Cardiovascular diseases contributed to 353 million disability-adjusted life years globally in 2016, of which 44% were attributed to smoking (Gakidou et al., 2017; Naghavi et al., 2017). Similarly, smoking was among the top contributors to disability-adjusted life years in Indonesia in 2017, particularly among males (Mboi et al., 2018). Smoking prevalence among men (15+ years) is among the highest in the world at 67%, while that among boys (13-14 years) is high at 36.2% (Ministry of Health, 2011; World Health Organization, 2018). The smoke-free policy (SFP), recommended by the Framework Convention on Tobacco Control, has been among the most effective policy against smoking. Previous studies showed that it is associated with reduced smoking rates in the United States, reduced indoor smoking in the United Kingdom, lowered secondhand smoke exposure in New Zealand, reduced myocardial mortality in Belgium, and increased indoor air quality in 15 countries in North America and Europe (
Introduction: Comprehensive tobacco control policies are lacking in Indonesia where smoking prevalence in males is among the highest in the world. This study aims to explore the knowledge, attitude, opportunities and challenges to tobacco control among local stakeholders. Methods: This is a qualitative study using in-depth interviews. Four study areas included Bengkulu Province, Bengkulu City, Seluma District, and Kaur District. Eighteen participants interviewed were from policymakers, legislators, and civil societies during November-December 2020. Thematic data analysis was used. Results: While knowledge and support of the existing Smoke Free Policy (SFP) were high, that of other policies such as outdoor tobacco advertising (OTA) ban and tobacco product display ban were low. Among others, one opportunity was there is already SFP regulation in each study area, to which such bans can be added. Among others, three major challenges were: (a) lack of enforcement of the existing SFP, (b) lack of national regulation to ban OTA and product display, and (c) counter actions by the tobacco industry. Conclusion: The opportunities and challenges identified could be lessons learnt for more comprehensive tobacco control especially by local governments in Indonesia and other countries with similar settings.
Bengkulu merupakan provinsi dengan tingkat perokok tertinggi kedua di Indonesia, yakni 27,8% dari penduduknya yang berusia 10 tahun ke atas merokok setiap hari. Data statistik pada tahun 2018 terdapat sekitar 28,14% penduduk Provinsi Bengkulu menderita hipertensi dan 33,8% terkena stroke akibat konsumsi atau terpapar nikotin. Salah satu upaya dari pemerintah Bengkulu mengatasi bahaya rokok adalah dengan mengesahkan Peraturan Daerah No 4 tahun 2017 tentang Kawasan Tanpa Rokok. Namun, sampai sekarang, Perda tersebut belum efektif terlaksana. Studi ini bertujuan untuk menggali bagaimana pelaksanaan Perda di wilayah KTR, apa saja penghambat dan bagaimana solusi dalam implementasi Perda KTR di Provinsi Bengkulu. Penelitian ini merupakan studi lapangan dengan pendekatan penelitian kombinasi (mixed methods). Tahap pertama mengumpulkan dan menganalisis data dengan metode kuantitatif dan tahap kedua, mengumpulkan dan menganalisis data menggunakan metode kualitatif, survei, wawancara dan observasi selanjutnya dianalisis dengan model Miles dan Huberman. Studi ini menemukan bahwa pelaksanaan Perda KTR di Provinsi Bengkulu belum berjalan efektif karena masih lemahnya komitmen pemerintah baik eksekutif maupun legislatif dalam empat aspek utama. Pertama, belum adanya kesepahaman di internal pemerintah tentang urgensi regulasi teknis terkait implementasi Perda KTR tersebut. Kedua, masih minimnya sosialisasi Perda KTR kepada masyarakat, terbukti sebesar 49,5% responden belum mengetahui adanya perda KTR. Ketiga, belum tersedianya anggaran dana bagi dinas terkait untuk melakukan penegakan Perda KTR di masyarakat. Keempat, belum adanya upaya pelibatan peran serta anggota masyarakat dalam pengawasan orang merokok di wilayah KTR. Selain tindakan tidak langsung, beberapa tindakan langsung seperti hukuman denda serta sanksi sosial sangat disarankan dalam mengatasai permasalahan tersebut.
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