Commentary: Indonesia's Tobacco Epidemic Is a Threat to Sustainable Development Goals


MAY 31, 2017

Today, the world is celebrating World No Tobacco Day on Wednesday (31/05) and this year's theme is, "Tobacco: a threat to development," by the World Health Organization. It encourages countries to strengthen their tobacco control strategy as an important effort to achieve Agenda 2030, or Sustainable Development Goals.

It will be too difficult in reducing one-third of premature deaths from noncommunicable diseases, cutting half the numbers of people living in poverty, and combating climate change, if we mistakenly perceive tobacco consumption as an opportunity rather than serious harm. Unfortunately, Indonesia still holds that belief.

According to the most recent WHO report, almost two out of three Indonesian males are current smokers who mostly started at ages of 15-19. The addiction has further pushed families into poverty as smokers could spend 14.5 percent of their national median income to buy 10 of the cheapest cigarettes every day. This has led to 200,000 tobacco-related deaths annually, surpassing 150,000 tuberculosis attributable mortality in 2015. Furthermore, Indonesia suffers annual losses of Rp 500 trillion ($ 37.5 billion) from the direct and indirect negative impacts of smoking, a number that outweighs the revenue gained from tobacco taxes which only contributes Rp 145 trillion annually. Thus, tobacco epidemic should not be treated as a mere health problem but also a crucial development issue.

However, the tobacco industry in Indonesia still prevails, yielding profits from people sufferings. It is estimated that cigarette sales in Indonesia were around 248 billion sticks in 2015 with 6.5 percent of the annual growth rate, makes Indonesia as the second-largest cigarette market in Asia after China. Although more than half of their market share has been taken over by international firms, tobacco companies continue to proclaim themselves — and by some groups as a tobacco farmers defender as well as the country's heritage preserver. No wonder they could conveniently interfere with tobacco control policy making, taking advantage of the already weak tobacco regulation in this country.

After they tried to smuggle out an important paragraph stating "nicotine is an addictive and dangerous substance" from the 2009 Law on Health, the tobacco industry has not stopped. They still made a move to bring the tobacco bill which included the cigarettes production growth target into the House of Representatives. Recently, the House announced that they might drop the bill if the government issues a ministerial regulation adopting substances of this proposed bill. The relentless tobacco industry's efforts bring benefits to none of the tobacco farmers, laborers and the poor. Why?

First and foremost, the tobacco industry provides less and less benefit for tobacco workers. Big companies, like Sampoerna whose more than 90 percent share owned by Philip Morris, keep cutting down the number of their laborers and shift to machine-made cigarettes. In addition to growing mechanization for these deadly sticks manufacture, cartel-like practices in the tobacco trade have turned off small and local manufacturers who relied on manual hand-rolled cigarettes. Due to the weather and monopoly of tobacco industry, farmers who still plant tobacco crops only earn one-third of those who former tobacco farmers, at Rp 775,000 per month compared to Rp 2.5 million. In nature, tobacco is an unsustainable crop which is worth less than other crops such as potato, corn, rice and tomato. The most staggering fact is that Indonesian and multinational tobacco firms make money off the backs and health of many child workers who exposed to hazardous nicotine, pesticides and other toxic chemicals.

Secondly, tobacco farming harms the environment as it requires large amounts of pesticides and fertilizers, which can be toxic and pollute water supplies. This business uses 4.3 million hectares of land, resulting in global deforestation between 2 percent and 4 percent. About 1.69 billion pounds of cigarette butts wind up as toxic trash. Additionally, tobacco manufacturing produces over 2 million tonnes of solid waste. This figure clearly demonstrates that the tobacco industry perpetuates climate change.

Lastly, tobacco endangers equality as the industry markets its product aggressively to women and children. Despite the hike of cigarette retail price almost every year, cigarettes are getting more affordable even for the poorest and youngsters. This potentially creates the economic gap even larger in the future. We could also lose our invaluable demographic bonus in the next 20-30 years if the young generation keeps puffing on the cigarettes either actively or passively. The last survey suggests the government should increase the cigarette prices threefold to Rp 50,000 per pack in average, to reduce 72 percent consumption. However, this might not come into force until the House amends the 2007 Law on Excise Tax which restricts the excise tax at a maximum of 57 percent of the retail price.

We should admit that tobacco destroys not only our body but also our growth as a sovereign nation. Therefore, a smoking addiction is not merely a personal responsibility. The narrative of tobacco should go beyond health. Indeed, the government must take real action instead of only showcasing symbolistic celebration for Wold Tobacco Day every year. We failed to achieve most of Millennium Development Goals because we began too late and acted fragmentedly. Now, the 2030 Agenda has become a new opportunity to start it off again by prioritizing and incorporating tobacco control in every development agenda. Likewise, as individuals, we can speak up against the myth by the powerful tobacco industry who repeatedly sway the public's opinion.

Beladenta Amalia is an Indonesian physician currently based in London and is a master of public health candidate at Imperial College London. She is also an Indonesia Endowment Fund for Education recipient. Her views are her own.