2
Introduction SUSENAS also collects information on exposure to second-hand smoke in homes. In 2010, about 35 of people were
exposed to second-hand smoke at home. The questionnaire on exposure to second-hand smoke was changed between 1995 and 2001.
Several retrospective studies in Indonesia showed a relationship between smoking behaviour and the risk of developing cardiovascular diseases including stroke, respiratory diseases and cancer.The Baseline Health Research 2007 revealed that
stroke is the leading cause of death 15.4 of total deaths, followed by neoplasm 5.7 and coronary heart disease 5.1. The prevalence of smoking among Indonesians aged 15 years and above is 34.7 28.2 daily smokers and 6.5
occasional smokers. About 30.8 of the rural population and 25.9 of the urban population smoke every day. The average number of sticks consumed per person per day is 12. The ageat initiation of smoking and percentages for each age
group are: 5 –9 years 1.7; 10–14 years 17.5; 15–19 years 43.3; and 20–24 years 14.6. The prevalence of
smoking at home is 76.1, of whom the largest proportion is in the Central Sulawesi Province 90.3 and Jambi Province 90.0. About 35.0 of smokers belong to the lowest socioeconomic group first quintile.
1.1.1. Smoking products in Indonesia
Kreteks pronounced cree-techs are clove cigarettes. Kreteks are popular in Indonesia, and typically contain a mixture consisting of tobacco, cloves and other additives. Broadly speaking, there are two types of manufactured cigarettes in
Indonesia –kreteks and white cigarettes. There is also a major market for non-factory made cigarettes, which are clove
cigarettes that may be either filtered or unfiltered. The kretek clove-blended cigarette dominates the market in both the machine-made and hand-rolled categories. The name kretek is derived from the crackling sound that results from burning
of the tobacco –clove mixture. The total sales of machine-made cigarettes kreteks and white cigarettes was some 180
billion sticks in 2010, up 4.5 from 2009 Euromonitor 2011. White cigarettes accounted for some 12 of the total machine-made market volume in 2010, the remaining being kreteks. White cigarettes are mainly imported global brands
and are hampered by the restriction on television advertisements for foreign brands. All global brands except for Marlboro Mix 9 are white cigarettes. Global brands excluding Marlboro Mix 9 are sold in packs of 20 sticks, while local brand clove
cigarettes are sold in packs of 12 and 16 sticks. Indonesia is a unique cigarette market because of kreteks and the strength of the ottage se tor that produ es ha d-rolled cigarettes. Hand-rolled kreteks are strongly associated with 12-stick
packaging. Country local brands of white cigarettes are sold in 20-stick packs.
Indonesian kreteks, both machine-manufactured and hand-rolled, have a higher tar level than white cigarettes more than 10 mg tar. The most common tar level for mild kreteks is 14 mg tar and 1 mg nicotine. Indonesia is one of the worlds
most attractive cigarette markets and international companies have been keen to establish themselves. The major cigarette manufacturers are Gudang Garam, HM Sampoerna PMI, Djarum, Bentoel BAT and Nojorono. In 2010, the top three
cigarette manufacturers accounted for some two thirds of the total machine-made cigarette volume sales, with Gudang Garam being the market leader. However, if hand-rolled cigarettes were included, total volume sales of Sampoerna would
exceed those of Gudang Garam. Standardized machine-smoking analyses indicate that kreteks deliver more nicotine, carbon monoxide and tar than conventional cigarettes. Kretek smoking is associated with an increased risk of acute lung
injury, especially among susceptible individuals with asthma or respiratory infections. Research shows that regular kretek smokers have 13
–20 times the risk of abnormal lung function compared with non-smokers.
1.1.2. Tobacco use among specific populations
