An important Declaration endorsed by over 1500 experts has
called upon Indonesia to ratify the lifesaving global tobacco treaty and hold
tobacco and nicotine industries liable. The declaration also calls for
implementing several other proven measures to protect its children and people
from deadly tobacco and nicotine products.
Of all the countries in the world, Indonesia is among one
of the only 8 nations globally that has neither signed nor ratified the global
tobacco treaty, formally called the World Health Organization Framework
Convention on Tobacco Control (WHO FCTC). This treaty was the historic first
public health and corporate accountability treaty of the UN health agency, WHO.
It is no surprise that tobacco smoking is shockingly high
in Indonesia, resulting in preventable diseases and untimely deaths of epidemic
proportions. Indonesia's economic losses due to tobacco-related diseases and
lost productivity are colossal.
"Indonesia is facing a severe tobacco crisis that
is costing more than IDR 288 trillion every year (over US$ 16 billion) and
claiming around 270,000 lives annually. Tobacco use is also worsening
Indonesia's tuberculosis epidemic and driving the growing burden of heart
disease, stroke, cancer, chronic respiratory disease, and diabetes. Most
concerning, millions of children and Gen Z are being relentlessly targeted by
tobacco and nicotine marketing. The government must take bold and urgent action
by strengthening tobacco control policies, ratifying the WHO Framework
Convention on Tobacco Control (FCTC), and protecting public policies from
tobacco and nicotine industry interference. Public health, not industry profit,
must be the priority," said Dr Tara Singh Bam, noted global health
advocate who leads Vital Strategies as Asia Pacific Director for Tobacco
Control. Dr Bam was awarded by the Indonesian Ministry of Health for his
dedicated contribution to advancing health in the country for almost two
decades.
In Indonesia, the situation is deeply alarming - tobacco
smoking prevalence is among the highest in the world. In 2023, 28.6% of the
population aged 15 and above were active smokers.
High tobacco consumption is a leading cause of
death, disproportionately affecting the poor and vulnerable in Indonesia.
Exposure to second-hand smoke remains a pervasive threat.
More than 78% of adults and 60% of children are exposed to tobacco smoke at
home or in public places.
11th ICTOH Declaration
1524 experts at the 11th Indonesian Conference on Tobacco
Control (11th ICTOH) in Surabaya, Indonesia, unanimously endorsed this
Declaration. While health ministers of 192 countries are meeting at the 79th
World Health Assembly (WHA79) in Geneva, this national meeting has put the
spotlight on national and sub-national actions which can be advanced for public
health and rights.
Double trouble: TB and tobacco
Tobacco smoking is a common major risk factor for several
deadly non-communicable diseases, such as heart diseases and stroke, cancers,
chronic respiratory illnesses, and others. Tobacco smoking is also a strong
risk factor for infectious diseases like TB.TB is the deadliest infectious
disease globally.
In many TB high-burden countries, malnutrition or
undernutrition is the biggest risk factor along with HIV, diabetes, tobacco and
alcohol. In Indonesia, tobacco use is the biggest risk factor for TB, as per
the WHO Global TB Report 2025.
The 11th ICTOH Declaration also underlines this: “About
319,000 TB cases, or approximately 30% of the total annual tuberculosis burden,
are linked to smoking. This poses a serious obstacle to the efforts to end
tuberculosis in Indonesia. Existing regulations are insufficient to
comprehensively address the tobacco epidemic. Urgent and robust evidence-based
action, in line with the WHO global best practices, is needed.”
Key asks
The Declaration calls on Indonesia's national and
sub-national governments, parliament and other stakeholders to:
* Ratify the WHO FCTC as a
national priority in health and development.
* Comprehensively ban all forms of tobacco and
nicotine product advertising, promotion, and sponsorship across
all media, including digital marketing, product displays, brand extensions,
sponsorships, events, and CSR activities by the tobacco and nicotine industry.
As the use of e-cigarettes (or vaping) and heated tobacco products continues to
rise, threatening public health, it has to be banned. Such harmful products are
rapidly gaining popularity, especially among younger people. Studies show that
more than10% of urban adolescents have tried or are currently using
e-cigarettes. According to the Global Adult Tobacco Survey (GATS), e-cigarette
use increased tenfold from 0.3% (2011) to 3.0% (2021). Indonesia must ban
tobacco and nicotine product advertising, promotion, and sponsorship.
* Increase excise taxes and prices of tobacco
products: Increase excise taxes on tobacco products, targeting
a minimum of 75% of the retail price as recommended by the WHO and the World
Bank, and simplify tax structure to reduce affordability, especially for young
people. Nicotine products must be banned as per earlier demand.
* Increase the size of health warnings and standardize
packaging: Increase pictorial health warnings to a minimum of
90% and standardize packaging to strengthen health education messages and
eliminate industry marketing elements.
* Optimize implementation of smokefree
policies: Expand and strictly enforce 100% smokefree policies
in workplaces, public spaces, and public transportation.
* Ban e-cigarettes and new tobacco and nicotine
products: Prohibit the production, sale, marketing, and use of
e-cigarettes, heated tobacco products, nicotine pouches, and other nicotine
products.
* Protect public policy from tobacco and
nicotine industry interference: Protect tobacco control
and public health policies from industry interference by adopting a code of
conduct to prevent all forms of interaction and cooperation between government
institutions and the industry.
* Optimize smoking cessation support: Integrate
smoking cessation into primary care services and strengthen smoking cessation
quit-line services.
* In the context of sustainable funding for tobacco control
in Indonesia, the Declaration calls for optimizing allocation and use of
tobacco excise revenue, sharing funds and cigarette taxes to support tobacco
control and farmers for crop diversification.
* Enforce sales prohibition regulations: Implement
and enforce bans on the sale of single cigarettes, sales to individuals under
21 years of age, and sales within a 200-metre radius of educational
institutions and children's play areas, to cut off purchasing access and
protect children from nicotine addiction.
* Create tobacco- and nicotine-free educational
environments: Implement tobacco and nicotine-free
educational environments at all levels of education by prohibiting use of
tobacco and nicotine products, tobacco advertising, promotion, sponsorship, and
donations from the tobacco industry.
* Reject tobacco and nicotine industry trade
fairs: We strongly urge the central and regional governments to
ban the holding of World Tobacco Asia and other similar trade fairs throughout
Indonesia.
"Indonesia stands at a critical juncture. The tobacco
epidemic continues to claim lives, burden families, and impede national
development. We already have the tools and scientific evidence. What is needed
now is political will and decisive implementation. We, the participants of the
11th ICTOH, reaffirm our collective responsibility and call on the government
and all stakeholders to act boldly and immediately," concludes the
Declaration.
