Support structures needed in anti-smoking drive


By Hafidz Baharom

Klang MP Charles Santiago may have gone overboard in accusing the Ministry of Health (MOH) of backtracking on its plan to introduce plain packaging for cigarettes.

In an article published this week, Santiago quoted the following statement from the ministry, issued last February by its Divisional Director of Disease Control, Chong Chee Keong: “The Health Ministry plans to introduce generic packaging for tobacco products with the aim of reducing brand recognition and ultimately reducing overall consumption.”

And then Santiago cited a more recent statement by Health Minister S Subramaniam to the effect that the ministry had yet to undertake public consultation on the matter.

One can see that neither Chong nor Subramaniam ever mentioned a time line. So one wonders whether Santiago really meant the ministry was backing off from the plan or simply that it was not carrying it out in a timely manner. After all, the government does have an objective to make tobacco no longer a major health problem by 2020, and we have just four years to go.

Meanwhile, let’s raise a proper question: Does plain packaging work?

Yes, it does, as proven in Australia, where it was introduced in 2013. According to a report done a year later, there was a 78 percent spike in calls to quit helplines within the first month.

Other countries planning to follow Australia’s example include South Africa and the United Kingdom.

Let’s start with a few worrying facts. According to a paper published in the Asia-Pacific Journal of Health in 2010, Malaysia had five million smokers back then. A million of these smokers were younger than 18 years, which goes to show that sales controls (as well as parental control, one might suppose) aren’t working.

Currently, Malaysia uses graphic warnings on cigarette packages. These warnings are apparently quite effective. According to the Australian report cited above, adolescent smoking went down five percent between 2002 and 2006. In fact, this effect of graphic warnings is a worldwide trend. The World Health Organisation in a news release confirmed a worldwide decline in the number of tobacco users as of 2015.

But let’s be frank. We need strong structures to support any anti-smoking measure. While we do have an “Infoline” number printed on every pack of cigarettes sold in the country, has there been any effort to find out how many calls this service has received? And are there any plans for follow-up actions? Is there any means of finding out how many smokers have quit as a result of graphic warnings?

In Australia, the anti-smoking campaign established a hotline to promote quitting before plain packaging was implemented. In Britain, where a debate is raging over plain packaging, there has been a month-long anti-smoking campaign every year since 2012. It is called “Stoptober” and is carried out in October.

So, where are our supporting structures? We do have a list of “Stop Smoking Clinics”, but it’s anyone’s guess how many smokers actually go there. Are financial incentives given to the doctors involved with these clinics? How much money is spent there? Indeed, how much money is the government willing to spend on anti-smoking campaigns? Perhaps someone should raise these questions in Parliament.

For the sake of reference, Britain’s Stoptober project in 2012 cost £5.7 million (roughly RM34.23 million today).

If Santiago’s intention is to promote a healthy lifestyle, he should consider looking at this from a proper health standpoint. If his intention was to highlight the fact that the MOH was lagging in its war against tobacco use, then there should have been a question on what has happened to the taxes imposed on cigarettes. Why wasn’t this money spent on anti-smoking campaigns? What was the money spent on?

Instead, his article reads like a tirade against Big Tobacco, which is far from what we need. What we truly need is a proper plan to reduce tobacco use. If we do indeed have such a plan, the Health Ministry has kept us in the dark about its effectiveness or about any study it may have done on the effectiveness of various strategies.

Hafidz Baharom is an FMT reader.

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