Cigarette consumption and nutrient intake in Indonesia: study of cigarette-consuming households.

Abstract

OBJECTIVE: This study aims to investigate the impact of cigarette consumption on household's nutrition adequacy (NA). This study also examines the opportunity cost of cigarette expenditure to children's nutritional adequacy. METHODS: We used an Indonesian cross-sectional household level nationwide data of 2018 National Socio-Economic Survey (SUSENAS). Using multivariate Ordinary Least Square (OLS) regression, we estimated the impact of cigarette consumption on household's NA as defined by household protein and energy intakes. With the same specification, we further ran a segregated OLS regression by household quintile expenditure. While the opportunity cost of cigarette consumption to children's nutrition adequacy defined the estimated forgone nutrition due to cigarette consumption by following the Ministry of Health (MOH) definition of Recommended Dietary Allowance (RDA) for children aged 4 - 6. RESULTS: Cigarette consumption decreases household's protein and energy intakes. We found statistically significant correlation between household's cigarette consumption and household's per capita protein intake while no statistically significant correlation on energy intake. Furthermore, the segregated estimate is significant for both protein and energy intakes among 60% lowest household quintile expenditure groups. The lower the quintile expenditure, the higher the decline in household NA due to cigarette consumption. With the average cigarette expenditure of IDR12,956 per household per day, giving up daily cigarette spending could meet children's energy intake by 27% - 85,4% of RDA and protein intake by 180.12% - 300.48% of RDA. CONCLUSION: Household cigarette consumption has negative impact on household's daily energy and protein intakes. The poorest group is most vulnerable to nutrition inadequacy due to cigarette consumption. Giving up household's cigarette expenditure daily could result in a substantial nutrition gain for children at their critical growth stages.