With a 264 million population and the second highest male smoking prevalence in the world, Indonesia hosted over 60 million smokers in 2018 . This number is increasing as the tobacco consumption prevalence (smoking and chewing) among aged 15+ years remained high at 34% in 2018. The male tobacco consumption prevalence was very high, at 63% in 2018. Among the youth 10–18 years, the smoking prevalence is 9.1% increased by almost 30% during 2013–2018 . All this contributes to the high burden of cardiovascular diseases. The Indonesian Global Burden of Disease study showed ischemic heart disease and stroke as the top two leading causes of death and disability in 2016 . Despite all this, the national tobacco control programs are very limited in Indonesia, partly due to not yet ratifying the Framework Convention on Tobacco Control (FCTC) [4,5,6].
One main argument against comprehensive tobacco control in Indonesia is the welfare and livelihood of tobacco farmers. It is believed that any tobacco control efforts would decrease the amount of tobacco consumed, and local tobacco farmers would be negatively affected. Data shows that the tobacco industry has experienced steady growth over time. Domestic cigarette manufacturing increased by 54% from 222 billion sticks in 2005 to 342 billion sticks in 2016. However, it has been a different story for local farmers. Local tobacco production decreased by 17% from 153,000 tons in 2005 to 127,000 tons in 2016 . These gaps between production and consumption have been filled by imported, usually cheaper, tobacco, which contributes to reducing the welfare of tobacco farmers. Increasing tobacco imports, together with other imports, also hurt economic growth.
Hence, Indonesia experiences the double burden of welfare from increasing tobacco consumption that decreases the public health, and rising tobacco import that reduces the economic growth and farmers’ well-being. As a developing country, Indonesia can learn from other developing countries who has a better situation, lower tobacco consumption, and lower tobacco import. This study aims to analyze the trend of tobacco import, and tobacco consumption of Indonesia compare to four other developing countries and determine what Indonesia can learn from them.