Banda Aceh’s anti-tobacco efforts are unfairly focused on women smokers
Smoking is a normal part of everyday life for the men of Aceh. Smoking is an inseparable aspect of Acehnese culture, practiced at almost every traditional and social event or festival. Cigarettes are shared and distributed at birthdays, wedding ceremonies and events that commemorate death. Cigarettes are a symbol of social interaction, generosity, friendship, and other positive parts of life. However, for women, smoking is considered culturally inappropriate and some suggest disrespectful of Islamic principles – which are followed by the majority of the city’s population. Although smoking was a recognised custom for elderly women in the past, women smoking in public today are looked down upon.
The number of female smokers across Indonesia remains low compared to males. In 2013, Indonesia’s national household health survey, Riskesdas, found that 57 per cent of men surveyed were active smokers. Men are far more likely to be smokers than women, but the last seven years have seen substantial growth in the number of female adolescents (now 4.5 per cent) and young adult women (now 6.7 per cent) taking up smoking across the country. In Banda Aceh as in other parts of Indonesia, smokers are predominately male. In 2016, 27.8 per cent of men and 0.18 per cent of women in the city were smokers. The province of Aceh has the fifth highest percentage of people smoking in Indonesia.
Regardless of who is smoking, cigarettes are everywhere. It is widely promoted by appealing advertisements and reinforced by cheap cigarette prices. Rising consumption rates are also fostered by a lack of knowledge and understanding of smoking hazards. Furthermore, attempts to regulate smoking have struggled due to poor implementation – regulations do exist but the penalties for smoking in public places, for example, have not been enforced.
In 2016, the City of Banda Aceh brought in a qanun (district regulation) on smoke-free areas (No. 5/2016). The qanun, which was an extension of a former mayor’s decree (No. 47/2011), prohibits smoking in 12 public spaces. In addition, Aceh’s Majelis Permusyawaratan Ulama (MPU, Consultative Assembly of Islamic Clerics) has issued a fatwa about smoking (No. 18/2014). Even though opinions differ among religious leaders and the prominent Islamic schools of thought (Muhammadiyah and Nahdlatul Ulama), the MPU’s fatwa follows the Muhammadiyah position – smoking is haram (prohibited) because of its health consequences and how it disrespects others.
These regulations have been powerless and ineffective due to a lack of enforcement by the responsible authorities – public order enforcers Satpol PP and the Syariah Police – many of whom are smokers themselves. Smoking thus remains common in public places such as health facilities, public and private education institutions and offices, children’s playgrounds, places of worship, indoor sports facilities, petrol stations and other open-air and enclosed areas.
The current legislation also has gendered implications. The qanun on smoke-free areas and the MPU’s fatwa both suggest smoking is permissible for men but not for women, especially if pregnant. Also, under the fatwa smoking is said to be haram because it inflicts passive smoke on innocent people, who are most likely to be women and children. However, women and children are often dismissed if they object to smoking in the public domain, or at home. They are not socially protected or safeguarded by these rules, though it is their right to be. If they try to ask people to stop smoking, smokers resist and often become disrespectful.
In addition, the regulations do not address prevailing vaping trends, despite the fact that e-cigarettes have become popular in the city. Misleading information about e-cigarettes being a pathway to quitting or cutting down has become a new challenge, in particular because e-cigarettes have not yet been legalised.
To smoke or not to smoke?
Despite the stigma, there are women in Aceh who choose to smoke. Ami is a young woman born in Banda Aceh who grew up in a moderate Islamic family. As a Muslim, she practises the religion’s primary principles, such as praying five times a day, fasting and giving to charity. However, as she is an adult and earning her own money, her parents never object to her smoking. Nor do they oppose her decision to not wear the jilbab (headscarf or veil). Ami wears the veil only to the mosque or when attending Islamic events and ceremonies. Ami’s mother used to smoke and many of her friends are smokers, which influenced Ami to become a smoker herself.
‘My father is not a smoker. My mother used to smoke. They don’t mind me smoking or not yet wearing the jilbab. But they told me if I later wear the veil, I have to give up smoking.’
Ami is well aware of the adverse effects of smoking, especially for her health. Yet she still cannot stop consuming cigarettes. Even though she is confident smoking in public spaces, such as in warung kopi (coffee shops), she admits feeling irritated when people start to stare and talk behind her back. She is mindful of the social stigma towards women smokers in the city, where smoking women are still seen as ‘bad women’, or as acting inappropriately. She has no choice other than to try to challenge the existing social norm that condemns women who smoke but tolerates, or even encourages, men to smoke.
Ami has attempted to quit smoking many times. However, addiction, peer-influence and her work environment make it hard for her to change her risky behaviour. She has tried switching from cigarettes to e-cigarettes, initially believing that vaping was a healthier option because some of them come without nicotine. Meanwhile, e-cigarettes currently remain a controversial public health issue. Pro e-cigarette experts claim that the substances they contain can help to reduce tobacco consumption while their opponents believe them to be are just as harmful as regular cigarettes. Ami confessed that although she now believes that e-cigarettes are not much better than regular cigarettes, she continues to both smoke and vape.
Another woman, Susi, a student at one of the public universities in Banda Aceh who is much younger than Ami said that she never used to like smoking. She took up the habit after being offered a cigarette from a male friend in her first academic year. She is now addicted.
Like Ami, Susi’s efforts to quit did not work out well, leading her to replace smoking with vaping. Unlike Ami, Susi prefers smoking privately at home. While her male friends have the freedom to smoke in public, she refuses to do so due to her parents’ objections and her concerns about how people see and judge a girl smoking in public in Banda Aceh.
Ami and Susi’s experiences are examples of how social stigmas around women smoking in Aceh play out in women’s everyday lives. Social stigmas exist, especially for those wearing the veil who are labelled as bad mannered or even immoral. The stereotyping of women smokers is groundless because it ignores the fact that the risks of smoking are real for all smokers, irrespective of gender. Virtue has nothing to do with it.
Moreover, this gendered stigma is counterproductive because it ignores why women take up smoking in the first place. Labelling them bad or immoral does nothing to discourage the habit because these women often smoke to challenge gender-biased restraints in Aceh. Muslim women are expected to act virtuously to reflect their Islamic clothing, and smoking while wearing the veil is acting badly. This false generalisation ignores the other circumstances that drive women to smoke, such as stress from work or home life and peer influences.
The need for gender sensitivity
Less attention is given to research on women’s tobacco-related health risks in comparison to men’s. A lower priority is given to studying the psychological, emotional and economic reasons that women take up smoking. Understanding these underlying circumstances is critical for providing insights and recommendations for further tobacco-control measures that target women.
Moreover, though women are the minority of smokers, their lives can still be impacted by tobacco use, often in very different ways to men. Some women choose to smoke and face discrimination. Even non-smokers are exposed to passive smoke as they often cannot avoid male smokers in their households or in public. Women, and all passive smokers, are vulnerable to non-communicable diseases caused by smoking. There is also the risk of becoming a single parent and/or the primary breadwinner if their spouses become sick or die due to tobacco use.
Women are placed in a difficult position when it comes to smoking. They are expected to act virtuously while at the same time are inevitably exposed to risky smoking behaviours. For the women who take up smoking this means quitting is harder due to not only addiction and peer and other pressures, but a lack of support for overcoming it all. Yet, the increased number of women smoking in Banda Aceh may generate a new problem not only for the women themselves, but also for their children and families and for society.
Ami and Susi are not the only ones who find themselves in this difficult position. Labelling them and others like them evildoers and ostracising them from society is not productive. Understanding better their motivations for smoking and establishing policies that discourage them from continuing would be far more useful. Embracing them with more gender-sensitive public health policies for reducing tobacco consumption may help them combat their forbidden habit.
Rizanna Rosemary (firstname.lastname@example.org) is a PhD candidate in the Media and Communication Department of the Faculty of Arts and Social Sciences at The University of Sydney.