Evaluation social marketing program to reduce a number of people smoking in Indonesia
1. 1. social marketing
Social Marketing is applies marketing techniques to social psychology theories in order to bring about population-wide behavior change. The most commonly used technique is mass media promotion, which borrows heavily from traditional marketing and the ‘four Ps of marketing’ – product, price, place and promotion (Egger, Spark et al., 1990 cited in Baum, F. 2008).
1.2. Social Marketing in Public Health
To confront the chronic disease epidemic that threatens to determine human health in the twenty-first century, public health practice must begin to focus on far more than providing basic medical care. To establish a favorable environment for human well-being, public health practitioners must concentrate on affecting social change by helping to modify individual behaviors and lifestyles, improve social and economic conditions, and reform social policies. (Siegel, M & Lotenberg, L.D. 2007).
Behavior-based health promotion starts from the premise that in developed countries the major killers are diseases or injuries that are linked to lifestyle, sometimes called the diseases of affluence, and that modification of the lifestyle linked to disease or injury will be beneficial to people’s health.
Like a sample in South Africa social marketing techniques are being used as part of the fight again HIV/AIDS and other STDs, as well as unwanted teenage pregnancy. LoveLife was launched in September 1999 by a consortium of leading South African public health organization in partnership with a coalition of more than a hundred community-based organizations, the South Africa government, major South African media groups and private foundations. The lovelife campaign uses social marketing to support a range community based initiatives, such as youth leadership program and campaigns to establish appropriate youth health services. Its general message is to encourage South African youth to adopt positive lifestyle options (Baum, F. 2008).
2. 2. Case Studies (social marketing program to reduce a number of people smoking in Indonesia)
Tobacco use has been identified as an important risk factor for many non-communicable diseases both in developed and developing countries. To date, about one-third of the world’s population smokes, mostly in China, India and Indonesia. These three Asian countries with large populations have been the main targets for tobacco companies’ expansion (Market, J.E. 2005). The three leading tobacco companies in Indonesia produced 146 billion cigarettes in 2004. The acquisition of 97% of HM Sampoerna, Indonesia’s third largest tobacco company in 2004, by Philip Morris International in 2005 intensifies the threat to tobacco control efforts in Indonesia (Aurora, L. 2005). As one of the top five tobacco-consuming countries in the world, Indonesia is lagging behind in terms of the Framework Convention of Tobacco Control signature and ratification. The reluctance of the Indonesian government to promptly adopt this global strategy as national policy aimed at reducing tobacco supply and demand has created an opportunity for the expansion of the tobacco industry (WHO, 2003). Even in the latest amendment of government regulation about tobacco control, sanctions for violation on production, advertisements and sales were eliminated (Achadi, A., Soerojo, W., Barber, S. 2005) and no laws prohibiting the sale of cigarettes to minors exist (cited in Nawi, N. L., Weinehall & Ohman, A. 2007).
. Given its large population and smoking prevalence, Indonesia ranks fifth among countries with the highest tobacco consumption globally at 182 billion sticks per year. Consumption has increased rapidly since the 1960s. Between 1970 and 1980, a 159% increase coincides with the mechanization of the clove cigarette industry. With a doubling of the GNP per capita in real terms between 1980 and 1997, tobacco consumption rose by 8.2% per year for a cumulative increase of 139%. Quite remarkably, the rise in consumption continued even after the economic crisis of 1997. Adult smoking prevalence rose from 26.9% to 31.5% between 1995 and 2001, reflecting an increase among males from 53.4% to 62.2%. Regionally, the highest male smoking rates are Gorontalo province (69%) in the northernmost tail of Sulawesi Island compared with the lowest in Bali (45.7%). East Java and Lampung provinces experienced steep increases in prevalence between 1995 and 2001 exceeding 60%, and relatively low educational levels could be a contributing factor. Female smoking prevalence more than doubled between 1995 and 2001 in Papua, East Kalimantan, Central Java and Bali provinces, although nationwide rates remain below 2%. The vast majority of smokers (68.8%) started their habit before 19 years of age (cited in Achadia, A., Soerojob, W., & Barber, S. 2004).
2.2. Social marketing program anti smoking in Indonesia
Indonesian government has developed some policies concerning smoking issue, including legislation approach, campaigns, and research. The legislation includes regulation about tobacco advertising; health warning on tobacco packages; safe tar and nicotine standard; smoke-free smoking areas in public places, schools, and workplaces; community involvement; training and supervision; fines for disobeying the regulations; tobacco price and taxes.
Indonesia Ministry of Health has developed anti-smoking programs, which are focused on educating people to understand more about the negative effect of smoking on health. The government has developed quit smoking programs that provide services to help smokers to quit smoking (MOH 2000).
One of program social marketing for anti-smoking in Indonesia is put health warning on the cigarette packages. Health warnings on cigarette packages have been implemented since 1991. The health warning reads that “Smoking can cause cancer, heart attacks, impotence and harm pregnancy and fetal development”. The health warnings must be placed on and comprise at least 15% of the wide of the package. The health warning on cigarette packages have objective to educate people to understand more about the negative effect of smoking on health and reducing a number people smoking in Indonesia.
The another programs doing by Ministry of Health is spread poster and leaflet in public space such as School, Government office, Airport, Bus Station, Market, etc.
2.3. Evaluation of Social marketing program to reduce number of people smoking in Indonesia
Research by Public Health Faculty of Indonesia University has found that health warning on cigarette packages not effective to reduce number of people smoking in Indonesia. The health warning on cigarette packages has not effective because that message to small and put in back side on cigarette packages (MOH Indonesia, 2008).
Social marketing Program with put health warning on cigarette packages in Indonesia has been not effective because the shape of the message only a small writing without pictures to explain negative impact of smoking. Based on survey by Public Health faculty of Indonesia University, 42,5% respondent not believe contents on health warning, 20% respondent say that health warning is not clear and 25% respondent is not care that message because they has to become addicted with smoking. 78% respondent say that the health warning on cigarette packages have to show pictures and put in the back and front of cigarette packages to becomes effective for educate people the negative impact of smoking (Cited in MOH Indonesia, 2008).
Programs social marketing to reduce a number of people smoking until now is not effective in Indonesia. This is because the cigarette promotion strategies are stronger than anti smoking promotion strategies. There is lack of government support regarding tobacco control programs. As a policy maker, government plays a vital role for policy implementation. Indonesian governments do not really manage the tobacco control seriously. They have a weak policy regarding limitation of cigarettes advertising. Most countries have regulation to ban the smoking advertising in any media, but Indonesia only restricts it. It seems that governments provide regulations that still don’t affect the tobacco industries. Supported by huge financial resources tobacco manufacturers develop their promotion strategies as widely as they can. They use television, posters, sponsorship, billboard, etc to promote their cigarettes. They develop their promotion strategies as subtly as they can. As an example, some schools accept donations from tobacco manufactures for several school activities. The anti smoking promotion strategies that are conducted by ministry of health are not comparable to the cigarette promotion strategies.
3. 3. Conclusion
Indonesia Ministry of Health has developed anti-smoking programs, which are focused on educating people to understand more about the negative effect of smoking on health is not effective. This is because there lack of government support regarding tobacco control programs. The cigarette promotion strategies by cigarette industries are stronger than anti smoking promotion strategies by ministry of health. The anti smoking promotion strategies that are conducted by ministry of health are not comparable to the cigarette promotion strategies.