Study Assesses Social Enforcement of Smoke-free Policies in Indonesia

06 Oct 2014
IndoSFpic

Young men smoke in an electronics repair shop in a mall in Bogor, Indonesia, where smoking in public spaces is now prohibited. Photo by Michelle Kaufman.

Research finds support for new government policies but varied comfort with social enforcement.

A study by the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHU∙CCP) finds widespread support for new policies to prevent smoking in public spaces in Indonesia, however, individual comfort to socially enforce these policies varies widely. The paper, ‘Excuse me, sir. Please don’t smoke here’: A qualitative study of social enforcement of smoke-free policies in Indonesia, is published in Health Policy and Planning.

“Indonesia has one of the highest rates of tobacco use in the world, and consequently, Indonesians have very high exposure to secondhand smoke,” said Michelle Kaufman, Research and Evaluation Officer at JHU∙CCP and lead author of the study. “In order to improve health outcomes, the Indonesian government is adopting smoke-free policies, but no one knows to what extent these policies are being enforced, or how they are impacting social norms in a society where smoking is so ubiquitous.”

Researchers examined whether smoke-free (SF) regulations in Bogor and Palembang cities – known as Kawasan Tanpa Rokok (KTR) – are being socially enforced. Both cities were early adopters of KTR and banned smoking in public spaces, including public transportation, schools, hospitals, mosques, restaurants, offices and malls, in 2009. However, enforcement differs between the two cities: in Bogor City, individuals who violate the law are subject to fines, whereas in Palembang City fines are levied on building managers. Qualitative data was collected through in-depth interviews with community members and key informants (health center, public building and NGO personnel, police officers and religious leaders), and focus group discussions with men, women and community leaders.

Researchers found that respondents were aware of the dangers of second-hand smoke and supported the Indonesian government’s SF policies to protect the health of non-smokers. “We found pervasive support for KTR in all our interviews,” said Kaufman. “But we also found a desired need for more consistent enforcement, especially among city officials who are perceived to not observe their own regulations.”

In addition, researchers found experiences of asking smokers to comply with SF regulations varied widely, with informants expressing more comfort if the transgressor was younger or of a perceived lower socio-economic status, or if the smoking was taking place around children or pregnant women.

Overall, the study found that there appears to be a greater acceptance of SF norms in Indonesia, a typically smoking-heavy country, and an evolving willingness to speak out in support of SF policies. These changing norms would be supported by increased government promotion and enforcement of the SF regulations.

This research was supported by an award from the Bloomberg Initiative to Reduce Tobacco Use to the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health.

Authors of this paper include Kaufman, Alice Payne Merritt, Risang Rimbatmaja and Joanna E. Cohen.

Read ‘Excuse me, sir. Please don’t smoke here’. A qualitative study of social enforcement of smoke-free policies in Indonesia.

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