Young smokers follow parental lead

By Ronald Hutapea

JAKARTA (JP): Everywhere one turns, it seems a smoker is lighting up. They also appear to be getting younger -- gangly junior high school students puffing away on the sidewalks and at bus stops are a common sight around the city.

Anti-smoking lobbies have made inroads in many Western and industrialized countries, but the campaigns have fallen on deaf ears in many parts of Asia.

Young people are taking up the smoking habit throughout this continent. World Heath Organization (WHO) studies reveal smoking is increasing among youths in Singapore, the Philippines, Japan, Thailand and Indonesia. In Malaysia, studies found 70 percent of teens had experimented with cigarettes, and nearly 50 percent of teenagers had tried smoking by the age of 16 in Hong Kong. The younger a person takes his or her first puff, the harder it is to stop later on.

Studies have also been conducted in Indonesia, and the findings are similarly gloomy. According to the Indonesian Household Health Survey in 1986, 13.2 percent of males aged 12-15 years had adopted the habit. A previous study by Maimunah in 1980 found that experimentation with smoking was present in elementary and even kindergarten students. A survey commissioned by the Indonesian Heart Foundation in 1992 found that up to 50 percent of Indonesian junior high school students smoked. More alarming was Anwar Yusuf's 1993 study. He found that about 24 percent of fifth and sixth grade students of elementary schools in East Jakarta had smoked, or considered themselves smokers.

In the U.S., the Food and Drug Administration (FDA) has come down hard on the tobacco industry by attempting to regulate cigarette products, facing equal opposition from the industry and their political allies. Although tobacco-industry officials charged the FDA didn't have the authority to regulate their products, they agreed to a huge payout last week to shield them from future litigation.

Beyond political considerations, the initiative of the FDA, WHO and health administrations in many countries to bar minors from smoking reflects bitter realities of addiction and health hazards. Numerous studies show the vast majority of smokers pick up the habit as children -- as many as 90 percent of adult smokers are addicted before age 21.

All these findings appear to indicate smoking is looming as a greater threat to society. It is not only an individual concern, but a public health disease, and, more specifically, a pediatric illness due to its effect on the young.

Advertising

Several countries have realized the need to check tobacco advertising, especially campaigns directed at the young. They have also imposed laws against selling cigarettes to minors.

Singapore and Thailand have implemented a total ban on cigarette advertising in the media, and Hong Kong, Malaysia and South Korea have partial bans. The Philippines and Indonesia are among the holdouts where cigarette advertising is still big business.

Tobacco advertising and promotional drives are not the only reason why young people are lured into smoking. Psychologists, educators and even tobacco advocates agree that more influential factors are peer group pressure, rebellion and, most of all, lack of parental guidance.

The family seems to be the central stage that is so important in creating a perception of smoking as "okay" and acceptable as children watch their parents and elders.

May 31 is annually observed as World No-Tobacco Day, and Indonesia as a WHO member nation has always participated in this campaign. But no statistical evaluation has been conducted on whether this one-day event has contributed to a downturn in smoking in Indonesia or other countries.

Hiroshi Nakayima, WHO director at an anti-tobacco campaign in 1995, said six trillion cigarettes are consumed every year and tobacco in the cause of almost 20 percent of deaths in developed countries. Every year tobacco causes the deaths of three million men and women, or one death every 10 seconds.

With the current smoking trends, in 30-40 years the tobacco epidemic will be responsible for 10 million deaths per year, with 70 percent of them occurring in developing countries, including Indonesia. And more children will be part of this unfortunate group, who are really not victims of disease but the quest for profit.

Many sports and cultural events are heavily dependent on the sponsorship of cigarette advertisers. The government needs to partially or totally ban of cigarette advertising in all sports and cultural activities, including those which has been so cunningly labeled and packaged as "brand awareness" or "corporate identity" promotions.

Real, concerted action is needed to lower the number of young smokers. Seminars, infrequently scheduled talks and tentative campaigns do no good. Smokers need help, not blame. Youngsters need to be reminded of the danger, not just in lectures, but through good examples. Tobacco advertisers who hint at fallacies must be punished.

The government may stand to lose vast amounts of money if many people stop smoking, but the overwhelmingly positive reward is that Indonesia will have a healthier generation.

Dr. Ronald Hutapea, Ph.D is a general practitioner and health educator in Jakarta.