Terminating tobacco troubles in Malaysia

Authors: Gan Shiz Yee, Muhamad Hairul Nizam bin Abd Hamid and Farizah Mohd Hairi, University of Malaya

Malaysia has implemented various tobacco supply and demand reduction strategies to curb the tobacco pandemic since ratifying the World Health Organization’s Framework Convention on Tobacco Control in 2005. Despite its efforts, smoking prevalence only declined slightly over the last two decades, notwithstanding a recent survey that showed that 85 per cent of Malaysian smokers would like to quit.

The increase in the proportion of adolescents (13 to 17 year olds) using modern smoking products — also known as electronic cigarettes or vapes — from 9.1 per cent in 2016 to 9.8 per cent in 2017 is of great concern.

Prevention is better than cure. Thus on 27 July 2022, Malaysia’s former health minister Khairy Jamaluddin introduced the Control of Tobacco Product and Smoking Bill 2022, which includes the Generational Endgame (GEG) measure. This prevents those born on or after 1 January 2007 from utilising all tobacco products, including electronic cigarettes. This is to prevent the cohort from developing nicotine addictions and tobacco-related diseases.

The Bill regulates the sale and distribution, the labelling and packaging, and the promotion and advertisement of electronic cigarette and vaping products. These are currently unregulated in Malaysia as the liquid solutions used in vaping do not contain tobacco, so they do not fall under the Food Act 1983.

Only conventional tobacco products are regulated under the Control of Tobacco Product Regulation 2004 made under this Act. Anyone with internet access can easily purchase vape products through e-commerce platforms or online food and grocery delivery platforms, with the lowest prices less than RM10 (US$2).

Those opposed to the GEG policy — namely the tobacco industry and pro-vape advocates — intended to use the Bill’s postponement to lobby politicians and policymakers in parliament.

The implementation of the GEG measure will not have an immediate impact on the tobacco industry. Tobacco companies can continue to sell their products to people born before 2007. Nearly 5 million smokers in the country will continue to buy tobacco and smoking products for the next 40 to 50 years.

Two studies assessed the support for the implementation of the GEG measure among Malaysian adults. The first study was conducted by CodeBlue and the Galen Centre for Health and Social Policy — an independent think tank for public policy — from 9 to 24 February 2022. In this study, 95 per cent of 676 respondents agreed with the proposed GEG policy. Support was strong across all groups, with 90 per cent of cigarette smokers, 92 per cent of vape users and 96 per cent of non-smokers approving of the measures.

The second study was conducted from 23 February to 13 March 2022 by the Malaysian Green Lung Association in collaboration with the Southeast Asia Tobacco Control Alliance. In this study, 97 per cent of 928 respondents agreed that the GEG policy should be implemented.

More than 90 per cent of the participants want the policy to be implemented in the country to reduce the burden of tobacco and smoking-related illnesses.

Tobacco Free Generation 2000 (TGF2000) was a proposal that aimed to end smoking in post-2000 birth cohorts. Massachusetts (United States), Balanga City (Philippines), Singapore, Tasmania (Australia), Guernsey (United Kingdom), Finland and New Zealand are places where the policy was actively discussed or implemented.

A 2010 survey conducted in Singapore revealed strong public support for the proposal, with 60 per cent of smokers and 72.7 per cent of non-smokers approving. The policy would only be imposed on citizens and permanent residents born after 2000, leaving tourists and foreign workers unaffected.

New Zealand also shares the same tobacco endgame vision. Its strategies are outlined in the Smokefree Aotearoa 2025 Action Plan that is currently under consideration by the New Zealand Parliament.

The TFG2000 proposal adheres to human rights principles. It may even become a part of a human rights strategy for controlling tobacco problems.

Malaysia’s GEG proposal does not violate the individual’s right to life guaranteed by Article 5(1) of the Federal Constitution. The definition of ‘life’ includes the promotion of life’s continuity, the right to live in a healthy environment and have a high quality of life.

Age differentiation would not be considered as ‘discrimination’ under Article 8(1) of the Federal Constitution. The law does not mandate that all people be treated equally, but that those in similar situations be treated similarly. The GEG measure would be imposed on everyone born on or after 1 January 2007.

Given tobacco’s negative impact on social, environmental and economic development, effective tobacco control should be recognised as a high-impact intervention that can accelerate progress on multiple Sustainable Development Goals.

Dr Gan Shiz Yee is currently attached at the Faculty of Medicine, University of Malaya.

Dr Farizah Mohd Hairi is Associate Professor at the Faculty of Medicine, University of Malaya.

Muhamad Hairul Nizam bin Abd Hamid is a physician currently working in the Disease Control Division, Ministry of Health Malaysia.

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