Despite international pressure, Indonesia is among the few countries in the world that have neither signed nor ratified the World Health Organization (WHO) sponsored Framework Convention on Tobacco Control (FCTC). Douglas Bettcher, the WHO Tobacco Free Initiative director, recently spoke to The Jakarta Post about the importance of the convention for Indonesia, where around one-third of the country’s total population of 237 million smoke. Here are some excerpts from the interview:
Question: Can you tell us more about the convention?
Answer: The FCTC, adopted by the 56th World Health Assembly on May 21, 2003, is aimed at creating an environment in which people can make informed, healthy decisions about cigarette use. It’s not [about] telling people what they must or must not do, or prohibiting cigarettes.
People in Indonesia are exposed to communications strategies and signals that encourage them to smoke, even more so than in some other countries.
For instance, billboards and TV commercials are still allowed to promote cigarette products. Then there are the cheap prices [for cigarettes], the absence of pictorial warnings about the dangers of smoking on cigarette packets and tobacco company-sponsored music concerts or fashion shows. Indonesia is a Disneyland for such companies, an environment in which the tobacco industry flourishes because of low tax restrictions, an absence of comprehensive services to help people to quit and very few public places that ban people from smoking.
The FCTC is one of the most successful and widely received conventions, in support of which 171 United Nations member states have already signed and ratified. Indonesia finds itself increasingly isolated in the global efforts to control tobacco use. US President Barack Obama has indicated the US will ratify the treaty, and now it is a matter pushing it forward to the senate. Brazil, a country with even larger tobacco farming and tobacco manufacturing sectors, has signed the treaty. So have the world’s most populous nations, China and India. They don’t have any problems with being part of the treaty.
Does it mean the convention aims to drive tobacco companies out of business?
We’re not trying to force them out of business, but we’re trying to create a “utopia” where the environment is in favor of a healthy decision-making process, especially for young people.
But in reality, it’s different here. There is a whole discussion about cigarettes not being addictive, or about tobacco providing economic benefits for Indonesia. This is absolute hypocrisy. Tobacco companies have manipulated scientific evidence related to the dangers of smoking. They are feeding the government and the people with propaganda by creating myths and false scientific research on the effects tobacco has on health.
For instance, one company that actively operates in Indonesia started using a free-basing technology to manipulate nicotine and make it appear less addictive. They add ammonia, a chemical compound used in kitchen bleach products, to cigarettes in order to release nicotine much freer and faster in the blood stream. This will make the nicotine strike your brain receptor faster and provide a much quicker boost. Drug dealers do this when they produce “crack” cocaine.
How can tobacco consumption hurt Indonesia’s economy?
Tobacco use is a risk factor behind six of the eight leading causes of death in the world, such as heart disease, chronic respiratory conditions and lung cancer. All are preventable, non-communicable diseases whose health care expenses cost Indonesia US$1.2 billion every year.
Indonesia currently has 57 million smokers, equivalent to 36 percent of the country’s total population—an increase of 26 percent since 1995. Tobacco is so addictive that many poor families in Indonesia prefer to spend a larger proportion of their income on cigarettes than on education and basic necessities for their children.