discover the varying ways in which a sense of community is forged alongside studying a degree, except this this experience was different, being in Banjarmasin a city with which I was both unfamiliar and embarrassingly bad at communicating with people.

It was here that I met Haitami, a Business Management student at Lambung Mangkurat University and was initially quiet but opened up about his life and ideas about the cigarette industry during our conversation. Haitami is originally from a small village some five hours away from Banjarmasin named Jamil (meaning ‘beautiful’), but rather than try to make the impossible happen and travel every day, he lives about a 20 minute walk from campus during semester. Haitami’s dedication to his studies is obvious, whilst he already attends classes five days a week he is a part of various university clubs whose meetings he attends on weekends. One of these endeavours includes being a part of AIESEC, with whom he was going to Thailand the following week to undertake a short-term volunteering trip.

During our conversation, Haitami was proud to announce that he himself was not a smoker, nor a fan of the smell it created and the negative impact on one’s health, having recently lost a brother-in-law to the effects of smoking. Still, he admitted that there is pressure to smoke in Indonesia, that it is expected of men to smoke (Hodal, 2012). He enjoyed telling me that the majority of the university campus was smoke-free, creating a more comfortable environment and the ability for non-smokers to be able to breather clean air, something which is often difficult to achieve in Banjarmasin.

Nonetheless, as our conversation continued I was surprised to learn more about Haitami’s perception of the importance of tobacco companies in a variety of aspects of life in Indonesia, including their sponsorship of music festivals, sports games and providing university scholarships to students from low socio-economic areas (Tobacco Free Kids, 2013). I began to realise that Haitami, alongside other Indonesians perceive the tobacco industry as playing an integral role across many aspects life in Indonesia, even expecting it due to the wide influence they wield and their deep pockets. I found this realisation to be particularly surprising, especially in trying to understand the paradox of an anti-smoking stance with a support of the tobacco industry.

Throughout the time I spent talking with Haitami, I became more aware of some of the nuances that make up the wicked problem that smoking is in Indonesia.  Whilst much of our time in Banjarmasin we looked at the issue of the cigarette itself, the influence of tobacco companies across other aspects of Indonesian life remains a complex web of issues that will take a long period of time to unravel.

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Myself and Haitami at Lambung Mangkurat University.

References

Daffi, R, 2012, ‘Taru Martani: A Story Of Cigars And Indonesia’. Latitudes, March 14, Viewed 20 January 2018, https://latitudes.nu/taru-martani-a-story-of-cigars-and-indonesia/

Hondal, K, 2012, ‘Indonesia’s smoking epidemic – an old problem getting younger’. The Guardian, 22 March, Viewed 20 January 2018, https://www.theguardian.com/world/2012/mar/22/indonesias-smoking-epidemic

Reynolds, C, 1999, ‘Tobacco advertising in Indonesia: “the defining characteristics for success”’. Tobacco Control, Volume 8, page 85 – 88. http://tobaccocontrol.bmj.com/content/8/1/85.info

The Jakarta Post, 2013, ‘Your letters: Tobacco sponsorship of sporting events’. June 20, Viewed 20 January 2018,  http://www.thejakartapost.com/news/2013/06/20/your-letters-tobacco-sponsorship-sporting-events.html

Tobacco Free Kids, 2013, Oh Really? Tobacco-Sponsored Indonesia Jazz Festival Now Claims It’s Opposed to Youth Smoking. Viewed 20 January 2018, https://www.tobaccofreekids.org/blog/2013_02_27_jazz

Group Durian – Billboard Project ‘The Hidden Voices of Banjarmasin’

Designing the billboard in partnership with Vital Strategies and the community of Banjarmasin was an exercise of iterating and responding to feedback quickly. This went a long way in completing the final design to our satisfaction, professionally and on time. Our brief was to ‘consider local motifs, styles and language’ as well as communicate a ‘global message’. So, we wanted to promote the positivity of not smoking by mirroring Banjarmasin’s lively social media culture but to also give a voice to youths who choose to not smoke, portraying them as the real heroes.

Concept Development:

The design audit was extremely valuable in gathering observations of attitudes around smoking, cigarette consumption and sales. For example, we learned that cigarette advertising is heavily glamourised but is also banned on the main streets of Banjarmasin and can only be found in small residential areas as shown on our map below.

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Cigarette advertising is heavily glamourised in Banjarmasin and can only be found in smaller residential areas, not the main streets. (Group Durian. 2018.)

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Map of observations in Banjarmasin from 8th of January 2018. (Group Durian. 2018.)

The concept of a WhatsApp screen was based on our observations of interacting with the Indonesian youth, who are very connected with each other through messaging and Instagram. There was one point where one of our new friends asked for a WhatsApp number, but sadly none of us actually used WhatsApp. Given that the rise of youth smoking was a large focus of Vital Strategies’ work, we chose to communicate through a familiar, relatable format that would project an oppositional stance against peer pressure and the popularity of smoking in Banjarmasin. In the end, this seemed to work well as when we presented the design, Vital Strategies commented that the concept is easily transferrable across different languages and cultures.

The Design Process:

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Our process started on paper, roughly sketching out how the design would work before we worried about perfecting it on the computer. (Group Durian. 2018.)

A primary research-based approach seemed to serve our group well throughout the whole project as we based the final outcome on interviews with Banjarmasin students and residents, shown in the images below. This constant back-and-forth process of creating mock-ups and receiving feedback from the Banjarmasin youth was very effective in breaking down our assumptions and reinforcing the fact that we were designing for their city. Furthermore, this direct line of communication allowed us to pay close attention to detail so we could refine the wording and learn about cultural differences in Indonesia. For example, we discovered that android is actually more popular over here, so making that change would increase relatability. Similarly, 24 hour time is used more frequently than 12 hour time. This development is shown in our iterations below.

Throughout the design process, we were always confident in our concept early on but the actual design went through many changes as we received feedback from Vital Strategies and accommodated the uncertain billboard dimensions and logos. We had to quickly adapt when Vital Strategies suddenly told us there needed to be multiple logos as we were not sure where to integrate them smoothly. But as a group, this taught us about learning how to successfully adapt to the situation and deliver what the client wants even if we were not sure how it would initially work. Creating a billboard also taught us a lot about designing to a larger scale. As oppose to designing at the actual size like we did initially, we soon discovered that we could design at a smaller scale by using vectors so that it did not pixelate when it was scaled up. Finding vector files was especially difficult for the emojis because they are not our own design.

Reflection:

In the end, this ongoing collaborative process was worthwhile to perfect the outcome and hopefully influence some change among the youth here. This opportunity from Vital Strategies to design a billboard, and contribute on this level in an event of this scale has been exciting, daunting and rewarding. As both designers and global citizens this process has challenged us but as a result we have taken valuable lessons from not only the experience but the people and city of Banjarmasin. It has given us so much more confidence heading into the early stages of our design careers. We would like to say ‘Terima kasih!’ to Vital Strategies for giving us this unique opportunity and we will never forget our first real world clients!