If I could change one thing about cervical cancer prevention in Indonesia, I would strengthen efforts to protect women from tobacco smoke.
Persistent infection with high-risk HPV is the main cause of cervical cancer. Smoking is an established risk factor, and secondhand smoke exposure is also associated with increased cervical cancer risk. Reducing tobacco smoke exposure therefore deserves attention alongside HPV vaccination, screening, and treatment of precancerous lesions.
Tobacco smoke exposure remains widespread in Indonesia. The 2021 Global Adult Tobacco Survey found that 64.7% of men and 2.3% of women aged 15 and older smoked tobacco. Despite the low smoking prevalence among women, 55.0% of women in this age group were exposed to tobacco smoke at home at least monthly. These figures highlight the importance of protecting women from smoke produced by other people, including husbands and other household members.
Although I do not have direct experience with cervical cancer survivors, I have observed that the husbands of breast cancer survivors in our district are often heavy smokers. This is a personal observation rather than a systematic finding, and it cannot establish that smoking caused these women’s cancers. It has nevertheless reinforced my concern about women’s exposure to tobacco smoke.
In Kapuas District, Central Kalimantan, we are working to strengthen the implementation of smoke-free areas to reduce tobacco-related harm. I would also like these efforts to encourage smoke-free homes and support smokers to quit.
For HIFA, an important contribution would be clear, reliable information that helps families understand the risks of secondhand smoke and the practical steps they can take to protect women’s health.
References:
National Cancer Institute. Cervical Cancer Causes, Risk Factors, and Prevention. Updated 2 August 2024. This source identifies persistent high-risk HPV infection as the main cause of cervical cancer and lists smoking and secondhand smoke exposure among the factors that increase risk.
Ministry of Health, Republic of Indonesia, with support from the World Health Organization and the US Centers for Disease Control and Prevention. Global Adult Tobacco Survey: Indonesia 2021 Fact Sheet. Published 17 May 2022. The survey reports that 64.7% of men and 2.3% of women aged 15 and older smoked tobacco, while 55.0% of women were exposed to tobacco smoke at home at least monthly.
HIFA profile: Jum'atil Fajar is Medical Care Director at RSUD, the Dr. H Soemarno Sosroatmodjo Hospital, in Indonesia. Professional interests: helping health professional to access up to date health and medical information to improve services. Jum'atil is a HIFA and CHIFA Country Representative. jumatil AT gmail.com