Contesting Tobacco-Control Policy in Indonesia

Abstract

Over the past decade and a half, the Indonesian government has progressed fitfully and inconsistently toward a stricter tobacco-control policy regime, albeit without much impact on the country's worsening tobacco epidemic. This article explains this pattern of reform in terms of the unequal but changing relationship of power between tobacco companies and tobacco farmers, on the one hand, and tobacco-control advocates based in NGOs, health professional organizations, universities, and international organizations, on the other. The first of these coalitions has had greater structural leverage, better political connections, stronger organizational capacity, greater ability to mobilize popular forces, and more capacity to cultivate a positive public image. But the second coalition has been able to exercise some influence over policy because of changes wrought by democratization. In this analysis, the author engages with the literatures on (1) Indonesia's political economy in the post-New Order period and (2) the politics of tobacco control in developing countries. With regard to the former, the author argues that we need to give greater attention to the role of actors previously excluded from the policy-making process than is currently the case. With regard to the latter, the author contends that more focus is needed on domestic actors and political institutions in shaping tobacco-control policy. Looking to the future, the author suggests that further progress in Indonesia's tobacco-control policies will be contingent upon an ongoing process of struggle; however, there are signs that the tide is turning in favor of the second coalition.

Children’s Exposure to Secondhand Smoke during Ramadan in Jakarta, Indonesia

“…While progress towards the objectives of the FCTC have been claimed by the Indonesian government [9], failure to ratify the FCTC has slowed progress toward those goals [35]. Ratification and full implementation of the FCTC by the government of Indonesia will provide a mechanism (under Article 20.4) for monitoring and responding to tobacco industry activities that undermine the implementation and enforcement of the legislation [20,37]. Evidence has shown that implementation of comprehensive bans is associated with adjustment and acceptance of bans by smokers [38], social denormalization of smoking [2], increases in voluntary home smoking bans [39,40,41], and decreased SHS exposure among children [42].…”

“…Evidence from Thailand and Malaysia suggests that regional support for comprehensive indoor bans is high, even when compliance is a challenge [43]. Community and religious organizations, local governments, and civil society should respond to the failure of current smoke-free policies in Indonesia by developing collaborative relationships in support of the enforcement of current laws [37]. With a comprehensive smoke-free policy that is properly enforced, Indonesian children and their families may benefit from smoke-free public venues not only during Ramadan, but at all times of the year.…”

Why is tobacco control progress in Indonesia stalled? - A qualitative analysis of interviews with tobacco control experts

“…Tobacco companies in Indonesia maintain a positive reputation through their perceived contribution to revenue, farming, and employment. [24] Meanwhile, tobacco farming is not a major contributor to the agricultural sector, accounting for only 200,000Ha, less than 1%, of the farming area, [25] yet it is seen as important especially in the tobacco growing provinces. TCEs highlighted that the government is "protecting" the tobacco industry and relies on cigarette revenue, which will significantly undermine tobacco control.…”

“…There is a longstanding power imbalance between the tobacco industry network and the tobacco control network in Indonesia, that heavily favours the industry. [24] While some progress in tobacco control advocacy has occurred at both the national and subnational level, it has not shifted the power balance. This third theme comprises sub-themes represent the two networks; namely the established and well-funded tobacco industry networks and the younger and less resourced tobacco control networks.…”

“…[32] The term "uang rokok" meaning "cigarette money for tipping" is still widely used. [24] Cigarettes have always been part of being a good host during social occasions [32]. These common practices are then manipulated by tobacco companies through aggressive marketing, advertising and promotion, which then preserve and overblow positive views around smoking as part of the culture, as normal and socially acceptable behaviour.…”