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Monday, May 30, 2022

Are we near the end of the game for tobacco sales?

 

As the world marks No Tobacco Day on May 31, Malaysia is in the throes of a tussle over one of the boldest moves taken by a health minister against tobacco sales.

The minister, Khairy Jamaluddin, announced in January that the government will include in the long-awaited and yet-to-be-tabled Tobacco Act a section on a “generational end game”, where young people born after 2005 will no longer be allowed to purchase, own or use tobacco-related products, including conventional cigarettes and vape.

The minister has taken a lot of flak for this move from many quarters.

Some “experts” decry the move as being a denial of the personal rights of young people who will now no longer have a “choice”.

The industry, of course, has come out with guns blazing in a multitude of ways, including pushing a whole narrative on harm reduction and how it would be a “crime” to deny people who genuinely wanted to quit their opportunity to quit by moving to so-called less harmful products such as vape.

And of course, there is another narrative of how honest “entrepreneurs” who are peddling vape are having their business, and by extension, the national economy, destroyed in the process.

Truth is, everyone has an angle in the tobacco-control landscape, and most have a commercial conflict of interest in doing so.

Conflicts of interest are increasingly common in healthcare and it is something I have highlighted before.

With billions of ringgit at stake within the tobacco landscape, you can imagine how many individuals or organisations want a piece of the stake.

Many of the so-called “experts” who are advocating against a generational end game are, in fact, being remunerated by the industry for their efforts to shape and present a narrative to the public under the camouflage of their credentials.

I am an avowed tobacco-control advocate and the narrative I put forward here is based on science and data, rather than rhetoric and misrepresentation. I have no conflict of interest whatsoever in this area and am genuinely advocating with the best health interest of all Malaysians at heart.

Others seem to have an axe to grind (especially when it seems to directly affect their wallets as well).

Why are we tobacco-control advocates so keen to get behind the generational end game? The main reason is simple. When passed as part of the Tobacco Act, Malaysia will have a legal and foundational framework from which to reduce the exposure and risk of tobacco harm for the next generation.

This will function as a concrete point from which cascade-down policies and programmes can be formulated, and implemented.

For naysayers, this by itself is the first point of objection. Policing such a move will be impossible, they say, and even currently, it is alleged that existing enforcement of cigarette purchases to under-18s is a joke.

Thus, according to the thinking of many who are loudly protesting against the generational end-game legislation, there should not be a law prohibiting these young people from purchasing and using tobacco products since we will not be able to enforce it.

This argument reflects a poor and false understanding of what laws and legislation are and how these instruments are used to shape public behaviour.

For example, there are laws on driving, which apply only to those of a certain age and who possess a valid licence, which is obtained after a written and practical test to ascertain their proficiency.

Despite that, there still remain cases of unlicensed, and even underage unlicensed drivers using vehicles in a manner that causes accidents. This doesn’t mean that we must enforce the laws through daily or even hourly checks on every vehicle on the road to determine whether the drivers have a licence.

Rather, we utilise a mix of education, awareness, social norms and community behaviour as well as random spot-checks at roadblocks to ensure that only licensed drivers are on the road.

The argument used by those against the generational end-game proposal is akin to doing away with driving licences altogether since we can’t ensure that we can check everyone’s licences every day before letting them drive.

To be clear, the passing of the Tobacco Act containing the generational end game proposal will by no means be anywhere near the end of the battle.

There is a long way to go in terms of changing the people’s hearts and minds, to denormalise tobacco and remove it from our daily lives. This, of course, also needs to be complemented by innovative, consistent and sustainable enforcement strategies.

The first step towards creating a smoke-free generation means the passing of a legal and structural framework that can ensure a Malaysia that is empowered to tackle tobacco control.

Everyone who is invested, especially the silent majority of non-smokers, must come out more vocally and support the tabling and passing of the Tobacco Act, including the generational end game. Only then can the beginning of the end happen. - FMT

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.

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