How Harmful is Smoking for Women? A Qualitative Study in Indonesia
Downloads
Introduction: In Indonesia, smoking is often perceived as a behavior associated with men, leaving women's perspectives on tobacco use largely unexplored. However, smoking has significant social, economic, health, and political implications for both genders. Despite the low reported smoking rates among women, their participation in tobacco control initiatives remains minimal. Female smokers face heightened social stigma compared to men, with stereotypes labeling them as socially unacceptable. This stigma often discourages quitting rather than deterring women from smoking in the first place, contributing to the underreporting of female smokers and making their numbers appear negligible. Objectives: This study aims to explore women’s experiences with smoking-related consequences in two locations, Banda Aceh and Jakarta. Findings indicate that both women who smoke and those whose partners are smokers encounter challenges in either starting or attempting to quit smoking. Additionally, beliefs about health and economic consequences serve as a common justification among smokers for not considering quitting. Methods: A qualitative study using semi-structured interviews seeks to explore the smoking-related experiences of women in two Indonesian cities, Jakarta and Banda Aceh. Results: The findings reveal that both female smokers and women with smoking partners face difficulties in initiating or maintaining cessation attempts. Additionally, perceptions of health and economic consequences often serve as justifications for avoiding efforts to quit smoking. Conclusion: The study found that socio-religious factors have a significant influence on women's experiences with smoking. Participants expressed beliefs about smoking tied to health and financial concerns, including the notion that outcomes like illness, death, and financial changes are predestined and beyond individual control (fatalism). This fatalistic perspective, shaped by their social and religious environment, hinders their efforts to quit smoking, making cessation more challenging.
Abrams, L. R., Kalousova, L., & Fleischer, N. L. (2020). Gender differences in relationships between sociodemographic factors and e-cigarette use with smoking cessation: 2014–15 current population survey tobacco use supplement. Journal of Public Health, 42(1), e42-e50.
Amos, A., Greaves, L., Nichter, M., & Bloch, M. (2012). Women and tobacco: a call for including gender in tobacco control research, policy and practice. Tobacco Control, 21(2), 236-243. doi:10.1136/tobaccocontrol-2011-050280
Chinwong, D., Mookmanee, N., Chongpornchai, J., & Chinwong, S. (2018). A comparison of gender differences in smoking behaviors, intention to quit, and nicotine dependence among Thai university students. Journal of addiction, 2018(1), 8081670.
Cholil, M., & Sudirman, S. (2019). Gender Equality in Islamic Family Law: Breaking the Chain of Domestic Violence to Achieve Harmonious Family. Kafaah: Journal of Gender Studies, 9(2), 131-146.
Christiani, Y., Byles, J., Tavener, M., & Dugdale, P. (2015). Socioeconomic related inequality in depression among young and middle-adult women in Indonesia׳ s major cities. Journal of affective disorders, 182, 76-81. doi:10.1016/j.jad.2015.04.042
Consortium, G. T. E. (2018). The health, poverty, and financial consequences of a cigarette price increase among 500 million male smokers in 13 middle income countries: compartmental model study. BMJ, 361.
Cruz, T. B., Rose, S. W., Lienemann, B. A., Byron, M. J., Meissner, H. I., Baezconde-Garbanati, L., . . . Unger, J. B. (2019). Pro-tobacco marketing and anti-tobacco campaigns aimed at vulnerable populations: a review of the literature. Tobacco Induced Diseases, 17.
Feeny, E., Dain, K., Varghese, C., Atiim, G. A., Rekve, D., & Gouda, H. N. (2021). Protecting women and girls from tobacco and alcohol promotion. BMJ, 374.
Ferretti, F. (2019). Understanding tobacco use in different countries Neuroscience of Nicotine (pp. 1-8): Elsevier.
Hardesty, J., Kaplan, B., Martini, S., Megatsari, H., Kennedy, R., & Cohen, J. (2019). Smoking among female daily smokers in Surabaya, Indonesia. Public Health, 172, 40-42.
Havard, A., Chandran, J. J., & Oei, J. L. (2022). Tobacco use during pregnancy. Addiction, 117(6), 1801-1810.
Heise, L., Greene, M. E., Opper, N., Stavropoulou, M., Harper, C., Nascimento, M., . . . Hawkes, S. (2019). Gender inequality and restrictive gender norms: framing the challenges to health. The Lancet, 393(10189), 2440-2454.
Hussain, M., Walker, C., & Moon, G. (2019). Smoking and religion: untangling associations using English survey data. Journal of religion and health, 58(6), 2263-2276.
Kodriati, N., Pursell, L., & Hayati, E. N. (2018). A scoping review of men, masculinities, and smoking behavior: The importance of settings. Global health action, 11(sup3), 1589763. doi:10.1080/16549716.2019.1589763
Kristina, S. A., Endarti, D., Wiedyaningsih, C., Fahamsya, A., & Faizah, N. (2018). Health care cost of noncommunicable diseases related to smoking in Indonesia, 2015. Asia Pacific Journal of Public Health, 30(1), 29-35.
Lindqvist, A., Sendén, M. G., & Renström, E. A. (2021). What is gender, anyway: a review of the options for operationalising gender. Psychology & sexuality, 12(4), 332-344.
Lindsey, L. L. (2020). Gender: Sociological Perspectives: Routledge.
Ma, C., Xi, B., Li, Z., Wu, H., Zhao, M., Liang, Y., & Bovet, P. (2021). Prevalence and trends in tobacco use among adolescents aged 13–15 years in 143 countries, 1999–2018: findings from the Global Youth Tobacco Surveys. The Lancet Child & Adolescent Health, 5(4), 245-255.
Mackay, J., & Amos, A. (2003). Women and tobacco. Respirology, 8(2), 123-130. doi:https://doi.org/10.1046/j.1440-1843.2003.00464.x
Malinakova, K., Kopcakova, J., Madarasova Geckova, A., van Dijk, J. P., Furstova, J., Kalman, M., . . . Reijneveld, S. A. (2019). “I am spiritual, but not religious”: Does one without the other protect against adolescent health-risk behaviour? International Journal of Public Health, 64, 115-124.
Manandhar, M., Hawkes, S., Buse, K., Nosrati, E., & Magar, V. (2018). Gender, health and the 2030 agenda for sustainable development. Bulletin of the World Health Organization, 96(9), 644.
Marthias, T., Anindya, K., Ng, N., McPake, B., Atun, R., Arfyanto, H., . . . Pan, T. (2021). Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study. BMJ Open, 11(2), e041870.
Martiana, A., Wardhana, A., & Pratiwi, P. H. (2017). Merokok sebagai simbol interaksi bagi perokok perempuan urban. Fakultas Ilmu Sosisologi. UNY.
Martins-da-Silva, A. S., Torales, J., Becker, R. F. V., Moura, H. F., Waisman Campos, M., Fidalgo, T. M., . . . Castaldelli-Maia, J. M. (2022). Tobacco growing and tobacco use. International review of psychiatry, 34(1), 51-58.
Nakagawa, S., Takahashi, Y., Nakayama, T., Muro, S., Mishima, M., Sekine, A., . . . Kosugi, S. (2022). Gender differences in smoking initiation and cessation associated with the intergenerational transfer of smoking across three generations: The nagahama study. International journal of environmental research and public health, 19(3), 1511.
Nargis, N., Yong, H.-H., Driezen, P., Mbulo, L., Zhao, L., Fong, G. T., . . . Giovino, G. A. (2019). Socioeconomic patterns of smoking cessation behavior in low and middle-income countries: Emerging evidence from the Global Adult Tobacco Surveys and International Tobacco Control Surveys. PLOS ONE, 14(9), e0220223.
Ng, N., Weinehall, L., & Öhman, A. (2007). ‘If I don’t smoke, I'm not a real man'—Indonesian teenage boys' views about smoking. Health Education Research, 22(6), 794-804. doi:10.1093/her/cyl104
Nichter, M., Padmawati, S., Danardono, M., Ng, N., Prabandari, Y., & Nichter, M. (2009). Reading culture from tobacco advertisements in Indonesia. Tobacco Control, 18(2), 98-107. doi:10.1136/tc.2008.025809
Organization, W. H. (2021). GATS Global Adult Tobacco Survey-Fact Sheet Indonesia 2021. Retrieved from
Penelitian, B. (2013). Riset Kesehatan Dasar (2013). Jakarta Indonesia: Kementerian Kesehatan Republik Indonesia.
Ridwan, A., & Susanti, E. (2019). Subordination of women and patriarchal gender relations at Islamic poor community. Masyarakat, Kebudayaan dan Politik, 32(2), 159-167.
Rosemary, R., & Werder, O. (2023). ‘To smoke or not to smoke’: Indonesian women contesting and negotiating the taboo. Journal of Substance Use, 1-7.
Seatca. (2021). The Tobacco Control Atlas: ASEAN Region, Fifth Edition. Seatca.
Sreeramareddy, C. T., Harper, S., & Ernstsen, L. (2018). Educational and wealth inequalities in tobacco use among men and women in 54 low-income and middle-income countries. Tobacco Control, 27(1), 26-34.
Tod, A. M. (2003). Barriers to smoking cessation in pregnancy: a qualitative study. British Journal of Community Nursing, 8(2), 56-64. doi:10.12968/bjcn.2003.8.2.11088
Widiyaningsih, D., & Suharyanta, D. (2020). Pengaruh Sosial Budaya Dan Geografis Terhadap Perilaku Merokok Pada Lansia Perempuan Di Wilayah Dataran Tinggi Dieng Wonosobo. Jurnal Manajemen Kesehatan Yayasan RS. Dr. Soetomo, 6(2), 245-254.

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

In order to be accepted and published by Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education, Author(s) who submit an article should complete all the review process. The copyright of received articles assigned to the Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education,and Department of Health Promotion and Behavior Science, Universitas Airlangga as publishers of the journal. The intended copyright includes the rights to publish articles in various forms (including reprints).
Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education's website. Authors are allowed to use their works for any purposes deemed necessary without written permission from Jurnal Promkes: The Indonesian Journal of Health Promotion and Health EducationS and/or Department of Health Promotion and Behavior Science, Universitas Airlangga with an acknowledgement of initial publication in this journal.
The Editorial Team of Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education and Department of Health Promotion and Behavior Sciences strive to ensure that no errors occur in the articles that have been published, both data errors and statements in the article.
Users of this website will be licensed to use materials from this website following the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. No fees charged. Please use the materials accordingly.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Attribution ” You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial ” You may not use the material for commercial purposes.
ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.