Abstract

BackgroundWith a 264 million population and the second highest male smoking prevalence in the world, Indonesia hosted over 60 million smokers in 2018. However, the government still has not ratified the Framework Convention on Tobacco Control. In the meantime, tobacco import increases rapidly in Indonesia. These create a double, public health and economic burden for Indonesia’s welfare.ObjectiveOur study analyzed the trend of tobacco import in five countries: Indonesia, Pakistan, Bangladesh, Zimbabwe, and Mozambique. Also, we analyze the tobacco control policies implemented in these countries and determine some lessons learn for Indonesia.MethodsWe conducted quantitative analyses on tobacco production, consumption, export, and import during 1990–2016 in the five countries. Data were analyzed using simple ordinary least square regressions, correcting for time series autocorrelation. We also conducted a desk review on the tobacco control policies implemented in the five countries.ResultsWhile local production decreased by almost 20% during 1990–2016, the proportion of tobacco imports out of domestic production quadrupled from 17 to 65%. Similarly, the ratio of tobacco imports to exports reversed from 0.7 (i.e., exports were higher) to 2.9 (i.e., import were 2.9 times higher than export) in 1990 and 2016, respectively. This condition is quite different from the other four respective countries in the observation where their tobacco export is higher than the import. From the tobacco control point of view, the four other countries have ratified the Framework Convention on Tobacco Control (FCTC).ConclusionThe situation is unlikely for Indonesia to either reduce tobacco consumption or improve the local tobacco farmer’s welfare, considering that the number of imports continued to increase. Emulating from the four countries, Indonesia must ratify the FCTC and implement stricter tobacco control policies to decrease tobacco consumption and import.

Highlights

  • With a 264 million population and the second highest male smoking prevalence in the world, Indonesia hosted over 60 million smokers in 2018

  • This study aims to analyze the trend of tobacco import, and tobacco consumption of Indonesia compare to four other developing countries and determine what Indonesia can learn from them

  • While one main argument against tobacco control in Indonesia is the welfare of farmers from local consumption and export, our findings show that is not the case

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Summary

Introduction

With a 264 million population and the second highest male smoking prevalence in the world, Indonesia hosted over 60 million smokers in 2018 [1]. This number is increasing as the tobacco consumption prevalence (smoking and chewing) among aged 15+ years remained high at 34% in 2018. Among the youth 10–18 years, the smoking prevalence is 9.1% increased by almost 30% during 2013–2018 [2] All this contributes to the high burden of cardiovascular diseases. The national tobacco control programs are very limited in Indonesia, partly due to not yet ratifying the Framework Convention on Tobacco Control (FCTC) [4,5,6]

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