Under a planned new regulation, the Health Ministry is looking to control the promotion and packaging of e-cigarettes, which have remained unregulated since their legalization in 2018.

The ministry is also seeking to increase the size of graphic health warnings on tobacco packaging from 40 to 90 percent, ban the advertising, sponsorship and promotion of tobacco products and prohibit the selling of single cigarettes.

Imran Agus Nurali, the ministry's director of health promotion and community empowerment, said that authorities were currently seeking to revise Government Regulation (PP) No. 109/2012 on the restriction of addictive tobacco substances for health.

The ministry argues that the prevailing regulation is no longer sufficient to prevent underage smoking.

"Underage smoker numbers continue to increase each year, especially following the legalization of e-cigarettes. We need stronger measures to reduce tobacco consumption to protect our future generations from the impact of smoking," Imran said in a webinar on Thursday.

Imran explained that based on a survey in Timor Leste, which has implemented 90 percent graphic health warnings on tobacco packs, increasing the size of the warning has proven to be effective in discouraging people from buying cigarettes and deterring first-time smokers.

Banning the advertising, sponsorship and promotion of tobacco products is also crucial as according to the 2019 Global Youth Tobacco Survey (GYTS), around 65 percent of Indonesia's children are exposed to tobacco ads through television, point-of-sale advertising and billboards.

Indonesia is the only country in the Southeast Asia region that still allows cigarette advertising in television and printed media.

According to the World Health Organization in 2021 some 144 countries in the world had totally banned the advertising, sponsorship and promotion of tobacco products in mass media and at point-of-sale.

Imran said that it was also important to prohibit the sale of single cigarettes.

Purchasing individual cigarettes tends to be more attractive to youth and could serve as a gateway for underage smoking, largely due to the fact that they are sold without warning labels and cost less up front.

Aside from revising the prevailing tobacco regulation, the government has also touted the idea of further increasing the cigarette excise tax next year.

Earlier this year, the Finance Ministry raised tobacco excise by 12 percent, leading to an average 35 percent increase in cigarette prices.

Worsening problem

Some 34 percent of Indonesia's population, 70.2 million people, are smokers with around 75 percent of them having started smoking before the age of 20.

Out of that figure, around 52 percent started consuming cigarettes between the age of 15 and 19 and around 23 percent started smoking when they were 10 to 14 years old.

The National Child Protection Commission (KPAI) commissioner Jasra Putra said it was important to ban advertising, sponsorship and promotion of tobacco products to curb the prevalence of youth smoking.

"Studies have shown that children between the ages of 13 and 18 who are exposed to cigarette advertising are 2.7 times more likely to start smoking compared with those who aren't," Jasra said.

The prevalence of children smoking continues to increase in Indonesia each year. In 2016 the prevalence of cigarette smokers under the age of 18 was 8.8 percent. The rate increased to 9.1 in 2018 and to 10.7 in 2019.

Statistics Indonesia (BPS) estimates that this figure could reach 16 percent, if the government does not carry out serious intervention to reduce tobacco consumption.

According to data from the Health Ministry, tobacco kills around 290,000 people in the country each year and in 2017 the economic burden of smoking in the country amounted to 531.8 trillion, roughly 3.6 times greater than the tobacco excise revenue that year.

Indonesia is one of the biggest tobacco markets in the word and cigarette sales continue to rise in the country, largely due to lax regulation and high affordability of tobacco products. In 2021, cigarette sales increased by 7.2 percent compared with the previous year, from 276.2 billion cigarettes to 296.2 billion.

The country is one of seven nations around the globe that is yet to ratify the World Health Organization's Framework Convention on Tobacco Control (FCTC).

Yet, despite the growing health concerns, efforts to implement stricter tobacco controls continue to be met with resistance from industry players. The Health Ministry has been seeking to revise the 2012 PP since 2018, but the progress remains sluggish.