Policy fragmentation a major obstacle to tobacco regulation in Indonesia

A study of tobacco-related regulations adopted by Indonesia during the years 2014-2020 points to the lack of coherence of public policies and the absence of real political will as major obstacles to reducing consumption in the country.

Indonesia is one of the few countries that has neither signed nor ratified the WHO Framework Convention on Tobacco Control. As the world's second largest tobacco producer and keen to preserve this agro-industrial sector, the country has a high prevalence of smoking (63% among men, 5% among women, 34% in total; the highest prevalence in the world among men today).[1]It is also a country that has not seen a decline in smoking in the last twenty years, due to the lack of a coherent national policy on the subject; smoking among 10-18 year-olds even increased from 7 to 9% between 2013 and 2018.

Conflicts of interest between ministries

A team of Indonesian and international researchers looked at national tobacco laws adopted in Indonesia between 2014 and 2020.[2]. These laws differed markedly depending on the ministries from which they originated: those from the Ministry of Health sought to protect the population from smoking and tobacco smoke, while those issued by the Ministries of Finance and Industry tended to protect local tobacco and cigarette producers. The Ministry of Communication and Information was characterized by years of silence on the subject of tobacco advertising; it was only after being publicly challenged by the Ministry of Health in June 2019 that it decided to take measures against advertising on the Internet and social networks.

Despite significant advocacy work by health stakeholders calling for stronger anti-smoking measures, the lack of political will and the proximity of many policy makers to the tobacco industry seemed to prevail throughout this period. The lack of clarity and inconsistency of tobacco policy would explain in particular the persistence of a high prevalence of smoking in this country when it was falling in surrounding countries. An observation that ultimately led to significant increases in tobacco taxes in 2020 and 2021, increasing retail prices by more than 35%, but which nevertheless remain among the lowest in the world.[3]An ambitious plan for anti-smoking measures supported by several ministries was also presented in March 2021, giving hope for a boost in favor of public health.

Necessary political coherence around the fight against smoking

The contradiction between public health imperatives and the protection of economic interests is widespread, particularly in tobacco-producing countries. The Indonesian case is a reminder that tobacco reduction policies face not only interference from the tobacco industry, but also competition between different ministries within the same government.

It is to avoid this dispersion of efforts and the tension between divergent interests that the WHO Framework Convention on Tobacco Control strongly recommends, in its article 4.2, the adoption of "comprehensive multisectoral measures and coordinated actions" to support tobacco control policies.[4]In 2012, the Court of Auditors made a similar observation for France, estimating that the fight against smoking "requires a coherent and simultaneous use of all the tools [prevention, prices, taxation, regulations, help to stop smoking, repression of trafficking] because favouring one instrument only leads to results that are not very sustainable"[5]To this end, it recommended the installation of "a steering, action and results monitoring system", enabling the coordination and evaluation of actions, which was brought to fruition in 2014 with the launch of the National Tobacco Reduction Plan (PNRT).

Keywords: Indonesia, interference

©Tobacco Free Generation

M.F.

[1] Generation Without Tobacco, Decryption, When the tobacco industry has a free hand: the Indonesian case,published on March 11, 2020, (accessed on 08/20/2021)

[2] Kramer E, Ahsan A, Rees V, Policy incoherence and tobacco control in Indonesia: an analysis of the national tobacco-related policy mix. Tob Control 2021;0:1–8. doi:10.1136.

[3] Generation Without Tobacco, Indonesia: discreet increase in tobacco taxes, published on December 15, 2020, (accessed on 08/20/2021)

[4] World Health Organization, WHO Framework Convention on Tobacco Control. 2003, 42 p.

[5] Court of Auditors, Anti-smoking policies. Evaluation report, December 2012.