COMMENT | Addressing smoking needs more than a blanket ban

COMMENT | If banning the sale of tobacco and vape products can reduce the prevalence of smoking; then illicit drugs should have been eliminated and there would not be a need for a narcotics unit, drug rehabilitation centre and drug smuggling.

Health Minister Khairy Jamaluddin recently said that with tobacco use being the leading cause of cancer, which contributes to 22 percent of mortality rates, a new law will be tabled in Parliament to ban smoking and possession of tobacco products for those born after 2005.

The intention of the government is good because smoking is a preventable cause of non-communicable diseases. However, if past experiences have taught us about fighting the use of illicit substances such as heroin, methamphetamine and cocaine; reducing tobacco use requires more than the passing of a law.

It is important to understand that the combustion of tobacco, which releases harmful chemical substances such as formaldehyde, lead, benzene, arsenic, hydrogen cyanide and others is the cause for cancer.

Therefore, if the main idea is tobacco reduction, we should be looking at evidence-based studies to complement the law and address the use of tobacco among current smokers.

The Health Ministry’s 2019 National Health and Morbidity Survey (NHMS) estimates that there are 4.8 million Malaysian smokers. In the same year, it was reported that over a seven-year period, only 73,836 smokers participated in smoking cessation programmes in Malaysia, with all of 16,930 quitting within six months.

The statistics and efforts by the government proves that the current public health agenda in addressing smoking is not working and there needs to be a change in strategy to tackle tobacco use.

Addiction to smoking is akin to addiction to caffeine and the use of illicit substances. The success rate of people in addiction quitting cold turkey is very low. The next best alternative in combating addiction is to gradually reduce the use of harmful substances.

In 2015, the Health Ministry’s NHMS had no statistics on the use of e-cigarettes of vape, whereas in the 2019 survey, it is mentioned that there are over 1 million e-cigarette or vape users and there is disaggregated data by state on these categories.

With the government recognising that e-cigarettes and vape are a growing trend among adults, it is important to note that the use of e-cigarettes and vape can assist smokers to quit smoking.

Certain quarters will argue that e-cigarettes are also a form of smoking because they contain nicotine and are equally harmful to health. However, e-cigarettes and vapes do not involve the combustion of tobacco and allow the user to inhale nicotine in the form of vapour instead of smoke.

Smoking and vaping trials overseas have also shown that e-cigarettes and vape are 50 percent more effective than nicotine replacement therapy, which includes nicotine patches, gums and mouth sprays.

While the percentage of e-cigarette and vape users is low, it is imperative for the government to develop policies that are proportionate to the risk of the product. Having a different strategy, regulation and tax rate for e-cigarettes and vaping may potentially encourage current smokers to switch to a less harmful product.

If regulations on nicotine products are to be implemented, the policies should also be parallel with the demand market. Imposing a blanket ban or a high tax rate will encourage people to go to the black market, just like illicit drugs.

Having a gradual phase out of tobacco within society takes time, especially with a product that dates 12,300 years ago, and it requires more than just a theory to prevent access.

CHRISTINE YP is a former journalist working on development programmes.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.