The 2013 Asia Pacific Association for the Control of Tobacco (APACT) Conference was held in August, 2013 in Chiba, Japan to address the prevention and control of tobacco use worldwide, with a special focus on the Asia Pacific region. One of the important achievements of the conference was the signing of A Declaration on Tobacco Control in Indonesia which was adopted by over 785 delegates from 42 countries assembled at the conference.
Unfortunately, Indonesia is not a Party to the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) and lags far behind many other Asian countries, which are Parties to FCTC and are enacting evidence-based tobacco control measures. Indonesia is an important member of the Southeast Asia (SEA) countries –which consist of the 10 countries of Association of South East Nations (ASEAN) plus East Timor. All of these 11 countries, except Indonesia, have recognized tobacco as one of the biggest causes hindering health and development and have already ratified the FCTC and are implementing it. On the contrary Indonesia, with a population of 240 million, is still allowing itself to be used as a platform to undermine tobacco control efforts.
The tobacco industry has aggressively (and perhaps successfully) tried to halt the adopting of a comprehensive tobacco control programme in Indonesia. Even as smoking prevalence and tobacco mortality rises in the country, it continues to be the world’s 5th largest tobacco market-- attractive for both local and transnational tobacco companies, so much so that the World Tobacco Asia 2012 held in Jakarta in September 2012 highlighted on its website that Indonesia is ‘a tobacco-friendly market with no smoking bans or other restrictions and regulations in contrast to neighbouring ASEAN countries’ and offered ‘the international tobacco industry a forum to build relationships and demonstrate their products and services to the Indonesian, Asia Pacific, and Australian tobacco communities.’
Smoking is largely unrestricted in Indonesia with 61.4 million or 36.1% of all Indonesian adults (67.4% of men and 4.5% of the women) currently using tobacco. Among youths aged 13-15 years, 20% smoke cigarettes (boys 41%, girls 3.5%). Nearly 80% of the smokers start before the age of 19 years. Also 97 million Indonesian non-smokers, including 70% of children less than 15 years old, are regularly exposed to second hand smoke (SHS). It is no wonder then that while smoking kills 235,000 Indonesians annually, SHS takes another 25,000 lives.
It is indeed a matter of grave concern that tobacco advertising, promotion, and sponsorship aimed at youth are rampant in Indonesia resulting in an unacceptable 400% increment of smoking prevalence among children between 5 to 9 years old and a 40% increment among those between 10 to 14 years old. Also, healthcare costs attributed to tobacco-related illnesses in Indonesia amount to IDR 11 trillion (USD 1.2 billion) every year. Indonesia’s poor households with smokers spent 11.5% of their household income on tobacco products and only about 4% for education and far less for health of their family.
Keeping in mind this mindless increase of tobacco use in Indonesia, the declaration strongly recommends that:
(i) The Indonesian government should accede to the WHO FCTC immediately, recognizing that reducing tobacco consumption substantially is an important contribution to reducing non-communicable diseases and can have significantly large health benefits for individuals and countries
(ii) The Indonesian government enact a strong tobacco control legislation that bans indoor smoking in all public places, workplaces, and public transport; bans all types of tobacco advertising, tobacco, and sponsorship; provides for larger (more than 50%) pictorial health warnings on all cigarette packs; raises price and tax (at least 70% of retail price) on tobacco products as recommended by the World Bank and the World Health Organization
(iii) The Indonesian Government ban World Tobacco Asia 2014, which will be organized in Bali, Indonesia
In an exclusive interview given to Citizen News Service - CNS, Dr Tara Singh Bam, Technical Advisor, Tobacco Control, International Union Against Tuberculosis and Lung Disease (The Union) wondered why the Indonesian government appears submissive in the face of the tobacco industry and remains hesitant to ratify the FCTC when it was involved in the setting up of the FCTC in 2003.
He said that, “Tobacco use is one of the major causes of Non Communicable Diseases (NCDs) globally. The September 2011 Political Declaration of the High-level Meeting of the UN General Assembly on Prevention and Control of NCDs, New York identified tobacco control as the most cost effective intervention to control NCDs. Their resolution No. 43 (c ) reads: accelerate implementation by Parties to FCTC, recognizing the full range of measures, including measures to reduce consumption and availability, and encourage countries that have not yet done so to consider acceding to the Convention, recognizing that substantially reducing tobacco consumption is an important contribution to reducing non-communicable diseases and can have considerable health benefits for individuals and countries and that price and tax measures are an effective and important means of reducing tobacco consumption. Indonesia was the co-chair of the session and adopted the resolution. Yet it is not complying with the commitment it had made i.e. accession of FCTC.”
Dr Bam reaffirmed that the APACT declaration is a reminder to Indonesian government that tobacco is a killer and it kills more than 200,000 people every year in Indonesia and these deaths are absolutely preventable. So urgent government actions are needed and ratification of the WHO FCTC is the only solution to prevent deaths and diseases in Indonesia caused by tobacco. (CNS)