title: Roadmap to a tobacco epidemic: transnational tobacco companies invade Indonesia.
abstract: BACKGROUND
  Indonesia is the world's fifth largest cigarette market in the world but for decades, transnational tobacco companies (TTCs) have had limited success infiltrating this market, due to their inability to compete in the kretek market. Kreteks are clove/tobacco cigarettes that most Indonesians smoke.
  
  
  OBJECTIVE
  To determine how Phillip Morris International (PMI) and British American Tobacco (BAT) have now successfully achieved a substantial market presence in Indonesia.
  
  
  METHODS
  We analyzed previously secret, tobacco industry documents, corporate reports on Indonesia operations, the Tobacco Trade press, Indonesia media, and "The Roadmap".
  
  
  RESULTS
  Internal, corporate documents from BAT and PMI demonstrate that they had known for decades that kreteks are highly carcinogenic. Despite that knowledge, BAT and PMI now own and heavily market these products, as well as new more westernised versions of kreteks. BAT and PMI used their successful basic strategy of keeping cigarettes affordable by maintaining the social responsibility of smoking and opposing smoke-free workplace laws but in the 21st century, they added the acquisition of and westernisation of domestic kretek manufacturers as an additional strategy. These acquisitions allowed them to assert influences on health policy in Indonesia and to grow their business under current government policy embodied in the 2007-2020 Roadmap of Tobacco Products Industry and Excise Policy which calls for increased cigarette production by 12% over the next 15 years.
  
  
  CONCLUSIONS
  PMI and Bat have successfully entered and are expanding their share in the Indonesia cigarette market. Despite the obvious and pervasive influence of the tobacco industry on policy decisions, the Indonesian government should ratify the FCTC and implement effective legislation to reduce tobacco consumption and exposure to tobacco smoke and revise the Roadmap to protect future generations of Indonesians.
authors.affiliation: Mayo Clinic Nicotine Dependence Research Program, 200 First Street SW, Rochester, MN 55905, USA. rhurt@mayo.edu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hurt
authors.forename: Jon O
authors.initials: JO
authors.lastname: Ebbert
authors.forename: Anhari
authors.initials: A
authors.lastname: Achadi
authors.forename: Ivana T
authors.initials: IT
authors.lastname: Croghan
mesh_terms: D004465:Economic Competition; D006291:Health Policy; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D040541:Marketing / Q000379:methods; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D019460:Tobacco Industry