Tobacco use in Indonesia is more than a personal habit, it is a structural issue that affects not just lungs, but livelihoods. In a country where 38.2% of adults aged 15 and above are smokers, the ripple effects of cigarette consumption on families are becoming more visible and more concerning.
When Smoking Becomes a Family Expense
Tulodo Indonesia’s staff conducted research for his undergraduate thesis highlighting how tobacco spending quietly erodes one of the most essential household priorities: health. Drawing on data from the Indonesian Family Life Survey (IFLS) covering the years 2007 and 2014, the study reveals a clear crowding-out effect, in which money spent on cigarettes reduces what families can spend on healthcare.
The analysis shows a causal relationship between cigarette consumption and household health expenditure. Households with smokers allocate significantly less to healthcare compared to non-smoking households by an average of 5.6%. The disparity becomes more pronounced in urban settings, where smoking households spend 7.9% less on health, compared to just 0.2% in rural areas.
The Hidden Trade-Off Between Cigarettes and Healthcare
These numbers may look technical, but the implication is personal. For every cigarette consumed, there may be a postponed doctor’s visit, a skipped vaccination, or untreated illness. The economic strain of regular tobacco purchases, on top of its health risks, creates a dual burden for families. The choice to smoke is not just a health decision. It is a financial one that silently diverts money away from long-term wellbeing.
The study offers a critical lens on how tobacco shapes household priorities. With limited income, especially in lower-income families, the decision to allocate funds is always a trade-off. Unfortunately, tobacco often wins at the expense of essentials like healthcare, education, and nutrition.
Why Tobacco Control Must Include Economic Messaging
These findings signal a need to reframe tobacco control messaging. Public campaigns often focus solely on the health consequences of smoking. While effective, they may not fully resonate with households managing tight budgets. There is a missed opportunity to emphasize the economic cost of smoking, how every rupiah spent on cigarettes could have gone toward keeping a child healthy or saving for an emergency.
It is recommended that policymakers integrate economic arguments into tobacco control efforts. Public health messaging should highlight not only the risk of lung cancer, but also the cost of not being able to afford basic care. At the household level, families need support and education on budgeting and financial prioritization, to ensure spending aligns with long-term wellbeing.
As Indonesia continues to battle high smoking rates and its public health consequences, studies like this serve as a reminder: tobacco use is not just a lifestyle issue, it is a socioeconomic trap. And escaping it will require more than warnings on cigarette packs. It demands a shift in how we value and protect what matters most in our households.
This research underscores a critical shift needed in public health messaging. Tulodo’s work in behavior change shows that economic narratives like the cost of skipping healthcare for cigarettes can resonate strongly with families. Integrating this lens into tobacco control policies could be a game-changer.
(By Faza Ayasi and Evi Noor Afifah)
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