IntroductionTobacco advertisement bans in Indonesia are rare and seldom evaluated. The recent introduction of an outdoor tobacco advertisement (OTA) ban in Banyuwangi District, East Java, Indonesia provided an opportunity to evaluate such policy.MethodsUsing a mixed-methods approach, we undertook an observational study of OTA in 15 locations where such advertising had been prohibited. We also interviewed a sample of 114 store-owners/storekeepers and 131 community members, and conducted indepth interviews with government officials and the Public Order Agency (POA), the designated enforcement agency.ResultsIn phase 1 we found only one location was free of advertisements. We identified 667 advertisement points and 1283 advertisement materials in the study location; of these, 7% and 7.8% were within 25 m of schools and religious sites, respectively. Phase 2 showed that 68% of the respondents were unaware of the regulation, but many supported an OTA ban. Indepth interviews revealed that not all members of the POA were familiar with the regulation. POA members believed they will enforce the regulation better if higher level regulation for ban on tobacco advertisements, promotions and sponsorships was made and digital application is available to support surveillance.ConclusionPolicy violations were evident 1 year after the launch of OTA ban in Banyuwangi. Tobacco advertisements are still visible, including near schools and religious sites, potentially stimulating adolescents to smoke. Regional regulation and setting specific violation reductions as a performance indicator for POA could improve compliance. App-based technology could assist violation surveillance and reporting, as could awareness-raising campaigns that encouraged community support to report violation through the apps.
Objective: To survey outdoor food and beverage advertisements (‘F&B adverts’) for products that may be a risk factor for obesity, diabetes and cardiovascular diseases located in the vicinity of gathering places for children and adolescents. Design: We recorded the GPS coordinates of all F&B adverts visible from the streets at distances of 0–100, 100–300 and 300–500 m from facilities often used by children and adolescents. Those for unhealthy foods and beverages were identified. The density (number per square kilometre) of such advertisements was calculated and evaluated using hotspot analysis. Setting: The sub-districts Mulyorejo and Sukolilo in Surabaya city and the sub-districts Banyuwangi and Giri in Banyuwangi District, Indonesia. Participants: None. Results: The proportion of all outdoor advertisements that were F&B adverts was slightly higher in Banyuwangi than in Surabaya. Of the 570 F&B adverts recorded in Banyuwangi, 227 (39.8%) and 273 (47.9%) were for unhealthy foods and beverages, respectively. Of 960 F&B adverts in Surabaya, 271 (28.2%) and 445 (46.3%) were for unhealthy foods and beverages. In both regions, F&B advert density increased near gathering places for children and adolescents; all recreational areas had at least one set of advertisements for unhealthy beverages and food at 100–300 and 300–500 m. Both regions had one hotspot with significantly high numbers of unhealthy advertisements; Banyuwangi had one cold spot with a significantly low number of healthy advertisements. Conclusion: Regulations to control advertisements for unhealthy foods and beverages in areas frequented by children and adolescents are urgently needed.
INTRODUCTION There are weak regulations and controls on tobacco sales to adolescents in Indonesia, and these may have contributed to the increase in smoking prevalence among adolescents in the country. Our study aims to calculate the density of cigarette retailers near schools and ascertain the factors associated with sales to minors. METHODS We conducted geographical mapping by recording the GPS position of cigarette retailers in 15 locations in Banyuwangi District, Indonesia, to assess the density and proximity of cigarette retailers to schools. We interviewed randomly selected retailers, from the geographical mapping, for information on sales to minors, the cheapest price cigarettes are sold and the most popular cigarette brand purchased by adolescents, as well as owners/keepers knowledge of the regulation regarding sales to minors. RESULTS We identified 770 retailers of consumer goods in the study location; 28.1% (216) sold cigarettes, with mean density of 1.1 cigarette retailers per 100 m. Of the cigarette retailers, 6.9% were located <25 m from schools and all schools had at least one retailer within a 250 m radius. Owners/keepers of 107 cigarette retailers agreed to be interviewed for information on sales to minors. Brands from Gudang Garam were the most popular among adolescents and the brand from Bentoel, part of British American Tobacco, was the cheapest. The median of the cheapest price sold was US$0.7 per pack. Only 43.6% of retailers ever refused to sell cigarettes to adolescents. Within a school complex, retailers' refusal to sell cigarettes to adolescents was higher than in other locations. CONCLUSIONS Schools in Banyuwangi are surrounded by cigarette retailers. Half of the retailers sell cigarettes at a price affordable by adolescents, attracting adolescents to initiate smoking. There needs to be strict regulation to control cigarette sales to minors, through zoning and licensing in Indonesia.
Abstrak: Sero-survei tahun 2010 di Bali melaporkan angka 1% HIV positif pada ibu hamil. Angka HIV dan AIDS yang dilaporkan ke Dinkes Propinsi Bali juga menunjukkan peningkatan laporan kasus HIV yang terjadi pada perempuan. Salah satu alasan yang menyebabkan perempuan menjadi terlibat dalam kelompok rentan tertular IMS dan HIV adalah karena suami atau pasangan seksual mereka memiliki perilaku seksual yang tidak aman diluar pernikahannya dan atau menggunakan narkoba suntik yang tidak steril. Kerentanan perempuan terhadap penularan penyakit seperti HIV ini didasarkan pada beberapa faktor yang terjadi pada level individu, rumah tangga dan masyarakat serta level makro yang sering membuat perempuan tidak menyadari bahaya HIV dan AIDS. Belum banyak penelitian yang menggambarkan bagaimana kerentanan perempuan dapat mempengaruhi risikonya untuk tertular HIV dan AIDS serta IMS. Penelitian ini bertujuan untuk menggali kerentanan perempuan terhadap penularan IMS dan HIV dikaitkan dengan perilaku seksual berisiko. Penelitian kualitatif ini menggunakan metode wawancara mendalam dengan pedoman wawancara semi terstruktur pada 21 informan yang terdiri dari informan perempuan, laki-laki, konselor dan penyedia layanan kesehatan di tiga tempat layanan di Denpasar. Data divalidasi menggunakan teknik member checking dan peer debriefing, kemudian dianalisis secara tematik. Gambaran perilaku berisiko yang menyebabkan kerentanan perempuan terhadap penularan IMS dan HIV adalah perilaku laki-laki yaitu hubungan seksual dengan lebih dari satu pasangan seksual, biseksual, membeli seks, IDU, serta tidak konsisten menggunakan kondom. Sedangkan perilaku berisiko perempuan diantaranya memiliki lebih dari satu pasangan seksual, posisi tawar rendah dalam negosiasi kondom, melacur dan hubungan seks dalam keadaan terpaksa.
designed the study, conducted data collector training, designed data architecture, conducted data cleaning and analysis, and prepared the manuscript. Desak Made Sintha Kurnia Dewi helped design the study, conducted training, data analysis and revised the manuscript. Septa Indra Puspikawati and Erni Astutik helped design the study, conducted training, coordinated field data collection, conducted data cleaning, and revised the manuscript. Soenarnatalina Melaniani helped design the study and revised the manuscript. Dian Kusuma helped design the study and analysis, and revised the manuscript.
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