KUCHING: Regulation and policies on tobacco products must be based on evidence-based science, said public health medicine specialist Prof Dr Sharifa Ezat Wan Puteh.
Sharifa, who is currently attached to UKM’s Medicine Faculty, also proposed reviewing the effects of the established regulations.
“Control of contraband or illicit cigarettes and vape is part of this strategy,” she said during Philip Morris Malaysia’s (PMM) East Malaysia media engagement session, here, recently.
“Banning vaping or increasing tax (on tobacco products) would not solve the problem if illegal cigarettes or e-cigs are sold everywhere.”
Globally, she said 1.18 billion people in 2020 regularly smoked some form of tobacco.
“Some 7.7 million deaths worldwide related to tobacco use – 6.7 million deaths of current smokers and 1 million deaths of non-smokers from second-hand smoke exposure.
“Smoking is the second highest risk factor for death behind high blood pressure, and in males, smoking is the leading risk factor for death,” she said.
She added that the projected prevalence of consuming any tobacco produced among males aged above 15 in 2020 was 40.2 per cent in Malaysia.
“Malaysia remains one of the world’s largest markets for illicit cigarettes.
“Nielsen’s latest study on illegal cigarettes, 57.7 per cent of cigarette consumption in the country was illicit – at least RM5 billion in tax revenue is lost each year.”
Sharifa said Malaysia’s vape market size reached US$558 million in 2021, accounting for 42 per cent of the country’s total domestic tobacco market.
She said alternative nicotine products (ANPs), including e-cigs, are very innovative but must be used with caution and care.
Citing a report, she said that e-cig use suggests potential long-term benefits for chronic obstructive pulmonary disease (COPD) outcomes.
“While e-cigs for abstinence or smoking reduction could mitigate some of the harm caused by tobacco smoking in COPD patients.
“While e-cigs are considered less harmful than traditional cigarettes, they are not risk-free,” she said.
Philip Morris Malaysia (PMM) Scientific Engagement Manager Dr Vijayndhran Balakrishnan said a smoker could opt for ANP if they face difficulty in quitting smoking.
“Of course, the gold standard is if you are a smoker, quit smoking. Nobody doubts that. Nobody denies that. Even we from PMI agree with that.
“But if you cannot stop, what is the next line? If a smoker cannot stop, that is where you need to switch.”
Vijayndhran said there are more than 1 billion smokers worldwide, and the figure may remain the same in the near future.
“We need complementary approaches to further drive this approach (quitting smoking) in terms of harm reduction.
“The industry itself has to commit to how we go forward with our harm reduction approaches,” he said.
He said two variable factors can be used to achieve population harm reduction.
“The first is individual risk reduction, and the other is smokers switching.
“But to get this individual risk reduction, it is not just the individual or smoker who needs to reduce the risk. It is a collaborative effort – it includes policymakers, the government, and the healthcare providers all coming into play for this.
“This means you need to have an evidence-based policy. The healthcare system needs to develop proper harm reduction implementations.”
As for smokers’ switch, they need to have appropriate tools.
“You need to have proper smoke-free alternatives to make sure that you can switch, and these products have to be scientifically substantiated,” he said.
On nicotine, he said, there had been a lot of misconceptions about it.
“The US FDA has said that nicotine does not make tobacco use deadly. It is the smoke which is being released when you are burning cigarettes – it releases harmful and potentially harmful chemicals.
“There are more than 6,000 chemicals that make it harmful. This is what causes smoking-related diseases. This is what causes cancer. So, it is not nicotine.
“Yes, we do admit nicotine is addictive, but it is not the primary cause of smoking-related diseases.”
He said the general concept of cigarette smoking involves the combustion process where the threshold of burning a cigarette is 400 degrees Celsius.
“But when the smoker takes a puff, the temperature rises even more, and there would be more harmful chemicals.
“The harm reduction approach is that if you can reduce the temperature, that itself is already a harm reduction approach – we can eliminate burning,” he said.
Another speaker, Assoc Prof Dr Ng Yee Guan from UPM’s Medicine and Health Sciences Faculty, encourages smokers who want to quit to go cold turkey.
“If it is possible for you, just quit. You do not have to damage your body any further.
“But of course, many people cannot (quit cold turkey). If you cannot, find an alternative to help you…slowly convert and switch to the better,” he said.
The sharing session, aimed to share some insights on tobacco harm reduction and the efforts toward a smoke-free future, was attended by more than 10 media practitioners.
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