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I met “Gita,” a petite, 13-year-old girl in East Lombok on a hot September day in 2014. As she sat on the floor in her brown school uniform, her knees tucked to one side, she described spending her afternoons, weekends, and school breaks working on tobacco farms.

Her job involved tying tobacco leaves to bamboo sticks before they were hung in a barn to dry, and untying and sorting the dried leaves afterward. It may sound like a simple task, but Gita often spent hours squatting or kneeling, her small frame hunched over a pile of tobacco leaves, twisting her wrists over and over in the same motion. “Your body hurts all over,” she said. “It’s painful.” She started this work when was 10 to earn money for school supplies.

She said working near the tobacco made her sick. “I feel sick to my stomach because I have to lean over and smell it [the tobacco] again and again. It hurts because it’s like you want to throw up, but the food won’t come out,” she said, describing painful dry heaving. “It’s better if you can actually throw up.” She also said she often felt dizzy while she worked. “It feels like I’m seeing stars all over my head, and I just want to fall down,” she said.

The symptoms she described are consistent with acute nicotine poisoning, an illness tobacco workers can suffer when they handle tobacco leaves and absorb nicotine through their skin. The most common symptoms are nausea, vomiting, headaches, and dizziness. Children are more vulnerable than adults because of their size, and because they are less likely than adults to have developed a tolerance to nicotine

Gita was one of the 132 child tobacco workers my colleagues and I interviewed for a new Human Rights Watch report. They worked on tobacco farms in four provinces: East, Central, and West Java, and West Nusa Tenggara. Indonesian and multinational tobacco companies buy the tobacco these children help to produce and use it in tobacco products sold in Indonesia and abroad.

All of these children handled tobacco while they helped to plant, maintain, harvest, and cure the crop. Half reported at least one symptom consistent with acute nicotine poisoning. The long-term effects of absorbing nicotine through the skin are unknown, but research on smoking suggests nicotine exposure during adolescence may have lasting consequences on the brain.

Many children also mixed and sprayed toxic pesticides, worked in extreme heat, used sharp tools, or worked at dangerous heights in barns with nothing to protect them from falling.

Indonesia is the world’s fifth-largest tobacco producer, with more than half a million tobacco farms. Most are small, family-run operations, often less than a hectare of land. Unaware of the hazards, families often allow children to start helping on the farm when they are young.

We could not find any official estimates of the number of child tobacco workers in Indonesia, but those we interviewed are probably only a tiny sample of the children doing hazardous work on tobacco farms each year.

We shared our findings with the largest companies operating in Indonesia—Djarum, Gudang Garam, Philip Morris International (which owns Sampoerna), British American Tobacco (which owns Bentoel), and others—hoping to learn about their policies and practices to prevent hazardous child labor in their supply chains. Surprisingly, the Indonesian national companies did not respond with any information about their position on child labor. We could not find any evidence that they are taking steps to prevent child labor in their supply chains, though tens of thousands of children—maybe more—work in conditions that compromise their basic health and safety.

Most large multinational tobacco companies have policies to prevent children from doing the most dangerous work on tobacco farms, and publicize their efforts, with varying degrees of transparency. Still, in Indonesia, none of these companies have taken effective steps to monitor for child labor when they buy tobacco through traders who bundle leaf from many farms. They, too, risk purchasing tobacco produced with child labor.

Business is booming in Indonesia for the tobacco industry: the World Health Organization estimates that 73 percent of Indonesian men and boys 15 and older smoke. More than 3.9 million children ages 10 to 14 become smokers each year in Indonesia, and at least 239,000 children under 10 have already started smoking.

Like most of the girls I interviewed, Gita does not smoke, and when I asked if she had ever tried smoking, she answered emphatically, “Oh no! It’s forbidden,” alluding to the social stigma associated with women smoking in Indonesia. But she is still surrounded by tobacco at every turn—at home, in her community, at school, and in the fields.

A recent study of 360 schools in five Indonesian cities found that billboards and banners advertising tobacco products were visible from one-third of the schools. Tobacco advertisements at kiosks, minimarts, and stores where they are sold were found near 85 percent of the schools. What the ads don’t say is, “This product may be made with child labor.”

Indonesia has enacted new policies in recent years to address the harm of smoking through pictures used as health warnings on cigarette packs and other measures. But much more needs to be done, including protecting children who might harvest the crop.

Indonesia is one of only a few countries that has not ratified the Framework Convention on Tobacco Control, the global public health treaty designed to protect the public from the harmful effects of tobacco products. Indonesia should ratify the treaty without delay.

Even with stronger policies to prevent children from smoking, child workers like Gita will still be vulnerable to the dangers of tobacco unless the industry and the government take action to protect them. Tobacco companies should ban having children under 18 work in direct contact with tobacco, and enforce those policies throughout their supply chains. Indonesia already bans children from working with toxic substances, but should make clear that this includes tobacco. The government should regulate the industry, enforce child labor laws, and carry out an extensive public health campaign to educate families about the hazards of tobacco farming for children.

Without better protection, too many childhoods will continue to be tainted by tobacco.

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