Indonesia struggles to offer quit services to smokers

According to the latest Global Adult Tobacco Survey in Indonesia, 63% of Indonesia's 70.2 million smokers intended to quit or were considering doing so. Despite this strong motivation, existing smoking cessation services in the country fail to effectively support these individuals.

According to the same report, only 38.9% of smokers who visited health care facilities received advice to quit smoking, highlighting a critical gap that the WHO says urgently needs to be addressed.[1].

The burden of smoking in Indonesia

Among Indonesian adults (aged 15 and over), 34.5% of Indonesian adults use tobacco, including nearly two-thirds of men (65.5% of Indonesian men), one of the highest prevalence rates in the world. There is a worrying increase in the prevalence of smoking among women, but there is also a steady increase in the prevalence of smoking among minors aged 10 to 18. Nearly 300,000 Indonesians die each year from tobacco use, and 50,000 of these deaths are caused by secondhand smoke.

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. Tobacco advertising is still widespread, and tobacco control and ban regulations remain insufficient to protect Indonesians and limit access to tobacco products, particularly among children and adolescents.

The need to provide cessation support services for smokers

In response to these challenges, the Indonesian Ministry of Health collaborated with WHO to organize a national planning meeting on smoking cessation. The main objectives were to raise awareness of the importance of smoking cessation support, identify challenges, and develop key recommendations for a national action plan to improve these services throughout Indonesia. The meeting brought together 45 representatives from various ministries and government agencies, as well as members of civil society organizations and academia.

Dr. Dongbo Fu, a physician in charge of smoking cessation at WHO headquarters in Geneva, shared WHO recommendations and best practices from around the world. He emphasized the need for a comprehensive system of cessation incentives and treatments, integrating population-level approaches, intensive individual interventions, and the use of medicines from the WHO Reference List of Essential Medicines. All participants agreed to increase access to cessation services by providing more training to health professionals so that they can offer smoking cessation advice to all patients throughout the care pathway. They also proposed leveraging digital technology with the development of mobile cessation applications to ensure that more people can access smoking cessation support.

A treatment policy through the management of smoking cessation is, however, only one aspect of a tobacco consumption reduction strategy, which must be comprehensive to be effective. A cessation policy is particularly difficult to implement independently, even from the healthcare system, in the absence of other protective regulations, particularly with regard to preventing the onset of smoking.

Very timid progress in the fight against smoking

Recently, Indonesia has made some progress in adopting tobacco-free policies. 456 cities and districts, representing approximately 86% of all Indonesian cities and districts, have adopted the establishment of smoke-free spaces. However, the effective implementation of these regulations still leaves much to be desired. One of the main obstacles is the lack of measurable data and monitoring tools to ensure the effective implementation of these policies.[2].

According to the Global Adult Tobacco Survey, an alarming number of adults are exposed to secondhand smoke: 74% were exposed in restaurants, 51% in public buildings or offices, 45% in indoor workplaces, and 41% on public transportation. Establishing smoke-free spaces is a particularly cost-effective measure that not only protects individuals from secondhand smoke, but also helps change social norms surrounding smoking and encourages smokers to quit.

Last December, the Indonesian Ministry of Health called for stronger tobacco control measures to curb tobacco consumption. It wants to increase taxes on tobacco and vaping products and limit advertising for these products; it particularly denounced the freedom enjoyed by tobacco companies in this regard.

AE