Tobacco has been used for many decades globally but also in Malaysia. Impacted by high medical cost for treatment of NCD related tobacco diseases, healthcare cost is hugely impacted by tobaccco use. Its widespread distribution (both licit and contraband) still occurs, amidst growing public awareness and disdain for tobacco smoke. It is estimated that 40% of our male population 15 years and above, are hooked on cigarettes and their negative externalities.
Unfortunately, their addiction to tobacco, its hand to mouth rituals and throat kicks have propelled continuous use among adolescents and adults. With these in place, the government needs to think of better safer options, stronger policies and platable decisions that sit well with consumers.
The government has planned to implement the Generation End Game (GEG) Policy, to start by next year and will place tobacco and all derivatives of nicotine, such as vapes, e-cigarettes, and possibly sinus into a similar Act. Hence those born in the year 2005 and above will not be able to purchase cigarettes and all other nicotine products. This is well celebrated, and has received much praise from the population at large.
However, we cannot ignore the burgeoning issue of what happens to the current heavy smokers’ population that is already struggling with tobacco use and its addictions? Conservative therapy such as the tried and tested Nicotine Replacement Therapy (NRT), has so far been used in the national quit smoking programs with mixed results. From low to moderate success rate, labile compliance and success depend on users’ income, NRT access, satisfaction and ease of use. Other methods are not routinely recommended. New strategies used by developed countries such as reduced-risk products (RRP), smokeless tobacco that includes vaping, heated not burn (HNB) and sinus is not accepted but are available on the market with poor regulations. The concept of tobacco harm reduction (THR), is not recommended or accepted by the government, this might cause duress among smokers, that would like to try other options such as RRP. Data from other countries like Japan, the UK, the US, New Zealand and Australia have come up with surprising conclusions, whereby the smokers prevalence has continuously declined, amidst rising numbers of RRP users. Their regulations, albeit minor differences but generally, do include safety on e-liquid quality as the utmost importance, with validated labs confirming results of pods and e- juice, and are following a predetermined standard set by their health authority such as MHRA and ERA. The GEG implementation by New Zealand has shown some success with declining smokers, vape regulations and Australia made vape prescriptions compulsory via medical prescription.
NICE in the UK has also adopted some guidelines that are used to much success in advising populations to stop smoking and switch to a safer alternative such as vaping. The end result would be a safer and compliant switching until finally, you are no longer addicted to nicotine and complete nicotine omission is possible. It is well anticipated that Malaysia will follow suit with better regulations for its vapers and regulate its use as originally intended, i.e. To stop smoking.