Indonesia is a major grower and exporter of tobacco and is the fifth largest market for tobacco consumption in the world. It has been estimated that Indonesia’s population of 242 million consume 182 billion cigarettes each year.1 Consumption increased rapidly between 1970 and 1980 (over 150%), largely due to the mechanisation of the clove cigarette industry.2 National survey data reveals that adult smoking prevalence is high, with 62% of men and approximately 1% to 3% of women smoking.1 3 4 Not only is smoking ubiquitous among males in Indonesia, but initiation begins early with over a quarter of urban and rural 10-year-old boys already smoking.3 It is estimated that tobacco-related mortality accounts for 10% of total deaths in Indonesia.5

Tobacco companies are politically and financially powerful in Indonesia because they are the largest source of government revenue after oil, timber and gas. As a relatively decentralised industry, their penetration into government at all levels makes them particularly effective at promoting their smoking agenda.

Cigarette excise taxes are an important source of national revenues and have increased over time from 4% in 1996 to nearly 10% of the total government revenue in 2002.5 The revenue for the Indonesian government from tobacco taxes was approximately 38 trillion rupiah (Rp) or approximately $4.2 billion US dollars in 2006.6^–8 Revenues from cigarette excise taxes are considered so critical to the functioning of the Indonesian government that the Minister of Finance was quoted as stating: “I sympathize with the idea of getting people to stop smoking, but for now the cost is too high”, referring specifically to Indonesia’s present economic situation.1 Despite the substantial revenue generated by excise taxes, tobacco is taxed at a very low rate compared to other countries in the region.1 9 There is a tiered system to excise taxation on tobacco in Indonesia. Kretek (clove cigarettes) carry a lower excise tax than white (Western style) cigarettes, which the industry has demanded, noting that kretek should be promoted as an indigenous Indonesian product similar to traditional medicines.

The tobacco industry employs about 11 million workers and is the second largest employer after the government.3 8 Because of the economic value of tobacco and the industry’s powerful political connections, Indonesia has minimal anti-smoking policies and regulations. Only in government offices, health facilities and schools are people officially prohibited from smoking, although these regulations are not strictly enforced.10 11 Notably, Indonesia is the only country in the Asia Pacific region that has not signed or ratified the World Health Organization (WHO) Framework Convention on Tobacco Control.

The tobacco market in Indonesia is unique because over 90% of all smokers smoke indigenous cigarettes, kretek, and 10% smoke “white” cigarettes.5 Kretek are locally manufactured clove cigarettes that contain a blend of ground cloves, tobacco and hundreds of additives, referred to locally as the spices (bumbu), which contribute to the cigarette’s unique flavour.12^–14

Kretek tend to be inhaled deeply due to the anesthetic quality of the clove and are worse for health than conventional “white” cigarettes smoked in the West. On average, they contain more nicotine (1.2 mg–4.5 vs 1.1 mg), more tar (46.8 mg vs 16.3 mg) and more carbon monoxide (28.3 mg vs 15.5 mg) than white cigarettes.15 16 Kretek far exceed WHO standards of not more than 1 mg nicotine per cigarette.13 Although legislation passed in Indonesia in 1999 stipulated maximum nicotine and tar levels for each cigarette (1.5 and 20 mg, respectively), these regulations were eliminated in 2003 due in part to pressure from the industry.1

Kretek are inexpensive, ranging in price from Rp 2500 ($.27 US) to Rp 23 500 ($2.55 US) per pack of 12 or 16, depending on brand. They can also be purchased by single cigarette for as little as Rp 300 ($.05 US); in fact, one of the major tobacco manufacturers (Sampoerna) claims that single cigarette sales account for over 30% of their total cigarette sales.17

Three companies maintain over 75% of the market share for kretek: Gudang Garam (30%), Sampoerna (29%) and Djarum (18%).5 In 1999, Gudang Garam was the top earning company in Indonesia, surpassing the major car manufacturer (Astra Indonesia) and instant noodle company (Indofood).18 In fact, Gudang Garam is 1 of the 10 largest cigarette manufacturers in the world.14 In 2005, Philip Morris bought Sampoerna for $5.2 billion dollars (US), with explicit plans to enlarge the industry in Indonesia and to export to other countries in Asia. In 2007, they launched the Marlboro kretek aimed at urban smokers. A pack of 12 “Marlboro Mix 9” kretek is competitively priced at Rp 7000 ($0.78 US).

The advertising environment

Indonesia can best be described as an “advertiser’s paradise”, as it is a largely unrestricted regulatory environment. Cigarette marketing in Indonesia is among the most aggressive and innovative in the world. As Sampoerna noted in their annual report in 1995: “Indonesian companies have almost total freedom to advertise their products in any format and through any communications vehicle in the country”.19 Unfortunately, this statement is as true today as it was over a decade ago. The reported expenditure by the tobacco industry on advertising in Indonesia in 2006 was Rp 1.6 trillion (approximately $178 million US dollars).20

Tobacco advertising literally saturates the landscape in the city of Yogyakarta in central Java, the site of the present study. Yogyakarta, which is a major cultural and educational centre, has a population of about 3.5 million. One can barely walk a few metres without seeing an advert for multiple brands of kretek. Much of the outdoor advertising is in the form of cloth banners that hang broadly across the width of multi-laned roads and as oversized flags hung consecutively on the side of roads, serving as a powerful reinforcement of brand name.

Tobacco billboards are placed prominently throughout Yogyakarta and are changed frequently. Spending on billboards by the tobacco industry has become increasingly important for local governments since decentralisation laws were implemented in 2001, and taxes on billboards became a key component of local government revenues. Decentralisation has also given rise to local tobacco factories, which bring additional revenue to local coffers. In Yogyakarta, the local government has benefited from direct revenues and from “social contributions” given by the industry that include constructing city gardens, creating bus shelters, city lights, etc.21 The local government of Yogyakarta has “special control” over placement of billboards throughout the city. At the national level, in 2004, 50% of all billboards in Indonesia contained cigarette advertisements.22

Most small kiosks and shops are covered with tobacco advertisements and small shop owners are provided with cash payments and art supplies for purposes of decoration. In Yogyakarta, a yearly competition is sponsored for the most creative advertising with impressive prizes provided to the winner. Sampoerna’s (Philip Morris International) popular brand Dji Sam Soe, for example, offers a grand prize of a trip for two to go on a pilgrimage to Mecca.

Tobacco advertising also pervades newspapers and magazines. Perhaps most prominent in Indonesia is the sponsorship by the industry of local and international jazz and rock concerts, cultural events, and sporting events such as Formula One and national and local basketball and soccer competitions. Between January and October 2007, there were 1350 events sponsored by the tobacco industry, or 135 each month, in Indonesia. Indonesian youth are frequently targeted: in 2007, 99.7% of youth reported seeing tobacco adverts on television, 87% on billboards, 76% in print media and 81% had attended at least one event sponsored by the tobacco industry in their lifetime.20 The tobacco industry offers numerous scholarships to attend colleges and until recently, to medical students. In most medical colleges—except for the few that have gone smoke-free—tobacco advertising is prominently displayed in the college canteen. Distribution of free samples or coupons for discounts on tobacco purchases are commonplace. During the 2004 election campaigns, cigarettes branded with the names of political parties were distributed widely during rallies.23

The tobacco companies are heavily involved with local celebrations. During the recent anniversary celebration of the city of Yogyakarta in 2008, Djarum served as the chief sponsor, increasing their advertising all over the city. Tobacco companies’ financial support for urban neighbourhoods (kampungs) is pervasive. For example, kampungs in Yogyakarta are offered funds by tobacco companies (eg, Djarum) to decorate the gate and/or entrance to their community with the logo of a particular cigarette brand. Multi-level prizes are provided for creative presentation. Prize money supports neighbourhood improvements such as installing street lighting, building a raised tower for improved night watch, etc. The frequency of these sponsored contests allows for kampungs around Yogyakarta to obtain tobacco industry support. Sponsorship allows a company to create prestige and credibility for tobacco brands building loyalty and ultimately political power, at the local, community level and at the same time creates gratitude from recipient organisations for the generosity of the industry. It also serves to socially legitimise and normalise smoking and to produce allies among community members for the industry.24

The only restriction on tobacco advertising that has been passed in Indonesia was in 2000, when it was determined that they could only be shown on television after 9:30 pm. Starting at this time and continuing until 5 am, advertisements appear at the rate of 15–20/h on the most popular channels, as calculated by the authors. By law, television advertisements are required to carry warnings that smoking increases the risk of having cancer, heart disease and stillbirths among pregnant women, but this warning is displayed so rapidly that it is almost imperceptible. In 2003, the Department of Health demanded a complete ban on tobacco advertising on television and radio, but this was not enacted. The primary resistance to restrictions on tobacco advertising on television is from the Ministry of Telecommunications, local governments and private television stations because the tobacco industry is the source of a large amount of revenue, estimated at Rp 414 billion or about US $48 million in 2002.5

Our interest in advertising is directly related to an ongoing project in which we are developing culturally appropriate tobacco cessation in Yogyakarta, the seat of a royal sultanate and a city that has been considered an archetypal site of Javanese culture.25 A factory under the auspices of Sampoerna is located in Yogyakarta and is owned by the Sultan. The name and emblem of the palace is used on the brand packaging (Kraton Dalem). Advertisements appearing throughout the city have the tag line “The taste of your role model” (Citarasa Panutan), implying that one should smoke the kretek of the Sultan.

During the first stage of our research, we conducted numerous interviews and focus groups with smokers and non-smokers about their reasons for smoking, their perceptions of the health risks of smoking at different levels and experiences quitting. It became clear that the harm of tobacco use was greatly underestimated, was largely thought to be confined to cancer and was associated with high levels of cigarette consumption (>12 per day).26 27 We also observed the commonality of cigarette advertisements in different social spaces, and the ways in which adverts were directed toward particular market segments using a variety of themes ranging from traditional to modern values, from pleasure to stress relief and from brute strength to intellectual cleverness.

In this paper, we briefly examine the social and cultural reasons for smoking in Indonesia and then discuss how the advertising industry reads, reproduces and leverages culture as a means of promoting smoking. At a time of intensified globalisation, when national identity is being negotiated through the consumption of branded products, kretek advertisements reflect core cultural values and aspirations while creating new cultural reference points, defining new values which they are uniquely positioned to exploit. Indonesians are both nostalgic for the past and wish to be seen globally as progressive and to embrace modernity on their own terms. Advertising is a major site of ideological influence.28 Deciphering the meaning of advertisements requires attentiveness to networks of association that must continually be reinforced and the masking of the negative health consequences of cigarettes. We were interested in seeing how smoking was represented as culturally positive and how tobacco companies represented themselves as supporters of Indonesian national identity.

METHODS

This study is a component of Project Quit Tobacco International (Project QTI), a National Institutes of Health Fogarty-funded project in Indonesia and India to develop culturally appropriate approaches to tobacco cessation. As part of the formative research that contributed to intervention development, we collected a wide sample of tobacco advertisements as a means of exploring key cultural themes used to sell cigarettes. It was reasoned that a study of advertisements would provide insights into a range of cultural meanings of smoking and the cultural benefits that cigarettes are purported to deliver, as well as how particular brands are targeted at specific populations. Of additional interest were the emotional and relational values that were being advertised and the larger social contexts in which the cigarette was presented.

Between November 2001 and March 2007, tobacco advertisements were collected from a variety of sources in Yogyakarta. Digital photographic documentation was made of adverts on billboards, street banners and storefront signs (n = 350) by the authors. Active surveillance of major roads, shopping centres and a cross section of neighbourhoods allowed us to capture new advertising campaigns and new signage as they emerged. Our monitoring efforts took place on a bimonthly basis. We did not isolate our documentation to a particular area of the city (ie, higher or lower socioeconomic strata areas), but rather focused on the major thoroughfares that traverse the city. We also collected over 300 tobacco advertisements from published print material including national (Kompas, Jawa Pos) and local newspapers (Kedaulatan Rakyat) and national news magazines (Tempo). On occasion, adverts were added to the collection from other sources (eg, Garuda Inflight Magazine).

Semiotic analysis of the advertisements focused on the copy and the image.29 As the vast majority of adverts collected were in Bahasa Indonesian, advertisements were first translated into English by the Indonesian authors to facilitate coding. An initial list of thematic codes was generated after the collection of the first 100 advertisements, with consideration paid to denotative (initial or apparent meaning) and connotative (extended, secondary, or implied) meanings of the text and image.29 As data collection continued, advertisements were coded in terms of these thematic codes. An iterative process was followed whereby new themes were added, others were removed and thematic labels were refined. The process of coding was completed by members of the Indonesian and the US team, and common agreement about the broad themes being communicated by the advert was achieved by discussion and consensus. Our interest was not in quantifying the number of adverts representing various themes, but rather in exploring the range of themes in popular advertising. Digital images allowed us to store our collection in terms of coded themes as well as by brand. Reviewing the strategies of particular brands allowed us to detail the strategies and positioning of particular cigarettes.

In-depth interviews were conducted with a convenience sample of urban male smokers (n = 30) from Yogyakarta to explore a range of issues including perceptions of the benefits and risks of smoking, ideas about addiction and brand preferences among different social groups.30 Informants were between the ages of 21 and 40 and ranged from lower class to middle class. Over 80% of the interviews were conducted by the Indonesian anthropologist (SP) with the remainder conducted by Padmawati with one of the foreign researchers (MN and MN). Interviews were conducted in Javanese (the local dialect), were recorded on tape and later translated into English. A coding scheme was developed based on the themes and concepts developed in the interview and emergent from the data. The anthropologists on the team (SP, MN and MN) coded the data.

Two rounds of focus groups were conducted (2004 and 2007).31 32 Four focus groups were conducted by the Indonesian authors in 2004. These groups consisted of a convenience sample of 6–8 lower socioeconomic class and middle class male smokers per group segmented by age (18–25, 26–35). Informants were shown a variety of cigarette packets and advertisements and were asked to provide opinions about the demographic target of specific cigarette brands (age, socioeconomic class, etc.) as well as the intended themes of the advertisements for particular brands. Informants were also queried about the appeal and use of different types of cigarettes (burn rate; different utility functions; starter cigarettes, etc.), the perceived harm of smoking and second-hand smoke and which brands were considered better or worse for health. Focus group interviews were recorded on tape, transcribed and translated into English and findings were reviewed and discussed by the authors.

In 2007, eight focus groups were conducted to provide data on counter-advertising messages and visuals that were under development by the project team. Each group consisted of 6–10 males, segmented by socioeconomic status and age: 4 groups of middle class smokers (aged 18–25; 26–35) and 4 groups of lower class smokers (aged 18–25; 26–35). A variety of potential counter messages have been developed by the team after reviewing ethnographic data. These were shown to the groups and discussed in relation to whether the target audience was clear, whether the message was understandable, if the visual was appropriate and interesting, etc. Focus group interviews were recorded on tape, transcribed and translated into English. Findings and suggestions garnered from the groups were discussed among the authors and were useful in adapting the materials. This is an ongoing process that will undergo further pretesting prior to distribution to the community.

RESULTS

Smoking and Indonesian culture: an overview

The distinctive smell of clove cigarettes permeates the air of public and private spaces in Indonesia. The taste of the kretek is often referred to as enak, meaning tasty or delicious, and many smokers describe clove cigarettes as sweet and refreshing.

During interviews, a range of topics emerged with regard to the social and cultural importance of smoking. Of particular importance was the social utility and exchange value of smoking among men. Smoking is common at cultural gatherings of men, and it is appropriate for cigarettes to be distributed at almost all important social occasions, including weddings, funerals, religious ceremonies and community meetings. Indeed, smoking is so normative among men and considered such an important component of masculinity that many informants commented that a man who does not smoke may be questioned or teased about whether he is a man or a transvestite. This appeared to be as true among high school students as it was for men in their thirties and forties.33 34 Younger and older men described how smoking was a common social pastime that facilitated friendship. Informants described feeling uncomfortable and out of place if they were in social situations and not smoking. One of the common barriers to quitting was the difficulty of refusing cigarettes as a form of social exchange. Informants also described how the ubiquitous smell of kretek in the air provided a continuous reminder that they should smoke. There is little awareness of the harm of second-hand smoke.35

One of our colleagues at the university, a young man in his twenties who was not a smoker, related to the project team how his uncle had expressed concern that neither he nor his brother smoked. He recalled that, at a family gathering, his uncle had told him, “There is nothing bad that will happen to you from smoking, you will not get sick. It’s a shame (malu) for our family line that you and your brother are not smoking—all the men in our family smoke—your father, your grandfather. You are breaking the chain of our family’s smoking history”.

Smokers typically describe their relationship to cigarettes in positive terms. Indeed, in interviews with smokers, it is rare to hear one say that they are addicted to kreteks, even if they smoke heavily. Notably, the concept of addiction is more commonly used with reference to alcohol and hard drugs than to cigarettes. For one to overtly state that they are addicted to cigarettes would indicate a lack of control over one’s behaviour, and a lack of willpower, strength and power. As discussed later, these are important cultural values in Indonesia.

Benefits of smoking: controlling emotions

In narratives, informants articulated the following benefits of smoking: cigarettes were a friend in times of loneliness, smoking helped enhance one’s confidence, smoking improved concentration and helped one to work harder. Of particular importance in the Indonesian context was the widespread notion that smoking helped in the control of emotions. In Javanese culture, it is considered inappropriate and dangerous to experience and/or express strong emotions. Taking time out to smoke a cigarette helped men reduce their feeling of stress (stres) and helped control perceived negative emotions, such as anger. As one informant explained, “smoking is a kind of escape from the tension”. Talk about stres is a popular topic in everyday discourse in urban Indonesia across social classes. Among the poor, suffering from stress is directly related to unattainable aspirations.36

Stress and the difficulties of daily life often weigh on one’s mind and can lead to uncontrolled introspection and states of anxiety. In Java, heavy thoughts (pikiran berat) and sensorial states attributed to stres and tension (tegang) are viewed as potentially dangerous conditions associated with health problems and states of vulnerability opening one up to spirit attack.36 A perceived benefit of smoking noted by informants was that it provided a direction or focus while deflecting attention away from one’s worries.

Smoking was described as giving one an immediate feeling of satisfaction allowing them to momentarily distance worry, anger and sadness. Smoking helped one stay steady (mantap), calm and better able to manage one’s emotions in daily life; vital attributes in Indonesian culture.

Themes in tobacco advertisements

Analysis of advertisements led the project team to identify overarching themes that were reproduced in different iterations (table 1). Table 2 provides a breakdown of how the different brands are positioned and targeted for specific age groups and themes utilised. Data for the table is drawn from the authors’ analysis and from focus groups.

Smoking as a way to enhance one’s masculinity

Smoking is almost exclusively a man’s behaviour in Indonesia and during interviews men commonly spoke of smoking and cigarette advertisements as tied to masculinity relating to physical strength and strength of character. Javanese masculinity values willpower and control as important components of strength of character. Many cigarette advertisements suggest a connection between a strong man, a clear sense of identity and his loyalty to his strong cigarette. Smoking also serves as an aid in establishing prihatin, a term referring to sacrifice or the denial of desire and physical needs. Prihatin is considered an important virtue, particularly for older men, and results in inner strength, potency (sakti) and an establishing of self-control (kalam). Practices to achieve prihatin include meditation, reducing the number of hours one sleeps, reducing one’s food consumption and eliminating sugar, salt and spices from one’s diet. Smoking is seen as an aid and “good company” in establishing prihatin, as well as getting focus and establishing control over one’s emotions. Rather than viewing smoking as an addictive substance that one needs to give up, cigarettes are considered a valuable aid in achieving Javanese ideals.

Because of the ever increasing number of cigarette brands in Indonesia, tobacco companies have to work hard to keep customers brand loyal. In one billboard advertisement for Gudang Garam, a closeup shot of a handsome man is featured with a cigarette in his hand and the smoke rising beside him. The tagline reads “A real man with a man’s taste” and “My coffee is thick and black, my music is heavy. My cigarette is steady”. He is a man who knows who he is and what he wants, a man who is decisive and loyal to his cigarette.

In another Gudang Garam advert, an affluent modern young man is shown wearing a leather jacket, a cigarette dangling from his mouth. An airplane is taking off in the background. The text reads “No compromise—a man’s kretek”. The message is that even though kretek are an indigenous product, they are modern and manly enough to travel with and smoke throughout the world, enabling a smoker to maintain strong ties with his home and his Indonesian masculine identity even when he travels abroad.

Youth masculinity: the pleasure of the crowd and identity seeking

Adverts that target masculinity for adolescents (eg, Sampoerna Hijau) commonly depict groups of young men having fun and laughing in the company of friends. This builds on the preference among Javanese, particularly youth, to be in the midst of others in social spaces that are crowded, busy and noisy (ramai). Smoking may be viewed as a facilitator of ramai as it is an inexpensive form of socialisation and exchange. In adverts, smoking is portrayed not only as socially acceptable for young men, but also part of the enjoyment of being young and establishing one’s masculine identity. Other adverts, such as those for Star Mild, feature the question “What’s your obsession?” (ie, what’s your identity?) with smoking portrayed as a positive behaviour that enables young men to explore their identity and encourages them to follow their dreams. These adverts depict youth obsessed with the idea of becoming an Indonesian movie star, film director, singer, or musician, imploring them to forget their stressors and follow their desires.

Control of emotions

An important theme found in tobacco advertisements is that smoking can assist in controlling one’s emotions. In advertisements, cigarettes are shown as a way to deflect negative emotions and to distance strong feelings. For example, a large billboard in Yogyakarta for Djarum Black kretek prominently displays a black and white yin yang symbol. The copy reads “No Black, No Balance”, implying that the cigarettes can help one to achieve a state of balance within as well as a state of harmony with others.

A series of adverts for Sampoerna’s popular A Mild kretek encourages the smoker to use cigarettes to shake off life’s difficulties. One advert in the series features a cropped photo of a man’s hand clasping an ear of corn and a cigarette. The tagline reads, “Rice has become expensive. Your business has failed. Just play. Enjoy”. Another advert in the series features a painter’s canvas and reads “Your brain is frozen, your canvas is waiting. Just play. Enjoy”, similarly suggesting that smoking can help you diffuse and distance the problems at hand.

Adverts targeted at adolescents and young adults depict age-related stressors such as college entrance exams, unemployment and more generally, social relations. A billboard advertisement for Djarum’s LA Lights, a brand targeted at the college-aged population, reads “You must suffer first to be happy later”, referring to failure to get admitted to the university of your choice. The advertising campaign ran at the same time that youth received notification about college admission.

In another edgy billboard advert for LA Lights, a young woman is shown angrily yelling at her boyfriend. Letters emanate from her mouth (BLA-BLA, with the LA letters highlighted in red). As the letters/words reach one ear of the boyfriend, they pass through his head and move out the other ear, transformed to LA-LA (LA Lights). He is smiling, unscathed by her adversarial words. The message is palpable: cigarettes will help diffuse negative emotions you receive from others (fig 1).

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Figure 1

Billboard for LA Lights.

Smoking associated with themes of tradition and modernity

Tradition, modernity and globalisation are also dominant themes in Indonesian tobacco advertising. Advertisements for the major companies represent themselves as preserving cultural knowledge, which is central to upholding traditional values. Two Sampoerna advertisements depict this theme. One magazine advert shows an aerial photograph of Borobodur Temple, one of the most famous Buddhist monuments in Indonesia, referring to the greatness of Indonesia’s past. The copy reads, “It’s a tradition of perfection inherited from our ancestors. If not us, who will continue the tradition?” (Sampoerna means perfect, so there is a double meaning here).37 Another Sampoerna advert features four traditional palm leaves inscribed with sacred text, representing an ancient form of transmission of knowledge. The message similarly reads “This tradition of writing on palm leaves has been inherited from our ancestors. Kretek is our tradition”.38 It is noteworthy that these adverts ran prior to the purchase of Sampoerna by Philip Morris in 2005.

Themes of modernity are prominent in adverts for the upscale kretek Djarum Black, which is one of the more costly cigarettes available (Rp 10 500 or $1.15 US for a packet of 16). In the magazine advert, extensive Bahasa Indonesian text that surrounds the sleek black packet describes how Djarum Black is a low tar, low nicotine cigarette that is being introduced into Indonesia after 5 years of success in the international market, particularly in the US.39 In actuality, with 25 mg tar and 1.6 mg nicotine, these cigarettes far exceed WHO standards for cigarettes (1 mg nicotine), although they are “lighter” when compared to Djarum 76 (which contain 38 mg tar and 2.4 mg nicotine). The advert explains that black represents elegance, as exemplified by its use by international designers such as Chanel and Armani in their worldly and upscale clothing. The advertisement directly appeals to the upper middle class, modern smoker, noting that those who smoke Djarum Black are progressive and appreciative of new ideas. A widely disseminated billboard campaign for Djarum Black similarly targets the upwardly mobile and features a large cup of cappuccino, a costly drink clearly not drunk by the masses. The copy reads “New Djarum Black Cappuccino” linking the distinctly modern, refined taste of this cigarette to its roots as a traditional Indonesian kretek.

The modern woman

Although it is traditionally considered culturally inappropriate for women to smoke, smoking does appear to be on the increase among affluent and educated women in urban areas, such as Jakarta, and among women working in non-governmental organisations.33 40 Since 2002, upscale young women have begun to be featured more commonly in cigarette advertisements, with men or alone. Adverts for Clas Mild, described by our respondents as a brand for adolescents and young adults, feature a wealthy, young modern woman on a cell phone, wearing a sleeveless tank top, noteworthy in a country where women are expected to dress modestly and many wear headscarves. She is perched next to an expensive foreign convertible car and appears to be dressed for a night out on the town. The tag line, which is written in English reads “Yesterday is gone, Clas Mild is today”. Although the attractive model in the advert is not holding a cigarette or smoking, the implication is that this is the type of fashionable young woman who could be a smoker (fig 2). The use of English for the copy emphasises that this is a global brand for those who are educated.

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Figure 2

Advert for Clas Mild.

Another Clas Mild billboard advert shows a beautiful young woman, heavily made up and adorned in a jacket with a fur collar, snuggling into her boyfriend, a westerner. The tag line repeats the message “Clas Mild is today”, suggestive of the changing possibilities for women. Indeed, most of the adverts for this popular youth brand portray modern women, with the tagline in English emphasising “the new sensation, the new classy breed” that the cigarette holds as its promise. Adverts for other youth brands, such as LA Lights, commonly feature a lineup of cosmopolitan males and females dressed provocatively. In this context of youth sociality, women appear to be lending approval to smoking as a behaviour one engages in to have fun. In interviews and focus groups, informants noted that young women who smoke tend to prefer A Mild, LA Menthol Lights and Marlboro Lights. Of the three, the former two include women in their adverts. In 2008, two new slim cigarettes (Djarum Black Slims and Surya Slims) were introduced into the market. The billboards and banners that line the streets do not have a photo, but rather feature the slim sleek package. Although women are not visibly connected to these new product lines, slims are typically the domain of women.

Political and cultural commentaries

Some tobacco advertisements in Indonesia are crafted to appeal to key tropes in Javanese language. Javanese is in the Bahasa Indonesian language family and is spoken by about 80 million speakers who live on the archipelago’s most populated island. Javanese speech is indirect and thus, to decipher the meaning, one needs to be clever and insightful (pandai). A long-standing series of advertisements for Sampoerna’s A Mild utilises sanepo, which is a particular speech form comprising indirect commentaries, veiled expressions and slippage at meanings (plesetan). These indirect commentaries invite the viewer to reflect on the political situation as well as one’s position in society, the need for social change and the difficulty in achieving it. This speech form is a widely utilised rhetorical strategy in Javanese society and people who are able to pun or “do word slippage” are highly respected for their cleverness. These adverts specifically appeal to educated upper middle class men who are in their late 20s to upper 30s—men who are capable of analysing and capturing the sensitive meaning behind these advertisements.

Many of the adverts for A Mild have the tagline “No small talk” (Bukan Basa Basi) in the corner, that is, that they are getting straight to the point, circumventing cultural rules of politeness. For example, one advert featured a pair of men’s boxers with copy that read: “I’m tired of covering up your shame (your secrets)”, referring to hidden scandals in the government and the need for transparency. Another advert pictured a chocolate layer cake with one piece cut out; the copy read: “Be patient! Everyone will get their piece!” The cake in the advert indexed corruption money; that is, when all players received their payoff, their voices would be silenced. A third advert in the campaign showed a comfortable modern chair with a sign that read, “Clean the bugs from the chair or you’ll never be rid of them!” asking the viewer to consider the need for a shift from corrupt political leaders. Such adverts challenge the viewer to think critically about the current political situation and at the same time, encourage Indonesians to find levity in their predicament. These adverts also identify the smoker of the cigarette, A Mild, as a man capable of nuance and deep understanding. The most recent advertising campaign provides more stringent commentary on modern life. A centrally placed billboard features a well dressed man sleeping in a chair, with the copy reading “Sleeping, dreaming, increasing your salary” (Tidur, Mimpi, Naik Gaji) referring to House Representatives who attend important meetings, fall asleep and then demand salary increases.

A Mild advertisements also express critical views on the powerlessness of the younger generation in relation to their elders. In one recent advert, an older businessman is shown holding puppet strings on a much younger businessman who is pointing at a flow chart. Both men are in grey suits. The tag line reads “The younger generation that is not trusted” (fig 3). The advert incorporates a popular cultural medium (shadow puppetry) while pointing out that despite one’s seemingly prestigious job in business, young men are controlled by those who are older. A similarly themed advert ran on television: a young woman is shown giving a talk on a tourist bus, and each time she speaks, her audience sleeps. At last, the bus driver, an older man, begins to speak, and the tourists’ interest is piqued, implying that the voice of one who is older and male is more likely to garner respect. By framing young people as relatively powerless and a group whose opinion is not yet respected, the tobacco industry is subtly inviting this age demographic to reflect on their social position. Other adverts encourage young people to wait until they come into their own, suggesting that, for now, they relax and have a cigarette.

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Figure 3

A Mild advert “The younger generation that is not trusted”.

Tobacco supports nationalism

Nationalist themes are prominent in tobacco advertising. For example, a Gudang Garam advert appeals to the hope of the nation’s youth, in an advert that shows a young boy dressed in a school uniform seated outside his school, his school books stacked by his side. The text reads “Millions of school children hope the leaders of our country will set them free from poverty and ignorance”, implying that the support of the tobacco company helps national education. Another advert for a brand called Country features two young men with backpacks looking over a famed national volcano and crater lake. The copy reads “It’s my pride, my country”, again implying that the industry is a strong supporter and maintainer of national parks. Nationalism as a theme is also apparent in the prominent placement of cigarette adverts in newspapers on Independence Day and during elections, when political parties often distribute their own brand of cigarettes.

Reframing themes used in advertising

As a tobacco cessation initiative in Indonesia, a major challenge faced by Project QTI is that adult smokers typically describe smoking as “cultural” and their relationship to their cigarettes in positive social terms. This is supported by tobacco advertising. As part of a comprehensive tobacco strategy, we realised the necessity of engaging the tobacco industry on cultural ground and the need to take back culture from the industry as a means of denormalising smoking. This represents one part of our multi-pronged approach, which also includes incorporating knowledge of the harm of tobacco use and tobacco cessation counseling into the medical curriculum, and working to facilitate tobacco cessation efforts in clinical and community.

Project QTI researchers are currently in the process of developing and testing counter-advertising messages that popularise a non-smoking identity. Two coextensive cultural themes that are being developed for use include: (1) willpower as a virtue associated with masculinity and (2) family responsibility as a value that eclipses personal pleasure. Both of these themes tap into Javanese images of strength and moral identity. Challenging one’s self to overcome hunger, thirst and even sleep is respected in Javanese culture. An association of strength with willpower and moderation is well articulated during Ramadan, a time when inner strength and control of one’s desires is valorised. During the fasting month, one must abstain from eating all day and, when breaking one’s fast, also exercise control to not indulge in the overconsumption of food.

With respect to the theme of family responsibility, Project QTI is encouraging men to have the strength of character to give up a habit that is not only harmful to their own body, but also to the health of their family. A first step for Project QTI has been a community education campaign making the health harms of tobacco more widely known. Next, we are attempting to reframe popular tobacco advertisements that encourage men to “just enjoy” and not worry about tomorrow. Instead, smokers are encouraged to recognise that while smoking may be a pleasurable experience in the moment, it renders one vulnerable to illness in the future. Moreover, by simply enjoying now, the smoker threatens the health and well being of his wife and children. These messages decentre positive values typically attributed to smoking by presenting it as a behaviour that is unhealthy and irresponsible. In this approach, an identity as a non-smoker is reframed as masculine, requiring will power, personal motivation and a strong sense of responsibility.

Developing counter adverts which involve women in tobacco cessation

In cigarette advertisements, smoking is presented as a way to relax and enjoy social functions associated with cultural events ranging from marriages to family gatherings. At present, there is little recognition of the harm of second-hand smoke among smokers and non-smokers in Indonesia. Project QTI is actively involved in educating women about the harm of second-hand smoke and promoting smoke-free households. This is being performed at the community level through presentations at women’s groups. Counter images are being developed that present responsible men as not smoking near women and children. We are in the initial stages of working with women’s groups in Yogyakarta to determine how the theme of quitting tobacco and male responsibility for not smoking in the household can become a part of neighbourhood, not just individually-oriented, tobacco control campaigns. We have recently sponsored a contest in which community members were invited to develop smoke-free household banners. Response has been outstanding and large anti-tobacco banners advocating smoke-free homes now hang on streets side by side with tobacco advertising.

Project QTI recognises that masculine identity differs for adult males and youth. While adult males may be appealed to through messages that play up responsibility and willpower, for the young what is more important is social identity and popularity. To decentre a positive smoking identity among young males, we are trying to enlist the support of young women hailing from secular and conservative backgrounds. Data from surveys among young college women conducted by Project QTI are being used to inform young men that most women do not find smoking sexually appealing or attractive as advertisements would have them believe. Indeed, the majority of college women disapprove of male smoking, find it neither masculine nor appealing and state that they would prefer to marry a non-smoker.

DISCUSSION

Indonesia is one of the last frontiers of largely unrestricted tobacco advertising and a challenging country in which to introduce tobacco cessation. Advertising at once sells products by reproducing culture and associating these products with core traditional values, and by producing culture by promoting commodities, such as cigarettes, as icons of cultural change, modernity and globalisation. Our investigation of tobacco advertisements has suggested that both sets of associations are being used creatively by the tobacco industry in their efforts to appeal to different market segments. Cultural knowledge is necessary for an understanding of the deeply nuanced statements and images embedded in advertisements that refer to a wide range of social values, group aspirations and anxieties and that use critical commentary on the current political and economic environment in Indonesia to attract attention to sell goods. By extension, the man who chooses to smoke A Mild, the brand known for its critical commentary, is a thoughtful, clever person who is concerned with and knowledgeable about current national affairs.

Why is the study of tobacco advertising in Indonesia important to tobacco cessation efforts? The normalising influence of advertising and the media has been well established globally.41 In Indonesia, the trillions of rupiah spent annually on tobacco advertising, promotion and sponsorship have served to entrench smoking as an important part of the national landscape. Thus, a critical first step in cessation efforts is to “denormalise” tobacco use.42 While this has typically been a component of school-based tobacco prevention programs, Project QTI is incorporating this within tobacco cessation efforts. To date, there is little awareness in Indonesia of the harm of tobacco and the tobacco control movement is in its early stages. Cessation programs can only attain success if associated with positive images of non-smoking and negative images that associate smoking with the ill health of people across age groups and not just the elderly, who have been exposed to many life hardships.

From our experience attempting to promote cessation in Indonesia for the past 5 years, we have recognised the need to confront and reframe the multitude of positive smoking images promoted by advertising. Several studies in developed countries have concluded that counter advertising can be effective in reducing cigarette consumption.43 44 We are in the process of discovering themes around which counter messages can be developed that undermine core messages promoted by the tobacco industry. A first step has been to assess key tobacco advertising themes and genres, and a second step has been to discover culturally salient themes that decentre proactive tobacco advertising campaigns.

Of particular importance has been to render a non-smoking norm visible and acceptable within Indonesian culture. Here we have met challenges that index core cultural values. For example, we are actively developing refusal messages for established smokers, because refusing to accept something (a cigarette) offered is counter to normative behaviour in Indonesia, which places great value on exchange and reciprocity. Indeed, accepting a cigarette when offered and smoking with others is so normative in Indonesian culture that to refuse signals to others that one is too ill to smoke or is construed as a sign of being unmanly. We are developing posters/adverts to help those trying to quit or those who have already quit to defuse negative comments they receive from others. In support of an alternative non-smoking norm, we are reframing tobacco cessation as a sign of health consciousness that speaks to the strength of a man’s character, his personal power and his concern for his family. Rather than smoking being an individual pleasure that men enjoy (as depicted in advertisements), smoking is presented in counter adverts as an addiction, a word not presently associated with tobacco use, and as a habit having physical consequences that affect others—especially one’s family. Our reframing depicts a man who is able to quit smoking as someone to be admired and respected, a man who is strong, not weak. We are proceeding cautiously in light of observations made by Kohrman in China.45 He notes that Chinese men are receiving mixed messages about the social and political appropriateness of smoking in a country now promoting “quality citizens” and health awareness.

At conferences in Indonesia where we have presented data from Project QTI, a question that has arisen is: “Smoking is so much a part of Indonesian culture, how can we be expected to give it up?” We have chosen to take back culture from the tobacco industry and to use cultural values as a solid footing on which to establish a non-smoking norm. Our response to the aforementioned question has been to pose an alternative question: “Which is more an Indonesian cultural value—social exchange with friends that often includes smoking, or being responsible for the health and well being of your family and community members?” Our aim is to make tobacco cessation not just a man’s issue, but a family responsibility issue.

The purview of our cessation efforts looks beyond the individual smoker to social spaces that need to become smoke free, including households, schools and colleges and work sites. Toward this end we are developing community-based interventions that will restrict not just smoking, but tobacco adverts that make smoking appear normative in these spaces. For example, community members have developed banners calling for smoke-free homes that are being prominently displayed near the gates of kampungs; gates that are presently decorated by tobacco advertisements.

Women figure centrally in our strategies for reframing smoking as an undesirable behaviour. First, we are developing counter adverts that feature women of differing ages and social identities expressing disapproval of smoking for reasons that range from the habit being dirty to displeasing to their senses and harmful to the health of the family. We are also representing their views on smoking as neither manly nor sexy. Second, women are presented as empowered to declare spaces, such as their households, as smoke free. Learning about the dangers of second-hand smoke confers legitimacy to women who can oppose smoking in the house for health reasons. To date, women have not been mobilised to voice dissent against smoking, in part because it is inappropriate for women to directly confront men in public. Project QTI research suggests that women are willing to speak out as a group against smoking in spaces that it is their responsibility to manage. As shown by the increased portrayal of young modern women in tobacco advertisements and the recent emergence of slim brands in Indonesia, there appears to be heightened efforts by the tobacco industry to target women. This attempt at an “engineering of consent”46 needs to be closely monitored by tobacco control activists, as women could be vulnerable to the predatory behaviour of the industry.

In summary, a counter-advertising component of Project QTI was deemed necessary in Indonesia for two reasons. First, to break the chains of positive association for smoking established by tobacco adverts and second, to counter the hegemony of the tobacco industry, which has represented itself as the keeper of cultural values as well an icon of Indonesia’s future. Hegemony (rule by consent as well as by coercion) as a process is most effectively carried out through appeals to culture and consent to practices presented as normative and diffused through the fabric of society. The naturalisation of smoking as custom must be critically engaged through interventions that promote not just primary prevention, but cessation in a country where over 60% of males smoke.

Hegemony is never complete and involves a negotiation process on the part of those who exercise power so as to appear responsible. This is particularly true for tobacco given the mounting knowledge of tobacco’s many risks in a society ever more open to the flow of information. Raising the consciousness of the public about the harms of tobacco creates spaces in which those in tobacco control can manoeuvre. But tobacco cannot be engaged only on the terrain of health. Tobacco’s positive social and cultural representations need to be engaged head on through not just counter adverts that are evocative, but by people visibly quitting smoking for reasons that appeal to different population sectors. The key to tobacco cessation may be to make quitting appear to be a credible personal and social performance that gains one respect.

It is important to recognise that the advertising analysis described in this paper and the strategies for reframing need to be part of a comprehensive tobacco control plan in Indonesia that would necessarily address tax policy, implementation of clean air laws, and strengthening and enforcing legislation that would actively curtail tobacco advertising and sponsorship including the signing of the Framework Convention on Tobacco Control. As noted by other researchers working in the country,1 this will require strengthening of the tobacco control community in Indonesia and the improvement of linkages with international groups.