BACKGROUND: Until 2024, 449 of the 514 Indonesian cities/districts have adopted partial and comprehensive smoke-free law (SFL) to protect people from second-hand smoke exposure, in the country with 70 million adult smokers. However, the implementation of the regulation in Indonesia has not yet been optimal. This study aims to assess compliance of 9 cities/ districts of Indonesia who have adopted comprehensive SFL.
METHODS: This study was a cross-sectional survey conducted in 2023. A total of 4,188 were selected through stratified simple random sampling and walking protocols for venues with no sampling frames. Compliance was assessed based on 6 indicators: absence of smoking, cigarette butt, ashtray, smoking room, smell of cigarette, and presence of no smoking sign. Three additional indicators: the absence of tobacco advertising, promotion and sponsorship; the absence of cigarette sellers; compliance to all 6 indoor indicators above for outdoor areas at four venues (healthcare facilities, school, university and children's playground).
RESULTS: The overall compliance was only 46.16%. Pontianak City showed the highest compliance (90.12%) while Denpasar City was the lowest (24.85%). Venues with the highest compliance were government offices (73.02%), lowest were nightclubs with zero compliance. The absence of a no smoking sign was the highest violation (39.8%), followed by presence of cigarette butts (13.27%) and ashtrays (12.03%) found in indoor areas. The violation on the evidence of indoor smoking (people smoking, cigarette butts, ashtray), was 26.91%, the highest was at nightclubs (90%), then universities (57.89%).
CONCLUSIONS: Compliance to SFL was varied across cities which reflects the wide range of the implementation capacity and commitment. Measures to improve compliance must be taken which include strengthening the capacity of the enforcement agents, better collaboration across sectors, optimal commitment including budget allocation and improving community participation.