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Controlling tobacco: Case of children's human rights
As of today, 67.4 percent of Indonesian males are smokers.
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Indonesia currently holds the world’s highest growing rate of new, young smokers. (Shutterstock/File)
I
ndonesia currently holds the world’s highest growing rate of new, young smokers. If its commitments to curb cigarette consumption remains low, in the next decade we will have the world’s largest population of smokers.
As of today, 67.4 percent of Indonesian males are smokers. This poor tobacco consumption control is a result of blunt tobacco control policies and tobacco industries’ aggressive marketing and promotion.
Over the past two decades, the number of Indonesians aged 10 to 14 who smoke has doubled and even tripled for those aged 5 to 9 years old. These devastating figures contribute to today’s staggering smoking prevalence among youths, as 41 percent of children aged between 13 and 15 are smoking, and almost 20 percent of adolescents first tried cigarettes before they turned 10.
The ever increasing number of active smokers among the younger generations will jeopardize the quality of future generations and affect our expected demographic dividend.
It is important to highlight the human rights of children regarding tobacco control. Children are regularly exposed to secondhand smoke, and when approximately 90 percent of smokers start before 18, children are seen as “replacement smokers” by the industry. Protecting children is thus critical if we want to curb the devastating impact of tobacco use and exposure in Indonesia.
The Convention on the Rights of the Child, a treaty that Indonesia ratified in 1990, compels governments and third parties to protect and promote a range of rights relevant to tobacco control.
These include children’s right to health and the general norm that a child’s best interest shall be the primary consideration in applying the treaty. Therefore, governments are obligated to protect children against the harmful effects of tobacco.
With the commemoration of National Children’s Day on July 23 we need to examine the measures being taken to reduce tobacco use among children.
Some dimensions that affect tobacco consumption are availability, accessibility and affordability. Government Regulation No. 109/2012 on tobacco states areas where children play and study must be smoke-free.
Schools, where children spend most of their time besides at home and where they develop habits and long-lasting behaviors, should be free from tobacco advertisements that promote ease in availability.
However, the 2014 Global Youth Tobacco Survey confirms that regardless of the ban, many schools are surrounded by cigarette advertisements, posters and banners, with youth-oriented messages attached to the walls of vending cigarettes stalls. Without any age restriction being applied effectively, cigarettes are completely accessible for children.
While many countries set a floor for tobacco excise tax in their laws to ensure tax efficacy in controlling consumption, the law in Indonesia sets a ceiling instead.
This restraining clause results in the constant affordability of cigarettes, despite a slight increase in pricing. In 2000, to purchase 100 packs of cigarettes, 8.6 percent of per capita gross domestic product (GDP) was required, while by 2010, this had declined to 3.7 percent.
Cigarette prices have become 56 percent more affordable in Indonesia since then. In fact, in Southeast Asia, the price of Indonesian cigarettes is among the cheapest and could be purchased in single sticks — affordable for children, despite restrictions.
When necessary policy making has taken place, its implementation still falls short.
When children are at stake, stakeholders must boost all efforts to protect them. At the grassroots level, civil society organizations such as Lentera Anak has creatively empowered children and youths to conduct surveys on the impact of the existing excise regulation to cigarette prices.
The results proved children can still easily buy cigarettes with the low prices. This should be advocated as an example to improve regulations that affects their lives.
At the policy level, multisectoral approaches are available for the government to decrease tobacco consumption and exposure in a child’s environment.
These options include advertising and display bans that have been closely associated with reduced smoking among youths.
The prohibition of smoking in public spaces and raising tobacco taxes significantly so cigarette prices are less affordable to children have also been related with health benefits.
Introducing a wider range of policymakers can also be an advantage. While the debate on tobacco control has largely fallen into the domain of health and economics, the issue of children’s rights requires the close involvement of others, such as the Women’s Empowerment and Child Protection Ministry, Education and Culture Ministry, and the Youth and Sports Ministry.
Having these institutions as decision makers in the formulation of relevant regulations such as advertising bans, smoke-free areas and tobacco excise will ensure policies are made with the best interest of a child.
While human rights-based reasoning has done well in general to prompt changes in social rights and health policies, it is necessary to apply the same consideration in protecting the rights of children in the context of tobacco control.
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Anindita Sitepu is a health psychologist with a master degree from Leiden University and Fadjar Wibowo is a global health physician with a master’s degree from the Karolinska Institute. Both work for the Center for Indonesia’s Strategic Development Initiatives (CISDI).
