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Policy incoherence and tobacco control in Indonesia: an analysis of the national tobacco-related policy mix
  1. Elisabeth Kramer1,
  2. Abdillah Ahsan2,
  3. Vaughan W Rees3
  1. 1Sydney Southeast Asia Centre, University of Sydney, Sydney, New South Wales, Australia
  2. 2Faculty of Economics, University of Indonesia, Depok, West Java, Indonesia
  3. 3Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Elisabeth Kramer, Sydney Southeast Asia Centre, University of Sydney Southeast Asia Centre, Sydney, New South Wales, Australia; elisabeth.kramer{at}sydney.edu.au

Abstract

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.

  • public policy
  • low/middle income country
  • taxation
  • advocacy

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.

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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.

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Footnotes

  • Twitter @liskramer

  • Contributors EK contributed to project conceptualisation, literature review, data collection, data analysis, and writing and review of drafts. AA and VWR contributed to project conceptualisation, data analysis and review of drafts.

  • Funding Funding for this project was received from the Australian Department of Education, Skills and Employment via the Endeavour Leadership Scheme and The University of Sydney-Harvard University Mobility Grant.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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