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TOBACCO CONTROL IN INDONESIA. ISSUES AND FUTURE DIRECTIONS Presented By: Indonesian Public Health Association at Donor Meeting in Mariott Hotel, Oct 17, 2011. INDONESIA RANK 3 rd ►of 1.3Billions smokers. Est 62 millions smokers. (WHO, Report on Global Tobacco Epidemic,2008). - PowerPoint PPT Presentation
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TOBACCO CONTROL IN INDONESIAISSUES AND FUTURE DIRECTIONS
Presented By:Indonesian Public Health Association at Donor Meeting in Mariott Hotel, Oct 17, 2011
INDONESIAN PUBLIC HEALTH ASSOCIATION
INDONESIA RANK 3RD ►OF 1.3BILLIONS SMOKERS
(WHO, Report on Global Tobacco Epidemic,2008)
Est 62 millions smokers
ASEAN: 46% Smokers in INDONESIA
Malaysia2.90%
Indonesia46.16%
Myanmar8.73%
Philippines16.62%
Singapore0.39%
Thailand7.74%
Viet Nam14.11%
Lao PDR1.23%
Brunei 0.04%
Cambodia2.07%
Est No.deaths related to tobacco*):
-427,948/yr
-1,172/day
*)Kosen, 2004. An Economic Analysis on Tobacco Use in Indonesia
53.4
62.2 63.1 65.6
1.7 1.34.5 5.2
2731.5 34.4
34.2
0
10
20
30
40
50
60
70
1995 2001 2004 2007
Laki
Perempuan
Total
INCREASING TREND IN INDONESIA
Sourse: Susenas 1995, 2001,2004 dan Riskesdas 2007
Smoker Prevalences among adultsIndonesia, 1995, 2001, 2004, dan 2007
MenWomen
INDONESIAN PUBLIC HEALTH ASSOCIATION
SMOKERS ARE GETTING YOUNGER
0,60,4
1,8
0
0,5
1
1,5
2
%
1995 1998 2001 2004
5 - 9 yrs
Trend among age group 5-9 yrs old
Case from a village:“Aldi (5yrs old) is addicted,” his mother said. “..if he could not get cigarette and smoke, he will cry so hard and bang his head to the wall.. “
Source Dr Widaystuti Soerojo, 26 Juli 2010
INDONESIAN PUBLIC HEALTH ASSOCIATION
13.7
24.2
32.837.3
0.3 0.2 1.9 1.67.1
12.717.3 18.8
0
5
10
15
20
25
30
35
40
1995 2001 2004 2007
Laki
Perempuan
Total
Source: Susenas tahun (1995, 2001, 2004) dan Riskesdas 2007
Indonesia, 1995, 2001, 2004, 2007
SAME PATTERNS AMONG 15-19 YRS OLD
MenWomen
2005: Expenditure for tobacco (2005): 23Mi packs= Rp 103.5T = US$ 11,5Bi Est Health care costs: 11 diseases (Cancers, CVD, etc)= Rp 1.99T =
US$ 221M
Est. economic loss (Macro) Rp 61.6T = US$ 6,8Bi Est. Death rates: 399,000 Productivity loss related to deaths: US$ 4.9B Productivity loss related illness: US$ 1.9B Total economic loss related to tobacco consumption
Rp 167.1T = US$ 18,5B 5.1 times greater than state income from tobacco tax
Kosen,2007 unpublished data presented in IPHA National Congress 2007
ECONOMIC LOSS
CONCLUSION-1:IN INDONESIA:Tobacco is un-controlled and un-regulated consumption good
INDONESIAN PUBLIC HEALTH ASSOCIATION
CURRENT STRATEGIES Increase Tobacco taxes and price
Graphic Health Warnings
Total ban for promoting smoking
Non-smoking areas
INDONESIAN PUBLIC HEALTH ASSOCIATION
3 BURNING ISSUES NATIONAL REGULATIONS (!)
Approval of the Implementation Regulation draft (PP draft) by the President, with provision of 100% smoke-free indoor environment and at least 50% pictorial health warnings
Absence (up and down process) of a comprehensive Tobacco Control bill
Indonesia has not ratified the Framework Convention on Tobacco Control (FCTC)
CONCLUSION-2:Strengthening all component including civil society to focus in achieving 3 “burning issues”
INDONESIAN PUBLIC HEALTH ASSOCIATION
ROLES OF IPHA4 Strategic roles:
Advocacy and communication
Knowledge holder
Strengthening health system thru its members
Network expansion among health professional organizations and NGOs
INDONESIAN PUBLIC HEALTH ASSOCIATION
ADVOCACY & COMMUNICATION Future short-term activities
Strengthening awareness among key stakeholders
Social pressures of those 3 “burning issues”
INDONESIAN PUBLIC HEALTH ASSOCIATION
KNOWLEDGE HOLDER Future short-term activities
Expanding data exchanges and warehouse
Seminars, workshops, roundtables
INDONESIAN PUBLIC HEALTH ASSOCIATION
HEALTH SYSTEM STRENGTHENING Future short-term activities
Assisting government in programming and health policies
INDONESIAN PUBLIC HEALTH ASSOCIATION
STRENGTHENING NETWORK Future short-term activities
Reposition IPHA as rainbow coalition for health development
Strengthening TCSC for coalition
INDONESIAN PUBLIC HEALTH ASSOCIATION
POINTS OF FUTURE DIRECTION AND STRATEGIES_1 (DISCUSSION RESULTS) Strengthening the health promotion efforts Leadership on anti smoking habit
Among bureacrats as a part of fit and proper test for career development
Strengthening advocacy efforts to presidential office and “javanese advocacy” approaches to the closest within president circle
Strengthening advocacy efforts to parliament for Tobacco Control Bill
Strengthening the health professions in politics and health policy of tobacco control
INDONESIAN PUBLIC HEALTH ASSOCIATION
Aggressive advocacy to parliament and government (i.e., president) to ratify the FCTC
Carefully “touch” tobacco tax, not only as tobacco control instrument but as a part of state revenue (for development)
Strengthening MoH structures and function for TC/NCD
POINTS OF FUTURE DIRECTION AND STRATEGIES_2 (DISCUSSION RESULTS)