The tobacco control situation in Indonesia is getting worrisome as during the past decade the tobacco control indicators show stagnated progress or even declining progress in some important indicators. According to Basic Health Research (Riset Kesehatan Dasar/RISKESDAS), the slight decrease in smoking prevalence during 2013–2018 from 29.3–28.8% of overall smoking prevalence for the population aged 10 + years was followed by an increase in smoking prevalence among female and a consistent rise in smoking prevalence among minor aged 10–18 year.[1] The female smoking prevalence nearly doubled from 2.5% in 2013 to 4.8% in 2018 whilst the smoking prevalence among the population aged 10–18 years consistently from 7.2% in 2013 to 8.8% and 9.1% in 2016 and 2018, respectively.
The non-optimal tobacco control effort in Indonesia resulting in stagnated progress is related to weak Framework Convention on Tobacco Control (FCTC) protocols enforcement in the country. Compared to other similar countries, Indonesia, being the only country that is neither a party nor a signatory of FCTC, is faced by though tobacco use situation as shown in Fig. 1 below.
Figure 1 above shows the comparisons in smoking prevalence between Bangladesh, Brazil, Pakistan, and Indonesia. Amid the four countries have a relatively similar large number population and falling into the same category of middle-income developing countries, the three former countries are parties of FCTC while Indonesia is not. Bangladesh ratified the FCTC in 2004 while both Pakistan and Brazil ratified FCTC in 2005. Figure 1 above shows that the three countries had successfully reduced the overall smoking rates consistently and significantly since 2005. In contrast, within the same period, Indonesia experienced increasing smoking prevalence by nearly 5%. Brazil, amid being the world's largest tobacco exporter, has successfully driven its smoking prevalence rate to 13.9% below the world smoking prevalence rate of 20.5%.[2] Among the four countries, Brazil is the only country that has complete policies on all of the MPOWER measurements, with remarkably 83% of tobacco tax implemented.[3] While Pakistan and Bangladesh still have rooms for moderate and or minimal policies are some of the MPOWER measurements, both countries, under FCTC ratification, can fully cover all the important policies measurement.[4, 5] Whereas Indonesia, being neither the party nor signatory of FCTC, remains with very weak policies on tobacco advertising bans and cigarette affordability.[6, 7] Hence, it comes as no surprise that Indonesia still struggles with tobacco control efforts.
Amid the alarming tobacco use condition, after 15 years, Indonesia still yet to ratify the Framework Convention on Tobacco Control (FCTC). Indonesia is currently the only country in Asia-Pacific to not ratify FCTC. FCTC, which was agreed upon by 192 WHO members country in 2003 and effective as per 2005, is currently ratified by more than 180 countries as it is seen as an important protocol to enforce tobacco control regulation. Economic concern still is the main reason that hinders Indonesia from FCTC ratification. It is believed that FCTC ratification which allows comprehensive tobacco control policies enforcement in Indonesia will negatively impact the economy through the decline in tobacco production and tobacco industry economic activities. The argument against FCTC ratification in Indonesia believed that the decline in tobacco production and tobacco industry economic activities will decrease the tobacco farmers' welfare, increases unemployment for tobacco industry workers, and eventually lead to major macroeconomic impact – poverty rate and unemployment rate increase and GDP rate decrease. Despite the strong statement provided by the opposition view, there is still no solid evidence to support this argument. This paper hence aims to provide evidence on how tobacco control actions under FCTC ratification impacts the economy by comparing the economic conditions of the countries that have ratified the FCTC between 2005–2010.
The topic of the economic impact of FCTC is very important for both academic discussion and the policymaking process. Lack of academic investigation on this topic leaves out the room for any negative speculation against the FCTC protocol and hence the academic research is very much needed to fill the space. Moreover, to investigate the economic impact of FCTC will help the policymakers to understand that while FCTC is highly important for tobacco control efforts, it does not necessarily relate to negative macroeconomic indicators as the tobacco industry does not significantly contribute to the Indonesian economy.