2003年-世界发展银行全球_Research_on_Tobacco_in_Indonesia___An_Annotated_Bibliography_and_Review_of_Research_on_Tobacco_Use_Health_Effects_Economics_and_Control_Efforts_66页_764kb

Summary of Research on Tobacco in Indonesia

Core Content

This document presents a comprehensive annotated bibliography and review of 46 studies on tobacco use, health effects, economics, and control efforts in Indonesia, published since 1990. The study is part of the World Bank's Health, Nutrition, and Population (HNP) Discussion Paper series and was prepared for the World Bank and presented at a policy research meeting on tobacco control in 2002. The authors, Triasih Djutaharta and Henry Viriya Surya, aim to identify research gaps and provide a foundation for future tobacco-related studies and policy development in Indonesia.

The document highlights the need for more systematic and nationally representative research on tobacco issues, as most existing studies are limited in scope, focusing on specific locations or populations. It emphasizes that while tobacco use is widespread in Indonesia, the economic and health impacts are often underestimated, and tobacco control efforts are hindered by misconceptions about the economic benefits of the tobacco industry.

Main Viewpoints

• Tobacco Use Prevalence: Tobacco use is common across various demographics, including low-income groups, children, youth, and even those in health-related professions such as nurses and athletes.
• Health Impacts: Smoking is linked to numerous health issues, including cardiovascular diseases (CVD), respiratory diseases, lung cancer, and mouth diseases. Second-hand smoke is also a significant health concern, with passive smokers being more prevalent than active smokers.
• Economic Impact: Tobacco use imposes a heavy economic burden, both on individuals and the healthcare system. The average household expenditure on tobacco products is about 4% of income, and the cost of health care due to tobacco-related diseases is substantial.
• Tobacco Control Strategies: The report advocates for stronger tobacco control measures, including increasing tobacco taxes, banning smoking in public places, and implementing comprehensive anti-smoking campaigns. It argues that tax increases are not only effective in reducing tobacco use but also increase total tax revenues.
• Research Gaps: The studies are largely localized and not representative of the entire country. There is a lack of national-level data, and many studies focus on specific groups rather than the broader population.

Key Information

• Taxation and Economic Impact: Tax increases are highlighted as the most powerful and cost-effective tool for tobacco control. They do not lead to a net loss of jobs and can actually create new ones. The report also suggests that smuggling is more a result of general corruption than high tobacco taxes.
• Health Risks of Smoking: Smoking is associated with a range of health problems, including lung cancer, cardiovascular diseases, and respiratory illnesses. The report notes that 10% of nurses are not adequately informed about the dangers of tobacco, and only 60% usually warn patients about smoking risks.
• Second-Hand Smoke: The impact of second-hand smoke is significant, especially on non-smokers. Passive smoking is a major cause of lung cancer, with women exposed to their husband's smoke being 3 times more likely to develop it. There is a need for more research and policy to protect passive smokers.
• Public Awareness and Education: Cigarette advertisements, particularly on television, are a significant source of information for schoolchildren, which may contribute to increased smoking among youth. The report suggests that anti-smoking education should be introduced early in the educational system.
• Policy Recommendations: The report calls for governments to implement stronger tobacco control policies, including higher taxes, comprehensive bans on tobacco advertising, and smoke-free public spaces. It also recommends further research to address the gaps in understanding the national impact of tobacco use.

Structure of the Document

• Introduction: Explains the purpose of the study, which is to summarize existing research and identify gaps.
• Brief Look at Tobacco Studies in Indonesia: Categorizes studies by research subject, location, and topic.
• Tobacco Control Studies: Discusses effective and cost-effective strategies for tobacco control.
• Additional Studies Suggested: Highlights areas where further research is needed.
• List of Studies with Summaries: Provides a detailed list of 46 studies with their summaries.
• List of Studies by Author and Subject: Organizes studies alphabetically by author and by subject.

Tables Overview

• Table 1: Lists studies by occupation, showing that studies focus on various occupational groups, including athletes, bus drivers, and street vendors.
• Table 2: Categorizes studies by age and gender, highlighting the focus on children, youth, and females.
• Table 3: Shows the distribution of studies by educational level, with a significant number focusing on school students.
• Table 4: Details the location of studies, with most conducted in Jakarta, indicating a lack of national coverage.
• Table 5: Classifies studies by topic, with individual behavior and health impact being the most frequently discussed.
• Table 6: Summarizes studies by type of impact, emphasizing the economic and health costs of tobacco use.

Conclusion

The document underscores the importance of tobacco control in Indonesia, emphasizing the need for more comprehensive and nationally representative research. It argues that effective policies, such as increasing tobacco taxes and banning smoking in public places, are crucial for reducing tobacco-related health and economic burdens. The authors hope that this annotated bibliography will serve as a useful reference for researchers and policymakers seeking to understand and address tobacco use in Indonesia.