Policy incoherence and tobacco control in Indonesia: an analysis of the national tobacco related policy mix

Abstract

ABSTRACT Introduction: Indonesia has a high smoking prevalence that has not diminished significantly since 1990. Considering this, we aim to summarize the existing national tobacco-related policy mix and explore markers of policy incoherence in tobacco control between 2014-2020.

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; (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: Health, Finance, Communication and Information, and Trade and Industry, with the Ministry of Finance most active. Evidence demonstrates that official inter-ministerial collaboration was lacking from 2014-2020 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 FCTC or another mechanism, there remains no formal impetus for intra-governmental cooperation. Nonetheless, this analysis reveals some governmental progress and “pressure points” that advocates can focus on to promote tobacco control policies within the current policy mix.