Wednesday, November 2, 2016
Indonesia - Quitting is harder for Indonesian smokers
Quitting smoking is hard for anyone given the addictive quality of the nicotine found in cigarettes, but in Indonesia, where 67 percent of men smoke and cigarette advertising is ubiquitous, the challenge is even greater.
The prevalence of smoking in Indonesia has become so high that people who try to quit smoking are constantly surrounded by active smokers and easily relapse.
“The reinforcement challenges in Indonesia are very strong. People who have quit smoking will start smoking again once they see their neighbors smoking and smell the smoke. They might also see cigarette ads and start smoking again,” Widyastuti Soerojo of the Public Health Scholars Association (IAKMI) told The Jakarta Post.
This has led to an extremely low quitting ratio for smokers in Indonesia. According to data from the World Health Organization (WHO), the quitting ratio for men in Indonesia is only 9 percent and 23.2 percent for women.
Lioni Hendrawaty, a 30-year-old NGO worker, is an example of someone who finds that the temptation to smoke again after quitting is too hard to resist.
Lioni has been a smoker for 14 years. Throughout that time, she has tried repeatedly to quit smoking. She said she noticed her breath getting shorter and was later diagnosed with hypothyroid, a common disorder in which the thyroid gland does not produce enough thyroid hormone. Her doctor then asked her to stop smoking as her habit would only exacerbate her illness.
But she kept smoking. “Actually I had succeeded in reducing my cigarette consumption to one daily. At the most, I smoked three cigarettes in one day,” she said.
According to Lioni, the hardest part of quitting smoking is when she hangs out with her friends, most of whom are smokers. “The most difficult part is when I hang out. If I am alone, I don’t smoke,” she said.
University of Indonesia (UI) demographic institute associate director Abdillah Ahsan said that Indonesians have a hard time giving up as smoking is the norm in the country.
Smokers who want to quit will be constantly seduced by people smoking around them as well as constant cigarette advertising.
“Access to cigarettes is very easy. If I live in a housing complex, I will find a kiosk selling cigarettes just a few doors from me. It’s also easy for children to buy cigarettes. If they step out of their schools, they will find food stalls. Above the foodstalls will be a banner advertising cigarettes,” Abdillah said.
Furthermore, public officials are often shown to be smoking in public spaces, such as lawmakers in the legislative building.
“They are public figures so they should have to follow the rules and not smoke inside the legislative building. Because it’s seen widely by the public and it becomes free advertising for the tobacco industry,” said Abdillah.
Cigarettes are also dirt cheap in Indonesia, making it easy for people to buy them. “All of these make smoking normal. So why should I quit smoking? It’s normal anyway. The thing that’s not normal is quitting smoking,” Abdillah said.
Therefore, it is important to denormalize smoking, to make it uncool as the stakes are too high for Indonesia.
While the government often argues that the tobacco industry brings in much-needed revenue, with
Rp 148.86 trillion (US$11.3 billion) raised in tobacco excise this year alone, the economic loss from tobacco consumption is much greater.
In 2013, the total losses due to tobacco consumption reached Rp 378.75 trillion, according to the Health Ministry, resulting from lost productivity due to illness, disability and premature death and medical expenses.
Indonesia’s economy is also expected to lose $4.5 trillion by 2030 from tobacco-related diseases.
Therefore, experts have urged the government to increase tobacco prices to deter people from smoking as well as to help people reduce and even quit smoking.
The Health Ministry has also launched a series of public-service announcement (PSA) TV advertisements, with the latest launched on Thursday.
The latest PSA aims to turn smokers’ thoughts about quitting into active quitting attempts by showing graphic images of real health harm from tobacco use, starting with a cancerous mouth, rotting teeth, a cancerous throat and clogged arteries.
Hans Nicholas Jong