Doctors: caution needed in tobacco generation end game
“Endgame generation, caution is needed”
The Tobacco Products and Smoking Control Bill 2022, currently before Parliament, calls for a ban on the smoking of tobacco products or substitute tobacco products and a ban on the use of smoking devices by anyone born in 2007 and later.
The objective behind the bill dubbed “Generation End Game” (GEG) is to achieve the long-term goal of promoting tobacco-free future generations of Malaysians. This is undoubtedly a desirable outcome. However, it should be remembered that the two frontline countries of the GEG, namely New Zealand and Australia, are the first developed countries in the world. They have spent decades implementing sustainable tobacco harm reduction (THR) policies, regulations and programs in preparation for this decision. In Malaysia, we have not yet launched any significant HTP programs. This contrasts with our previous experience with opioid addiction, where our HR (harm reduction) program, launched in 2006, was a game-changer, resulting in long-term recovery for addicts, reducing drug-related arrests and rates HIV-related mortality among injecting drug users. -users.
The bill appears to have completely ignored the overwhelming scientific evidence that THR can work with the proper regulatory framework in place. This is documented in detail in the Royal College of Physicians, UK 2016 report (Smoke-free Nicotine: Tobacco Harm Reduction).
Provision 9(1) of this bill has the effect of prohibiting the dissemination of the information contained in this report and also makes it a criminal offense for anyone to discuss it.
It would be helpful for lawmakers on both sides of the House to re-examine this authoritative document and consider implementing proven policies before embarking on the GEG. Pushing the GEG without this groundwork will be a dangerous social experiment.
The dangers and consequences of tobacco products, particularly combustible cigarettes, are well documented. It is responsible for more than eight million deaths a year worldwide.
Smoking, vaping and consuming tobacco products have major health consequences and are addictive diseases. Like all addictions, they lend themselves to appropriate medical intervention and treatment by specially trained professionals and not to the criminalization of the addict.
The bill has a fundamental flaw. It contains a provision that could potentially criminalize young children caught in possession of a cigarette or vaping device. This criminalization approach is unlikely to work in the long term.
There are also no provisions in the bill to address the current generation of smokers and vapers with sustainable HRT programs.
Our experience in community medical treatment of opiate dependence has shown that a specially trained national network of general practitioners (GPs) and family doctors is best equipped to handle this task. They are also the best first point of care for children caught experimenting with smoking and vaping. However, there is no provision in the bill to facilitate and empower the healthcare professional in this task.
Our message to the current generation and the next generation of Malaysians should be: “Don’t start, if you have started, stop and if you can’t stop, ask for help.
We call on our legislators to consider
- if we take a shortcut to GEG without the benefit of sustainable THR policy-focused prerequisite programs
- review provision 9(1), and
- put medical intervention at the center of smoking and vaping cessation policy, not criminalization.
Dr. Steven Chow, President
Federation of Private Medical Associations Malaysia (FPMPAM)
Founded in 1989, the FPMPAM has more than 5,000 members in seven state associations in the country. While primarily committed to improving the quality of private health care through continuing medical education, continuing professional development of its members, and ethical advocacy, in recent years it has focused on the medicine of advanced, addiction medicine and a mentorship program for trainee physicians.