6 August 2021
Elisabeth Kramer, Abdillah Ahsan, Vaughan W Rees Source: BMJ Journals
Introduction Indonesia has a high smoking prevalence that has not diminished significantly since 1990. Considering this, we aim to summarise the existing national tobacco-related policy mix and explore markers of policy incoherence in tobacco control between 2014 and 2020.
Methods We conducted (1) a review and synthesis of Indonesian tobacco-related legislation and regulations; (2) a systematic search and synthesis of related literature and news reporting; and (3) interviews with tobacco control activists and academics to understand political will towards tobacco control regulations and the tobacco industry.
Results Indonesia’s existing tobacco-related policy mix lies across the president’s office, six national ministries and one independent agency. However, current responsibility lies primarily with four government ministries: Ministries of Health, Finance, Communication and Information, and Trade and Industry, with the Ministry of Finance most active. Evidence demonstrates that official interministerial collaboration was lacking from 2014 to 2020 and suggests that institutional will to introduce more effective tobacco control varies considerably between different arms of government.
Discussion Political will differs according to ministerial mandates and priorities, fostering a fragmented policy approach and undermining the development of a coherent response. Without political will from the president or national parliament to create an overarching framework for tobacco control, either via ratification of the Framework Convention on Tobacco Control or another mechanism, there remains no formal impetus for intragovernmental cooperation. Nonetheless, this analysis reveals some government progress and ‘pressure points’ that advocates can focus on to promote tobacco control policies within the current policy mix.
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. The regulatory review uses publicly available data. Relevant interview data are included in the article, but full interviews and the identities of interviewees are not available due to ethical and privacy concerns.