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Background: Indonesia shoulders a significant tobacco burden, with almost two million cases of tobacco-related illnesses and more than two hundred thousand tobacco-related deaths annually. Indonesian tobacco control is progressing but lags behind other countries. Our study evaluates factors that contribute to the slow progress of tobacco policy change in Indonesia from the perspective of tobacco control experts (TCEs).Method: We conducted qualitative interviews with four international and ten national TCEs, who have been active in tobacco control for at least 5 years. Our interview guideline included questions on the current tobacco control situation in Indonesia and explored reasons why tobacco control is progressing so slowly. The interviews were conducted either in English or Bahasa Indonesia, recorded and then transcribed verbatim. We conducted a thematic analysis based on five core causal factors for policy adoption: institutions, networks, socio-economic factors, agendas and ideas.Results: The multistage delay of tobacco policy adoption is principally due to political structures and policy hierarchy, complex bureaucracy, unclear roles and responsibilities, and a high degree of corruption. The low bargaining position and lack of respect for the Ministry of Health also contributes. There are contrasting frames of tobacco as a strategic economic asset and tobacco control as a sovereignty threat. There is an imbalance of power and influence between well entrenched and resourced tobacco industry networks compared to relatively young and less established tobacco control networks. The policy agenda is likely influenced by the privileged position of tobacco in Indonesia as a socially acceptable product with high consumption. There are constraints on transferring ideas and evidence to successful policy adoption.Conclusion: Tobacco companies have substantially influenced both policy decisions and public perceptions, signifying a power imbalance within the government system and broader networks. Acceding to and enforcing the World Health Organization- Framework Convention on Tobacco Control (WHO-FCTC) would enable the Indonesian government to shift the power imbalance towards public health stakeholders. Tobacco control advocates must enhance their network cohesion and embrace other community groups to improve engagement and communication with policymakers. [ABSTRACT FROM AUTHOR]

Introduction: The city of Denpasar has implemented the smoke-free law for five years. However, the compliance remains low. Smoking remains highly accepted in society, and the provision of cigarettes in several religious and customary events. Hence, this study aims to assess how social smoking norms affect compliance with smoke-free laws. Methods: This was a cross-sectional study located in Denpasar, Bali, Indonesia. This study was conducted from December 2019 until February 2020. The sample size was 192 and was selected using multistage random sampling. Data were collected through interviews using a structured questionnaire then analyzed using multiple linear regression. Results: Descriptive norms of smoking affected the compliance in worship places (standardized coefficient beta of 0.175 and p=0.01). Moreover, the effect of descriptive norms to compliance was significantly moderated by perceived of injunctive norms (standardized coefficient beta of 0.216; p<0.01); benefits to one-self (standardized coefficient beta of 0.199; p<0.01); benefits to others (standardized coefficient beta of 0.164; p=0.02); anticipatory socialization (standardized coefficient beta of 0.146; p=0.03); similarity (standardized coefficient beta of 0.141; p=0.04); aspiration (standardized coefficient beta of 0.131; p=0.06); and local leader role (standardized coefficient beta of 0.129; p=0.06). Conclusion: The social norms of smoking remain an important predictor of compliance with the smoke-free law, particularly in countries with strong cultural characteristics. However, its effect could be moderated using appropriate culture-sensitive strategies. [ABSTRACT FROM AUTHOR]