Jakarta. With one of the largest adult smoking populations in the world, Indonesia on paper seems particularly vulnerable to Covid-19 since the disease attacks the body's respiratory system. But try telling that to the more than 100 million active smokers in the country who so far seem unfazed by the epidemic. 

Nadya, a 44-year-old housewife, smokes light cigarettes and is not planning to reduce her smoking habit because of Covid-19. "I don't go outside much and have been staying home all day since the pandemic began. I think smoking or not smoking won't affect [my chances of getting infected], so I smoke anyway," she said.

Sukma Adji, a 22-year-old office worker, said he has not cut down on his smoking habit, but switched to lighter cigarettes. "I have not reduced my smoking, but now I only smoke low-nicotine cigarettes. I don't see myself stopping just because of Covid-19," Adji said.

Mohammad Kabus, a 25-year-old intern, now smokes hookah every day. He said he had reduced his cigarette intake and switched to hookah since the pandemic began, but not because he was afraid of Covid-19.

"I've cut down a lot on smoking cigarettes for the past two months, but that's because I had been very busy, not because of Covid-19. I don't care [about Covid-19's effect on smokers], we're all going to die one day anyway," he said.

The National Tobacco Control Commission, the Association of Indonesian Pulmonologists and the Eijkman Molecular Biology Institute have warned that smoking increases the risk of Covid-19 infection and might cause complications from the disease.

On March 8, World Health Organization (WHO) Indonesia issued a statement reminding Indonesians of the link between Covid-19 and smoking behavior.

"Smokers are at high risk for heart and respiratory diseases, which are factors in severe Covid-19 infections and complications. This means smokers in Indonesia are at high risk for Covid-19," N. Paranietharan, WHO's representative in Indonesia, said.

Chinese researchers said male Covid-19 patients in China were often found in worse condition than female patients. This they said might be attributed to the fact that most heavy smokers in China are men.

In a study by Chinese doctor Wei Liu, out of a total of 78 Covid-19 patients under his care, eleven got worse and 67 got better within two weeks. Twenty-seven percent of the patients whose conditions became worse had a history of smoking, while only three percent of the patients who improved smoked.

"People need to know that smoking can aggravate Covid-19 complications. We need to be more alert to this fact since Indonesia has a very high number of male smokers," Amin Soebandrio, the director of the Eijkman Institute, said.

According to data from the World Population Review, almost 40 percent of Indonesia's 273 million population are smokers. More than 76 percent of the country's adult males – above 15 years old – are smokers. Only 3.6 percent of Indonesian women smoke, the data showed.

A study by the University of Indonesia projected 144,000 deaths from Covid-19 in Indonesia over the next two months if the government continues with its voluntary physical distancing advice and does not restrict travel. This even before taking into account the prevalence of smokers among the population. 

However, despite the warnings, die-hard Indonesian smokers are loath to throw out their cigarettes.

Siti Yuni, a 26-year-old shopkeeper at an Indomaret convenient store in Tangerang, Banten, said she had not seen any reduction in sales of cigarettes in the store since the government started reporting Covid-19 cases in Indonesia. "Cigarette sales have been steady, motorcycle taxi drivers still buy their cigarettes here," Siti said. 

More than 240 billion sticks of cigarettes are sold in Indonesia every year. Most of them are produced by three listed tobacco companies – Gudang Garam, HM Sampoerna and Bentoel Internasional Investama – who posted combined sales of Rp 231 trillion ($14 billion) last year.

Fortunately, some smokers have started to heed the health warnings. 

Deascy Kalalo, a 23-year-old office worker in Jakarta, said she immediately stopped smoking after Covid-19 started hitting Indonesia in early March. "I heard that Covid-19 attacks smokers and causes black spots in the lungs. I'm scared so I stopped smoking," she told Jakarta Globe.

Syerdan Wijaya, a 29-year-old employee, stopped smoking his electronic cigarettes since he was declared a person under surveillance (ODP) for Covid-19 and told to self-isolate for two weeks.

"Since I became an ODP, I stopped smoking my e-cigarettes. I'm now waiting for the result of my swab test. If it's negative, I might take up smoking again," he said.

Abdullah Hamid, who being a 60-year-old is medically considered to be more vulnerable to Covid-19, said he had reduced his smoking not because of Covid-19, but because he suffered from lung problems.

"I now smoke one pack a day, less than normal [which was two packs a day]. I still smoke regardless of the virus. As long as I wear masks, I believe I will be fine," he said.