Roadmap to a tobacco epidemic: transnational tobacco companies invade Indonesia

Abstract

Background Indonesia is the world’s fifth largest cigarette market in the world but for decades, transnational tobacco companies (TTCs) have had limited success infiltrating this market, due to their inability to compete in the kretek market. Kreteks are clove/tobacco cigarettes that most Indonesians smoke. Objective To determine how Phillip Morris International (PMI) and British American Tobacco (BAT) have now successfully achieved a substantial market presence in Indonesia. Methods We analyzed previously secret, tobacco industry documents, corporate reports on Indonesia operations, the Tobacco Trade press, Indonesia media, and “The Roadmap.” Results Internal, corporate documents from BAT and PMI demonstrate that they had known for decades that kreteks are highly carcinogenic. Despite that knowledge, BAT and PMI now own and heavily market these products, as well as new more westernized versions of kreteks. BAT and PMI maintained the basic strategy of keeping cigarettes affordable by maintaining the social responsibility of smoking and opposing smoke-free workplace laws but in the 21st century, they added the acquisition of and Westernization of domestic kretek manufacturers as an additional strategy. These acquisitions allowed them to assert influences on health policy in Indonesia and to grow their business under current government policy embodied in the 2007-2020 Roadmap of Tobacco Products Industry and Excise Policy which calls for increased cigarette production by 12% over the next 15 years. Conclusion PMI and Bat have successfully entered and are expanding their share in the Indonesia cigarette market. Despite the obvious and pervasive influence of the tobacco industry on policy decisions, the Indonesian government should ratify the FCTC and implement effective legislation to reduce tobacco consumption and exposure to tobacco smoke and revise the Roadmap to protect future generations of Indonesians.

Inadequate collaboration: A challenge to reaching global targets for non-communicable disease control and prevention

“…Many critics of the government's weak NCD control policies have commented on the negative influence of industries on policies. 6,7 It appears to us that other factors are at play too -notably ineffective interactions between the key stakeholders.…”

A Cross Sectional Study of Kretek Smoking in Indonesia as a Major Risk to Public Health

“…Eugenol has been classified as a possible human carcinogen (WHO International Agency for Research on Cancer, 1985) and could be more detrimental to pulmonary tissues than other major constituents of kreteks (Polzin et al, 2007). It also has anesthetic properties that allow smokers to tolerate higher concentrations of total particulate matter, or tar (Hurt, Ebbert, Achadi and Croghan, 2012). Similar to eugenole, coumarin and anethole are found in conventional cigarettes at a lower level, and present health risks when inhaled in high levels (Polzin et al, 2007).…”

Contesting Tobacco-Control Policy in Indonesia

“…15 Mietzner 2013. 16 Lawrence and Collin 2004;Hanafiah 2011;Hurt et al 2012. I also seek to contribute to the small, but growing, literature on the politics of tobacco control in developing countries. 17 In general, this literature has portrayed tobacco-control policy in developing countries as externally driven.…”