Premature deaths

By 2030, tobacco use is projected to be the leading cause of premature death and disability among adults worldwide, which will reduce the effectiveness of social protection programs and place a significant economic burden on health systems and other social institutions and will be particularly pronounced in low- and middle-income countries[1]. Globally, the annual number of tobacco-related deaths is expected to rise from 6.4 million in 2015 to 8.3 million in 2030[2], with 80% of these deaths occurring in low- and middle-income countries[3]. The top five leading causes of premature death in Indonesia are tobacco-related, accounting for approximately 16.2% of total deaths (24.3% of adult male deaths; 6.3% of adult female deaths).

Prevalence

According to the 2019 Indonesia National Socio-Economic Survey, the prevalence of smoking among adults in 2019 was 32.8%, with the prevalence among adult males in Indonesia reaching 64.5%. The prevalence of smoking among children is also increasing. the prevalence of smoking among children aged 10-18 years increased from 7.2% in 2013 to 9.1% in 2018[6]. Approximately 51.3% of adults and 66.2% of adolescents aged 13-15 are regularly exposed to second-hand smoke[8]. Women are also passive smokers. Women whose husbands smoke are 3 times more likely to develop lung cancer than a woman with a non-smoking husband. The number of passive smokers in Indonesia is much greater than the number of smokers. Non-smokers lack protection from smoking due to second-hand exposure[9]. The national medium-term development plan for 2020-2024 recognizes smoking as a threat to national development.

                        Kids from Indonesia

Diseases

Diseases caused by cigarettes include cardiovascular disease, respiratory disease, lung and other cancers, oral and gum disease and asthma[10]. The most commonly studied is lung cancer and based on a review of the relevant literature in Indonesia, it is known that smokers are eight times more likely to develop lung cancer than non-smokers. It is estimated that lung cancer patients in Indonesia only survive 1-2 years after the onset of the disease[11].

Economic impact

And the impact of  tobacco is not only on the health and longevity of the individual, but also has a huge economic impact on the individual and society[7]. Back in 1998, an academic studied the economic impact of respiratory disease.The total number of cases attributable to smoking in 1995 was 6,426,630(2,834,470 male and 3,592,160 female). Hypertension caused the largest number of cases (3,940,520 cases). The total DALY loss due to disease and injury attributable to smoking in Indonesia (1995) was 8,914,930 (4,667,700 males and 4,247,230 females).  The microeconomic loss can be broken down into the average cost for medical treatment (US$ 738), the lost of income due to illness for one patient (US$ 115/year) and the loss of income of family members due to taking care of patient (US$ 115/year). It is estimated that there are 5,670 cases of trachea, bronchus, and lung cancers, giving a total economic loss of US$ 5,488,560 for these diseases alone[12]. Reducing tobacco use is one of the most important public health issues, as tobacco is the single most important risk factor for chronic diseases. Political action could substantially reduce smoking prevalence and the related health risks and thus reduce this economic loss for the government and the community.

A point  to watch

Finally, there is a problem that deserves people’s attention. Social assistance programs have income effects that enable low-income groups to increase consumption to improve well-being. However, this may inadvertently increase their consumption of tempting commodities, including tobacco. By analyzing large-scale social assistance programs distributed by the government, an article examines whether these programs have led to increased smoking intensity in Indonesia[7]. And there is no doubt that the increase in smoking will again aggravate the economic burden on low-income groups and society.

References:

[1]World Health Organization (2018) WHO global report on trends in prevalence of tobacco smoking 2000–2025, second edition.

[2]Mathers, C. D. & Loncar, D. (2006) Projections of global mortality and burden of disease from 2002 to 2030. PLoS medicine. [Online] 3 (11), e442–e442.

[3]World Health Organization (2006) Fact Sheets on tobacco products. IDEAS Working Paper Series from RePEc.

[4]Anon (2014) PERAN PERSEPSI PENGEMBANGAN KARIR DAN DUKUNGAN ORGANISASI TERHADAP KOMITMEN ORGANISASI (PENELITIAN TERHADAP PERAWAT BADAN PELAYANAN KESEHATAN RUMAH SAKIT DAERAH ‘MARDI WALUYO’ BLITAR JAWA TIMUR). 4 (1), 1–11.

[5]Warsito, G. M. et al. (2020) Identifying the Weak Foundation of Public Health Resilience for National Disaster Policy in Indonesia’s Mid-term DevelopmentAgenda 2015–2019: A Policy Content Analysis. Kesmas (Depok). [Online] 15 (2), .

[6]Palipudi, K. et al. (2014) Prevalence and sociodemographic determinants of tobacco use in four countries of the World Health Organization: South-East Asia region: Findings from the Global Adult Tobacco Survey.(Tobacco Control Issue – Original Article). Indian journal of cancer. [Online] 51 (5), 24–.

[7]Dartanto, T. et al. (2021) Good intentions, unintended outcomes: Impact of social assistance on tobacco consumption in Indonesia. Tobacco induced diseases. [Online] 19 (April), 29–16.

[8]LEMBAR INFORMASI (no date) Indonesia, 2019 Global Youth Tobacco Survey. Available at: https://www.who.int/docs/default-source/searo/indonesia/indonesia-gyts-2019-factsheet-(ages-13-15)-(final).pdf?sfvrsn=ac88216_2 (Accessed: November 13, 2022).

[9]Djutaharta, T. & Surya, H. V. (2003) Research on Tobacco in Indonesia: An annotated bibliography and review of research on tobacco use, health effects, economics, and control efforts. IDEAS Working Paper Series from RePEc.

[10]Kosen,T. (1998) Analysis of Current Economic Impact of Smoking in Indonesia: Government and Community Prospective. Health Services Research and Development Center. National Institute of Health Research and Development. Ministry of Health. Jakarta. Unpublished report, 13–.

[11]Situmeang & Sutan B. T. (2001) Hubungan Merokok Kretek dengan Kanker Paru [The Relationship between Clove Cigarette Smoking and Lung Cancer]. Department of Pulmonology Faculty of Medicine University of Indonesia. Jakarta. Thesis. 53–.

[12]Kosen, Soewarta. 1998. Analysis of Current Economic Impact of Smoking in Indonesia: Government and Community Prospective. Health Services Research and Development Center. National Institute of Health Research and Development. Ministry of Health. Jakarta. Unpublished report, 13–.

The impact of big Tobacco on people’s health and premature deaths in Indonesia / The impact of big Tobacco on people's health and premature deaths in Indonesia by blogadmin is licensed under a Creative Commons Attribution CC BY 3.0