Indonesia’s smoking epidemic – an old problem getting younger

26-Mar-2012 Intellasia | guardian.co.uk | 7:01 AM Print This Post

A cloud of smoke hovers above his small frame, a cigarette dangling at his lips. As he blows rings high above his head, 14-year-old Faisan explains why he has just bought his third cigarette of the day. “When I have a problem to solve – and I have so many problems at school – I have a smoke,” he says. “It relaxes me and makes me forget.”

In most other countries, the fact Faisan is an underage and regular smoker would be startling. But in Indonesia, he is but one of thousands across the archipelago – a nation of islands where nearly 70 percent of men aged 20 and over smoke, and where the average starting age has fallen from 19 a decade ago to just seven today, activists say.

There is no minimum age limit on smoking or buying cigarettes in Indonesia, which explains why videos of smoking Indonesian toddlers exist on YouTube – such as that of two-year-old Sumatran Ardi Risal, who regularly smoked 40 cigarettes a day before undergoing treatment.

Last week, another child – this one, eight-year-old Ilham on the island of Java – made local headlines for smoking two packs a day and flying into a rage if he couldn’t have his fix. “He spends his whole day smoking and playing,” his father told local news agency Antara, adding that Ilham, who started smoking aged four, would “smash glass windows or whatever’s around” if he wasn’t allowed to smoke.

Eght-year-old Aldi Ilham smokes a cigarette at his house in Sukabumi, Indonesia. Ilham started smoking when he was four. Photograph: Bayu Aji/EPA


Although half of Indonesia’s population survives on less than GBP 1.20 a day, cigarettes are the second-largest household expenditure after food, according to official statistics. “Smoking is a rite of passage here,” explains office clerk Andre Kuntaro, 23. “If you don’t smoke, it’s like you’re not Indonesian.”

According to the National Commission for Children’s Protection, nearly 2 percent of Indonesian children start smoking at the age of four. The World Health Organization says the practice has risen 600 percent in the past 40 years in this nation of 240 million, where, despite increased taxes on tobacco, a standard pack of 20 costs only around 75p, with many street stalls selling single sticks for as little as 1,000 rupiah (about seven pence).

Anti-smoking activists have long pointed to Indonesia’s feeble industry regulations, as well as its failure to ratify the WHO Framework Convention on Tobacco Control, as proof that the government is doing too little to tackle a massive problem.

“For the umpteenth time, the Indonesian government is reminded by these child smokers that smoking addiction in Indonesia has already reached full alert, is real and needs further handling,” said Arist Merdeka Sirait of the National Commission for Children’s Protection. The commission aims to sue all cigarette manufacturers that market their products in Indonesia and has called for a ban on all tobacco advertisements, as well as for producers to provide health facilities to treat nicotine addiction.

Smoking is a way of life

Dr Boy Luwia, who heads a free health clinic for low-income groups in Tangerang, 15 miles west of the capital, Jakarta, says that smoking is “a way of life in Indonesia” and that most patients never consider quitting “until they get so sick they have to”. “For young smokers, quitting is very, very difficult. Unfortunately, for those of any age who want to stop, I can’t recommend them standard therapies like the patch or nicotine gum, because they can’t afford them. So I just suggest they try something else, another activity.”

Indonesian doctors know their “suggestions” are nearly meaningless without government help, but they argue there is little else they can do. So many Indonesians, too poor – and too addicted – to quit their habit, continue to smoke despite knowing they are harming themselves.

“I really want to stop smoking – I try to every day – but it’s impossible, I need it,” says Jakarta-based student Teddy Iswarita, 25, who took his first puff at 12 and has smoked a pack a day ever since. “My doctor told me to imagine something positive instead, like candy, every time I want a cigarette, but that didn’t work. All my friends smoke, my family smokes, the whole city smokes. I figure I’ll be smoking until I die, and maybe that’s why I will die.”

According to the WHO, smoking claims around 425,000 Indonesian lives a year and is responsible for nearly a quarter of all annual deaths. Though the practice is banned in an ever-increasing number of public areas, including healthcare facilities, public transport, schools and universities, everywhere else – from restaurants to indoor offices – it is allowed.

Cigarette adverts – many of them showing fit, happy, middle-class Indonesians – are plastered everywhere: on billboards, along roads, in magazines, in newspapers and on TV. Television adverts often depict teens in absurdly inspirational circumstances, climbing mountains, taking on adversaries, and living their dreams in a world where courage, adventure, freedom, independence, romance and excitement rule. Many of the bigger brands’ adverts have found a viral home on YouTube, where videos such as those from Sampoerna’s “Go Ahead” campaign – clearly targeted at Indonesia’s upmarket, internationally aware youth with its Britpop music backdrop – show a glossy production of teens haunted by their black-clad alter egos until they are brave enough to carve out their own destiny.

School sports event

Sampoerna is the country’s largest cigarette maker and is owned by Philip Morris. In other adverts by popular brands Gudang Garam and LA Lights, messages reading “Others are acting, but I’m the real thing” and “Real freedom comes from following your heart” flash at the end. Many such brands are major sponsors of youth-oriented nights out such as music concerts and cultural events, and sometimes sponsor school sports events.

“Things are better now than they were several years ago, but when we talk about tobacco, we’re talking about big companies and the government,” says Dr Dita of the independent Indonesian Cancer Fund, alluding to the fact the tobacco industry currently employs thousands across Indonesia and is estimated to generate $7bn (GBP 4.4bn) in revenue for the Indonesian government every year. The wealthiest man in Indonesia, Robert Budi Hartono, is a tobacco billionaire and owner of Djarum, the world’s third-largest producer of clove cigarettes.

It is perhaps telling that smoking is primarily a man’s activity. The number of women smoking in Indonesia is extremely low – at just 5 percent of the female population compared with 20 percent in the UK. While some women themselves argue that it is “dirty and ugly”, social stigma also surrounds their taking up the practice, with many men citing it as “too unhealthy, dangerous and bad”.

“I wouldn’t want my girlfriend to ever smoke,” says 14-year-old Faisan. “Women have babies and if they smoke then that’s bad for the baby. So they should never start.”

http://www.guardian.co.uk/world/2012/mar/22/indonesias-smoking-epidemic

 


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