Health versus Economic Security: An Ambivalence of Anti-Tobacco Norm Internalisation in Indonesia

Abstract

It is widely accepted that tobacco is a threat to public health security. Anti-tobacco norms are intensively campaigned by international agencies, such as World Health Organisation (WHO) and non-government organisations (NGOs). Indonesia has not signed and ratified the WHO Framework Convention on Tobacco Control (FCTC); however, Indonesian legislation obligates government agencies such as ministries, universities, and the local government to control tobacco use. Meanwhile, tobacco remains one of the central sources of income for Indonesia's state and local economies, a reality that is especially salient for tobacco farmers and labourers. This study aims to examine the extent to which Indonesia internalises the anti-tobacco norm. We focused our investigation on features including norm internalisation and human security, with specific attention to economic and health security. Our study revealed notable ambivalence in the internalisation of tobacco norms in Indonesia. This ambivalence reflects conflictual interests over economic and health security and ambiguity in policymaking concerning tobacco control. Using a qualitative approach, the authors of this study gathered primary data via in-depth interviews and FGD with knowledgeable stakeholders, such as government officials, NGO representatives, health agency workers, farmers, smokers, and academics, and integrated this data with support from the relevant literature. The findings of the present study enrich the existing discussion on norm internalisation, particularly as it relates to tobacco control and other controversial norms.