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Smoking in Indonesia: Strong public health response required
Smoking is extraordinarily common in Indonesia. Anecdotes of children smoking and friends exchanging cigarettes as gifts abound. The statistics underscore just how valid those anecdotes are.
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Smoking Consultation, nicotine patch illustration (Shutterstock/Image Point Fr)
O
ne of us recently took a trip to Indonesia. Upon stepping out of the airport in Indonesia, her nostrils widened in response to the kretek (clove cigarette) scent in the air, and her eyes widened at the sight of just how many men were smoking kretek.
With each passing day, such scents and sights became commonplace, and she came to appreciate just how embedded smoking is in the everyday culture of Indonesia. Our foundation recently examined why that is so. The resulting report brought three key insights into sharp relief.
First, smoking is extraordinarily common in Indonesia. Anecdotes of children smoking and friends exchanging cigarettes as gifts abound. The statistics underscore just how valid those anecdotes are.
Recent data reveal that Indonesia has one of the highest―if not the single highest―rate of smoking in the world, with nearly 34 percent of adults being smokers, according to the Health Ministry’s Basic Health Survey (Riskesdas, 2018). Men make up almost all of these smokers, with over half of all Indonesian men reporting that they smoke and virtually all women reporting that they have never smoked.
The reasons for this are complex and multifactorial. Culture plays a critical role but so, too, does economics. Indonesia has a large tobacco industry and, by extension, is home to many whose livelihoods depend on tobacco across the value chain.
Other influences include policy (Indonesia has not signed the World Health Organization’s Framework Convention on Tobacco Control), social perception (many appear to perceive smoking as not only acceptable, but also desirable among men) and medical training (four out of five physicians report needing more training in smoking-cessation practices – see Yayi Suryo Prabandari et. al “Laying the groundwork for Tobacco Cessation Education in Medical Colleges in Indonesia”, Education for Health, 2015.
Second, the resulting toll of such widespread smoking is striking. Studies estimate that over 290,000 Indonesians died of tobacco-related deaths in 2019. That is nearly an order of magnitude more than the number of Indonesians who have died of COVID-19 since the start of the pandemic, and it is a toll that is exacted year after year after year.
