Smoking and respiratory infections: implications for public health in Indonesia

Dear Editors,

We read with interest the further analysis of the detrimental impact of smoking on respiratory health and its association with increased risk of severe infectious respiratory diseases by Luke J. McGeoch and colleagues.¹ The authors showed that the incidence of all severe respiratory diseases was positively related to the number of cigarettes smoked, and the risk for each respiratory disease (except influenza) also decreased with time since smoking cessation. The study by Luke J. McGeoch et al. focused only on adults in the UK, limiting the generalizability of the findings to other populations.

Smoking in Indonesia has a serious impact on public health, including the risk of severe respiratory infections. Data from the 2018 Riset Kesehatan Dasar (Riskesdas) show that around 67% of adult men in Indonesia are active smokers.² The high prevalence of smoking contributes to the high risk of developing severe respiratory infectious diseases. In addition to active smokers, people in Indonesia are also exposed to secondhand smoke. The practice of smoking in public places and within households increases the risk of secondhand smoke exposure for non-smokers, including the risk of severe respiratory infections. Children exposed to secondhand smoke are also susceptible to respiratory health problems, such as asthma and upper respiratory tract infections.³ Exposure to toxic substances in cigarette smoke can damage the immune system and make smokers more susceptible to severe respiratory infections.⁴

As a public health expert, I strongly support the implementation of strong public health policies to address smoking and the risk of severe infectious respiratory diseases in Indonesia. To effectively address these issues, it is imperative to implement comprehensive tobacco control policies that are aligned with the guidelines set by the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC). Evidence shows that comprehensive tobacco control policies can significantly reduce smoking prevalence and the incidence of related diseases.⁵ These programs should be accessible, affordable and tailored to the specific needs of different community groups. They should include a combination of counseling, behavioral support and pharmacotherapy to improve smoking cessation success rates.⁶ By expanding the availability and reach of programs, we can effectively support individuals to quit smoking and reduce the risk of severe infectious respiratory diseases in Indonesia. Policy success depends on collaboration among various stakeholders, including government agencies, health professionals, non-governmental organizations and community leaders. By working together, we can advocate for stronger policies, raise awareness about the health risks of smoking, and promote a culture of tobacco-free living.

By implementing public health policies, it is expected to have a significant impact on smoking cessation rates and reduction in the risk of severe infectious respiratory diseases. Tobacco taxes, smoke-free policies and comprehensive tobacco control programs have been proven to effectively encourage smokers to quit and protect individuals from the harmful effects of smoking and second-hand smoke. Implementing and strengthening these policies is critical to reducing severe respiratory infections and thus creating a healthier future for all Indonesians.

Funding

The author guarantees that this article has no sponsorship and does not get funding from any party.

Conflict of interest

The authors declare no conflict of interest in this paper.