Indonesia: 65% of men consume tobacco

The new report from the Global Adult Tobacco Survey (GATS – 15 years and older)[1] 2021 provides an overview of the tobacco situation in Indonesia since 2011, when the last survey was conducted. It shows that one-third of Indonesian adults remain active smokers, reflecting no significant change over the past decade. In addition, it highlights a tenfold increase in the use of new tobacco and nicotine products over the same period.

The Global Adult Tobacco Survey (GATS) is a nationally representative household survey conducted in 32 countries. It aims to monitor tobacco use among individuals aged 15 and over and to measure key indicators of tobacco use. The results help countries that conduct it design, implement and evaluate tobacco control programmes.

Very high tobacco consumption among men

The report states that in Indonesia, 34.5 % of adults, or 70.2 million people, use tobacco (smoked, chewed or heated tobacco). Nearly 27% are daily users. The percentage of smoking among men in this survey conducted in 2021 was 65.5 % and 3.3 % among women. Considering current smokers and former smokers, only 17.5% of men aged 15 and above have never smoked in this country.

The highest prevalence of daily smokers was found in the age groups 25–44 years (37.7%) and 45–64 years (33.9%). Among the types of cigarettes used, kretek cigarettes (cigarettes containing tobacco and cloves) were the most commonly used, with 28.6% of those aged 15 years and older (55.5% of males and 1.7% of females). The percentage of smokers consuming only manufactured cigarettes was 6.2% and that of hand-rolled cigarettes was 6%. A total of 2.1 million of those aged 15 years and older (1.0%) in Indonesia were current users of smokeless (chewing) tobacco. The prevalence of current smokeless tobacco use is limited with no particular gap between women (1.1 %) and men (0.9 %). Finally, 0.3% of individuals were currently using heated tobacco.

Increase in the use of electronic cigarettes

E-cigarette use has increased tenfold over the past decade, from 0.3 % in 2011 to 3 % in 2021. Among current users, 2.3% vape daily, with the highest prevalence among adolescents and young adults aged 15–24 years (7.5%). Overall, the main reasons for current e-cigarette users to use e-cigarettes are socialization (62.7 %), flavors (62.6 %), enjoyment of use (43.6 %), and smoking cessation (30.3 %).

Quitting smoking remains difficult for consumers

According to the survey, 63.% of the 70.2 million Indonesian smokers had the intention to quit or were considering quitting. Despite this strong motivation, only 43.8TP3T reported having tried to quit smoking in the past 12 months and nearly three-quarters (73.3%) tried on their own and without professional help or treatment. A greater proportion of women (49.8%) than men (43.6%) tried to quit smoking. For the 15-24 age group, 53.6TP3T of them tried to quit.

Only 38.9% of smokers who visited health facilities were asked about their smoking, highlighting a critical gap that urgently needs to be addressed, according to WHO.

In response to these challenges, the Indonesian Ministry of Health collaborated with WHO, representatives from various ministries and government agencies, and members of civil society organizations and academia to raise awareness of the importance of tobacco cessation support. The aim is to develop key recommendations for a national action plan to improve cessation services across Indonesia.

Exposure to passive smoking remains high in public places

Today, some 309 cities and districts in Indonesia have adopted smoke-free policies, covering approximately 192 million people. However, compliance rates remain low and exposure to second-hand smoke in public places remains high. A total of 91.81% of individuals reported exposure to second-hand smoke in coffee shops, 74.2% of adults were exposed to second-hand smoke in restaurants, and 44.8% were exposed to second-hand smoke at their workplaces. 43.1% were exposed to second-hand smoke at universities and 40.1% were exposed to second-hand smoke on public transportation. In schools, 25.1% of those aged 15 and above reported exposure to second-hand smoke.

Delay in implementing anti-smoking measures

Indonesia is one of the few countries in the world that has not ratified the WHO Framework Convention on Tobacco Control due to a strong tobacco industry lobby. Advertising of tobacco products is still widespread. More than three-quarters of the population (75.3 %) have noticed advertisements, sponsorships or promotions for a tobacco product in the past 30 days in various public places and media. The five media in which cigarette advertisements were most noticed were television (50.7%), cigarette shops (43.7%), large billboards (43.6%), posters (39.1%) and public walls (24.9%). 64.8% reported having noticed information in public places about the dangers of tobacco use.

Cigarette prices in Indonesia were among the lowest compared to other countries in the Asia-Pacific region. To date, there is no ban on the sale of single cigarettes by street vendors. At around €0.10, cigarettes remain very affordable, making it easier to buy and consume tobacco; this encourages smoking initiation and makes quitting more difficult. However, Indonesian Health Minister Budi Gunadi Sadikin intends to reverse these sales modalities[2] and recently indicated that he wanted to raise the age of sale of tobacco products to 21. The minister also plans to ban the sale of tobacco products near establishments frequented by children (schools, playgrounds) and to ban advertising for tobacco and vaping products on the Internet and social networks.

While health professionals have welcomed the minister's recent commitment, they warn of the need to monitor the implementation of these measures. In addition, some of the bans put in place by the government are only partial since the sale of single cigarettes only concerns manufactured cigarettes but not cigars or kreteks which are the most consumed by Indonesians.

©Tobacco Free Generation

AE

[1] World Health Organization. Country Office for Indonesia. (‎2024)‎. Global Adult Tobacco Survey (‎GATS)‎ Indonesia Report 2021. World Health Organization. Country Office for Indonesia. https://iris.who.int/handle/10665/378343. License: CC BY-NC-SA 3.0 IGO

[2] Generation without tobacco, Indonesia introduces new anti-smoking measures to protect children and adolescents, published on August 4, 2024, accessed on August 22, 2024