Indonesia has one of the highest rates of smoking globally with nearly 62 million
Indonesia is characterized by markedly high rates of tobacco use among men with an estimated 58.3% of men consuming tobacco (see Figure 1).
Smoking is dramatically lower among women with only 3.5% estimated to smoke (see Figure 1).
Tobacco use consists almost entirely of smoked tobacco, where kreteks and factory-made cigarettes are particularly popular smoked tobacco products. Just under 70% of those who report using tobacco smoke kreteks, and 44% report smoking factory-made cigarettes. A subset of these users engages in dual use. Relatively modest numbers of people roll their own cigarettes (14%) or use electronic cigarettes (2.8%).
Tobacco use in Indonesia follows clear demographic, economic, and social characteristics. The prevalence of smoking appears to vary by age and level of education.
Smoking prevalence dramatically increases as adolescents get older, peaks for those in their 30s, and then modestly ebbs among those who are older.
Smoking prevalence also appears to increase by level of education, although this may ultimately reflect the aforementioned increase associated with age, especially among adolescents and youths.
Additional data on tobacco use among these age groups come from the GYTS, which found that among adolescents aged 13 to 15 years, 35.6% of boys and 3.5% of girls used tobacco (totaling 19.2% of all students).
Tobacco use also appears to vary by setting, with 26% of rural participants reporting smoking daily and less than 23% of urban participants reporting smoking daily.
Figure 1: Age-adjusted Prevalence of Smoking in Indonesia
Health and Economic Burden From Tobacco Use
Underscoring the contribution of tobacco to the country’s burden of health, tobacco use is responsible for over 290,000 deaths each year in Indonesia in 2019.
The economic costs associated with death, disease, and disability due to tobacco use are substantial. In 2019, the cost of treating tobacco was estimated to be RP 17.9-27.7 trillion (1-0.2% of the country’s GDP).
Despite the high rates of tobacco use and their resulting health burden, Indonesia has not signed on to the WHO Framework Convention on Tobacco Control (WHO FCTC) and has implemented only modest tobacco control measures. Indonesia was evaluated by WHO to have made minimal progress in developing smoke-free environments, no and/or weak measures in instituting advertising bans, moderate progress in developing cessation programs, health warnings and taxation and completed measures related to monitoring of tobacco use prevalence.
Although nicotine replacement therapy products are available over the counter, demand remains low, knowledge about them is limited, and their prices are high. Other pharmaceutical options such bupropion and varenicline are not legally allowed in the country at this time. In recent years, the most significant changes to the landscape have included the streamlining of taxes on cigarettes and the introduction of novel tobacco harm reduction products such as e-cigarettes and heated tobacco products. There are no restrictions on the sale, manufacture, supply, use, or advertising of e-cigarettes (hardware or e-liquid) or nicotine pouches in Indonesia. Heated tobacco products are not regulated in Indonesia. The government has placed a 57% excise tax on e-liquids. In 2020, excise burden on cigarettes was 62.3% of the retail price of the most sold brand of cigarette in Indonesia. Cigarettes were not considered less affordable in 2020 compared to 2018.
TOBACCO PRODUCTION AND DIVERSIFICATION
Indonesia is the fifth largest producer of unmanufactured tobacco. In 2020, it produced 200,000 tons of tobacco and was surpassed only by China, India, Brazil, and Zimbabwe.
The vast majority of tobacco production in Indonesia―roughly 85%―occurs in Java. Less than 10% occurs in West Nusa Tenggara, and the remainder occurs across a small number of other regions.
Although proponents of the tobacco industry may argue that these harms are offset by the employment provided by the tobacco economy, this appears unlikely in light of studies finding that smallholder tobacco farmers are disproportionately poor, are dependent on social assistance, and suffer from food insecurity.
As research findings become available that are inclusive of additional gender identities, the Foundation will update the information presented.