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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: Indonesia is one of the countries with the highest number of tobacco advertisements, promotion, and sponsorship (TAPS) across the globe, which play a significant role in increasing smoking prevalence. Since 2019, Klungkung District has adopted a TAPS ban at point of sale (PoS). Accordingly, this study aims to evaluate compliance with the total TAPS ban at PoS in Klungkung and the factors associated. Methods: This cross-sectional study was conducted in the Klungkung district from August to October 2021. The survey involved 200 samples of PoS and also the managers, which selected using stratified simple random sampling for registered PoS and a walking protocol for unregistered PoS. Data was collected through observation using a checklist and interview using a structured questionnaire by eight well-trained enumerators. Data were analyzed using SPSS. Results: The study successfully observed 200 PoS and also interviewed 200 PoS managers. The result showed the compliance was 72.5%. Of 9 factors analyzed using regression analysis, it was found that factors associated with the compliance were knowledge and attitude PoS manager toward TAPS ban (OR=11.3; CI:1.233-103.414; p=0.008), perceived of socio-economic impact factor (OR=8.1; CI:3.584-18.400; p<0.01), and tobacco industry interference (OR=2.8; CI:1.441-5.594; p=0,003). Conclusions: Compliance with the TAPS ban at PoS remain sufficient, even though it has not reached the target. Factors mainly associated with the compliance were the attitude of PoS manager, and tobacco industry interference. Hence, socialization and enforcement should be improved and sustained. [ABSTRACT FROM AUTHOR]