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Indonesia's 'smoking baby' kicked his habit but the battle against tobacco rages on
Sydney Morning Herald - June 18, 2017
Shocking footage of the toddler precociously puffing on fags went viral on YouTube and became a symbol of the smoking crisis in a country described as a last Eden for tobacco manufacturers.
Six years after two-year-old Aldi started sneaking ciggies while his mother sold fish at the market, Fairfax Media tracked him down in the remote village of Teluk Kemang in South Sumatra. Now almost nine and in fourth grade, Aldi is one of the world's youngest reformed smokers.
"I kept watching people smoking and it looked delicious. It feels good when smoking. But now I think chocolate is better than smoking," Aldi tells us.
He quit four years ago with the assistance of famous child psychologist and TV personality Dr Seto Mulyadi. It was an arduous struggle and one that saw Aldi initially swap cigarettes for food, leading to a fresh battle to control his ballooning weight.
"After he quit smoking, he ate a lot whenever he felt like smoking," says Aldi's mother, Diana Rizal.
"He would eat three chicken legs at one meal, three bowls of bakso (meatball soup) at once, one tin of condensed milk in the morning and one at night. If I said to eat less, he would throw tantrums and threaten to go back to smoking. So I just let him eat what he wanted. His weight got out of control then."
When Aldi started school, kids made fun of his huge lunch box. He began to cut down on the size of his meals and his weight is now under control.
The infamous "Indonesian smoking baby" YouTube videos raised international awareness about the alarmingly high child smoking rate in Indonesia: 20 per cent of Indonesians aged 13 to 15 smoke according to the 2014 Global Youth Tobacco Survey.
But now health experts are alarmed that a controversial bill before parliament aimed at increasing cigarette production will roll back regulations discouraging smoking in Indonesia.
"My parents know I smoke, they don't mind. My parents only ask for one thing, I don't inhale glue. I smoke, but I am not addicted to it. It's just like candy. I can stop anytime."
Indonesia and three other tobacco-producing countries have also appealed against Australia's world-first cigarette plain packaging laws to the World Trade Organisation, arguing they created an illegal trade barrier. The final ruling is expected next month but a leaked draft reportedly found in Australia's favour.
Aldi's internet notoriety meant that Diana was pilloried for being a bad mother. She blames herself, in part, for Aldi smoking at such a young age because she craved cigarettes while pregnant, whereas with her other children her cravings had been for sour fruits and green mangoes.
But Diana also tells us of her struggle to get Aldi to quit in the middle of a fishing village where smoking is ubiquitous and villagers would give him money to buy cigarettes because he was "cute and funny".
"The first thing I did was confiscate the cigarettes and he would throw a tantrum. He started banging his head, he stabbed himself in the knee with a knife," she says. "He woke at 3am and started demanding cigarettes."
Diana says she tried every method available to make him quit including hot ointment on cigarette tips and taking Aldi to an isolated river house. "He said: 'If you don't give me a cigarette I will jump'. I thought, like other kids, it was just an empty threat. He jumped."
She shows us the scar on his head. "There was blood everywhere. After that I caved in. If he wanted cigarettes he got cigarettes." It was not until a local journalist reported the case to Dr Seto that Aldi received two months of therapy in Jakarta and managed to quit.
Like many a reformed smoker, Aldi now warns of the difficulties of quitting. He wants to be a doctor and tells his dad to stub out his cigarettes: "I quit and you didn't," he tells him. "If we smoke, we will ruin our lives," he says. "Nerves and brain, all will be ruined. Throat, teeth..."
On the main road of Aldi's village of Teluk Kemang, an enormous billboard blocks the sky advertising Sampoerna – the leading tobacco company in Indonesia and part of Philip Morris International. "Size is important," the slogan says.
Increasing restrictions in countries such as Australia means Indonesia – where public smoking and cigarette advertising are largely unregulated – is one of the final frontiers for Big Tobacco.
Point-of-sale advertising here is startling after coming from Australia where cigarettes are banned from even being displayed in shops.
In Indonesia TV screens above rows of cigarettes in mini-marts have commercials on endless replay. Cigarette ads ranked fifth in television advertising spending in 2016.
"We [Australia] banned tobacco advertising 25 years ago but in Indonesia it's rampant," says Mike Daube, a professor of health policy at Curtin University. "Any controls are notional where kids are heavily exposed to cigarette adverts that make smoking seem cool and glamorous."
A 2015 survey found 85 per cent of schools in five cities in Indonesia – including the capital of Jakarta – were surrounded by cigarette ads.
Daube does not mince his words. "I think Indonesia is a public health nightmare," he says. "It's just desperately depressing. When you look at the magnitude of the problem it is quite catastrophic. Even with conservative estimates we are looking at 200,000 deaths a year caused by smoking."
Cigarettes are also among the cheapest in the world here. A pack of Marlboro – one of the most expensive brands – will set you back just 25,000 rupiah (about $2.50). Single sticks, known as loosies, are sold at roadside stalls for the equivalent of a few cents.
Thirteen-year-old Sandi Saputra works nights at a nasi goreng (fried rice) stall in Palembang, the capital of South Sumatra, and attends school by day. He earns the equivalent of $2.50 a night, most of which he gives to his parents, but has a bit of leftover pocket money to spend on loosies.
"I started smoking when I was in first grade, seven years old, because everybody was smoking, all my friends," he says. "My parents know I smoke, they don't mind. My parents only ask for one thing, I don't inhale glue. I smoke, but I am not addicted to it. It's just like candy. I can stop anytime."
While smoking is decreasing globally, it is increasing here. Indonesia already has the highest male smoking rate in the world – 67 per cent according to the 2011 Global Adult Tobacco Survey – although for cultural reasons the female smoking rate is much lower.
About one-third of the population of 250 million smokes, compared with 12 per cent of Australians.
In 2014 Indonesia began mandating that 40 per cent of cigarette packets must be covered with the sort of graphic pictorial health warnings – cancerous mouths and tracheotomy holes – familiar to Australian smokers.
It was a rare victory for anti-smoking activists in a country where health reforms pose a dilemma because the tobacco industry is a significant part of the economy. Indonesia is the fifth-largest tobacco leaf producer in the world and Sampoerna its largest taxpayer.
It is one of only a few nations not a signatory to the World Health Organisation's Framework Convention on Tobacco Control, which stipulates that government policies be protected from the vested interests of the tobacco industry.
The 2016 Tobacco Industry Interference Index found Indonesia had the highest level of tobacco industry participation and interference in government policy in the ASEAN region. "There is currently a pro-tobacco bill in Parliament for debate which serves to protect tobacco farmers rather than public health," it says.
The bill seeks to triple cigarette production to 524 billion by 2020. "If passed, this bill has the potential to roll back the few achievements in tobacco control such as the pictorial health warnings currently applied on cigarette packs."
This has raised alarm bells within Indonesia's health ministry. "The problem now is that many of our children are smoking," says director for health promotion Dedi Kuswenda.
He says the health ministry would like to see the warnings enlarged to cover 75 per cent of packs and then move to plain packaging. "In Australia more people are not smoking now. But it is as if we [Indonesia] are becoming a cigarette sale area. At the end of the day it is about increasing profit when we need to be healthy."
But Syarif Abdullah Alkadrie, one of the parliamentarians debating the proposed new law, says the bill is about protecting tobacco farmers. He says 50 per cent of Indonesia's tobacco is imported and lawmakers want this restricted to 20 per cent. "We must look at this issue from both sides," he says. "A lot of people earn their living from tobacco."
The Indonesian government has made no secret of its irritation with Australia over the plain packaging laws. A final ruling on the WTO appeal, expected next month, is predicted to uphold Australia's argument that the rules don't violate trade laws because they qualify as a legitimate public health measure.
But it will come at a sensitive time. Australia and Indonesia are negotiating a free trade deal – slated to be concluded by the end of the year – and Indonesia is already angry about dumping duties slapped on its A4 paper exports.
Trade Minister Enggartiasto Lukita "joked" to his Australian counterpart, Steven Ciobo, that he would consider requiring Australian wine sold in Indonesia to pass halal certification and use plain packaging in retaliation. "I deliver it in a light way though, and it was just an expression of my resentment," he was quoted as saying in The Jakarta Post.
Smoking has long been a vexed issue in Indonesia. A 2009 fatwa prohibiting smoking in public places or by pregnant women and children was the most controversial ever issued by Indonesia's highest Islamic clerical body.
"So far we have always been able to come to the same conclusion, with no dissenting opinion except for once, when we issued a fatwa on smoking," Indonesian Ulema Council (MUI) chairman Ma'ruf Amin told Fairfax Media earlier this year. "We argued for two days and could not come to a solid conclusion. Some agreed to smoking and some did not."
The local variant of cigarettes – Kretek – are a source of national pride. A mixture of tobacco and cloves, they lend the streets of Indonesia a distinctive sweet smell.
Aditia Purnomo and Muhammad Nur Azami are members of the smokers' rights group Komunitas Kretek. Both were activists – Azami a "green" warrior" and Aditia involved in the labour movement – who happened to smoke and became angry about regulations they felt discriminated against smokers. "So we decided to fight back against the government," Aditia says. "It [smoking] is a human right."
Aditia says the first major anti-smoking campaign was by Hitler's Nazis, who wanted to protect the health of the Aryan master race. He believes it hypocritical of the government to regulate smoking while reaping tax benefits from its revenue: "If health is a priority, just say smoking is illegal."
In the past, Aditia says, people believed Kretek could be used as medicine to treat flu or coughing because they contained cloves. He still believes they have some benefits, but acknowledges there are also side effects.
Azami's black T-shirt is emblazoned with the slogan "Kretek are not cigarettes". He says the anti-tobacco movement serves the interests of the health industry that produces nicotine patches and electronic cigarettes. "It's not fair only tobacco products have pictorial warnings. What about junk food, KFC, McDonalds, children driving motorbikes?"
The June edition of global trade magazine Tobacco Reporter carries a story, "Trouble in Paradise", which notes that Indonesia's tobacco industry is facing new challenges. It points out the nation's two largest cities – Jakarta and Surabaya – have moved to make indoor places smoke-free.
Notwithstanding that "Indonesia's tobacco control efforts are half-hearted and the government's attitude towards the sector remains ambivalent", Tobacco Reporter says, the country is slowly moving to a more restrictive environment.
"It is only a matter of time before the country's tobacco industry will be operating in the same conditions that have long been common in other parts of the world."
Perhaps the remarkable story of Bone-Bone, a tiny village in South Sulawesi with a population of 800, provides a glimpse into this future.
In 2000, former hamlet head Idris, who ran a small warung (roadside stall), noticed villagers were spending big chunks of their incomes on cigarettes. "They were just wasting their money," he tells us.
Idris approached village leaders to discuss how to stop smoking. The first step was an initially unpopular proposal that the village warungs stop selling cigarettes. Within six months all eight had signed up.
Smoking was then banned in public places. No smoking signs were posted everywhere with horrible pictures of blackened lungs. "One kid went home crying. He said he didn't want his dad's lungs to turn black like in the pictures."
Idris preached against smoking during Friday prayers. He even offered cash incentives to children to dob in their parents. "By 2007 there were no more smokers," Idris says.
"The village then issued a regulation that smoking was not allowed." Transgressors – and there have only been two villagers caught to date – have to confess over the mosque speaker.
Even visitors are not immune to the ban. Local government officers who smoked in Bone-Bone – ironically there to promote health programs – were fined up to 1 million rupiah ($100).
"Villagers can see the effect of not smoking," Idris says. "They are healthier and no more children have to drop out of school because now their parents can afford to send them."
[With Amilia Rosa and Karuni Rompies.]
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