Life is Healthy

Chain-smoking two-year-old Ardi Rizal is down to 15 cigarettes a day thanks to therapy. (AFP Photo)

A chain-smoking Indonesian toddler has cut back to 15 cigarettes a day thanks to “therapy focused on playing”, a child welfare official said on Tuesday.

Two-year-old Ardi Rizal shocked the world when a video of him smoking a cigarette appeared on the Internet last month and drew attention to Indonesia’s failure to regulate the tobacco industry.

Six months after his father gave him his first cigarette, the overweight boy from Sumatra island was smoking 40 a day and threw violent tantrums if his addiction was not satisfied.

Child welfare officials called in to try to wean the toddler off cigarettes said that when they played with him he did not smoke as much.

“The boy has been able to reduce his cigarette intake significantly, very quickly, after the treatment,” National Commission for Child Protection chairman Seto Mulyadi said.

“The therapy focused on playing — we occupied him with toys so that he forgets cigarettes,” he said.

Ardi developed his nicotine addiction while spending his days at a traditional market where both of his parents worked, Mulyadi said.

Simple toys and someone to play with were enough to take his mind off cigarettes, at least for a while. The therapists also encouraged Ardi to associate cigarettes with bad things.

“The boy likes singing songs so we tell him that if he continues smoking, he won’t be able to be a singer one day, and it works,” Mulyadi said.

“It’s much easier to help kids like him than teenage tobacco addicts.”

Ardi’s case has highlighted the tobacco industry’s aggressive marketing to women and children in developing countries like Indonesia, where regulations are weak and many people do not know that smoking is dangerous.

Cigarette consumption in Indonesia soared 47 percent in the 1990s, according to the World Health Organization.

Indonesia’s biggest cigarette manufacturer, PT HM Sampoerna, is an affiliate of Philip Morris International.

Agence France-Presse

Antara News, Sunday, June 6, 2010 03:05 WIB

Jakarta (ANTARA News) - Former chairman of the National Commission for Child Protection, Seto Mulyadi, has expressed concern over the phenomenon of toddlers developing the cigarette smoking habit and the lack of public worry about it.

In his written statement received by ANTARA here on Saturday, he said the phenomena was indeed not an ideal reflection of parents or families which are supposed to protect children from cigarette smoking which could affect their right to live and grow.

As recently reported in the media, a number of cases of below five year old children smoking cigarettes have been found in the country, he said, referring among others to a four-year old child smoker in Malang, East Java, and a two-year old child smoker in Teluk Kemang, Munyi, Banyu Asin, South Sumatra.

The two-year old child in South Sumatra was even reported able to smoke 40 cigarettes a day.

Mulyadi said he believed this had happened because their families and adults living around them had been very permissive and ignored the danger of cigarette smoking.

He said cigarette smoke had long been known as containing thousands of substances that could disrupt lung and intelligence development in children, cause infection of respiratory channels, ears and asthma.

Mulyadi said in the past four years the prevalence of smoking children has risen by 400 percent.

Related Article:

Ardi Rizal, a two year old from Sumatra puffs his way through two pack of cigarettes per day. (Photo courtesy SCTV)

Ardi Rizal is a two year-old from Musi Banyuasin in Sumatra with a difference - he is addicted to cigarettes and smokes two packs a day.

According to his mother Diana, "he's totally addicted. If he doesn't gets cigarettes, he gets angry and screams and batters his head against the wall.'

She said that he suffered withdrawal symptoms when he was denied cigarettes. "He complains that he feels dizzy and sick if he doesn't get a cigarette," she said.

His father, Mohammed, first introduced Ardi to smoking at the age of eighteen months.

Ardi, who weighs about 25 kilos, is also too unfit to play with other children and instead gets around on a toy truck.

Ardi refuses to smoke anything other than his favourite brand.

When his father was asked if he thought smoking would harm Ardi, he said "Ardi looks pretty healthy to me. I don't see the problem."

A young girl smoking a cigarette at shopping mall in Jakarta. JG Photo/Jurnasyanto Sukarno

Jakarta Governor Fauzi Bowo announced on Friday that a city bylaw to totally ban smoking in all public buildings would soon be finalized.

If the ban is treated seriously, unlike earlier attempts to restrict smoking in public areas, Jakarta could finally join the growing list of major cities around the world that have virtually eliminated smoking inside bars, restaurants, offices and shopping malls.

As an interim measure, Fauzi on Friday issued a decree to revise a widely ignored 2005 bylaw on smoke-free areas that mandated the creation of smoking rooms in public buildings.

Under the 2005 bylaw, smokers can be fined Rp 50 million ($5,400) or even jailed for six months for violating the ban, but enforcement has been virtually nonexistent.

The revised bylaw, which still has to be ratified by the City Council, states that smoking areas have to be separated physically from any public building and cannot be located next to an entrance or exit door. This would replace the current system of smoking rooms.

“It is easier to shoo smokers away than to make special rooms for them, and that is what is already happening in other countries right now,” Fauzi said.

The revision is being pushed by the Jakarta Environmental Management Agency (BPLHD) in cooperation with Swisscontact Indonesia, a nongovernmental organization. The revision is based on tests conducted in 34 city buildings by Swisscontact in 2009 that found evidence of nicotine in almost all surveyed locations.

“Schools and hospitals are categorized as ‘totally smoke-free areas,’ however, we found that 32 percent of the tested locations in schools and 68 percent in hospitals had nicotine residue,” said Dollaris Suhadi, executive director of Swisscontact Indonesia.

Based on the current bylaw, there are seven areas where smoking is not allowed: public spaces, health facilities, workplaces, houses of worship, aboard public transportation and in areas dedicated to education and children’s activities.

Smoker Stephan Pramono, 27, said he was skeptical of the new bylaw. “The regulation cannot be properly applied if the people who work for the government themselves don’t do it,” he said. “I know that many civil servants smoke in their offices.”

Dimas A Kusuma, marketing communications manager for Plaza Semanggi mall, said that the biggest challenge would come from shoppers.

“When the 2005 bylaw was issued, we had a 90-day joint campaign with community organizations and NGOs to socialize the new smoking rules,” he told the Jakarta Globe on Friday. “Tenants do not complain, but customers do, because some of them are really addicted to smoking, especially after drinking or eating.”

The mall, which bans smoking throughout the building, still fights an uphill battle despite telling security guards to remind smokers who are inside to extinguish their cigarettes.

“I think the new regulation will be easier to accept because smokers know to smoke in one designated area, and now the new regulation has moved that area outside,” Dimas said.

Tulus Abadi, chairman of the Indonesian Consumer Protection Foundation (YLKI), said that according to a survey his group conducted last year, only half of 60 malls in Jakarta complied with the 2005 bylaw.

“During our survey we still found cafes or restaurants that did not provide a special smoking area, or insufficient no-smoking signs or customers smoking in non-smoking areas,” he said.

The survey found that 45 percent of government offices also ignored the smoking ban.

“The implementation of these regulations relies on the regional government’s seriousness in enforcing them,” Tulus said.

“We are hoping that Jakarta can follow international standards that ban smoking not only in malls and offices, but also in pubs, cafes and discotheques,” he added.

“We hope that the new bylaw can be issued by the government this year or in early 2011.”

Friday’s gubernatorial decree is far from being the Jakarta administration’s first attempt to stamp out smoking. Here is a full list:

Gubernatorial Decree No. 11 of 2004 [ Surat Keputusan Gubernur ] to prohibit smoking inside government offices.

Gubernatorial Decree No. 75 of 2005 specified certain areas as smoke-free. Bylaw No. 2 in 2005 on air pollution control was issued to enforce Decree No. 75. It also mandated smoking rooms in public buildings.

Gubernatorial Decree No. 88 of 2010 has now revised that bylaw to say smoking rooms must be separate from the main building, and not near entrances or exits. This will be the basis for a new bylaw.

Indah Setiawati, The Jakarta Post, Jakarta | Tue, 03/30/2010 9:08 AM

The city will extend the smoking ban in public places and buildings after finding that smoking rooms in buildings do not stop smoke infiltrating non-smoking areas.

The Jakarta Environment Management Board (BPLHD) head of law enforcement Ridwan Panjaitan said his office would revise the 2005 gubernatorial decree to do this.

“People working in the buildings can still smoke, but they will have to smoke outside the buildings,” he said Monday.

He said the smoking free regulation would be imposed on all spaces in buildings because a laboratory test found that the non-smoking areas were contaminated by smoking rooms when they were available.

The 2005 bylaw on air pollution control states that people are not allowed to smoke at all in five types of facilities, namely public transportation, healthcare buildings, schools, children’s areas and places of worship. In offices and public spaces, including malls, restaurants, terminals airports and train stations.

Ridwan said he realized the new regulation could spark opposition in night clubs, bars and restaurants, but he was confident the entertainment and food industry would comply once they knew the rules.

He said according to a survey by BPLHD and the Swisscontact Indonesia Foundation with the University of Indonesia Demography Institute, that 96 percent of respondents supported the plan for 100 percent free smoking areas.

The survey said 93 percent of the respondents were aware of the regulations and 60 percent of them stated that the non-smoking areas regulation should prohibit people to smoke in public closed areas.

“The survey revealed that 62 percent of the respondents would still visit restaurants although they would not be allowed to smoke after the ban is imposed,” Ridwan said.

The survey, held from October to November in 2009, involved 747 respondents living in five municipalities in the city. The survey comprised 65 percent females and 34 percent males aged 20-49 years old with education background of Senior High School and above.

The BPLHD, he said, would make an assessment to measure “the level of compliance” of building owners to encourage implementation.

A building will then be given one of four ratings: poor, satisfactory, good and very good.

“We will also publish data on buildings that breach the regulation in the mass media. We hope prestige and shame will be more effective than law enforcement,” he said.

Tulus Abadi from the Indonesian Consumer Protection Foundation (YLKI) said the city should impose stern sanctions to make this work.

“Publishing information on buildings violating the regulations in the media will only affect them for a while. The city should impose sanctions with a financial impact, like revoking permits,” he told The Jakarta Post.

YLKI found there were violations of the smoking ban in 89 percent of 549 public buses and minivans surveyed in July 2009. In 2008, the foundation found violations of the ban in half of 60 city malls.

People on the city's free health plan should stop jeopardizing their health by smoking, city officials said. (EPA Photo/Jurnasyanto Sukarno)

Governor Fauzi Bowo on Tuesday announced a new proposal that would restrict the access of smokers to the city’s free health care program for low-income residents.

“How can they enjoy the free health care scheme when they know that smoking can cost them their health? That is just not fair,” he said.

Fauzi said deliberations were under way on a possible new city regulation that would alter the terms of the Gakin program, which provides free health care for less fortunate families across the capital.

He said the issuance of the SKTM, a letter normally issued by community leaders to confirm the low-income status of residents, could also be revised.

According to city records, more than 164,000 low-income households across Jakarta have a Gakin card, while an additional 50,000 households have SKTM letters.

Quoting data collected by city officials, Fauzi said that almost a quarter of the average low-income worker’s income was spent on cigarettes.

“When Gakin cardholders smoke, 22 percent of their income goes up in smoke,” the governor said, adding that the number of women and young people taking up smoking was increasing annually across the capital.

Fauzi said he was determined to tackle this problem head on.

“I am not eliminating the Gakin scheme; I just do not want to give free health care to smokers,” he said.

Dien Emawati, who heads the Jakarta Health Agency, said on Tuesday that the city administration’s plan would stress that Gakin cardholders and residents with SKTM letters were not allowed to smoke.

That message, she said, would be formally publicized and strictly implemented across state hospitals, clinics, subdistricts and urban wards.

“We guarantee free health care for the poor, but they need to give up smoking and stop jeopardizing their health,” she said. “If there is even one person who smokes in a family, the entire household is affected.”

Dien said deliberations over a gubernatorial decree to restrict the Gakin card and SKTM letters to nonsmokers were already under way, with talk of “trained field officials” being tasked with checking the teeth and mouths of those claiming low-income status to determine whether or not they were smokers.

Dien said discussions would cover a number of issues, including whether medical services would be immediately stopped for active smokers suffering from lung-related illnesses.

A large number of low-income residents, she said, already suffer from lung diseases such as pneumonia and acute respiratory infections.

Husna Zahir, chairwoman of the Indonesian Consumers Foundation (YLKI), told the Jakarta Globe that her organization agreed in principle with the city administration’s proposal and would support its implementation if it were passed.

She said the strict measure could help increase awareness about the financial and health impacts of smoking.

“Many poor people still prioritize cigarettes over food,” Husna said. “Smoking is one bad thing that can be prevented and stopped.”

According to data collected by the University of Indonesia in 2008, some 35 percent of all Jakartans were active smokers.

The university’s research also found that a family of smokers would spend on average Rp 113,000 ($12) every month for cigarettes. That is slightly more than the Rp 100,000 direct cash assistance package (BLT) given to low-income residents by the government.