Influence of religious organisations’ statements on compliance with a smoke-free law in Bogor, Indonesia: a qualitative study

OBJECTIVE To explore the Bogor public's perspective on Muslim organisations' pronouncements against smoking and the effect of these pronouncements on compliance with a new smoke-free law in the context of a prosmoking social norm. DESIGN Semistructured focus group discussions were conducted, transcribed, coded using ATLAS.ti software, and analysed using thematic content analysis. Photo elicitation was also used during the focus groups. SETTING Bogor, Indonesia. PARTICIPANTS 11 focus groups (n=89), stratified by age, gender and smoking status, with members of the public (46 male, 43 female, ages 18-50). RESULTS There was limited knowledge of and compliance with both the smoke-free law and the religious pronouncements. In most of the focus groups, smoking was described as a discouraged, but not forbidden, behaviour for Muslims. Participants described the decision of whether to follow the religious pronouncements in the context of individual choice. Some participants felt religious organisations lacked credibility to speak against smoking because many religious leaders themselves smoke. However, some non-smokers said their religion reinforced their non-smoking behaviour and some participants stated it would be useful for religious leaders to speak more about the smoke-free law. CONCLUSIONS Religious organisations' pronouncements appear to have had a small effect, primarily in supporting the position of non-smokers not to smoke. Participants, including smokers, said their religious leaders should be involved in supporting the smoke-free law. These findings suggest there is potential for the tobacco control community to partner with sympathetic local Muslim leaders to promote common goals of reducing smoking and public smoke exposure. Muslim leaders' views on smoking would be perceived as more credible if they themselves followed the smoke-free law. Additionally, public health messaging that includes religious themes could be piloted and tested for effectiveness. These findings may also inform similar efforts in other Muslim cities implementing smoke-free laws.