Voices Without Cigarettes

The sight of a woman, a victim of secondhand smoke and cancer, with a hole on her neck, was a first for an Indonesian audience. Her image resonated with Indonesians, a majority of whom are Muslim, and it started a new kind of conversation in Indonesia.

Wijayanti’s barely-there whisper entreating smokers to quit for the sake of their loved ones reverberated across YouTube, Facebook and Twitter and encouraged others to come forward with their own stories on social media.

“We worked to de-normalized the taboo over talking about tobacco diseases,” said Enrico Aditjondro, Vital Strategies’ deputy director for Southeast Asia, who oversaw the campaign. “It was the kind of disease that people thought, ‘It’s shameful. I don’t want to share stories about my cancer or that I can’t speak anymore because I don’t have a vocal cord anymore because of an operation.’ ”

The positive response to Wijayanti’s story inspired Vital Strategies to take more messages to the internet; early campaigns had been on broadcast TV. Local advocates crafted the name SuaraTanpaRokok, Voices Without Cigarettes, and a social media phenomenon was born. Voices Without Cigarettes appeared on Facebook, Instagram and Twitter/X and millions of people took part.

Wijayanti’s story led to more people coming forward, too. One of them was Robby Indra Wahyuda, 26, a former smoker who had developed throat cancer despite quitting tobacco. Like Wijayanti, he had a hole in his neck. Unlike her, he did not live to tell about it.

“Look at me, don’t I look cool with this hole?” he joked with self-deprecating humor on Facebook along with a photo of his decidedly unglamorous neck scars. The post started trending, was shared by thousands, and drew media coverage. Vital Strategies invited him to share his story for a television campaign.

“Of course!” he replied, promising to get back to them in a month after some more surgeries.

It was not to be. Treatment complications killed Wahyuda before the month was up. His parents, honoring their son’s wish to help, gave Vital Strategies permission to use their home videos of him for the campaign. His mother weighed in on the videos too, articulating her wish that “there would be no more” Robbies.

The video aired on seven national television stations, and on YouTube Wahyuda’s story racked up 500,000 views in about a month — a record for tobacco control videos in Indonesia at the time. More and more victims came forward, and the campaign added a micro-site where people could record their own testimonials in an appropriately named Gallery of Voices.

“Throughout the campaigns people realized, ok, it’s a disease, it’s a problem, I should be sharing it so that other people won’t be caught with the sickness I suffer,” Aditjondro said. “It helped create conversations.”

At least 10 million people were exposed directly to the digital campaign, Vital Strategies found when it analyzed the results of the Wijayanti, Wahyuda and SuaraTanpaRokok initiatives. The campaign had expanded people’s understanding of the harms of tobacco and inspired many to quit smoking.

In a survey of people across five regions, among those who recalled Wijayanti’s video, 93%  said the ad provided new information, and 88% said the ad made them feel concerned about the effects of smoking on their family’s health. And the video spurred important behaviors: 73% said they had discussed smoking with others after seeing the ad, and 77% said they had tried to persuade people to not smoke in front of others. The video especially resonated when it came to children, with respondents saying the video stories had made them much more aware of secondhand smoke’s effect on their children and would avoid exposing them.

Tobacco use is an epidemic in Indonesia, with 67.4% of men and 4.5% of women puffing away. One in five male deaths is due to smoking. Kids start smoking as young as 10 years old, and 38.3% of boys aged 10 to 14 already smoke. Even those who don’t smoke can’t escape, since 85% of the country’s people are exposed to secondhand smoke.

Nationally there are very few controls on tobacco. Cigarettes are highly affordable, and the industry has a huge influence. In some cities, though smoking is not allowed in most public spaces, compliance and enforcement are spotty.

The social campaign seemed to particularly influence many nonsmokers who used the information to talk to the smokers in their lives. Nonsmokers thus became a main focus of the SuaraTanpaRokok campaign. Campaigners targeted this so-called silent majority, especially women and youth with anti-smoking attitudes.

Advocates called out big tobacco companies and their marketing ploys and collaborated with health advocates, artists and the people of Kali Code Village, Yogyakarta, on the unveiling of “Show Your True Colors,” a community project to paint anti-tobacco graphic murals throughout the village.

This was a direct counter to the actions of Philip Morris International, which had gained notoriety by painting the village in the colors of one of its tobacco brands as part of its “Show Your Colors” marketing campaign. Vital Strategies estimated that the industry’s painting of the village gave the company brand exposure worth more than US$220,000 a month. None of the occupants of the painted houses received any of that money.

The campaign’s hashtag for this initiative, #TunjukkanWarnaAslimu (“Show Your True Colors”), became a top Twitter/X topic, trending at number one during the unveiling, and even beating buzz over a soccer match organized by the president of Indonesia. The campaign was also featured in the She Ji: Journal of Design, Economics and Innovation.

Another important feature was the use of local languages and dialects to make the campaign an ever more grassroots effort, which helped it become self-sustaining.

“Creating a sense of ownership was our goal as well,” Aditjondro said.

The Kali Code Village initiative was later replicated in different forms by other cities, also in collaboration with SuaraTanpaRokok. The city of Bogor did something similar with its mini-buses, to enforce smoke-free public transportation, while Banjarmasin used its boats and Ambon used its landmarks, hanging banners from bridges and taking campaign slogans to the water with divers.

Ambon especially was a big win.

“We started from zero,” Aditjondro said. “They had no policy whatsoever. Eventually we got a whole set of smoke-free regulations in that city.”

SuaraTanpaRokok also kept the pressure on Big Tobacco. Several actions were organized under the social media tag #TheyLieWeDie. A group of students organized a “die-in” at a Jakarta shopping mall that was not complying with the city’s smoke-free policy. Banjarmasin youth groups organized occupy-like actions in front of tobacco company offices and advertisements near schools.

In Bali, the 12th Asia Pacific Conference on Tobacco or Health (APACT) coincided with the Soundrenaline International Music Festival, sponsored by Philip Morris subsidiary Sampoerna. More than 100 tobacco control advocates converged outside the concert venue to voice their concerns while forming a giant “puzzle” of messages by holding signs over their heads that formed a tobacco-protest slogan as seen from above. The event was recorded with a drone.

Evolving further, SuaraTanpaRokok shifted its focus to Instagram after the team noticed its popularity with young people. One of the videos posted was of Sutopo Purwo Nugroho, who represented the Indonesia National Board for Disaster Management and was a well-known and loved figure during the early days of COVID-19. Nugroho was navigating his own disaster—a lung cancer diagnosis, even though he had never smoked.

The Vital Strategies team interviewed him as he battled stage 4 lung cancer developed from secondhand smoke he’d been exposed to by his colleagues. He died a few months later. The posthumous video of him speaking about the issue went viral.

The online campaign is still going strong. SuaraTanpaRokok’s social media pages are still pointing out the insidious ways that tobacco companies infuse their products into popular culture. A recent Instagram post about a mother commenting on a 13+ rated Netflix series which was riddled with smoking scenes garnered more than 30,000 views in just one day. The campaign has become self-sustaining, which has been the goal all along.