On average, 76 Malaysians die prematurely from tobacco use every day – a tragic and completely unnecessary loss of life. — AFP Relaxnews
Imagine if there was a new recreational drug which was addictive, contained many toxic chemicals, including 70 carcinogens, and eventually killed half of its regular users.
Would any government make it legal? Not a chance!
Yet today, we have such a product in every convenience store across the country. If introduced today, tobacco would never be made legal. Nicotine is very addictive, while the 4,000 chemicals identified in tobacco smoke include hydrogen cyanide, arsenic, formaldehyde, carbon monoxide, benzene and ammonia.
“Cigarettes are infused with many chemicals like ammonia for rapid uptake of nicotine to create addiction,” explains anti-tobacco activist Muhammad Sha’ani Abdullah, adding that vape liquids also reportedly contain ammonia.
Tobacco is the greatest cause of preventable and premature death today, linked to all major chronic diseases. It causes 22% of all cancer deaths locally and 80% of lung cancer deaths globally. But most smokers will likely die of heart disease – smoking triples the risk of dying from it. The cost to the nation is enormous, at RM3bil a year.
Since January 2020, almost twice as many Malaysians have died from tobacco use than from Covid-19 (based on a 2019 national survey estimate of 27,000 annual deaths from tobacco). On average, 76 Malaysians die prematurely from tobacco use every day. Every. Single. Day. This is a tragic and unnecessary loss of life.
Doesn’t it make sense that we should save the young from this deadly habit?
That’s the plan of the government’s “Generational End Game” or “Gegar-18” proposal to ban the sale of tobacco products to those born from 2005 onwards, starting next year. The move follows a similar bid in New Zealand, expected to become law next month there.
Who can argue against protecting our young from the most deadly legal product available?
“Smoking initiation happens primarily during adolescence,” explains Muhammad Sha’ani, the Tobacco Control Coordinator at the Federation of Malaysian Consumers Associations (Fomca). “We want to stop children from trying smoking.
“It cannot be as before – in the last 30 years smoking prevalence did not reduce meaningfully,” he says.
Currently one in five Malaysians smoke. Worse, 17% of teens aged 13 to 15 smoke. The younger people start smoking, the more likely they are to continue and to die early.
Many anti-smoking measures have encountered problems. High tobacco taxes (which have reduced smoking rates in other countries) have been counteracted here by a thriving black market. Smoke-free rules are often defied – government premises have been officially smoke-free since 1985, but some still smoke in the office.
“If all public officials had refrained from smoking during the eight to 10 hours at the work place, most of them would have ceased smoking by now,” observes Muhammad Sha’ani, adding there are even teachers smoking in schools, setting a bad example for children.
He says such regulations are important in “denormalising” smoking. That means making smoking less “normal” and visible to reduce its social acceptability. Another blow to tobacco control was the abolishment of the Malaysian Health Promotion Board (mySihat).
What’s also urgently needed are smoking cessation services, says pharmacologist Prof Dr Mohamad Haniki Nik Mohamed from the International Islamic University Malaysia Kuantan.
“Some smokers are still unaware of approved smoking cessation medications, which when combined with behavioural support, can increase the long-term success rate of quitting smoking by 70%, compared with those who quit unassisted,” he says, adding that 1,700 pharmacists have been trained in smoking cessation services.
By contrast, vaping is not a route to end smoking, Muhammad Sha’ani says. In fact, it’s a smokescreen – literally. E-cigarettes can have a higher addictive potential than smoked cigarettes among the young, studies using the Fagerström Test for Nicotine Dependence have shown.
He outlines three rules of ethical smoking: never smoke in a “No Smoking” area; never invite anyone to smoke (assume a smoker is trying to quit); and never smoke in front of a child.
Some smokers insist on their “right” to smoke. But what about the right to live? Non-smokers who breathe secondhand smoke at home or at work have a 25% higher risk of developing heart disease and higher risks of respiratory problems including asthma.
Smoke-free environments have a far-reaching impact. A year after Scotland introduced smoke-free legislation in 2006, an evaluation of hospitals found admissions had dropped by 17% for heart attacks and by 18% for asthma attacks among children, a report by ASH (Action on Smoking and Health) Scotland found.
One local doctor offers this simple advice for parents of asthmatic children: Don’t smoke in the house and car. Smoking leaves toxic residues.
When I first started as a rookie reporter in the 1990s, smoking in workplaces was the norm. One night while working late, I looked up to see a thick cloud hanging over the desks of the chain-smoking sub-editors. Thankfully, my feisty editor, who was then pregnant, campaigned hard and The Star became an early pioneer of smoke-free offices in the country.
End Game is a great move, but ultimately, we also need a public that understands how important anti-smoking measures are for the nation’s health. We need people to take a stand against smoking. Will you?
Human Writes columnist Mangai Balasegaram writes mostly on health but also delves into anything on being human. She has worked with international public health bodies and has a Masters in public health. Write to her at lifestyle@thestar.com.my. The views expressed here are entirely the writer's own.
