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JUUL from the USA to Indonesia: implications for expansion to LMICs
Elizabeth N Orlan, 1 Mark Parascandola,2 Rachel Grana2

Indonesia has one of the largest tobacco markets in the world, well known for their clove cigarettes, kreteks. However, electronic cigarettes (e-cigarettes) are growing in popularity among Indonesians. While conventional cigarettes are sold in stores and kiosks,1 e-cigarettes are sold online (35.3%) and through vape shops (64.7%).2 The 2011 Indonesian Global Adult Tobacco Survey, the latest available national data, reported awareness of e-cigarettes was 10.9% and current use was 2.5%.3 Recent social media and sales data imply that e-cigarette use has grown since then. Indonesia has the second largest share of Instagram posts about vaping of any country,4 and e-cigarette sales reached 2.1 trillion rupiah (US$144.5 million) in 2018. Total sales are forecasted to reach 6.1 trillion rupiah (IDR)
(US$419.6 million) by 2022.2

JUUL is the leading e-cigarette brand in the United States of America (USA), with 72% of the vapour product market share as of August 2018.5 According to their website, JUUL sells their products in the USA, Canada, Israel, UK, Italy, Germany, Switzerland, France and Russia.6 However, these products are also reported to be sold in low-income and middle-income countries (LMICs) like Indonesia, where interest in vaping and JUUL (as measured by Google Trends) has increased from 2018 to 2019.7

On 19 October 2018, JUUL filed trademark applications with the Indonesian Ministry of Law and Human Rights for formal entry into the Indonesian market. The applications sought trademarks for JUUL devices and cartridges, downloadable software for mobile devices (to use with JUUL devices) and troubleshooting services for the products.8 However, JUUL products are already being sold in Indonesia. In September 2018, while following up on an audit of vape shops in Jakarta,9 JUUL products were observed in some vape shops. Some of the products found had the US Food and Drug Administration (FDA) warning label (figure 1). Further, products are also being sold on popular Indonesian e-commerce websites including Bukalapak10 and Tokopedia11 (figure 2). During vape shop visits, store staff commented to the researchers that the products were ‘not new’, maintaining that the products were being sold in Indonesia prior to when the trademark application was submitted in October 2018.8

The current price for a JUUL starter kit in Indonesia (approximately 750 000 IDR or US$51.50 on Tokopedia)11 is comparable to current US pricing. However, that price stands in stark contrast to the price of cigarettes in Indonesia, where a premium pack of cigarettes (Marlboro Gold) is sold for 25 700 IDR or US$1.76.12 With formal entry into the

Indonesian market, we expect that a more strategic price plan would be developed to make the devices more affordable to smokers and vapers. Given JUUL’s US activities, we also expect in-country promotional events and advertising that would increase product and brand recognition among Indonesians.

Figure 1 JUUL product found in a Jakarta vape shop with the US Food and Drug Administration e-cigarette warning label, September 2018.

Tobacco products in Indonesia are regulated under the Health Law of 200913 and the Tobacco Product Safety Regulation of 2012.14 Currently, e-cigarettes remain unregulated in Indonesia, but were deemed legal products as of July 2018. Indonesia’s tax policy calls for a tax of 57% of the e-liquid price, the highest possible tax on tobacco products by law.15 However, the tax policy has been implemented based on size of the e-liquid bottle and self reported ‘quality’—either premium or non-premium—from the manufacturer or distributor, rather than ad valorem, as specified in the policy. It is unknown how the Indonesian government would tax cartridges that are prefilled with e-liquid, which is the case with JUUL, since to date, these have been less popular than refillable devices. Moreover, JUUL’s entry introduces a ‘new’ type of e-cigarette product to the Indonesian market, which may not be easily regulated under the existing e-cigarette policy.

Indonesia has relatively weak tobacco control policies and high tobacco use.16 17 For example, the only national law addressing tobacco advertising limits the broadcast window for television advertisements to between 9:30 pm and 05:00 am Western Indonesian Time.18 Banners and posters advertising cigarettes are ubiquitous on and around street-side kiosks.19 Tobacco industry sponsorship is common, especially in restaurants and bars, on social media20 and at concerts and art events; venues that typically attract youth. In this environment, e-cigarettes, particularly those products with substantial tobacco industry investment, may exacerbate conventional cigarette smoking and encourage dual product use.

Figure 2 JUUL products found on an Indonesian e-commerce site, June 2019.

Recent media reports highlight JUUL’s plans to expand to Indonesia and other LMICs.21 Indonesia may serve as a bellwether for expansion of JUUL and other e-cigarette products to LMICs. Because the WHO Framework Convention on Tobacco Control does not yet provide explicit guidance on how to approach e-cigarette regulation and the long-term harms of these products are not yet certain, many countries are unsure how and whether to regulate these products.

In the US, the FDA has implemented steps to curb youth e-cigarette use and has proposed limitations on the sale of flavoured products (other than tobacco, mint and menthol flavours). Nearby countries have banned the products (Singapore)22 and some have included e-cigarettes under existing, strict regulations pertaining to nicotine (eg, Malaysia’s Poisons Act).23 The e-cigarette industry is present in many countries with varying levels of oversight and is increasingly seeking additional business opportunities. Indonesia and other LMICs have limited capacity to monitor and regulate these novel devices which pose potential threats to public health. JUUL’s entrance into the Indonesian market and the markets of multiple countries in Asia and Europe emphasises the need to monitor trends in e-cigarette use around the world, in order to prevent increasing global use of these products, and further nicotine addiction.

Contributors ENO conceptualised this manuscript alongside MP and RG while doing a fellowship under their supervision at the National Cancer Institute. All authors contributed to drafting and editing of the manuscript.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Patient consent for publication Not required.

Provenance and peer review Not commissioned; externally peer reviewed.

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Well, This is Awkward. Juul, the E-Cig Company, Just Had to Ban Vaping in Its Own Offices
An in-office perk is no more at Juul, the wildly successful e-cigarette company.

Juul, the fast-growing e-cigarette startup recently valued at $15 billion, had to deliver awkward news to its employees last week.

The mandate arrived via email from CEO Kevin Burns on Dec. 11. Effectively immediately, vaping was officially banned inside the Juul offices.

Its 800 employees are no longer allowed to use Juul products in the office. If employees want to vape, they now have to go to the Silicon Valley version of smoker’s lounge: a tent outside the office.

Wall Street Journal reported the news:

“It may feel nonsensical to prohibit at-work use of the very products we work hard to create and promote,” Burns’ email said, “But the bottom line is we need to comply with legal requirements the same as any company.”

Since 2016, e-cigarettes have been included in California’s statewide smoking ban, which covers workplaces, many public spaces, restaurants, and bars. Juul hadn’t been enforcing the ban in their own offices. Now they’re complying.

This isn’t the first time Juul has come under fire. The last few months have been rocky for the most popular e-cigarette on the market. The FDA conducted a surprise inspection of Juul headquarters earlier this year, seizing thousands of documents about the company’s marketing and sales practices.

To address claims that Juul targeted their products towards teens, the company suspended retail sales of flavored e-cigarettes and shut down its Facebook and Instagram profiles. Though Juul is no longer selling mango, fruit, creme, and cucumber flavors in retail stores, mint and menthol flavors are still sold. Truth Initiative, a non-profit that works to reduce the popularity of tobacco products among teens and young adults, found that mint is the most popular Juul flavor among 12-to-24 year olds.

Despite its rocky relationship with the FDA, the company is still going strong. The Altria Group, the parent company of Marlboro, is reported to be in talks to buy a minority stake in Juul. It’s become so popular, the brand name has become a verb.

“Smoking is gross,” a high schooler told The NewYorker earlier this year. “Juuling is really what’s up.” According to the magazine’s reporting, Juul owns 60 percent of the e-cigarette market. ?

PUBLISHED ON: DEC 16, 2018


War on e-cigarettes: Hong Kong intends to jail vaping offenders. But will it make people quit?

By Jenni Marsh, CNN

Updated 0131 GMT (0931 HKT) February 20, 2019

(CNN) – Robert Chan lit his first cigarette aged 18. He quickly became hooked, smoking 15 a day for more than a decade.

Like so many other smokers, Hong Kong-based Chan didn’t savor his addiction. He wanted to quit smoking cigarettes, but struggled to end his nicotine habit.

Two years ago, on his 30th birthday, Chan started using a device that heats tobacco — instead of burning it — to release a nicotine-laced vapor.

Chan is one of the 35 million people around the world believed to be using e-cigarettes or heat-not-burn products, according to Euromonitor.

“I wanted to stop smoking but I wasn’t quite ready to quit nicotine yet,” he says. “I saw this as a bridging device to do something less harmful than cigarettes … There’s no ash, no smell and my lungs and breathing feel better when I use it.”

E-cigarettes at a shopping mall in Mong Kok, Hong Kong.

But today that industry is facing a battle. While many smokers are embracing alternative devices in an attempt to quit cigarettes, governments around the world are divided.

This month, the Hong Kong government announced plans to push ahead with a controversial blanket ban on all e-cigarettes and heat-not-burn products.

Under the sweeping draft law, which begins its path through the legislature on February 20, anyone who imports, makes, sells or promotes new smoking products could face six months in jail or a HK$50,000 ($6,370) fine.

Chan says that legislation will make him choose between between becoming a criminal or doing something that’s worse for his health.

“This is either going to send people back to smoking real cigarettes or drive the whole industry underground to a black market,” he says.

The first e-puff

In 2003, Chinese pharmacist Han Li filed a patent for “a flameless electronic atomizing cigarette,” in the manufacturing heartland of Shenzhen, just across the border from Hong Kong.

A year later the world’s first e-cigarettes hit the market in China, and within 12 months they were being shipped around the world. E-cigarettes were seen as an enjoyable and safer smoking alternative — an important product in a country like China where more than 50% of adult males still smoke and lung cancer is the leading cause of death.

The technology works like this: a small lithium battery atomizes a liquid solution of nicotine to produce a fog which looks like cigarette smoke. When smokers inhale they get a similar sensation to puffing on a cigarette, but industry players claim the products can be 95% safer than burning tobacco.

The World Health Organization has cautioned that the long-term effects of vaping are unknown, and the nicotine they contain is addictive.

Today the United States is the world’s biggest e-cigarette and heat-not-burn market, worth $5.1 billion last year, followed by Japan and the United Kingdom, according to Euromonitor.

The products have widely been lauded as a way to wean people off traditional smoking. A study published earlier this month by the New England Journal of Medicine showed that e-cigarettes helped people quit smoking at double the rate of those using nicotine replacement therapy.

But consider this: of the 3 million people using the devices in the UK, only half are ex-cigarette smokers. And in the US, popular e-cigarette brand JUUL — which has 75% of the market — has come under fire for adding sweet flavors to its “e-liquids” that supposedly appeal to young people. Vaping has become so ubiquitous in many American high schools that the US Food and Drug Administration has called it an “epidemic.”

So are the products a pathway to giving up smoking, or merely an alternative gateway to nicotine?

For the Hong Kong government, protecting young people from vaping is more important than giving smokers an alternative to traditional tobacco products.

“These products are being marketed as trendy products to attract youngsters who don’t already smoke,” said Antonio Cho-shing Kwong, chairman of the Hong Kong Council on Smoking and Health, which lobbied the government for the proposed ban.

“The smoking prevalence for secondary school children in Hong Kong is 2.5%. With a rate that low, anything that would attract youngsters is dangerous.”

A spokesperson for the Hong Kong Food and Health Bureau said it considered all alternative smoking products “a gateway to the eventual consumption of conventional cigarettes,” and noted that “all these new smoking products are harmful to health and produce second-hand smoke.”

Under the ban, citizens can smoke their current supplies at home. But once those run out, buying alternative smoking products will pose a legal challenge.

The great vape debate

The world is divided over e-cigarettes.

Currently, 39 jurisdictions have outlawed alternative smoking products outright, including Brazil, the United Arab Emirates and Thailand. In Australia, e-cigarettes not containing nicotine are legal to buy — although such products are rare. The UK and US have ruled sale of e-cigarettes to adults is legal. The debate over whether or not to ban e-cigarettes is still rumbling in the Philippines.

Legislation and regulation has been slow to catch up with the industry as new products such as heat-not-burn devices, including the Iqos produced by tobacco giant Philip Morris, have entered the market.

Iqos technology is different from the e-cigarettes conceived in Shenzhen. The device heats rather than burns a stick of tobacco, which the company claims is 90% less harmful as it produces far fewer carcinogens.

“The Hong Kong legislation has wrapped everything into one: e-cigarettes and heat-not-burn, but the government has to understand the difference between what the two are and how they could regulate them,” says Brett Cooper, general manager of Hong Kong and Macau for Philip Morris.

In Japan, where 34% of people still smoke, nicotine e-cigarettes have been banned — but the Iqos is legal, and a runaway success.

“One in five people have switched from cigarettes to these alternative products in Japan,” says Cooper, noting that Iqos accounts for 15% of the tobacco market in Japan, where 3 million people use the device.

With the new legislation, Hong Kong is showing that it is opposed to “innovation, technology and emerging science,” Cooper adds.

Going underground

Nav Lalji has a difficult job. He is chairman of the Asian Vape Association, a group formed in 2015 to unite vapers in the region. However, it has since become a defensive body, as Singapore, Thailand, Malaysia and Japan have all outlawed e-cigarettes.

A former smoker who quit cigarettes for vaping, Lalji says he is “devastated” by the Hong Kong government’s decision — especially when other tobacco products, which kill more than 7 million people a year globally, will be left on shelves.

Lalji believes the ban in Hong Kong is simply going to turn smokers of e-cigarettes and heat-not-burn products into criminals.

“The thing is we’re located in Hong Kong which right next to Shenzhen, the hub and heartland of manufacturing e-cigarettes,” says Lalji, adding that the Chinese mega-city makes 95% of the world’s e-cigarette supply.

“So if anybody in Hong Kong can’t procure them legally, they could simply go across the border to China to pick them up, or order online.”

For others, the proposed law threatens to move Hong Kong into nanny state territory.

“The ban goes against a few values that I hold dear: freedom of choice as a consumer and freedom to get access to less harmful products,” says Brice L, a French expat living in Hong Kong who asked that CNN did not use his last name due to the legal sensitivities surrounding e-cigarettes.

?”Overall, it feels like the Hong Kong government is going backwards — and I don’t understand the reasoning behind it.”

Israel bans Juul e-cigarettes citing ‘grave’ public health risk

JERUSALEM (Reuters) – Israel on Tuesday outlawed the import and sale of e-cigarettes made by Silicon Valley startup Juul Labs, citing public health concerns given their nicotine content.

A statement by Israel’s Health Ministry said the Juul device was banned because it contains nicotine at a concentration higher than 20 milligrams per millilitre and poses “a grave risk to public health.”

Since launching in 2015, the flash drive-sized vaping device has transformed the market in the United States, where it now accounts for nearly 70 percent of tracked e-cigarette sales. The company is valued at $15 billion based on its most recent funding round, according to venture capital database Pitchbook Inc.

In a statement Tuesday, Juul Labs Inc said it was “incredibly disappointed” with what it called a “misguided” decision by the Israeli government. The San Francisco company said it planned to appeal the ban, adding that its devices provide smokers “a true alternative to combustible cigarettes.”

The Israeli move was consistent with similar restrictions in Europe, the ministry’s statement said.

The ban, which goes into effect in 15 days, was signed by Prime Minister Benjamin Netanyahu, who also holds the health portfolio.

Israel’s Haaretz newspaper reported in May that Juul e-cigarettes were already available for purchase at 30 locations around the country.

Juul says it targets adult smokers, but it has faced scrutiny over the popularity of its products with teenagers.

In April the U.S. Food and Drug Administration launched a crackdown on the sale of e-cigarettes and tobacco products to minors, particularly those developed by Juul Labs.

Writing by Dan Williams; editing by David Gregorio and Tom Brown

These holiday destinations have made vaping illegal

While vaping may be fine in your home country, there are parts of the globe where owning an e-cigarette can land you in serious trouble. Ever since the World Health Organisation published a study which claimed that e-cigarettes may not help smokers kick the habit, several countries have clamped down on their use.

Just recently, Cambodia, parts of India, Lebanon, Philippines and Vietnam, issued strict vaping bans which will see harsh penalties imposed on those who flout the law. In a puff of smoke, travellers could see their trip of a lifetime turn into a holiday from hell.

Thailand has some of the world’s strictest vaping laws and travellers caught with an e-cigarette can face up to ten years in prison. The laws are also especially strict in Singapore, Brunei and Taiwan.

There are plenty of grey areas around vaping laws and while you may have heard claims from fellow travellers that they encountered no such issues while bringing e-cigarettes intro countries where they’re banned, it is never worth the risk. Legislation around e-cigarettes can differ dramatically from country to country so it’s worth doing your homework ahead of travel. To get you started, here’s a list of countries that have made vaping illegal:

Argentina: Vaping has been banned in Argentina since 2011. You cannot legally purchase, sell or import e-cigarettes and even nicotine-free e-cigarettes are banned.

Brazil: The Brazilian government banned the manufacture and sale of e-cigarettes in 2014. Fines have been known to be handed out for any product confiscated.

Brunei: E-cigarettes have been illegal in Brunei in 2010. Anyone caught using a vaping device in a no-smoking area can be fined $300 (€256) if it is their first offence or $500 (€427) for a subsequent offence. Personal use is not specifically outlawed but travellers are advised to exercise caution.

Cambodia: E-cigarettes have been banned since 2014.

Egypt: While there are lots of grey areas surrounding the law, e-cigarettes have been banned since 2015 and they can be confiscated at customs.

India: E-cigarettes are banned in six states, including Jammu, Kashmir, Karnataka, Punjab, Maharashtra, and Kerala. The laws are strictly enforced in these states. In 2016, a man was sentenced to three years in prison and fined for allegedly selling and using vapes in Punjab.

Indonesia: Although travellers have reported that e-cigarettes are openly available for purchase in tourist areas and a number of e-cigarette cafes openly operate in Bali, vaping is banned in Indonesia.

Jordan: E-cigarettes, including those without nicotine, have been banned since 2009.

Lebanon: E-cigarettes have been banned since 2016.

Oman: While some expats report that personal use is still permitted, e-cigarettes have been banned since 2012.

Qatar: E-cigarettes have been banned since 2014 and cannot be brought into the country.

Malaysia: The laws around vaping in Malaysia can be confusing for travellers. While there is no nationwide ban on vaping, the states of Johor, Kedah, Kelantan, Negeri, Terengganu and Sembilan have banned their sale. Vaping is illegal in parks, gas stations and public buildings in Selangor and could result in a $2,300 (€1964) fine or up to two years in prison.

Mexico: E-cigarettes are banned as anything that resembles a tobacco product but is not a tobacco product cannot be sold or imported in Mexico. Although many tourists have been known to enter the country without any complications, there have been reports of authorities confiscating e-cigarettes for various reasons.

Norway: All products containing nicotine are banned in Norway. However, Norwegians can import e-cigarettes if they have a medical note to prove that they need them to quit smoking. Travellers cannot bring e-cigarettes into the country.

Panama: Despite reports that the personal use of e-cigarettes are generally tolerated, the importation and sale of e-cigarettes is illegal and they can be confiscated.

Philippines: E-cigarettes are banned and anyone caught breaking the law can face up to four months in prison.

Singapore: All vaping devices, supplies and accessories have been illegal to buy, sell or use since 2010. Fines of up to $5000 (€4270) can be applied for the first offence. E-cigarettes can be confiscated at customs and are considered contraband.

Taiwan: E-cigarettes are classified as a regulated drug and their import and sale can lead to prison sentences and fines.

Thailand: Thailand has some of the harshest vaping laws in the world. If you’re caught with an e-cigarette you could be fined and potentially face a prison sentence of up to ten years.

Turkey: E-cigarettes are banned in Turkey and there have been reports of e-cigarettes and accessories confiscated from travellers at customs.

United Arab Emirates: The sale and import of e-cigarettes is illegal. The product will be confiscated at the airport if travellers attempt to bring it into the country.

Uruguay: The sale of e-cigarettes has been illegal since 2009.

Venezuela: While travellers have reported being able to vape in some public places, the purchase and sale of e-cigarettes is banned in Venezuela. Be aware that fines can be given on the spot.

Vietnam: Vaping has been recently banned in Vietnam and harsh punishments can be enforced.

It’s worth noting that many other countries have imposed various restrictions around vaping without enforcing an outright ban. Always check the rules before travelling to avoid any hassle.

 

Pemerintah Harus Segera Memperkuat Kebijakan
Pelarangan Total Iklan Rokok di Semua Media Khususnya Media Online

 “iklan rokok di media online berpengaruh terhadap sikap anak dan remaja pada perilaku merokok. Iklan rokok muncul pada semua jenis media online, terutama pada semua platform media sosial yang populer digunakan kalangan anak dan remaja.”

 

Jakarta, 29 April 2019  – Tobacco Control Support Center, Ikatan Ahli Kesehatan Masyarakat Indonesia (TCSC, IAKMI) hari ini di Jakarta mengadakan sebuah diskusi publik mengenai pelarangan iklan rokok di media online. Diskusi publik ini menghadirkan nara sumber dari berbagai kalangan yang kompeten membahas isu penting ini, selain dihadiri pula oleh penggiat dan pemerhati pengendalian rokok di Indonesia. Para nara sumber adalah dari            Direktorat Jenderal Aplikasi Informatika Kementerian Komunikasi dan Informasi RI, Direktorat Pencegahan dan Pengendalian Penyakit Tidak Menular (P2PTM) Kemenkes RI, Komisi Perlindungan Anak Indonesia (KPAI)  dan Asosiasi Media Siber Indonesia (AMSI).

“Pelarangan total iklan rokok di media online sudah saatnya dilakukan. Pemerintah harus memperkuat larangan iklan rokok sebagian di media massa dengan larangan total iklan rokok di semua media termasuk media online,” papar dr. Sumarjati Arjoso, SKM, Ketua TCSC IAKMI. Hal ini karena terpaan iklan rokok di media berdampak pada sikap anak dan remaja pada perilaku merokok.  Riset Kesehatan Dasar tahun 2018 menunjukkan data bahwa terjadi peningkatan prevalensi perokok anak dan remaja usia 10-18 tahun dari 7,2% di tahun 2013 menjadi 9,1% di tahun 2018.

Seperti kita ketahui, di era industri 4,0 dunia kominikasi digital semakin berkembang pesat dan berperan amat penting dalam lalu lintas pesan publik. Tak bisa dielakan, imbasnya juga merambah media konvensional yang perannya semakin tergeser oleh media online. Salah satu hal yang kasat mata adalah beralihnya pemasangan iklan dari media cetak dan elektronik ke media online. Bisa kita lihat pada penempatan iklan produk rokok yang semakin gencar menyasar anak dan remaja lewat media online. Anak dan remaja, yang sejak dulu merupakan target utama iklan rokok, saat ini adalah generasi asli digital (digital native) dengan tingkat konsumsi media online yang tinggi. Sudah pasti, iklan rokok membanjiri media online dengan amat gencar dan masif demi memberikan terpaan tinggi bagi target utamanya, anak dan remaja. AC Nielsen dalam laman reminya menyebutkan, di Indonesia iklan rokok di media televisi menunjukkan penurunan volume sebesar 1,2 triliun rupiah pada tahun 2018 (1,6T) dibandingkan tahun 2017 (2,8T).

Drs. Anthonius Malau, M.Si, Kasubdit Pengendalian Konten Internet Kementerian Komunikasi dan Informasi RI, menyatakan, “Jika Kementerian Kesehatan berani mengeluarkan aturan yang menyatakan produk rokok dilarang diiklankan, termasuk di internet, maka Kementerian Kominfo akan melarang semua konten iklan rokok di internet.” Drs. Anthonius menambahkan, sebaiknya pendaftaran di media sosial berdasarkan nomor handphone sehingga mencegah anak yang belum cukup umur memiliki akun di media sosial dan tentunya mengurangi kesempatan anak untuk dapat melihat iklan di internet.

Di sisi lain, perlindungan anak dan remaja dari terpaan iklan rokok di berbagai media masih amat lemah. Kebijakan pelarangan total iklan rokok di Indonesia belum ada, iklan rokok hanya dilarang parsial. Padahal pelarangan iklan rokok sebagian terbukti tidak efektif melindungi anak dan remaja dari terpaan iklan.

Ridhwan Fauzi, MPH, peneliti TCSC-IAKMI memaparkan hasil studi yang dilakukan oleh lembaga ini pada akhir 2017 bahwa anak dan remaja usia dibawah 18 tahun paling banyak terpapar iklan rokok melalui TV. Selain itu, anak dan remaja juga lebih besar terpapar iklan rokok melalui internet disbandingkan orang dewasa. Ridhwan juga mengutip hasil studi yang dilakukan STIKOM LSPR, Jakarta tahun 2018 yaitu sebanyak 3 dari 4 remaja mengetahui iklan rokok di media online. Iklan rokok banyak ditemui oleh remaja pada platform media social seperti Youtube, berbagai website, Instagram, serta game online. Terpaan iklan rokok di media online ini memiliki pengaruh yang signifikan terhadap sikap merokok remaja di Indonesia dengan kekuatan pengaruh sebesar 31,8%.

Rekomendasi kepada Pemerintah:

  • Memperkuat kebijakan pelarangan total iklan rokok di semua media, khususnya di media online.
  • Meningkatkan kemitraan dengan Perguruan Tinggi, masyarakat sipil, organisasi profesi bagi penerapan dan pengawasan secara periodik dan terus menerus mengenai kebijakan pengendalian konsumsi rokok di Indonesia.

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Tentang TCSC IAKMI
Tobacco Control Support Center, Ikatan Ahli Kesehatan Masyarakat Indonesia (TCSC IAKMI), berdiri tahun 2017 di Jakarta, adalah organisasi sipil kemasyarakatan yang khusus bergerak di bidang advokasi kebijakan pengendalian tembakau dengan tujuan utamanya menciptakan generasi berkualitas bebas dari adiksi racun tembakau.

  

Kontak:

Kiki Soewarso
kikisoewarso@yahoo.com
0818820084

 

TCSC IAKMI
Gd. Mochtar, lt. 2, Jl. Pegangsaan Timur/ 16, Cikini, Jakarta Pusat
www.tcsc-indonesia.org; @tcsc.iakmi

Pemerintah Harus Segera Memperkuat Kebijakan
Peningkatan Ukuran Peringatan Kesehatan Bergambar Pada Bungkus Rokok

 “Mayoritas Masyarakat Indonesia mendukung Peningkatan Ukuran Peringatan Kesehatan Bergambar Pada Bungkus Rokok”

Jakarta, 14 Maret 2019 – Tobacco Control Support Center, Ikatan Ahli Kesehatan Masyarakat Indonesia (TCSC, IAKMI) hari ini di Jakarta memaparkan hasil studi tentang “Opini Publik Efektifitas Peringatan Kesehatan Bergambar Pada Bungkus Rokok”, yang telah dilakukan pada bulan September – Desember 2017 di 16 kota besar di Indonesia. Penelitian ini bekerjasama dengan 14 Universitas dan 1 Organisasi Kemasyarakatan meliputi kota Jakarta, Serang, Bogor, Semarang, Magelang, Jember, Kediri, Padang, Palembang, Medan, Pontianak, Banjarmasin, Makasar, Menado, Denpasar dan Mataram dengan total 5.349 responden. Tujuan penelitian untuk mengetahui persepsi masyarakat dan tingkat dukungan masyarakat terhadap upaya meningkatkan ukuran peringatan kesehatan bergambar.

Peringatan kesehatan bergambar pada bungkus rokok merupakan sarana edukasi publik yang efektif dan murah mengenai dampak buruk rokok bagi kesehatan guna menurunkan konsumsi rokok masyarakat yang masih terus meningkat. Saat ini, peringatan kesehatan bergambar pada bungkus rokok yang beredar di Indonesia luasnya sebesar 40% dari permukaan bungkus bagian depan dan belakang. Sedangkan Permenkes no. 40 tahun 2013 mengamanatkan luas peringatan kesehatan bergambar tersebut harus sebesar 75% dari permukaan bungkus rokok untuk tahun 2015 – 2019. Sayangnya hingga kuartal pertama 2019, belum ada tanda-tanda bahwa akan ada perluasan dimaksud.

Hasil opini publik yang dilakukan oleh TCSC IAKMI 6 bulan setelah implementasi peringatan kesehatan bergambar dilaksanakan pertama kali pada tahun 2014, menunjukkan 78,8% publik menginginkan perluasan peringatan kesehatan. Hasil studi terbaru yang dilakukan pada akhir 2017, semakin menunjukan mayoritas publik mendukung peningkatan peringatan kesehatan bergambar ini. Sebanyak 80,90% responden mendukung peningkatan sebesar 90% dan 64,10% mendukung peningkatan sebesar 75%.

Direktur Promosi Kesehatan dan Pemberdayaan Masyarakat, Kementerian Kesehatan RI, dr. Rizkiyana SP, Mkes, mengatakan dalam paparannya bahwa, “Peringatan kesehatan bergambar adalah upaya paling efektif dan murah untuk menurunkan prevalensi perokok pemula. Perlu adanya peningkatan kualitasa peringatan kesehatan bergambar ini.”

Tara S. Bahm dari Union, menegaskan bahwa tujuan utama implementasi peringatan kesehatan bergambar adalah untuk membangun kesadaran dan pengetahuan publik akan bahaya rokok, mendenormalisasi produk tembakau, juga melindungi anak dan remaja dari godaan menjadi perokok pemula, serta meyakiinkan perokok untuk berhenti merokok.

“Peringatan kesehatan bergambar di negara lain banyak yang amat bagus,” menurut Dina Kania, SH, LL.M dari WHO, menyoroti pelaksaan peringatan kesehatan bergambar di dunia. Sepuluh besar yang terbaik pelaksanaanya berasal dari negara berkembang, salah satunya Timor Leste dengan ukuran peringatan kesehatan bergambar sebesar 92,5%. “Padahal beberapa tahun yang lalu mereka masih jauh tertinggal, namun sekarang sudah jauh lebih maju dari Indonesia,” papar Dina selanjutnya.

Ridhwan Fauzy, MPH dari TCSC, IAKMI dalam diseminasi hasil studi ini menyajikan data bahwa ukuran peringatan kesehatan bergambar yang lebih besar, efektif dalam menginformasikan bahaya rokok kepada publik. Mayoritas responden (79,2%) menilai bahwa peringatan kesehatan bergambar 90% amat sangat dan sangat efektif dalam menginformasikan nahaya rokok kepada masyarakat. Hal ini, sesuai dengan studi eksperimental di Kanada bahwa ukuran peringatah kesehatan bergambar yang lebih besar memperkuat keyakinan orang dewasa dan remaja mengenai bahaya rokok bagi kesehatan.

Hasil studi ini juga menunjukan sebagian besar masyarakat merasa ukuran peringatan kesehatan bergambar yang lebih besar menimbulkan rasa takut terhadap bahaya rokok. Hal ini sejalan dengan hasil studi longitudinal di Uruguay (2016), bahwa peringatan kesehatan bergambar dengan luas 80% secara signifikan mendorong responden memikirkan bahaya merokok.

Peringatan kesehatan bergambar dengan ukuran lebih besar juga terbukti efektif memotivasi perokok untuk mengurangi jumlah konsumsi batang rokok dan membantu mereka berhenti merokok. (Hammond, 2011). Lebih dari setengah responden (53,5%) dalam penelitian ini merasa bahwa ukuran peringatan kesehatan bergambar 90% amat sangat efektif dan sangat efektif memberi motivasi perokok berhenti merokok.

Rekomendasi kepada Pemerintah:

  • Memperkuat kebijakan mengenai ukuran peringatan kesehatan bergambar menjadi 90% serta ukuran tulisan
  • Mencantumkan tulisan rokok dilarang dijual kepada anak usia 18 tahun ke
  • Larang penjualan rokok eceran dan menerapkan standar pengemasan rokok minimal 20 batang per bungkus.
  • Pita cukai tidak boleh menutupi peringatan kesehatan
  • Hapus pencantuman informasi tentang kadar tar, nikotin dan zat adiktif
  • Meningkatkan kemitraan dengan Perguruan Tinggi, masyarakat sipil, organisasi profesi bagi penerapan dan pengawasan secara periodik dan terus menerus mengenai kebijakan pengendalian konsumsi rokok di

 

-selesai-

Tentang TCSC IAKMI
Tobacco Control Support Center, Ikatan Ahli Kesehatan Masyarakat Indonesia (TCSC IAKMI), berdiri tahun 2017 di Jakarta, adalah organisasi sipil kemasyarakatan yang khusus bergerak di bidang advokasi kebijakan pengendalian tembakau dengan tujuan utamanya menciptakan generasi berkualitas bebas dari adiksi racun tembakau.

 

Kontak:

Kiki Soewarso
kikisoewarso@yahoo.com
0818820084

TCSC IAKMI
Gd. Mochtar, lt. 2, Jl. Pegangsaan Timur/ 16, Cikini, Jakarta Pusat
www.tcsc-indonesia.org; @tcsc.iakmi

Studi Paparan Iklan, Promosi, dan Sponsor Rokok
Pada Anak dan Remaja Usia dibawah 18 tahun di Indonesia

“Media TV, Acara Musik dan Pembagian Sampel Rokok Gratis adalah Tiga Kegiatan Iklan, Promosi dan Sponsor Rokok yang Paling Mempengaruhi Status Perokok Anak dan Remaja di Indonesia”

Jakarta, 28 September 2018 – – TCSC IAKMI hari ini melakukan diseminasi hasil penelitian mengenai “Paparan Iklan, Promosi, dan Sponsor Rokok Pada Anak dan Remaja Usia dibawah 18 tahun di Indonesia”. “Trend merokok pada anak dan remaja laki-laki dan perempuan yang terus mengalami peningkatan, menjadi latar belakang dilakukannya penelitian ini (Oktober – Desember 2017) di 16 Kota/ Kabupaten dengan total responden 1098 anak dan remaja usia di bawah 18 tahun,” jelas dr. Sumarjati Arjoso, SKM, MPH, Ketua TCSC-IAKMI. Lebih lanjut dr. Sumaryati menjelaskan, penelitian ini melibatkan enumerator dari 14 Universitas dan 1 Organisasi Masyarakat Sipil, bertujuan mengetahui: tingkat keterpaparan iklan, promosi, dan sponsor rokok; hubungan antara paparan iklan rokok dengan status merokok; hubungan antara paparan promosi dan sponsor rokok dengan status merokok pada anak dan remaja usia di bawah 18 tahun di Indonesia.

Hasil studi ini menemukan bahwa, secara umum, remaja paling banyak terpapar iklan rokok dari media TV (85%). Hal ini menunjukan bahwa media TV merupakan media iklan yang paling sering dilihat oleh anak dan remaja. Selain itu paparan iklan rokok di internet jauh lebih besar pada kelompok usia remaja (45,7%) dibandingkan dengan kelompok usia dewasa (38%). Secara umum, paparan promosi dan sponsor rokok terhadap anak dan remaja usia dibawah 18 tahun sama dengan paparan pada dewasa, yaitu paling banyak terpapar dari toko yang menjual rokok.

Dr. Hendriyani, S.Sos, M.Si dari Yayasan Pengembangan Media Anak (YPMA) mengatakan, “Penelitian mengenai pengaruh paparan dan dampak paparan iklan, promosi dan sponsor rokok pada anak dan remaja sangat penting. Selama ini industri rokok sangat agresif merekrut anak dan remaja menjadi perokok baru dan menjadikan mereka pelanggan tetap jangka panjang melalui kegiatan iklan, promosi dan sponsor rokok. Untuk itu semua kegiatan iklan, promosi dan sponsor rokok harus dilarang total!” Dari 10 media iklan rokok, ada 5 media yang memiliki pengaruh signifikan terhadap anak dan remaja usia dibawah 18 tahun untuk menjadi perokok yaitu, TV, radio, billboard, poster dan internet. Anak dan remaja usia dibawah 18 tahun yang terpapar iklan rokok di TV memiliki peluang 2,24 kali lebih besar untuk menjadi perokok dibandingkan dengan anak dan remaja yang tidak terpapar iklan rokok di TV. Sedangkan pada media Radio, Billboard, Poster dan Internet, kecenderungannya berkisar 1,5 kali lebih besar. Sebanyak 8 dari 9 media iklan rokok mempunyai hubungan dengan status merokok pada anak dan remaja di bawah usia 18 tahun. Toko yang menjual rokok paling tinggi paparannya, hal ini karena toko yang menjual rokok merupakan hal yang umum di kalangan masyarakat. Anak dan remaja usia dibawah 18 tahun yang melihat pembagian sampel rokok gratis memiliki peluang 2,8 kali lebih besar untuk menjadi perokok dibandingkan dengan anak dan remaja yang tidak melihat pembagian sampel rokok gratis. Pada kegiatan promosi dan sponsor lain angkanya bervariasi sebagai berikut, promosi di acara musik (2,45), kupon/ voucher rokok (2,07), diskon harga rokok (2,05), hadiah gratis (1,99), surat (1,93), logo rokok pada merchadise (1,74), acara olahraga (1,49). “Media TV, acara musik, dan pembagian sampel rokok gratis adalah tiga kegiatan iklan, promosi, dan sponsor yang paling berhubungan dengan status perokok pada anak dan remaja. Untuk itu iklan, promosi dan sponsor rokok harus dilarang total jika kita mau menciptakan generasi berkualitas tanpa asap rokok,” papar dr. Sumarjati Arjoso, SKM. DPR harus segera mengesahkan kebijakan yang tegas tentang larangan total iklan, promosi dan sponsor rokok seperti tercantum dalam RUU Penyiaran, yang sampai saat ini masih menggantung dalam pembahasan, himbaunya lebih lanjut.

 

-selesai –

Kontak: Kiki Soewarso
0818 820084
kikisoewarso@yahoo.com

Baby Smoker” Masih Tetap Ada!

Perlu Kebijakan Pengendalian Tembakau Yang Kuat dan Pro Kesehatan Publik Untuk
Menghentikan Munculnya Baby Smoker Baru di Seluruh Pelosok Indonesia

Jakarta, 21 Agustus 2018 —— Saat ini, peningkatan angka konsumsi rokok pada anak di Indonesia sangat mengkhawatirkan. Fenomena baby smoker di Indonesia atau perokok bayi tidak pernah hilang dan masih terus bermunculan baby smoker-baby smoker baru di pelosok-pelosok pedesaan dengan usia yang semakin muda. Kejadian yang masih terus berulang ini telah mencoreng nama Indonesia di dunia internasional. Tahun 1995, sebanyak 9,6 persen penduduk usia 5-14 tahun mulai mencoba merokok. Pada 2001, jumlah ini naik jadi 9,9 persen, kemudian terus melonjak hingga 19,2 persen pada 2010. (Fakta Tembakau, TCSC IAKMI, 2014). Angka-angka tersebut saat ini terus memburuk. Hal ini amat mengkhawatirkan, mengingat anak usia 5-14 tahun seharusnya masih di bawah pengawasan orangtua. Sedangkan para orang tua masih banyak yang menjadi perokok dan belum mendapat informasi serta pengetahuan yang benar tentang bahaya rokok.

Baru-baru ini kembali ditemukan batita perokok, Rapi Ananda Pamungkas asal Cibadak, Sukabumi belum genap berusia 2 tahun. Kasus Rapi ini sangat memprihatinkan, selain karena usianya yang masih amat muda, konsumsi merokoknya perhari amat tinggi, melebihi orang dewasa pada umumnya. Ini memperlihatkan bahwa usia pertama kali merokok pada anak-anak semakin dini. Setelah mencoba merokok dan terkena racun adiksi nikotin, anak-anak akan terus menjadi perokok dengan jumlah batang yang dihisap per harinya semakin banyak.

“Sungguh ironis, di saat Kementerian Kesehatan menggalakkan GERMAS (Gerakan Masyarakat Untuk Hidup Sehat) kejadian Baby Smoker masih terus ada, bukan terjadi pada anak SD atau TK, tapi pada batita yang bahkan belum berusia 2 tahun,” ujar dr. Sumarjati Arjoso, SKM, Ketua TCSC IAKMI. Hal ini merupakan kesalahan semua pihak. Dimulai dari perokok yang membuang rokok sembarangan, orang tua dan lingkungan yang merokok dekat anak-anak, penjualan rokok tanpa pembatasan, iklan rokok yang masif menyasar anak dan remaja, “Untuk itu Pemerintah perlu segera membuat aturan yang tegas guna menghambat munculnya baby smoker baru!” Demikianpapar dr. Sumarjati. Sejalan dengan itu, Rita Pranawati, MA, Wakil Ketua Komisi Perlindungan Anak Indonesia (KPAI) setuju bahwa, “Perlu peran negara untuk melindungi anak dari racun adiksi rokok.” Bukan hanya menjadi tanggung jawab pemerintah tapi juga masyarakat luas dan keterlibatan semua pihak berperan penting untuk menciptakan anak Indonesia yang berkualitas bebas dari asap rokok. Inilah satu-satunya cara menghambat munculnya bayi-bayi perokok baru.

Ketua No Tobacco Community, Ir. Bambang Priyono, M.T menelusuri jejak Rapi Ananda sampai ke rumahnya. “Awal mula anak ini merokok dari memungut puntungpuntung rokok yang ada di halaman rumah sampai akhirnya kecanduan,” tuturnya. Lebih jauh Bambang mendapati bahwa kondisi Rapi dipicu oleh ayah perokok dan Ibu berjualan rokok. Selain itu Rapi juga amat sadar dengan iklan rokok walapupun iklannya tidak menampilkan produk rokok. Jika melihat iklan rokok, Rapi langsung spontan minta dibelikan rokok dan tidak akan berhenti memaksa dengan segala cara hingga keinginannya terpenuhi.

Penelitian TCSC IAKMI pada tahun 2017 di 15 Kota/ Kabupaten menemukan bahwa, anak dan remaja usia dibawah 18 tahun paling banyak terpapar iklan rokok melalui TV (83%), banner (73,80%), billboard (67,10%), poster (64,80%), dan tembok publik (54,10%). Anak dan remaja usia dibawah 18 tahun yang terpapar iklan rokok di TV memiliki peluang 2,24 kali lebih besar untuk menjadi perokok dibandingkan dengan anak dan remaja usia dibawah 18 tahun yang tidak terpapar iklan rokok di TV. Begitu pula dengan anak usia dibawah 18 tahun yang terpapar iklan rokok di radio, billboard, poster, dan internet memiliki peluang sebesar 1,54 kali, 1,55 kali, 1,53 kali, dan 1,59 kali lebih besar untuk menjadi perokok. Kebijakan pengendalian tembakau yang komprehensif mutlak diperlukan guna mencegah bayi-bayi Indonesia menjadi perokok-perokok dini dan melindungi mereka dari ancaman adiksi racun tembakau. Anak dan remaja adalah target empuk industri rokok yang akan menjadi market jangka panjang mereka. Masyarakat perlu mendapat informasi yang jelas dan benar mengenai bahaya asap rokok. Peringatan Kesehatan Bergambar

Dalam Bungkus Rokok perlu diperbesar ukurannya agar lebih efektif lagi menginformasikan tentang bahaya rokok kepada masyarakat luas. Penerapan Larangan Total Iklan Sponsor Promosi rokok harus dilakukan, termasuk didalamnya adalah melalui UU Penyiaran. Kebijakan Kawasan Tanpa Rokok harus dilaksanakan dengan tegas dan tanpa kompromi melalui Peraturan-peraturan Daerah. Peningkatan pajak rokok perlu segera diberlakukan untuk membuat harga rokok menjadi amat mahal, agar sulit dijangkau oleh anak dan remaja juga masyarakat miskin. “Tanpa kemauan yang tinggi untuk membuat kebijakan pengendalian tebakau yang kuat dan komprehensif dan implementasi yang ketat, baby smoker akan terus bermunculan, semakin dini usianya dan semakin banyak jumlahnya. Indonesia akan semakin dipermalukan!” Pungkas dr. Sumarjati Arjoso, SKM.

 

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Tentang KPAI

Komisi Perlindungan Anak Indonesia (KPAI) adalah lembaga independen Indonesia yang dibentuk berdasarkan Undang-Undang Nomor 23 Tahun 2002 tentang Perlindungan Anak dalam rangka meningkatkan efektifitas penyelenggaraan perlindungan anak.

Tentang TCSC IAKMI

Tobacco Control Support Center, Ikatan Ahli Kesehatan Masyarakat Indonesia (TCSC IAKMI), berdiri tahun 2017 di Jakarta, adalah organisasi sipil kemasyarakatan yang khusus bergerak di bidang advokasi pengendalian tembakau dengan tujuan utamanya menciptakan generasi berkualitas bebas dari adiksi racun tembakau.

Tentang NOTC

No Tobacco Community adalah LSM yang berlokasi di Kota Bogor, melakukan kegiatan di bidang kesehatan, yaitu upaya penanggulangan masalah tembakau, khususnya masalah merokok.

 

Kontak:

Kiki Soewarso

kikisoewarso@yahoo.com

0818820084

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