City Research Online

Abstract

Objectives
In Indonesia, 61 million adults smoked in 2018, and 59 million were exposed to secondhand smoke at offices or restaurants in 2011. The Presidential Decree 109/2012 encouraged local governments to implement a smoke-free policy (SFP), and the city of Jayapura enacted a local bill (1/2015) to that effect in 2015. This study aimed to evaluate compliance with this bill and to explore challenges in implementing it.

Methods
We conducted a mixed-methods study. Quantitatively, we assessed compliance of facilities with 6 criteria (per the bill): the presence of signage, the lack of smoking activity, the lack of sale of tobacco, the lack of tobacco advertisements, the lack of cigarette smoke, and the lack of ashtrays. We surveyed 192 facilities, including health facilities, educational facilities, places of worship, government offices, and indoor and outdoor public facilities. Qualitatively, we explored challenges in implementation by interviewing 19 informants (government officers, students, and community members).

Results
The rate of compliance with all 6 criteria was 17% overall, ranging from 0% at outdoor public facilities to 50% at health facilities. Spatial patterning was absent, as shown by similar compliance rates for SFP facilities within a 1-km boundary around the provincial and city health offices compared to those outside the boundary. Implementation challenges included (1) a limited budget for enforcement, (2) a lack of support from local non-governmental organizations and universities, (3) a lack of public awareness at the facilities themselves, and (4) a lack of examples set by local leaders.

Conclusions
Overall compliance was low in Jayapura due to many challenges. This information provides lessons regarding tobacco control policy in underdeveloped areas far from the central government.

Publication Type:	Article
Additional Information:	This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords:	Compliance, Smoke-free policy, Tobacco control, Jayapura, Indonesia
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments:	School of Health & Psychological Sciences > Healthcare Services Research & Management
SWORD Depositor:	Symplectic Administrator

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