The protracted revision of tobacco control regulation

It has been five years since the Government Regulation (PP) Number 109/2012 on “Safeguarding of Materials Containing Addictive Substances in the Form of Tobacco Products for Health” came into effect.

However, the implementation of this regulation has not resulted in decreasing cigarette consumption. In fact, smoking prevalence rate in Indonesia within five years increased by almost 2 percent, from 7.2 percent in 2013 to 9.1 percent in 2018.

“Currently, 35 percent of Indonesian people are active smokers, and 70 percent are passive smokers. The rate of child smokers grows significantly, reaching more than 8.9 percent. It is the fastest in the world. And since 1997, WHO has declared that tobacco and cigarette consumption is a global pandemic,” Tulus Abadi, Chairman of the Indonesian Consumers Foundation, said in a press release received by on Sunday, May 30, 2021.

Based on a 2019 report from the Southeast Asia Tobacco Control Alliance (SEATCA), entitled The Tobacco Control Atlas, Indonesia is the country with the highest number of smokers in Southeast Asia, reaching 65.19 million people.

The report also shows that around 79.8% of smokers can easily buy cigarettes at kiosks, stalls or minimarkets. Meanwhile, about 17.6% of smokers buy cigarettes from supermarkets.

The results of a survey by the National Tobacco Control Commission in 2020 stated that as many as 64.5 percent of respondents believed that a smoker was more susceptible to get infected with Covid-19.

On the commemoration of World No Tobacco Day (WNTD), which falls on Monday, May 31, 2021, smokers were encouraged to immediately stop smoking, in accordance with the theme of this year’s commemoration, “Commit to Quit”. According to data from the World Health Organization (WHO), the tobacco product causes 8 million deaths every year.

In addition, an evidence released this year suggests that when exposed to COVID-19, smokers are very likely to experience more severe symptoms of the illness than those who do not smoke.

Given this condition, the Chairperson of the Lentera Anak Foundation, Lisda Sundari, urged the government to immediately revise PP 109/2012. “In the past, we hoped that this regulation would be able to encourage a decline in cigarette consumption. Currently, however, the number of smokers is increasing instead,” said Lisda when contacted by by telephone on Monday, May 17, 2021.

According to Lisda, the high rate of child smokers was due to the government’s indecisiveness in regulating cigarette commercial advertisements, both on television, outdoor advertising and the internet. Article 46 paragraph (3) letter c of Law Number 32 of 2002 concerning Broadcasting (Broadcasting Law) only prohibits commercial advertisements that demonstrate the form of cigarettes. This condition is exacerbated by the practice of selling retail cigarettes. “Cigarettes are getting more and more rampant,” she said.

As long as there is no strict regulation, Lisda is pessimistic about the 2020-2024 National Medium-Term Development Plan target related to reducing the prevalence of child smokers to 8.7% in 2024.

In this regards, The Coalition of People Care for Health (Kompak) consisting of the Lentera Anak Foundation, the Indonesian Consumers Foundation, Surakarta Child Care Foundation, Pusaka Indonesia Foundation, and the National Commission for Child Protection encourage the government to revise PP 109/2012. “We see that this regulation lacks of legal force,” Lisda said.

According to her, PP 109/2012 needs to regulate retail cigarette sales, advertisements for tobacco products in public spaces, the internet, television and the placement of cigarette displays more firmly. “We believe that the revision will reduce smokers,” said Lisda, referring to Presidential Decree No. 9 of 2018 concerning the Program for Drafting Government Regulations.

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PP 109/2012 is one of the 43 Draft of Government Regulations (RPP) that are about to be revised. The content of the proposed changes includes three things, including pictures and writings of health warnings on tobacco product packaging, inclusion of information on tobacco product packaging and prohibitions.

President Jokowi has set a target that the revision will be completed within one year. “The Government Regulation Drafting Program, as intended, is set for a period of 1 (one) year,” stated the RPP issued in May 2018.

Meanwhile, in the 4th dictum, President Jokowi ordered the Ministry of Health to provide a quarterly report on the drafting of the PP to the Ministry of Law and Human Rights.

“The Minister of Law and Human Rights verifies and evaluates reports on the progress of the preparation of the Draft Government Regulation as intended to be subsequently reported to the President,” reads the fourth dictum of the Presidential Decree.

However, two years later, the Ministry of Health has not implemented this request. The two letters that Kompak sent on November 12 and 26, 2020 to the Ministry of Health were unanswered. “Revision of PP 109/2012 which is the responsibility of the Ministry of Health, seems to be slowing down. We are disappointed,” said Lisda.

Unsatisfied with slow response from the Ministry, the coalition then reported the Minister of Health, then held by Terawan Agus Putranto to the Ombudsman of the Republic of Indonesia (ORI) on December 3, 2020. The coalition suspected that Minister of Health Terawan had committed maladministration in the revision of PP 109/2012.

“However, the process of handling the alleged maladministration has not yet been completed. Then, at the end of December, there was a change of minister,” said Lisda referring to the appointment of Budi Gunadi Sadikin as Minister of Health to replace Terawan on December 22, 2020.

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The chairman of the National Tobacco Control Committee (Komnas PT) Hasbullah Thabrany also highlighted the importance of revising PP 109/2012. One of them is about the convenience for the public to access smoking cessation program services, as well as ensuring the availability of drugs used in smoking cessation programs.

“We believe that the Minister of Health currently has very good priorities who prefer preventive health rather than curative efforts. Therefore, the ongoing vaccine program must be accompanied by strengthening health regulations, among which the most urgent at this time is the revision of PP 109/2012 to suppress health curative problems that must again be carried out in the future,” he said as quoted from the website.

Not only the community coalition, an encouragement to the Ministry of Health to immediately complete the revision of PP 109/2012 was also sent by the Coordinating Ministry for Human Development and Culture (Kemenko PMK). The Head of the Non-Communicable Diseases Division of the Coordinating Ministry for Human Development and Culture, Rama Prima Syahti Fauzi, said that the ministry had sent letters to the Minister of Health three times. His request was almost the same, which is to urge the Ministry of Health to immediately complete the revised draft in accordance with President Jokowi’s orders and to re-propose discussions on the revision of the PP. “No agreement has been reached so far,” said Rama to by telephone, Thursday, May 20, 2021.

The Coordinating Ministry for Human Development and Culture, said Rama, has perfected the revised draft by including articles related to e-cigarettes. This is because Law Number 36 of 2009 concerning Health, including its derivatives, has yet to regulate the existence of e-cigarettes. “We have perfected the revision to include e-cigarettes to provide legal clarity about the issue,” said Rama.

According to Rama, the government wants to reduce the rate of consumption of e-cigarettes, which young people are starting to like. “In addition to regulating non-conventional cigarettes, it can also reduce the influence of children’s cigarettes,” said Rama.

Both Lisda Sundari and Rama Prima Syahti Fauzi hope that the Ministry of Health will no longer ignore Presidential Decree Number 9 of 2018 concerning the Program for Drafting Government Regulations. “We hope the revision will no longer protracted. Do not make it too long until they pass the deadline again,” concluded Rama.

A source told that the Ministry of Health in April 2021 had written to President Joko Widodo to request permission for the initiative to draft a presidential regulation as well as to ask for additional discussion time on the revision of PP 109/2012.

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However, the Ministry of Health has not been able to explain in detail about the discussion on the revision of the regulation. Head of the Advocacy and Partnership Division of the Ministry of Health’s Health Promotion Directorate, Sakri Sab’atmaja, when confirmed, handed over to the Health Promotion Director, Imran Nurali. Meanwhile, Imran did not answer even though he had been contacted by phone or Whatsapp.

Meanwhile, Head of the Bureau of Communications and Community Services, Widyawati, confirmed that the ministry was still discussing the revision of PP 109/2012. The ministry also promised to immediately submit a review and draft revision to the Coordinating Ministry for PMK, Ministry of Industry, and Ministry of Trade.

“Currently, we have yet to conclude the discussion, so we can not provide any information. In the near future, we will immediately report the progress,” said Widyawati to on Thursday, May 20, 2021.

The revised plan of PP 109/2012 will focus on expanding the health warning images from 40% to 90% and a total ban on promotions and advertisements in various media including point of sale. The prevailing version of PP 109/2012 is considered to be not strict enough in regulating the control of cigarette products and in limiting communication between producers and consumers.

Responding to this revised plan, Director of PT H.M Sampoerna, Elvira Lianita said that she did not know about the specific changes to PP 109/2012. To answer Jaring’s question, Elvira then asked to send the questions via Whatsapp message. However, as of this article has been published, there was no response from PT H.M Sampoerna. “Please send us the questions, we will answer it,” she said when contacted by on Wednesday, May 19, 2021.

Meanwhile, General Secretary of the Indonesian Personal Vaporizer Association (APVI), Edy Suprijadi, said that he had not received any information regarding the contents of the revised PP 109/2012, especially the part that is related to e-cigarettes. He added that he was not involved in the process of discussing the revision. “I do not know about the contents of the PP 109/2012 draft. I will find out first,” said Edy when contacted by via Whatsapp on Monday, May 24, 2021. (Abdus Somad)

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