This year, the World Health Organization (WHO) is taking momentum from the World No Tobacco Day on 31 May 2012 to remind the world of the tobacco industry’s efforts to weaken the WHO Framework Convention on Tobacco Control (FCTC).
According to the WHO, the tobacco industry today is daring to fight the government’s tobacco-
control program. The WHO states that, in its bid to resist the adoption of health warnings on packets of tobacco products, the industry has filed a lawsuit against individual countries under bilateral investment treaties, claiming that the warning intrudes companies’ rights to use their legally-registered brands.
The tobacco industry has aggressively tried to halt the FCTC due to the potentially destructive impact it can have on the industry. The core demand-reduction provisions in the FCTC are price and tax measures, and non-price measures to reduce the demand for tobacco, such as protection from exposure to tobacco smoke; regulation of the contents of tobacco products; regulation of tobacco-product disclosures; packaging and labeling of tobacco products; education, communications, training and public awareness; tobacco advertising, promotion and sponsorship; and demand-reduction measures concerning tobacco addiction and cessation.
Indonesia currently has 57 million smokers, equivalent to 36 percent of its total population. It is a big market for the tobacco industry. Despite the increasing number of campaigns on the hazards of smoking, according to a survey, cigarettes are only second to rice in terms of priority spending among poor families.
Altough it is explicitly stated that smoking can cause a number of diseases, ranging from coronary heart disease to sexual dysfunction, still cigarette consumption increases.
Nowadays, the major concern about smoking in Indonesia is the increasing number of women and child smokers. According to the Health Ministry, only 1-2 percent of all smokers were women in 2007 but during the intervening four years, that number has risen to 6 percent.
Imam Prasodjo, a sociologist from the University of Indonesia (UI), says that if the number of female smokers continues to climb, Indonesia’s future generation will be at risk as many children will be born unhealthy, having been subjected to cigarette smoke while in the womb.
Similarly, the national survey in 2007 revealed that the number of child smokers had multiplied by 6 times since 1995, to 426,000. According to Arist Merdeka Sirait from the independent National Commission for Child Protection, the growth of child smokers in the country has reached an alarming level. We can see how easily a student can buy cigarettes in the mini market near his school or watch a video posted on YouTube of a young Indonesian child who smoked almost one pack of cigarettes a day.
The other cause for concern is the tactics employed by the tobacco industry, which cleverly encourages the younger generation to smoke. There are still a great deal of music concerts and sporting events sponsored by the tobacco industry. The industry knows that its sponsorship will help it build a good image among the young and thereby multiply its sales of cigarettes.
Furthermore, local and foreign musicians do not feel ashamed if their concerts are sponsored by the tobacco industry, despite their responsibility as role models. In Europe, this is a big issue as evinced in the social fine handed down to Real Madrid player Fabio Coentrao who was banned for several games after the media spotted him smoking.
These facts should provide justification to the Indonesian government to do more to fight and control tobacco. But, why does our government remain hesitant to ratify the FCTC and appear submissive in the face of the tobacco industry?
One of the reasons is because of the government’s addiction to easy-to-get revenue from cigarette tax excise, which last year reached Rp 16.5 trillion (US$1.75 billion). But, if the government calculates well, it should push for tobacco-control programs because, according to the Health Ministry, health spending on smoking-associated diseases hit Rp 127.4 trillion in 2004 alone.
Without any bold anti-tobacco regulations, the government will only leave the tobacco industry uncontrolled while, at the same time, children, women and adolescents remain unprotected from smoking hazards.
Concrete action should be taken in the form of regulations; moral sanctions; awareness campaigns; advertising prohibitions; tax increases on packs of cigarettes; raising awareness of the diseases associated with smoking spelled out on cigarette packets; building clinics to help people stop smoking and training more counselors for people who want to quit smoking.
Indonesia can learn from the Uruguay Ministry of Health and its Egyptian counterpart, which respectively require compulsory health warnings to be printed on cigarette packs and have increased tobacco excise duty to 70 percent. The two ministries won Bloomberg awards during the World Conference of Tobacco or Health in 2012.
Indonesia needs a strong government to tackle the tobacco industry’s intervention in the tobacco-control program. To honor World No Tobacco Day, the government should act to control tobacco.
The writer is a physician.