W

hile in elementary school, my long vacation would be a one-month stay at my grandfather’s house in a village in Central Java known for its tobacco farms. My chain-smoking grandfather used to tell me about himself and other villagers who could make a living on growing tobacco plants.

Ten years ago, he died of chronic obstructive pulmonary disorder (COPD), a lung disease associated with smoking.

Many Indonesian tobacco farmers, like my grandfather, simply are not aware of the long-term health hazards of tobacco use. They only know that tobacco is profitable. Sadly, the government shares such ignorance. The threat looks to be the tip of an iceberg.

This year’s World No Tobacco Day highlights tobacco as a threat for development, which is relevant for Indonesia. As a developing country, Indonesia is a huge market for tobacco products.

According to the Tobacco Atlas, Indonesia’s smoking population exceeds 56 million, including 2.6 million children. According to the World Health Organization, 6 million people die from tobacco use every year, a figure that is predicted to increase to more than 8 million by 2030 without intensified action to prevent it.

This decade, Indonesia has a stronger demographic advantage than other countries simply because it has more people in their productive ages, but this bonus is meaningless if their productivity is very low because of the effects of smoking.

For ages Indonesia has been known as one of the world’s biggest tobacco producers. Tobacco giants in the country produce 336 billion cigarettes per year. By 2020, the production is expected to increase to 520 billion cigarettes per annum.

Tobacco excise contributed nearly Rp 150 trillion (US$11.25 billion) to state revenues last year. More cigarettes mean more money for the government.

However, tobacco does more harm than good according the Health Ministry, which found in 2013 that material losses from tobacco consumption hit Rp 378.75 trillion.

The figure was derived from smoking effects that contributed to a loss of productivity through illnesses, disabilities and premature death in youth and medical expenses.

Yet the economy’s addiction to easy money from tobacco excise has made the government more reluctant to fight tobacco companies, the sources of state revenues and job providers.

Tobacco companies are indeed a mighty force that can influence the government and House of Representatives to issue policies in their favor.

Given the enormous threat facing Indonesian people, tobacco control is a must for the sake of the nation’s future. According to WHO, Indonesia can do the four “best buys” in its tobacco control policy: raising tobacco excise, enforcing a comprehensive national smoke-free law and a ban on tobacco advertisement and promotion and mandating large graphic warning labels on tobacco product packages.

Emulating other countries, Indonesia should implement a minimum national tobacco price that is higher than today’s price. As a comparison, Japan sets the price of every cigarette brand almost the same at 440 yen ($3.9), three times the average price of cigarettes in Indonesia.

Cigarette purchases slash 14.5 percent off the national median income each day. If the government sets the price high, it will give a chance for many to quit because 80 percent of the smokers who are breadwinners come from the low income group.

Another option is raising tobacco excise. Last year excise accounted for 43 percent of cigarette prices, still lower than in other countries, which can charge 75 percent. Through increasing cigarette excise worldwide by $1, an extra $190 billion could be raised for development.

High tobacco excise will increase state revenues, which the government can allocate to various development activities.

From the policy side, Indonesia should ratify the WHO Framework Convention on Tobacco Control (FCTC), which guides the global fight against the tobacco epidemic.

Today, more than half the world’s countries, representing nearly 40 percent of the world’s population (2.8 billion people), have implemented at least one of the WHO FCTC’s most cost-effective measures to the highest level.

While other countries do their utmost to control tobacco, Indonesia has been too lenient and does not protect its people from its harmful effects.

On World No Tobacco Day, we realize our path to change Indonesia’s reputation as a haven for smokers and the tobacco industry is still long and winding.
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The writer is medical doctor who is pursuing a doctorate at Gunma University in Maebashi, Japan.