Insight: Tobacco control: Are we protecting children's rights?
Leaders’ envoy and board chair for the Asia Pacific Leaders’ Malaria Alliance (APLMA)
Jakarta / Mon, September 10, 2018 / 09:39 am
I have been an antismoking and tobacco control activist for over 25 years. I have concerned myself with children’s health, wellbeing and rights for longer than that. I write today to call for more attention on the interplay between these important issues and to urge the strengthening of rights-based work in this field, particularly as it relates to children and adolescents.
The negative impact of both active and passive smoking on the health of people of all ages is well documented. The Global Burden of Disease Study shows the importance of smoking as a risk factor in disease, disability and mortality. It shortens life and reduces the quality of life for millions of people around the world.
In Indonesia, the personal and financial costs of smoking are huge. Between 2005 and 2015, tobacco was the third most important risk factor to health. Users of the Healthcare and Social Security Agency (BPJS Kesehatan), uninsured individuals and people choosing private care pay for the expensive treatment of a wide range of tobacco-related illnesses like cancers, respiratory problems, stroke and cardiovascular diseases.
Children are more vulnerable than adults to the ill effects of tobacco smoke and smoking. In fact, children’s very right to life, survival and development are all at risk if they grow up surrounded by smoking adults or if they take up smoking themselves. Tragically, the harm caused by teen smoking can be life threatening and lifelong. It can lead to early tobacco addiction. Furthermore, cigarette smoking by preteens and adolescents is often the first step in a disastrous succession of events — experimentation with narcotics including use of injected drugs and the possibility of death from overdose, infection with HIV, hepatitis C and other lifelong ailments that reduce life expectancy, productivity and quality of life.
I raise this issue in connection with Indonesia’s hosting of the 12th meeting of the Asia Pacific Association for Control of Tobacco (APACT) in Bali on Sept. 12 to 15. Since 1989, APACT has promoted shared learning, exchange of experience and formation of networks to address the global challenges of smoking and tobacco control in our own settings.
This year’s theme of the APACT meeting is Tobacco Control for Sustainable Development: Ensuring a Healthy Generation and includes workshops on youth work, strategic communication, smoking cessation, litigation and media advocacy. World class leaders and experts in tobacco control will address plenary sessions, updating participants on science, policy and practice related to the most immediate challenges in the field, namely the tobacco control agenda to accelerate progress on the sustainable development goals, the impact of tobacco taxation on the economy and poverty reduction, tobacco, trade, interference and good governance, and the great debate on electronic cigarettes — would public health benefit?
The 2018 APACT meeting provides an ideal opportunity to strengthen promotion and integration of the human rights perspective, particularly child rights in our advocacy, education and journalism related to tobacco control and antismoking. Such an approach can definitely help mobilize new partners and move us forward toward achieving a tobacco-free world to which we aspire.
The issue of tobacco control and antismoking are not exclusively health issues or issues of marketing and economics. It is a fundamental issue of child rights and the protection of our children to provide the mental, physical and social environments that will allow healthy development and a full range of life choices as children grow.
Indonesia takes pride in having been selected as the host of APACT 12. Shamefully, Indonesia remains one of the few countries that have not yet acceded to the Framework Convention on Tobacco Control. We are known as the home of an aggressive tobacco industry and weak monitoring, despite existing national tobacco control regulations.
Yet we find good things happening at the local level — youth work, media coverage of tobacco related issues, community leadership, local regulation and implementation. In May this year, Tomy Patria Edwardy of South Tangerang in Banten was honored by the Indonesian National Committee for Tobacco Control for sustained community leadership, leading to a community of more than 400 households free of tobacco sales and smoking, who are committed to maintaining a community free of addiction — of both narcotics and cigarettes. Other communities have also banded together and created positive, healthy environments for their children. Such efforts are admirable and encouraging, but not yet enough to reduce the negative impact of smoking-related ill health and death for people across the Asia-Pacific.
The date Nov. 2, 2019 is the 30th anniversary of the United Nation’s adoption of the Convention on the Rights of the Child (CRC). This UN instrument, a straightforward but comprehensive statement of mutually interactive and indivisible rights, has long since been accepted by Asia-Pacific countries.
In line with APACT 12’s theme, I urge that we increase our use of this widely accepted instrument and the rights approach to strengthen our work in achieving a tobacco-free world. Through our APACT partnership, let us set ourselves the task of celebrating and honoring 30 years of the CRC by developing policies, tools and guidelines to help ourselves move more effectively and further to achieve two mutually supportive goals: effective tobacco control and reduction of smoking across the Asia-Pacific, and create the opportunity for more of our children to enjoy their full right to life, survival and development without the threat of tobacco smoke at home or in the community.
The writer is a pediatrician and was the health minister from 2012 to 2014. She was also a member and chairperson of the United Nations Committee on the Rights of the Child from 1997 to 1999.