THE world turns its attention New Zealand for its innovative and bold policy to bar future generations from smoking by ensuring those who are currently aged 14 and below will never be legally able to buy any tobacco product.

The new legislation effective in four years to raise the legal smoking age every year means the population born after 2008 cannot legally smoke, hence creating a smoke-free generation of New Zealanders.

In 2019, 13.4% of New Zealand’s adult population were smokers. The Labour government which pledged a Smokefree 2025 as headline policy is determined to reduce the national smoking rate to 5% by 2025. 

Many doubt whether Malaysia can replicate the policy and effectively stop teenagers from getting cigarettes at the shops or on the black market.

Illicit trade of tobacco due to smuggling activities (sometimes even orchestrated by the industry themselves) is a common tactic used to undermine the government’s tobacco control policy.

Getting youngsters addicted first to tobacco and start picking up the smoking habit is always the industry’s hidden agenda and game plan for profit sustainability and bottom-line in future, no matter if it is in the form of cigarettes or vapes.

According to the National Health and Morbidity Survey (NHMS) 2019, Malaysia has a smoking prevalence of 21.3% among the adult population. It was estimated that 4.8 million Malaysians aged 15 years and above currently smoke, with men disproportionately at risk (30 times higher prevalence to women) and also higher prevalence found in rural areas (25.4%) compared to urban areas (20.1%).

What is more worrying, 12.3% of the 15-19 age group are already smokers. As more young people pick up up e-cigarettes or vapes, a bad health outcome is a certainty. 

Smoking is one of the world’s largest preventable causes of premature death, killing more than eight million people and costing the global economy US$1.4 trillion (RM6 trillion) each year.

Malaysia is no exception. A 2018 study found that smoking presented a 45% attributed risk of death in Malaysia for male smokers aged 15-64 while 23.5% of deaths among men is attributed to smoking.

Some 213,122 patients were treated and 12,167 patients died in MOH hospitals of diseases and cancers related to the respiratory system in 2020 (Health Indicators 2021, MOH).

Since the public healthcare cost is largely subsidised by government revenue, the negative health consequences of the smoking habit are eventually borne by the taxpayers. The excise tax collected by the government for cigarettes is unlikely to cover all expenses.

Besides health, loss of productivity, happiness and even lives are social costs associated with smoking habits. The people surrounding the smokers could also be affected by the second-hand smoke.

Thus, as much as the tobacco industry wants people to believe that it is their choice to smoke, once they are in it, they lose the freedom to choose because of addiction.

The intention is increasingly obvious. The tobacco industry is using “harm reduction” campaigns through third party or front groups for diversion, attempting to divide public health communities and influence the policymakers so that they can stay in the game.

There is no good information to suggest that switching to the so-called “next generation products” such as vapes and heated tobacco products will lead to harm reduction or facilitate quitting smoking altogether.

The appeal of vape to young “nicotine-naïve” people cannot be overstated. They can be lured with misleading information (e.g., vaping is better, safer and “cleaner” than conventional cigarettes) and enticing choices of vape flavours. It makes them look cool to their peers.  In fact, the most prevalent (14.7%) vapers are in the 20-24 age group (NHMS 2019).

Personally, I have not seen a single person successfully transition from cigarettes to vape and later quit smoking. Instead, more have become dual smokers and vapers.

Quitting is never easy; sometimes the smoker does not even wish to quit. Smokers need help and support from family and friends, not another product that perpetuates their addiction to nicotine.

Anti-tobacco activists are familiar with the tactics of the tobacco industry, therefore they push for “zero harm” for a quit-smoking approach. 

When the harm reduction concept is applied to drug users, they are usually supervised by medical personnel to help them stop drug-related harmful behaviours or the use of harmful products.

The concept may not be a bad idea for tobacco use but the problem is, there is little evidence  to show that the alternative products are actually less harmful, and merely “switching” does nothing much to encourage quitting.

Also, for the concept to work, one must switch completely to a genuinely less harmful product if he is not able to quit smoking. Continuing to smoke cigarettes alongside other tobacco or nicotine products will defeat the purpose.

We have to bear in mind that nicotine is classified as a Group C poison under the Poisons Act 1952. It is actually illegal to put nicotine in vape liquids but the products are not as strictly regulated as cigarettes.

This means anyone, including youngsters, can easily gain access to the products. The vape industry is also lobbying to remove the provision stating “nicotine as poison” so that nicotine-containing vape liquids can be sold freely.

In Malaysia, the tobacco product and e-cigarette draft bill will be presented to parliament in the first quarter of 2022.

It is likely that it will stay in line with the WHO recommendation stating that electronic nicotine delivery system devices, such as e-cigarettes, should be strictly regulated for maximum protection of public health.”

More independent studies are needed to find out how to effectively achieve smoking cessation and study the public health claims of all sorts of nicotine-containing products.

We expect the tobacco industry to continue churning out new products and making unsubstantiated health benefit claims. These claims have to be vigorously and independently studied and assessed.

All in all, prevention is always better than treatment. Preventing non-smokers from becoming new smokers should be the endgame policy for our government.

New Zealand has sent out a bold statement with its policies and actions.

Will Malaysia accept the challenge to follow suit to reach the target of 5% smoking prevalence by 2045? –  December 14, 2021.

* Lim Chee Han is a founding member of Agora Society and a policy researcher. He holds a PhD in infection biology from Hannover Medical School, Germany, and an MSc in immunology and BSc in biotechnology from Imperial College London. Health and socioeconomic policies are his concerns. He believes a nation can advance significantly if policymaking and research are taken seriously.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.