Indonesia is still a smokers’ paradise. The number of male smokers in the country remains the highest globally. Although not as much as male smokers, smoking among females is increasing. Amid the significant challenges and rudimentary efforts to implement comprehensive tobacco control, the increasing trend of electric cigarette (e-cig) use in society has become the government’s new ‘homework’ to deal with.

Smoking vs. Vaping

Much information and evidence are found on the harmful effect of electronic cigarettes on health, including one cause of death. In particular, there were several death cases due to e-cigs consumption found in the United States in 2019. Responding to the increasing trend of ill and death-related to vaping, some official organisations in Indonesia, such as the Medical Doctors Association or  Pengurus Besar Ikatan Dokter Indonesia (PB IDI), has issued the recommendation to ban e-cigs. Nevertheless, the idea was strongly challenged by the vapour industries. Nevertheless, the idea was strongly challenged by the country’s vapour industries  (Asosiasi Personal Vaporizer Indonesia) in the country.

For some smokers, e-cigs usage, or vaping, is a solution to reduce their addiction to conventional smoking cigarettes or ways for smoking cessation. Electronic cigarettes are considered to have less health impact compared to consuming regular cigarettes. The seemingly ‘misleading’ perception about vaping became one of the reasons for smokers, especially women, to switch their smoking habits to vaping practice. A recent qualitative study found that women smokers have higher concern for their family members’ health and well-being, especially children. These women believe that vaping helps them to slowly reduce and stop smoking addiction, which at the same time helps to minimise the health risks of smoking to their offspring.

Interestingly, the rapid growth of the vaping industry in Indonesia is not just because of the high demands for the substances; but also because of the ‘additional addiction’ that this industry offers. Smokers, including women, chose to vape over smoking and were involved immensely in the ‘grey business opportunity.’

The vaping traps

So-called ‘Lani’—a young woman from Aceh, 38 of age. With her consent, she told her story of her smoking behaviour and how she was later involved with vaping. Like other women smokers in the city of Banda Aceh, Lani Lani felt uncomfortable with the stigma placed on her and other women smokers found smoking in public places by most people in the community. However, the stigma does not apply to men who have every freedom to smoke both in public and in private, such as inside the house. Male smoking is regular in society, despite tobacco control regulations (Smoke-Free Area) having been applied to restrict smoking practices in the city. This condition has encouraged women smokers to smoke within close door (privately).

Contrary to most women who choose to smoke secretly due to the negative labelling by the community, Lani does not mind smoking in public places despite few who look at her displeased and sometimes cynically. Along with some male smokers, she continues smoking regardless of the smoking ban is displayed in the coffee shop under the Qanun (Regional Regulation) No.5 of 2016 concerning No-Smoking Areas (KTR) in Banda Aceh City. Weak law enforcement is one of the reasons for Lani and other smokers to keep smoking within the restricted areas.

Lani considers herself a “smokers with attitude” since she claimed never to smoke in front of children. She is consciously aware of the dangers of smoking to health. Living a healthy lifestyle is why Lani switched from smoking to using electronic cigarettes four years ago. Since then, she has been actively involved in the vapers or vapours community at the provincial, national, and even international levels. She interacted intensively with the vapour community from Malaysia. Lani was even elected as the ‘Vapor Squad ambassador’, the only woman representing Aceh at the national level.

Vaping misleading behaviour

As the ambassador of the ‘Vapor Squad’, Lani and other ambassadors are encouraged to become ‘a smart vapours”, which among other responsibilities, their job oversee the sale of e-cigarettes to minors (underage). Even though, under observation, many young people are found to buy and use e-cigarettes in the Banda Aceh city.   Moreover, Lani and her team must counter the so-called ‘black campaigns’ addressed to the vapour’s community. For example, the issue of e-cigarettes exploded in the mouth. Lani said that bad incident during vaping depends on the device used and how well vapour understands the maintenance of the device. For Lani, her responsibility is good and noble and supports her value as a smoker with attitude.

According to Lani, the vaping industry is a promising career. TSo many businesses derive from vaping. For instance, the vaping device service and maintenance, named coiling, has become a new business avenue explored by people in Aceh. Likewise, the invention of new liquid flavours has grown significantly in the past couple of years. Vapour liquids with various fragrances evolve and are sold at varying prices that are more expensive than conventional cigarettes—i.e. IDR 150.000,00 for 30 ml liquid. Lani is happy to get free vapour liquids as the ‘Vapor Squad’ ambassador. Another promising work from vaping is the ‘vape trickers’, the ability to perform attraction while vaping. Such as Byron Datau from Indonesia, who has become a famous global vape tricker.

As part of the vapours community, smoking is not allowed. However, Lani admitted that she still consumes conventional cigarettes. The pleasure of smoking is different from the feeling she found using e-cigarettes. There is already increasing evidence showing how e-cigarettes are as dangerous as smoking. Including the danger of e-cigarettes to women during pregnancy which could cause damage to the lung function, as well as long-term risk of lung development of the child they are carrying. However, many e-cigarette users are unaware of the risks posed, especially those endorsed (fully supported) by e-cigarette companies. Like Lani, who is in a dilemmatic position. When trying to withdraw from the dependency of using conventional cigarettes, she found herself trapped in a new type of dependency, i.e., vaping and the industry behind the products.

Lani is not the only smoker and vapour dependent on toxic products. Many other ‘Lani’ have become addicted to cigarettes and e-cigarettes from a young age, especially where vaping has become a new trend and is well-accepted by society.

To break the dependency chain of these two harmful products, the needs to seriously and decisively apply regulations to control the use of both products, including raising the price of cigarettes, vigorously enforcing the Smoking Free Area (SFA), and total ban on Tobacco Advertising, Promotion, and Sponsorships (TAPS). The current statement about ban e-cigarettes released by the Muhammadiyah Indonesian Ulama (Majelis Tarjih dan Tajdid Muhammadiyah) is a vital breakthrough in stopping people’s misperceptions about the impact of the e-cigarette. However, this top-down approach needs to be accompanied by efforts to make smoking and vaping behaviour no longer socially unacceptable. That is by educating the public about the magnitude of adverse effects of these addictive products when compared to the benefits mentioned above through workshops, seminars, and focus group discussions (bottom-up approach).