The challenges of e-cigarette regulation in Indonesia

Despite being promoted as an “alternative” tobacco product for adult smokers, e-cigarettes are currently being used not only by smokers trying to quit, but also among youth who never smoked. This phenomenon has the potential to exacerbate the epidemic of nicotine product use among the next generation of Indonesians.

By Mouhamad Bigwanto

Double burden of epidemic

In Indonesia, smoking prevalence among youth aged 10-18 was 7.2% in 2013. The Indonesian government set a target to reduce this to 5.4% in 2019, but, instead of declining, the prevalence of smoking among young people increased to 9.1% in 2018. Aside from the increasing number of young people smoking in the conventional way, Indonesia is now faced with an invasion of new nicotine products – e-cigarettes.

Indonesia’s National Health Indicator Survey reported that the prevalence of e-cigarette use among youth aged 10-18 had reached 10.9% in 2018, increasing tenfold from 1.2% in 2016. A new study published in the International Journal of Adolescent Medicine and Health surveyed a sample of high school students in Jakarta and reported that 11.8% of students were e-cigarette users, with 6% being dual users (using e-cigarettes and cigarettes). Among those who use e-cigarettes, only 28.9% were formerly cigarette smokers and 20% of them had never smoked cigarettes before.

Unregulated and freely promoted

In 2010, The National Agency of Drug and Food Control (NADFC) in Indonesia declared e-cigarettes to be dangerous and designated them as illegal products. However, the agency lacks the authority to regulate this, meaning that their declaration had no impact and e-cigarettes remain widely available and freely promoted, both in stores and online. In order to control consumption, the Ministry of Finance took the initiative to impose the maximum excise rate of 57% on these products – meaning that their manufacture is heavily taxed, making them expensive to produce. This is the only regulation that exists for e-cigarettes to date.

E-liquid and vaping device
E-liquid and vaping device © HAZEMMKAMAL/Getty Images

The absence of regulation allows e-cigarette sellers to frame their product as a harm reduction tool, despite guidance from the global public health community. Findings from this new study revealed that students were motivated to vape, among other reasons, because they think it is less harmful and less addictive than cigarettes. Moreover, vape shops and online shops were reported as the main source for students to purchase e-cigarette devices and liquid, without any barriers given their age.

“Our research findings show that e-cigarettes are being used among Jakarta youth and highlight that e-cigarettes are seen as less harmful than cigarettes”, Dr. Mouhamad Bigwanto, the lead author of the research study, explains.

Health consequences

Recently, the World Health Organization (WHO) stated that Electronic Nicotine Delivery Systems (e-cigarettes) are “undoubtedly harmful and should therefore be subject to regulation.” The WHO also discourages the use of e-cigarettes as a smoking cessation tool. Many studies revealed that e-cigarette products have a detrimental effect on health, harming the pulmonary, immune, central nervous and cardiovascular systems.

Instead of acting as the solution to Indonesia’s smoking epidemic, these products are attracting youth and raising the potential for increased health risks. Government regulations, further research and surveillance are needed to ensure that young people stop using e-cigarettes, as well as preventing more young people from starting to use them.

Read the original article here:

Mouhamad Bigwanto, Mochamad Nurmansyah, Elizabeth Orlan, Yoli Farradika and Tri Bayu Purnama: Determinants of e-cigarette use among a sample of high school students in Jakarta, Indonesia, 04.12.2019.

The Editors

Articles signed by the editors were written in a collective effort.

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