Turning Away from Tobacco?

Vaping in Indonesia - New Naratif

The visibility is poor inside the vape shop and cafe in Tangerang, Banten Province. The vapour is everywhere, hanging in the air. Such vape shops are easily found in Indonesia’s bigger cities, especially in Java and Bali.

Eight or nine young men are hanging out in the cramped shop, roughly the size of a garage. Some perch on bar stools facing the display table; others lounge on a set of rattan benches. They chat with one another, all puffing away on vaping devices.

The shopkeeper, 22-year-old Claudius Hans, stands behind the display table, handling the customers as they search for liquids or replacements for the cottons and coils in their vaping devices. Whenever there’s a lull in business, Hans reaches for his own device and inhales deeply.

“People have leisure time here almost every night. Most of them are my friends, so I started to try [vaping],” he says. He’s the only vaper in the room who had never actually smoked cigarettes. “It’s been a year and half now. I wasn’t even a smoker before. Vaping is now a kind of lifestyle, but I could stop any time. I’m not hooked on this.”

Vaping: a replacement for smoking?

Generally considered a recreational activity, vaping uses e-cigarettes; a user inhales vapours produced by heating an e-liquid with a battery-operated device. Most e-cigarette liquids contain nicotine, and labels indicate the nicotine level: 0mg, 3mg, 6mg or higher. Other ingredients are also often added, including flavours like mango, banana, cream, blueberry or vanilla.

Often marketed as a replacement for smoking tobacco, vaping has been a controversial practice over the past decade, with critics arguing that e-cigarettes could be a gateway for children or non-smokers to eventually get on to real cigarettes.

Despite being vaguely known to Indonesians before 2010, the rising phenomenon of e-cigarettes can be traced to the start of 2014, when the first public fair was organised in Jakarta by vaping enthusiast Herwindo Prakoso and a friend. In that same year, the Association of Personal Vaporizer Indonesia (APVI)—an organisation of vapers who have since been seen as representatives of the industry—was initiated by a number of store owners, importers and users, including Prakoso.

Often marketed as a replacement for smoking tobacco, vaping has been a controversial practice over the past decade

Thousands of visitors attended that first e-cigarette fair, and the number of attendees has been significantly growing over the years. “There are several fairs each year. The biggest one is called Vape Fair, which is held annually and attracts hundreds of thousands of visitors,” says Prakoso, now an events administrator with APVI.

According to APVI, the number of e-cigarette users reached over 950,000 by the end of 2017, including over 650,000 active users. The APVI also stated that, by the end of last year, there were approximately 3,500 vape entrepreneurs in Indonesia, which is good news for the local job market.

“If a vape shop owner employs a minimum of two or three staff members to run the business, we can say that there are over 10,000 job opportunities. The turnover could be trillions of rupiah,” Prakoso adds.

Regulating e-liquids

The liquid used in e-cigarettes was regulated by the Indonesian authorities in July 2018, although an exemption was given to products that were manufactured prior to the start of the regulation and have yet to be labelled with tax bands. Full implementation of the regulation, to include all vaping liquids, will be put in place by October 2018. It’s a profitable move: once all manufacturers are registered, the government expects a revenue of IDR3 trillion (over USD207 million) a year from taxing e-cigarette liquids.

“Vaping liquids contain extracted nicotine,” says Deni Sujantoro, head of communications and public relations for the Directorate General of Customs and Excise. Extracted nicotine, he explains, is among goods subject to tariffs in Indonesia.

Sujantoro says that the issue was discussed extensively before the government’s decree  (link in Bahasa Indonesia) that introduced taxes on vaping liquid last year. “We [heard] different perspectives and interests,” he says. “Some emphasised the potential impact on public health, while others worried [about] its influence on children and so on. Therefore, it was decided that the products should be regulated by high taxes—the maximum.”

The 57% excise tax slapped on to e-cigarette liquids is four times higher than the maximum tax levied on tobacco cigarettes. “The goal is clear… To make all kinds of e-cigarette products not too cheap so they will not be easily purchased by those underage,” Sujantoro adds.

A 2015 report by BPS has also shown that an average household where at least one family member is a smoker might spend three to five times more on cigarettes than on education

But it seems strange that local authorities are so circumspect about vaping, especially as Indonesia is one of the countries with the largest number of tobacco smokers in the world, along with China and India. Out of a population of 260 million, over 72 million people in Indonesia aged 15 and above are cigarette smokers—some 62 million of them smoke daily. According to data provided by the World Health Organisation and the Global Health Observatory Data Repository, about 76% of the adult male population smokes; a sharp increase from the 61% in 2000.

Today, tobacco consumption is a heavy burden for many households in the country,” said the Indonesian Consumers Foundation (YLKI) in a press release on World No Tobacco Day in May 2018. According to Indonesian Central Bureau of Statistics (BPS), cigarettes are the second largest household expense after rice. A 2015 report by BPS has also shown that an average household where at least one family member is a smoker might spend three to five times more on cigarettes than on education. One would have thought that something to reduce cigarette addiction would be embraced with open arms.

The public health debate

Among developed countries, the United Kingdom was the first to see the potential of e-cigarettes in reducing the number of tobacco smokers. In August 2015, Public Health England (PHE)—an executive agency under the country’s Department of Health—declared that e-cigarettes are about 95% less harmful than smoking regular cigarettes. It also said that “there is no evidence so far that e-cigarettes are acting as a route into smoking for children or non-smokers.”

In an explanation of the report, Professor Kevin Fenton, the Director of Health and Wellbeing at PHE said, “E-cigarettes are not completely risk free but when compared to smoking, evidence shows they carry just a fraction of the harm. The problem is people increasingly think they are at least as harmful and this may be keeping millions of smokers from quitting.”

But the Indonesian government doesn’t seem quite as convinced. Some vapers have protested the 57% excise tax rate, arguing that e-cigarettes could be good for public health by helping smokers quit, but to no avail. It doesn’t help that some members of the government aren’t fans of e-cigarette use, and think of it as being just as unhealthy—or even more so—than smoking regular cigarettes. In November last year, Minister for Trade Enggartiasto Lukita commented that e-cigarette users “should be tobacco smokers instead.”

In January 2018, Minister of Finance, Sri Mulyani, was quoted by the media and said that a 57% excise tax imposed on e-cigarettes made sense, “since it’s for health’s sake.”

A question of price

Deni Sujantoro considers e-cigarettes a “middle-class thing”; even if vaping does help some Indonesian smokers to quit, it’ll mainly be confined to the middle class due to the high taxes that the government wants to impose on vaping products.

E-cigarette liquids currently cost between IDR100,000 (USD7) and IDR300,000 (USD21) per container, although shop owners plan to increase the price by at least 10% once the regulation is fully implemented. A pack of e-cigarette liquid—which comes in 60 millilitre containers—may last two to three weeks, depending on one’s consumption level. When asked during a vape fair in Jakarta, one user said that, “Vaping is more affordable. I was a tobacco smoker consuming two packs of cigarettes a day.”

Such a cigarette smoker, who goes through two packs of Marlboro Lights every day, will end up spending a total of IDR1.5 million (USD104) per month. On the other hand, a user consuming two packs of liquids priced at IDR150,000 (USD10.40) each could spend at least IDR600,000 (USD42) per month, inclusive of the device’s maintenance. It’s a significant saving.

But the numbers don’t also work out this way for everyone. “Users must do the maths themselves,” Hans says. “I would say it’s not necessarily cheaper.”

Vaping in Indonesia - New Naratif
Young men spend a leisure time at a vape shop and cafe in Tangerang, Banten province, Indonesia, 25 June 2018. Despite a maximum excise tax on the liquids, vape shop is a booming business in Java and Bali, Indonesia. Credit: Reynold Sumayku

The type of vaping device, Hans explains, can often be a determinant in one’s calculations. A user with a common device—without an e-liquid tank—needs to pay at least IDR25,000 (USD 1.70) for the cotton or coil replacements. “The cottons need a change every three or four days, and ideally once a week for the coils,” he explains.

It also depends on how much one smokes, and what one smokes. While Marlboro Lights cost IDR25,000 (USD1.70) per pack, locally-produced tobacco cigarettes—mostly clove and tobacco cigarettes known as kretek—are priced between IDR15,000 (USD1) to IDR17,000 (USD1.18). Unless one smokes a huge amount, it could still be cheaper to stick with local smokes than switch to vaping. A survey done by the Centre for Social Security Study at the University of Indonesia (PKJS-UI) found that 66% of respondents said they would only stop smoking if the price of cigarettes went up to IDR60,000 (USD4) per pack. More (74%) would quit if the price was IDR70,000 (USD4.80) per pack.

National interests and harm reduction

Despite some of the benefits that vaping may provide, there seems little interest in trying to steer smokers away from cigarettes. Indonesia has long struggled to reduce the number of smokers in the country, but activists say there’s no strong political will from the government to do so. Although Indonesia participated in the preparation of the Framework Convention on Tobacco Control (FCTC)—a document initiated by the World Health Organisation for tobacco control—it has not yet signed or ratified the agreement.

Last year, local media quoted the government saying that it has chosen to prioritise its “national interests”, despite planning to ratify the FCTC. Among these “national interests” is the welfare of tobacco farmers—the World Bank reported that 43% of Indonesian households involved in manufacturing tobacco are poor.

However, the “national interests” also include government revenues. During the period from 2005–2015, revenue from tobacco excise increased from IDR33 trillion (USD2.2 billion) in 2005 to IDR140 trillion (USD9.7 billion) in 2015. Two years later, in 2017, this reached over IDR153 trillion (USD10.6 billion). This was excluding tax on other tobacco products and corporate tax on tobacco companies.

“The problem with tobacco smoking is that any delay [in getting people to quit smoking] will cost millions of lives each day”

Konstantinos Farsalinos, a cardiologist and researcher with Onasis Cardiac Surgery in Athens, thinks that e-cigarettes should be pitched in terms of tobacco harm reduction. Currently conducting a survey among Asian vapers, including those in Indonesia, Farsalinos uses the analogy of using seat belts or helmets: “Not driving a car or not riding a motorcycle is the best option to eliminate the risk of accidents. Although not absolutely safe, the use of seat belts when driving cars or helmets when riding motorcycles are accepted as harm reduction approaches.”

A former smoker himself, Farsalinos had tried nicotine gum and other products without much success before trying e-cigarettes. But he has also observed fear-mongering and bias in the discourse around vaping. “I can see there is a substantial predisposition against the use of nicotine in any form, even against a cleaner product such as e-cigarette,” he writes in an email.

“We saw that a lot of research regarding e-cigarettes was driven by [this] predisposition, which has always been a less appropriate approach to research,” he adds. “As a result, we saw many examples of misinterpretation, which led to incorrect conclusions and misleading arguments.”

By 2017, according to the WHO’s data, more than six million deaths were the result of direct tobacco use. In addition, around 890,000 deaths are the result of non-smokers being exposed to secondhand smoke.

“E-cigarettes are a special product for smokers, and should be used as an aid to quit smoking, by switching to a product that has lesser impacts,” Farsalinos says.

“The problem with tobacco smoking is that any delay [in getting people to quit smoking] will cost millions of lives each day.”

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