National Children's Day 2020 is the best momentum to keep Indonesian children away from exposure to the tobacco industry. (Image source: Pexels)

National Children's Day is celebrated every July 23 as a tribute to the rights of children in Indonesia. Children belong to a vulnerable group whose rights must always be protected by the government. Children always have the right to be loved, understood, and surrounded by happiness. On the other hand, children also need to get guarantees for a decent and healthy life for their future.

Unfortunately, the Government of Indonesia has so far been unable to ensure a healthy future for Indonesian children. One indicator worth looking at is the increasing number of child smokers in Indonesia. Cigarettes do not have any health benefits for children. Thus, its presence in public facilities should be strictly regulated.

In fact, the 2019 Global Youth Tobacco Survey (GYTS) data shows a sad truth. Through a survey of school-age children between 13 to 15 years in Indonesia, it is known that 19.2 percent of them smoke. The Basic Health Research (Riskesdas) also shows the number of smokers aged 10-18 years has also continued to increase, from 7.2 percent in 2013 to 9.1 percent in 2018.

The consistent rise of child smokers over the past few years is evidence of the government's failure to fulfill the 2015-2019 National Medium-Term Development Plan (RPJMN) promise to reduce child smoking by up to 5.4 percent. The lack of regulation towards the cigarette industry is the reason why the prevalence of child smokers continues to grow. The government's firm effort is also needed.

The Health Risk

Smoking at a young age clearly causes chronic disease at a more mature age. The younger a person is, the easier it is for him to become addicted to smoking and the more difficult it is to stop the addiction. WHO also notes that nicotine exposure in children and adolescents has a negative impact on brain development. On the other hand, children and adolescents who smoke from an early age are also more susceptible to developing asthma and impaired lung growth and development which can cause diseases such as COPD (Chronic Obstructive Pulmonary Disease).

Smoking at a young age is also certain to damage performance and endurance. Not only active child smokers who have health risks due to smoking, passive smokers are similar and even have higher health risks. Cigarette smoke contains at least 4,000 types of chemical compounds, 400 harmful substances, and 43 carcinogenic substances that can cause cancer. Children who are exposed to cigarette smoke can experience various health problems, ranging from coughing, tooth decay, ear infections, eye problems, to respiratory problems.

Weak regulation and supervision of no-smoking areas (KTR) makes child smokers often smoke around school areas. Notes from the news-medical state that such a situation can cause various health consequences that can interfere with the teaching and learning process, such as damaging children's comprehension. Allowing cigarettes to be accessed by children not only violates their rights, but also damages their health which can threaten their future.

The Regulation

Massive advertising and low prices are the main reasons why cigarettes are still accessible to children. (Image source: Pelita Kasih Radio)

There are many reasons why cigarettes can still be accessed freely by children in Indonesia. One of them is because Indonesia has not acceded to the Framework Convention on Tobacco Control (FCTC) proposed by WHO. This has resulted in nonoptimal tobacco control and the rules do not strictly regulate the circulation of these processed tobacco products. Apart from that, there are also other problems that make cigarettes easy to circulate.

First, the cheap price of cigarettes is one of the most striking reasons. The rating site from Japan, Numbeo, noted that the price to buy one pack of cigarettes in Indonesia is only around IDR 26,000.00. The price is two times cheaper than the price for similar items in Malaysia and 10 times cheaper than similar items in Singapore.

Second, the tobacco industry is also free to promote their products. Since the first, the cigarette industry has targeted young people and teenagers as loyal consumers. In Indonesia, the appearance of cigarette products with adventure and fantasy themes influences children's perceptions of cigarettes. Advertising takes on the role of changing the bad and harmful image of cigarettes into something cool and necessary.

The Indonesian government has indeed regulated broadcast times and acts of smoking on television shows, but exposure to brand images and activities still encourages children to normalize smoking behavior. The government should have banned all forms of advertising of tobacco products.

Third, the regional government's role in regulating the distribution of cigarettes has not been maximized. So far, several regions have initiated Regional Regulations on Non-Smoking Areas (Perda KTR). KTR is a room or area that does not allow the act of smoking, producing, advertising, promoting, or trading cigarettes.

The existence of this regulation is necessary to protect children who are vulnerable to exposure to smoke and the promotion of smoking products. Even though as of May 2018 there were 19 provinces and 309 districts that had regulated KTR, the implementation in the field was still lacking because the violations were not categorized as misdemeanors to give a deterrent effect.



Indonesia expects a demographic bonus in the 2030-2040 range. The prerequisite for achieving this is the presence of superior and competitive human resources. The health factor is the key to achieving these qualities. If the Indonesian government still turns a blind eye to breaking the relationship between smoking and children, is it possible that Indonesia Gold 2045 target can really be achieved?

Sources:

Global Youth Tobacco Survey 2019: Indonesia. World Health Organization. Update terakhir 26 Mei 2020.

How does passive smoking affect children’s lung? https://www.blf.org.uk/support-for-you/risks-to-childrens-lungs/passive-smoking. Update terakhir September 2019.

Passive Smoking Risks to Children. https://www.news-medical.net/health/Passive-Smoking-Risks-to-Children.aspx. Update terakhir 27 Februari 2019.

Price Rankings by Country of Cigarettes 20 Pack (Marlboro) (Market). https://www.numbeo.com/cost-of-living/country_price_rankings?itemId=17. 2020.

Rokok dan Ancamannya bagi Masa Depan Anak. https://mediaindonesia.com/read/detail/238938-rokok-dan-ancamannya-bagi-masa-depan-anak. 1 Juni 2020.



Smoking still a core challenge for child and adolescent health revelas WHO report. https://www.euro.who.int/en/health-topics/disease-prevention/pages/news/news/2020/6/smoking-still-a-core-challenge-for-child-and-adolescent-health-reveals-who-report. 5 Juni 2020.