Nicotine Addiction: Malaysia’s End Game To Public Health

Aug 02, 2023

Until each MP discloses their stand, talk about May tabling of the smoking product bill remains smoke and mirrors. Every day, the government is creating new generations of nicotine addicts. The real end game, it turns out, is public health – not the GEG.

Vape is the new tobacco. The tactics are familiar: the fashionable design of sleek vape pens that appeals to the young, the sponsorship of sporting events, and the claim that vaping is healthier (or less harmful) than traditional cigarettes.

Yet, the unity government appears oblivious to the tobacco industry positioning of electronic cigarettes as the new nicotine delivery device, seemingly choosing instead to promote – not discourage – the growth of the local vape industry by declassifying liquid nicotine as a scheduled poison and enforcing taxes on e-liquids with nicotine from last April 1.

Many anti-tobacco activists and medical experts are generally opposed to the legalisation of vape and e-cigarettes.

But what makes the government decision shocking is that liquid nicotine was removed from the Poisons Act 1952 before the tabling and passage of a tobacco and vape control bill in Parliament.

Malaysia currently has no regulations whatsoever on vape or e-cigarettes with nicotine, such as restrictions on sale to minors under 18; locations for sale; ingredients, nicotine content, or volume of e-liquids for sale; as well as labelling requirements and warnings or bans on advertising, promotion and sponsorship.

This means that every day from now – until the passage of the illusory smoking product bill – vape stores can legally sell e-cigarettes to children and teenagers, with nicotine content as high as 5 per cent and disposables with as many as 10,000 puffs, in colourful devices and unrestricted marketing to impressionable minds.

Proponents of the declassification of liquid nicotine argue that vape has been widespread for years, despite having been illegal under the Poisons Act; hence, it's better to tax and regularise e-cigarettes. This misses the point entirely – should we get rid of speed limits just because drivers repeatedly break them?

Prime Minister Anwar Ibrahim, who is also finance minister, made his views on the matter clear in Parliament yesterday.

First, Anwar revealed that the Control of Smoking Product for Public Health Bill 2023 – a name change for the Control of Tobacco Product and Smoking Bill 2022 – had received "many negative reactions" from MPs, presumably after briefings by Health Minister Dr Zaliha Mustafa and Ministry of Health (MOH) officials as the bill has yet to be tabled in the Dewan Rakyat.

Many legislators, according to Anwar, wanted a review of certain "overly harsh" provisions in the bill, which he did not specify.

Crucially, the prime minister appears to believe in self-regulation, saying that banning cigarettes and vape is "extreme" and "drastic" and that the more "moderate" approach is to tax such products and to simply prohibit them in Parliament and schools, a "sufficiently wide" restriction.

Neighbouring Singapore, however, bans vape and "other emerging tobacco products" that Singapore's MOH believes "can be gateways to smoking". In an article last June, Dr Chow Wai Leng, director of epidemiology and disease control at Singapore's MOH, wrote that Singapore's tobacco control efforts contributed to a steady decline in smoking prevalence from 13.9 per cent in 2010 to 10.1 per cent in 2020.

This shows that it's possible to drastically reduce smoking – if there is political will – instead of apathetically saying that smoking has been around for "thousands of years".

In Malaysia, the decline of smoking prevalence has slowed to 21.3 per cent in 2019, twice as high as Singapore and nearly three percentage points higher than the 18.5 per cent goal in the National Strategic Plan for Tobacco Control.

Malaysia's tobacco problem, which we still can't curb effectively, is compounded by people taking up vaping, especially women and young people who aren't traditional smokers. According to the Galen Centre for Health and Social Policy, 4.9 per cent of the Malaysian population currently vape. Young women make up more than 30 per cent of those who vape and the estimated number of new vapers has overtaken the number of new smokers.

Like Anwar, I personally do not believe in banning cigarettes and vape either, as personal freedom includes the right (for adults) to choose to do or consume things that are bad for health. But a responsible government would still use legislation and regulations – among other strategies like preventive health – to discourage the use of harmful substances like nicotine.

Taxation is just one of many tools in the State's arsenal.

Critically, a responsible government would prohibit the sale of nicotine products to minors aged below 18, instead of simply leaving it to parents to ban smoking at home or to forbid their kids from experimenting with vape. Children and teenagers do not have the mental capacity to make an informed decision, unaware that nicotine can leave them hooked for years after impulsively picking up a fruity disposable vape at a 7-11.

I am not remotely confident that Anwar will be able to fulfil his commitment for the government to table the Control of Smoking Product for Public Health Bill next month, especially if the bill includes the generational end game (GEG) – which bans smoking and vaping for anyone born from 2007 – that had been widely opposed by MPs from the 14th Parliament.

CGS-CIMB Research reportedly said in an analysis yesterday that British American Tobacco (M) Bhd's income source would likely be affected if the GEG included vape: "We are not particularly concerned by the move to outlaw cigarettes among youngsters because we believe the activity is already passé, but we find vapes to be popular among the youth."

When I asked a government backbencher a few days ago if he would vote for the smoking product bill, he indicated that he would prefer not to make a stand because his constituency was split. When I suggested that he run a poll among constituents to help him decide how to vote, he said he would only be able to do so after seeing the draft bill.

The GEG failure last year – due to the hubris of anti-tobacco advocates and then-Health Minister Khairy Jamaluddin, who tried to bulldoze the tobacco bill through Parliament despite its many problematic authoritarian provisions – shows us the darkness at the end of the tunnel.

Since Anwar has publicly opposed a ban on cigarettes and vape, does this mean that the GEG may be dropped altogether or exclude vape? Decoupling the GEG from the bill – if this is the sole sticking point among MPs – might require the Attorney-General's Chambers to look at the bill again, before it can be tabled in Parliament.

The Dewan Rakyat's upcoming meeting beginning May is only 11 days long. If the government does not publish the draft bill this month for perusal by both MPs and the general public – before formal tabling in the House – this leaves very little time for a parliamentary special select committee to review the bill, as suggested by Anwar, for amendments before a debate and vote. MPs, rightfully, would probably want time to go through the bill before voting on it.

The following parliamentary meeting will only be held in October.

Until each and every MP publicly discloses their stand towards the smoking product bill, talk about May tabling of the bill remains smoke and mirrors.

Every day, the government is creating new generations of nicotine addicts. The real end game, it turns out, is public health – not the GEG.

Boo Su-Lyn is the co-founder and editor-in-chief of CodeBlue.