08
08
Th e HEALTH | JANUARY, 2019
ISSUE: SMOKING
ISSUE: SMOKING
NO SMOKING
FOR ALL
Greater anti-smoking enforcement
needed for the wellbeing of Malaysians
M
Dr Noor Hisham
say WHO had
estimated more
than 20,000
adult males in
Malaysia die
every year from
complications
caused by
smoking.
ALAYSIA has been a
member of the World
Health Organization
(WHO)’s Framework
Convention on Tobaccol
Control (FCTC) since 2005. According
to the Director-General of Health
Malaysia, Datuk Dr Noor Hisham
Abdullah, as a member, Malaysia has to
implement all the obligations set by the
FCTC.
“Th e overall no-smoking policy is
implemented according to Article 8 of
the FCTC which aims to protect the
public from the dangers of cigarette
smoke,” he says. In addition, the
proclamation of the non-smoking zones
under Law 11 of the Tobacco Control
Law (PPKHT 2004) was done with the
aim to protect the public especially
non-smokers from being exposed to the
dangers of cigarette smoke.
Another purpose for the enforcement
is to instill a no-smoking culture among
Malaysians, by limiting the smoking
zones in and around public areas. All
food and beverage establishments,
including mobile food trucks, providing
seating areas (indoor and outdoor) must
now prohibit smoking and to display a
clear ‘no smoking’ sign.
Th e smoking habit is considered the
main culprit for prevalent non-
communicable diseases such as cancer,
cardio-
vascular
diseases,
and chronic
lung diseases. “WHO had estimated
more than 20,000 adult males
in Malaysia die every year from
complications caused by smoking,”
Dr Noor Hisham adds.
Due to complications and a high
death rate, smoking has aff ected
the country’s economy in multiple
aspects, including high burdening
cost of treatment for smokers, lesser
productivity in the workplace due to
falling ill, and creating loss for the
country due to premature deaths.
How smoking would aff ect the country if policy is not in place
T
HE total number of passive smok-
ers, which includes second and
third-hand smokers will increase
year by year. “Research has proven
that the risks to befallen to diseases are
higher for active smokers,” says Dr Noor
Hisham.
The Global Adult Tobacco Survey
(GATS) of Malaysia 2011 has shown
that most of the public are susceptible to
cigarette smoke when in public places (see
Table 1). Moreover, there is an increasing
number of new smokers among teenage
girls 13 to 15 of age, with 4.2 percent in
2003 to 5.7 percent in 2017.
“Th is shows that teenagers are much
easier to fall prey to smoking when they
are exposed to the habit while in public
restaurants and such.”
GOVERNMENT
SPENDING INCREASES
Dr Noor Hisham also delineates that one
of the main reasons behind the policy
is the increasing costs to treat diseases
relating to smokers and the smoking
habit. “Th e government has to spend a
lot every year to bear the medical costs
related to cigarette smoke,” he says.
Th e economic costs relating to smok-
ing had been in research before. The
Ministry of Health has collaborated with
local and international universities to
take part in the study.
“Research such as ‘Health Care Cost in
Malaysia’ was done in 2007 by Universiti
Kebangsaan Malaysia (UKM) with the
help of the Health Ministry. Th e study
has shown that the annual treatment cost
for the three diseases linked to smoking
such as lung cancer, ischemic heart dis-
ease, and chronic obstructive pulmonary
disease (COPD) was recorded at RM2.92
billion. 67.5 percent of it were supported
by the government (service providing
cost) while 32.5 percent were paid by the
patients themselves.” He explains.
The total equals to 0.7 percent of
Malaysia’s Gross Domestic Product
(GDP) and 26.1 percent of the Health
Ministry’s overall budget. “Th is is a huge
monetary burden to the Malaysian gov-
ernment,” Dr Noor Hisham comments.
BEARING THE HIGH
TREATMENT COST
Projection study made by the Health
Ministry in 2017 had also shown that
if tobacco control in Malaysia are not
enforced and the habit is not reduced,
the government will bear its highest
treatment cost of about RM7.4 billion by
2025.
“Th e treatment cost projection was
made according to the Health Care Cost
of Smoking in Malaysia research (AlJunid
Table 1
LOCATION
%
Cafés and coffee shops 85%
Bars and night clubs 70%
Restaurants 71%
Workplace 40%
Home 38%
et al., 2007) with the help from the the
Department of Statistics Malaysia (show-
ing 1.5 percent increase in population in
5 years’ time).”
He adds, new smokers, especially
among school children is increasing. Th is
will add burden the government even
more in treatment cost caused by direct
and indirect exposure to cigarette smoke.
“We hope that smokers can respect
the public, mainly non-smokers, and
to quit smoking altogether. This will
directly reduce the number of smokers
in Malaysia, helping us to succeed in
making Malaysia free of cigarette smoke
by 2045.”
Various eff orts has been made by the
government to reduce the number of
heavy smokers among the public.
Other than enforcing the existing law
according to the Tobacco Control Laws
2004 (PPKHT) on the outdoor areas of
restaurants, the Health Ministry also
continuously organize tobacco control
eff orts advised by the World Health Orga-
nization (WHO). Th e activities include:
u To give Blue Ribbon accreditations to
premises upholding the non-smoking
culture voluntarily.
u Advocacy programs to children and
teenagers at school through ‘Doktor
Muda’ and IMFree to strengthen the
awareness of cigarette smoke dangers.
u Implementing health hazard images
on cigarette packages.
u Prohibits any promotion of cigarettes,
be it in advertisement, sponsorship,
or product.
u Provide stop smoking services which
include stop smoking clinics within
public clinics and hospitals as well as
working with private clinics, hospi-
tals, and pharmacies through the stop
smoking program mQuit.
u To increase the level of public aware-
ness in the dangers of smoking and its
eff ects towards health.
u Collaborating with public/private
agencies, associations, organizations,
and more to help grow the public
awareness in the dangers of smok-
ing, being a passive smoker, as well as
enforcement implementation. – Th e
Health