Killing Culture or Culture that Kills?

By Dioputra Ilham | 10 Apr 2017
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According to Global Health Observatory (GHO) data published by the World Health Organization (WHO) in 2016, Indonesia has one of the most prevalent smoking rates in the world (tobacco and cigarettes alike), occupying the fourth position. There were also approximately 200,000 tobacco-related deaths in 2016. Despite that, Indonesia has not yet agreed to sign and ratify the FCTC (Framework Convention on Tobacco Control) which has proven to be very effective in countries with very difficult and complex environments to impose tobacco control laws, such as Russia.

Putting health implications aside, can the prevalence of smoking in Indonesia be attributed to deep-rooted cultural history? For starters, it is important to assess the legal aspects involved. Written in the Draft Legislation on Tobacco (Rancangan Undang-Undang Pertembakauan) or the Draft Tobacco Bill, tobacco and processed tobacco have become important parts of Indonesian culture. The Draft Legislation on Tobacco also states that the tobacco used to make cigarettes, along with the cloves mixed into them which have become a signature mark of Indonesian cigarettes, have made kretek (flavoured cigarettes) a primary source of income and livelihood for a large portion of Indonesians. Where kretek has not only had a prominent presence in Indonesia’s culture and history but also in its socio-economic environment, the government has now been obligated to protect, preserve, and promote cigarettes in the name of cultural heritage.

Tracing back the history, according to records by Thomas Stamford Raffles, the population of Java had smoked in the 1600’s, despite there still being large debates regarding whether it was the Dutch of the Portuguese who introduced them to cigarettes. It is important to note that cigarettes were introduced to the population by foreign cultures, so can it be considered a cultural heritage if it was itself inherited from other cultures? To answer this question, it is possible to compare it to the situation in China—opium and its use have been and are still heavily associated as a part of the Chinese culture. However, opium was brought into China by Arabic and Turkish merchants in the 7th century.

Smoking, as stated by Imam Prasodjo, a sociologist from Universitas Indonesia, is not a cultural heritage, but a habit. Prasodjo argues that if any widely-shared habit can be labeled a cultural heritage, then Indonesia stands to inherit many bad things alongside the good. This is contradictory to the clauses contained in the Draft Legislation on Tobacco, where tobacco and processed tobacco are mentioned to have become an important part of Indonesian culture.

To look deeper, the idea that smoking is a cultural heritage mentioned in the Draft Legislation on Tobacco, which refers to the smoking of tobacco mixed with flavoured cloves, has roots in the city of Kudus. Here, the mixing tobacco with cloves was a result of the findings of Haji Djamari at the end of the 19th century, and this specific type of tobacco is what is referred to as rokok kretek. These cigarettes are what are primarily produced and consumed in Indonesia. Even though the smoking culture was brought to Indonesia by other nations, smoking has become heavily associated with Indonesian culture through the modification of the average cigarette to adhere to the Indonesian tongue.

When it comes to economic implications of the thriving tobacco industry in Indonesia, there are two sides of the coin which we have to carefully observe as the Draft Legislation on Tobacco has incited polemics between the pro- and contra- parties with both parties having strong arguments to protect their stance. It is important to note that even though tobacco may be a significant part of Indonesia’s culture due to the famous kretek cigarette and is said to be one of the biggest sources of income for Indonesia’s national economy through the exports by the tobacco industry, the price which has to be paid for the consequences is also large.   

Indonesia has been facing rapid demographic growth, and as stated on April 2016 by the Chairman of Indonesia Institute of Demography, it might be very difficult to attain high economic growth if a large fraction of government spending is used to provide medical coverage for diseases linked with smoking, such as lung cancer and heart failure, instead of more productive things. Moreover, 51 percent of smokers in Indonesia are from the lower class of the economic hierarchy and spend more money on cigarettes than their own daily needs, asserting that government’s burden to accommodate their welfare has significantly increased.

The Ministry of Health further stated that losses due to smoking has reached its worst peak in 2017, amounting to Rp 378.75 trillion in 2017, which is a much larger amount of money than the income from tax and sales received through the tobacco industry. As a consequence, there have been numerous outcries from anti-tobacco activists, particularly from the public health arena, demanding the government to immediately sign and ratify the FCTC to suppress the increasing danger of the tobacco industry. There was once an attempt to increase the price of cigarettes to Rp 50.000 to impose tobacco control to the public and meet the tax income target in 2016. According to a survey conducted on 1,000 people from 22 provinces with income level ranging from below Rp 1 million to above Rp 20 million, 82 percent of the respondents agreed. Another survey also showed that most people would not buy cigarettes at such a high price.  However, it was impossible since increasing the price by 300 percent had never occurred in the history of Indonesia’s economy.

Moreover, attempts to drastically decline the consumption of cigarettes and tobacco is considered harmful to the welfare of the tobacco farmers by some. Tobacco industries are also against the ratification of FCTC and deem it as absolutely unecessary since government regulations pertaining to tobacco control already exist. The East Java administration has even gone as far as to say that the ratification of FCTC would affect the average livelihood of the people in the province which many of whom depend on tobacco as the source of their income.

The whole dilemma is worsened by a last minute decision that sparked anger amongst the anti-tobacco activists, the Joko “Jokowi” Widodo administration decided to give a shot to the Tobacco Bill by sending a presidential letter (surat presiden/ surpres), to the People's Representative Council, stating that it would agree to discuss the House’s initiative. There is a possibility of the bill being included in the 2017 National Legislation Program (Prolegnas). Unsurprisingly, “I emphasize that the Ministry of Health will stand on the side of health,” was the Minister of the Health’s immediate reaction to the decision, as the Tobacco Bill seeks to triple production to 524 billion cigarettes by 2020.

As of now, Jokowi is still trying to find a solution to accommodate the interests of all the parties involved: the workers working in the tobacco industry, the tobacco industry itself, and the general public. He is indeed concerned with the welfare of workers in the tobacco industry, but he is also aware of the damages caused by tobacco, particularly damages to the national economy due to excessive need for medical coverage. This is where the ultimate question lies: can cultural heritage and the welfare of workers still be protected without undermining public health?