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Combating tobacco: The youth taking control

Every year, World No Tobacco Day is observed on May 31 to draw attention to the paradoxes surrounding tobacco.

There is now wider agreement that there is a tremendous price to pay for cigarette consumption: respiratory troubles, lives and productivity lost from smoking-attributable diseases, or all the money spent. It is a burden that more and more countries are not willing to carry anymore. Except Indonesia.

Cigarettes are everywhere here. You just need to look around wherever you’re standing to see people blowing cigarette smoke, or flicking ashes to the ground.

Myriad cigarette ads practically line the streets. It is “normal” to smoke. We are in fact the world’s third-worst cigarette smoking country — and smokers here are getting younger.

Three out of 10 smokers are aged between 15 and 30, and most smoke their first cigarette before they turn 19, according to the national 2013 Basic Health Survey (Riskesdas).

Production of cigarettes is being strongly pushed, with the Industry Ministry targeting a whopping 421.1 billion cigarettes for production this year through its tobacco production roadmap.

Combined with lax regulations on cigarette marketing and advertisements, it’s no wonder that Indonesia has a rampant smoking problem, an old problem getting younger as it is increasingly noticeable among youths.

Remember that unsettling viral video of the smoking baby, already addicted at the age of 2. The impact on young people goes much deeper than smoking itself even.

The global NGO Human Rights Watch recently released a report on the thousands of children in Indonesia that work on tobacco farms with hazardous conditions, their lives being endangered by acute nicotine poisoning and harmful pesticides.

Thus, we cannot just rely on the government’s efforts, which are lukewarm at best. Apart from policies like Law No. 109/2012 regulating materials that contain addictive substances in tobacco products, and the Health Minister’s Decree No. 28/2013 concerning pictorial health warnings and health information, there has been neither much breakthrough nor serious commitment on strengthening tobacco control.

Thus, the government no longer functions as a controlling and regulating organization for society.

Therefore, civil society actors have strived to become influential over policy. The youth, in particular, have done so in ways unimaginable in earlier times. They are steering the tobacco control reform to break out of the lethargic mode it is stuck in.

There’s no sense in waiting for a stronger, better effort on tobacco control. If this problem persists, there will be little chance for young people to maximize their potential and be productive, which will lead to a disastrous waste of the anticipated demographic bonus.

It’s simple — there are currently 65 million people classified as youth, and more than a quarter of them are smokers, so in the next 30 to 40 years they face a high probability of contracting non-communicable diseases attributed to tobacco.

There is hope though. Young people today are not staying silent and doing nothing. In fact, the Global Youth Tobacco Survey of school-aged young people, revealed that three out of four students agreed that tobacco smoke was dangerous and that smoking should be prohibited in public spaces.

This awareness marks a rise in young voices, such as those of millennials, who are conscious of their ability to create social movements, and fight for causes.

There are many initiatives started by young people that aim to reduce the negative impact of tobacco, such as Penggerak Nusantara (Archipelago Movers) who promote peer education among students on the impacts of tobacco.

There is also Smoke Free Agents, an initiative that encourages students to demand their right to tobacco-free spaces and identify violations of tobacco control regulations in their schools and neighborhoods.

All these initiatives aim to inspire and empower young people to make informed decisions regarding smoking. This also demonstrates a shift from a top-down and hierarchical cascade of information to one that is peer driven.

Social norms can change, including the normalization of cigarette smoking. There is of course the factor of power relations that underlies tobacco control. But youth leaders have the power to influence not only their peers, but important policies as well.

It might be a hefty challenge, but focusing prevention efforts relentlessly on young people will be the key to achieving not only a tobacco-free World No Tobacco Day, but a tobacco-free generation.

Anindita Sitepu is a health psychologist and Olivia Herlinda is a pharmacist and health policy observer. Both work for the Center for Indonesia’s Strategic Development Initiatives.

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