Lighting Up: A Look at Malaysia's Smoking Ban

Just how far are we willing  to go to punish smokers?
Thursday 14 March 2019
In Malaysia smoking-related deaths account for about 20% of all deaths annually. Photo:istock

The Malaysian government is on a health and moral crusade, the idea being that with sufficient political will and enough public support, its ambition of turning Malaysia smoke-free will eventually become a reality. For the good of the majority, a few individuals hell-bent on dying a premature and horrible death will just have to change their ways whether they want to or not. The government’s weapons to induce this change: shame, isolation and financial retribution.

Let’s not get into the whole smoking is bad/not bad for you debate. I think most of us, including smokers, are already sold on the science that this filthy habit can lead to fatal diseases such as pneumonia, emphysema, heart attack and cancer, and that passive smoking is equally as dangerous, especially for children. Soberingly, in Malaysia smoking-related deaths account for about 20% of all deaths annually and more than 15% of total hospitalisation is the result of smoking-related illnesses.

However, the truth is smoking isn’t just a habit – it’s a chemical dependency that causes changes in an individual’s brain chemistry that are not easily reversed. It is an addiction with well-known long-term consequences that start with making you cough, then suffer shortness of breath and possibly end in painful death. And for this perilously habit-forming addiction, smokers are punished incrementally over the years through gory images of cancer-ridden corpses on cigarette packs, advertisements showing smokers’ children crying at their parents’ funerals, higher and higher prices of cigarettes which hit the poorest the hardest, and harsh smoking legislations.

A smoking ban on all restaurants and cafes as well as open-air street food stalls and hawker centres became mandatory on 1 January with smokers only allowed to light up three metres away from these premises. Photo: istock

Now to their horror the government is going further still. A smoking ban on all restaurants and cafes as well as open-air street food stalls and hawker centres became mandatory on 1 January with smokers only allowed to light up three metres away from these premises. Those caught smoking in public face fines of RM10,000. The good intention of protecting us all from the disastrous health effects of smoking has come with a price – ostracising and shaming smokers to the point where they are driven further and further towards the outer fringes for their tobacco fix, shuffled out into the street, puffing anxiously near road traffic as unsympathetic pedestrians scoff and dodge their plumes.

I would describe myself as a non-smoker, but one who has had the occasional cigarette, often to keep the serious smoker company and boy, this group is an unpopular bunch. During a recent dinner party I mentioned that I was writing an article on smoking and every single person around the table was vocally contemptuous of smokers. “I’m amazed by how little smokers seem to understand how strongly the smell of cigarette smoke clings to them and their clothes, and how disgusting it is to many non-smokers,” said one rather hefty diner, while tucking into his second pudding. Another who was steadily drinking six gin and tonics in a row agreed: “They are incredibly silly and selfish, aren’t they?” So never mind that thousands die from obesity and alcohol-related diseases every year, it is smoking that is the people’s number one enemy.

In fact stigmatisation against smokers runs so deep that while lung cancer is responsible for 32% of cancer deaths worldwide, this disease only receives 10% of cancer research funding behind other types of cancers such as breast, prostate and bowel. This discrepancy has come about because society blames victims of lung cancer for bringing the disease upon themselves due to its link with smoking, which does not happen for any of the other cancers.

Sadly, despite the triple hell of physical, financial and social suffering faced by smokers, an estimated five million Malaysians or 22.8% of the population still cannot resist picking up a cigarette every day, according to the National Health and Morbidity Survey (NHMS) in 2016. That is just a mere reduction of 0.3% compared to 23.1% in 2011.

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Those caught smoking in public can face fines up to RM10,000. Photo: iStock

 

Hopefully, these new and more stringent anti-smoking policies will result in more smokers stubbing out the cigarette. But maybe another possibility is that these type of government efforts have peaked. Perhaps the endless merry-go-round of taxation, banning and giving people more health information have limits in their effectiveness. Regardless of regulations and public education campaigns, there is still a sizeable portion of the population who continue to smoke – after all it is unreasonable and naive to assume that policy can make everyone quit smoking. Many don’t want to stop; some do, but can’t.

Still, all this misses the real issue. Smoking remains legal, and raises a staggering RM3 billion plus a year for the government, making the cigarette industry the second largest contributor to the Royal Malaysian Customs Department excise collection after the automotive industry. So lies the double standard. The government want smokers to stop smoking but they also really, really want their money. After all, if the government is really serious about stopping people from smoking this poison, they could ban it completely as a class A drug or at the very least quadruple the price of cigarettes in one go like Australia which would seriously shock demand rather than slowly creep prices up which so far has little impact.

Neither it seems is the government keen to compromise. Smokers I spoke to are not against reasonable regulations that protect public health. However, they feel these increasingly harsh anti-smoking rules represent an unwarranted restriction on their freedom of choice and movement. It’s pertinent to remember that between 1933 and 1945, Nazi Germany had the most stringent anti-tobacco laws in Europe which included banning smoking in trams, buses, and city trains, promoting health education, limiting cigarette rations and raising the tobacco tax. Tobacco-hating Hitler, unlike his war-time foes Winston Churchill and Franklin Roosevelt who were both passionate smokers, also imposed restrictions on tobacco advertising and smoking in public spaces. Sound familiar?

Smokers feel increasingly harsh anti-smoking rules represent an unwarranted restriction on their freedom of choice and movement. Photo: iStock

 

So smokers are stuck in limbo, pawns to both the government as well as the Big Tobacco, the “big five” largest global tobacco industry companies (Philip Morris International, British American Tobacco, Imperial Brands, Japan Tobacco International, and China Tobacco), which not only manipulate their products to make them more seductive and addictive but also offer cheap tobacco alternatives to entice those on a tight budget. So even though there are fewer smokers worldwide today than there were decades ago, smoking remains the number one cause of preventable death.

Perhaps it is possible for the Government to dial up the pressure to the point where smokers are terrorised into breaking addiction against their will. But maybe a better solution is compromise. In Belgium and Denmark for instance, there are designated smoking rooms in bars, restaurants and clubs with appropriate ventilation while in Italy and United Kingdom, smokers can still enjoy a puff at outdoor beer gardens and al fresco dining areas. So as a society we have to ask ourselves: are our policies punishing or taking care of smokers? How much humiliation and degradation are we willing to inflict on a person to stop them from smoking? And how much of a nanny state do we want our country to be, telling us when and where we can do something that is legal?

Related: Up in Smoke : New Research Says E-Cigarettes Still Damage Lungs