OBAMA SMOKING "SOMETHING"

Smoking is not merely a matter of choice

Sudirman Nasir , Melbourne | Thu, 04/15/2010 8:52 AM | Opinion

A recent Youtube video showing a toddler named Sandi, a four-year-old boy from Malang, East Java, smoking and swearing has triggered wide concern.

People have expressed their anger and surprise through various media channels including social networking sites such as Facebook and Twitter, particularly upon finding out that he was just 18 months old when he started smoking.

However, a more careful observation toward the social and economic context of the daily life of Sandi would help us to better understand why he initiated smoking, drinking coffee and even alcohol at an early age, behavior that may seriously impede his physical and mental development.

It was widely reported that Sandi was born in a low-income neighborhood in Malang. Sandi’s parents are poor, working long days and struggling to make ends meet.

It is not a surprise that Sandi suffers from lack of attention and supervision from his parents and spends most of his time with his parents’ friends of whom most are also poor and working as parking lot attendants.

It is noteworthy that most of them are heavy smokers. It is therefore justified to say that Sandi is growing up in a “high-risk environment” in which smoking, drinking and swearing are the norm.

The case of Sandi provides additional evidence that it is misleading to argue that smoking (and involvement in other risky practices) is merely a matter of choice. Individuals’ upbringings are crucial to the initiation of such practices.

There is a growing body of literature maintaining the key role that structural factors such as economic deprivation, social inequality, poor neighborhood as well as cultural factors such as local construct of masculinities play in facilitating risk-taking behavior such as smoking.

Though the association is not causal and mechanical (not all poor people are smoking and engaged in risk taking), it should be noted that people from disadvantaged background are more at risk and less protected from factors that initiate smoking at an early age, the subsequent dependence on tobacco and the severe health risks that comes with it.

They also generally show more resistance and less support to quitting smoking. Among many of them smoking is perceived as an affordable luxury providing an outlet as well as an expression of masculinity in the context of limited access to more viable pleasures.

In addition, studies indicate that though there has been a significant decrease in rates of smoking and dependence among people from middle and high-income backgrounds in developed countries due to progressive health promotion programs and higher taxes on tobacco and intensive bans on smoking in public spaces, such significant decrease do not occur among people from low economic background.

Those same studies site that people from disadvantaged backgrounds are caught in an environment in which smoking rates remain higher than in higher social tiers and therefore advocate that significant decreases to smoking rates cannot be achieved without improving structural factors such as education, social inequality, housing and access to decent employment.

Individualized health promotion activities that merely focus on an individual’s behavioral changes without addressing structural and environmental factors are not sufficient in tackling the smoking epidemic among people from low socio-economic background.

A more careful look at the daily lives of smokers in low-income neighborhoods in both the developed and developing world clearly indicates that smoking is not merely a matter of choice. Smoking (and engagement in other risk-taking behaviors) among the poor people is a vivid sign of deeper socio-economic marginalization.

Individualized health promotion activities that focus on an individual’s behavioral changes without addressing structural factors are not sufficient.



The writer is a lecturer at the Faculty of Public Health, Hasanuddin University, Makassar and a PhD candidate at School of Population Health at the University of Melbourne, Australia.

______________________________________________________

As a last resort, cigarette workers hold mass prayer

Wahyoe Boediwardhana , The Jakarta Post , Malang | Fri, 04/16/2010 10:26 AM | The Archipelago

Thousands of workers from cigarette factories in the Greater Malang area in East Java performed a mass prayer Thursday, in what they described as their final appeal for the government to revoke increased taxes on cigarettes and to drop an anti-smoking draft bill.

Many of the workers said the bill would threaten their livelihoods.

Heri Susianto One, a member of the Community Forum of the Indonesia Cigarette Industry, said the prayer was the workers’ last and most desperate attempt to appeal to the government.

“We protested. We also went to Jakarta to present our demand to the government but to no avail. This [mass prayer] is our last resort,” he said.

The government increased excise tariffs on cigarettes and alcoholic beverages on Jan. 1 and April 1, respectively. The new excise tariffs on cigarettes, passed in a Finance Ministry regulation issued on Nov. 16, 2009, range from Rp 65 to a maximum of Rp 320 per cigarette, depending on whether the cigarette is hand or machine rolled.