Congress logo
Back to Conference page

The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Wednesday, July 12, 2006 - 5:30 PM


Tjandra Yoga Aditama, Department of Pulmonology & Respiratory Medicine - Faculty of Medicine University of Indonesia / Persahabatan Hospital, Jl. Persahabatan No. 1 Rawamangun, Jakarta, 13230, Indonesia

Indonesia consumed 215 billion cigarettes every year. Type of cigarettes mostly consumed is kretek , locally made clove-blended cigarettes mixed with "sauces". On top of that, one single brand of kretek may include over 30 different varieties of tobacco.

This kretek contain a wide range of exotic flavourings and eugenol, which has an anasthesting effect, allowing a deeper smoke inhalation. Inhaling clove cigarettes were also associated with severe lung injury among people with existing pulmonary problems . Eugenol itself has been linked to behavioral health effects when inhaled and is considered carcinogenic, and is closely related to safrole, a weak hepatic carcinogen.

Kretek also has a quite high tar and nicotine content. A single brand of kreteks can have hundreds of different additives in its “sauce”. The “sauce” makes the tobacco less harsh while maintaining the flavor of a particular brand of cigarettes over time given large variations in leaf quality. During the manufacturing process, hundreds of other chemicals are added to ease inhalation and reduce the amount of tobacco in each stick. In addition to taste-enhancing flavorings, additives can include ammonia to increase nicotine absorption and cocoa to dilute airways. The first kretek creation is thought to be in the early 1880s. Initially a home industry, hand rolled kreteks were commercially produced in Indonesia in 1906. Their popularity soared further after the industry mechanization in the 1970s. Most kreteks now are machine made, and may also come with or without filters.