While our Tobacco and Smoking Control Bill 2022 will probably be effective in preventing younger generations from smoking, the adult population of smokers remains.
Automated behaviours and how to redirect them with alternatives
IT turns out that every habit we have is formed in a three-part process. This psychological phenomenon is called a habit loop.
According to American journalist Charles Duhigg and his book The Power of Habit:
> First, there’s a cue or trigger that tells your brain to go into automatic mode and let a behaviour unfold.
> Then there’s the routine which is what we commonly think about when we think of habits.
> Thirdly is the reward stage whereby your brain associates something it likes with the behaviour, leading to a feedback loop which reinforces the habit.
Duhigg notes that multiple studies have shown that people will perform these automated behaviours – like brushing your teeth, going to bed at a certain hour or smoking – if they are in the same environment.
“If you want to quit smoking, you should stop smoking while you’re on a vacation because all your old cues and all your old rewards aren’t there anymore. So you have this ability to form a new pattern and hopefully be able to carry it over into your life,” he said in a radio interview.
Non-combustible alternative
The World Health Organisation estimated that there will be roughly one billion to 1.1 billion smokers by 2025, despite a growing number of antismoking campaigns to encourage smokers to quit and increasing regulatory restrictions like with our newly introduced Tobacco and Smoking Control Bill 2022.
The fact is that not every smoker can quit cold turkey and this is where science and technological advancements come into the picture to offer a better alternative for smokers.
According to Universiti Putra Malaysia Occupational Safety and Health Associate Professor Dr Ng Yee Guan, “combustion, also known as burning, is an intensive chemical reaction between a fuel source typically in presence of oxygen”.
“For conventional cigarettes, the combustion is self-sustained once lighted due to the sufficient and continuous presence of heat, fuel (shredded tobacco leaves) and oxygen in the atmosphere,” Dr Ng explains.
“During combustion, the presence of high temperature (up to 900°C) provides energy for rapid chemical reactions to occur. Particularly, the carbons in the fuel are separated and reassembled into various configurations of new chemical compounds, especially volatile organic compounds (VOCs) which are mostly toxic.
“For non-combustible cigarettes, perhaps it’s due to the insufficient presence of heat that prevents combustion to take place despite the presence of fuel and heat. As such, the lower temperature provides a lower threshold of energy that prevents a certain chemical reaction from taking place. This may result in a lesser quantity and quality (types) of VOCs being produced during the combustion process.”
Currently, the US Food and Drug Administration (FDA) distinguishes between combustible and non-combustible products.
There are two types of modified risk tobacco product (MRTP) orders the FDA may issue – a “risk modification” order or an “exposure modification” order.
After reviewing one alternative – that is the IQOS Tobacco Heating System – the FDA determined that the “evidence did not support issuing risk modification orders at this time but that it did support issuing exposure modification orders for these products”.
Importantly, the FDA also determined that “the IQOS Tobacco Heating System heats tobacco and does not burn it, it significantly reduces the production of harmful and potentially harmful chemicals compared to cigarette smoke”.
The agency also stated that “the toxicological assessment also found that, compared with cigarette smoke, IQOS aerosols contain considerably lower levels of potential carcinogens and toxic chemicals that can harm the respiratory or reproductive systems”.
This distinction is also why the tobacco and vape industry players are urging our government to create different categories to separate combustible and non-combustible products in the Tobacco and Smoking Control Bill 2022.
Like heated tobacco products, e-cigarettes don’t create smoke because they don’t burn tobacco. E-cigarettes heat a liquid that often contains nicotine to produce an aerosol, of which the act is called vaping.
Case studies
To achieve a smoke-free Malaysia, we can look at case studies in the United Kingdom, for instance, in reducing smoking prevalence.
Public Health England, the executive agency of the Department of Health and Social Care, found that around 60% of smokers (in the UK) want to quit – 10% of whom intend to do so within three months.
The agency also saw that “around half of all smokers in England try to quit unaided using willpower alone, despite this being the least effective method” and listed support options and their efficacy:
> Using nicotine replacement therapies (NRT) or e-cigarettes makes it one and a half times as likely a person will succeed in quitting smoking.
> A person’s chances of quitting are doubled if they use a stop smoking medicine prescribed by a general practitioner, pharmacist or other health professionals.
> Combining stop smoking aids with expert support from local stop smoking services makes someone three times as likely to stop smoking successfully.
To sum up, stop smoking aids play an important role in breaking the habit of smoking.
Clearly, there’s more to be done to combine these quitting methods and to incorporate them into our Tobacco and Smoking Control Bill 2022 if we really want to help smokers quit and create a smoke-free generation.
