THE tobacco endgame proposed by the Government should move beyond tobacco control and towards a tobacco-free future wherein commercial tobacco products would be phased out or their use and availability significantly restricted.
No single definition of the endgame (ie. the method or policy approach) or the endpoint (ie. the specific, measurable outcome) has emerged despite all the talks.
Without a comprehensive approach, the generational end game (GEG) approach now merely shifts the tobacco trade into the black economy.
The demand and supply will be forced to illegal channels, eg. young people will buy their tobacco online or on the black market.
Under this circumstance, local businesses and jobs will suffer while people will still be able to obtain tobacco.
Yes, smoking imposes costs. In Malaysia, a cost-analysis study has estimated that the total annual healthcare cost attributable to smoking amounted to RM2.9 bil annually.
But tobacco control also comes with costs too. Implementing the legislation and putting in place a monitoring and enforcement mechanism to ensure compliance is not cheap.
In 2014, the US government spent US$250 mil on “The Real Cost” cigarette prevention campaign to stop youths from smoking.
It aims to educate more than 10 million at-risk teens in the US about the harmful effects of cigarette smoking, saving US$180 for every dollar of the nearly US$250 mil invested in the campaign.
The campaign reached 95% of its target US youth audience aged 12-17 with thousands of messages through television, digital, social, outdoor and radio platforms.
More than 21.9 million youth have spent time on TheRealCost.gov since its launch in 2014, and 31.6 million youth have engaged with the Food and Drug Administration (FDA) on social media.
So what will be the cost of implementing and putting in place sustainable monitoring and enforcement mechanisms for the GEG legislation in our country? RM250 mil per annum?
Even though the draft Act has yet to be made public, all aspects of the enforcement mechanism, including where authority is vested, the structure of the penalties – eg. a graduated penalty structure that starts with a moderate fine for the first offence and escalates in severity with each subsequent offence – and the person within the establishment who will be penalised should be made simple and included in the legislation.
Weak legislation and ineffective enforcement tend to lead to poorer retailer compliance and have minimal effect on youth smoking rates.
To be effective, legislative measures to reduce access need to be regularly enforced in order to ensure high compliance rates and be uniform so that minors cannot avoid them by shopping elsewhere.
The effectiveness of the GEG legislation is highly dependent on the implementation of the legislation and the level of enforcement of the legislation, which are two different aspects that the Government should distinguish.
Implementation encompasses educational activities, dissemination of materials to the public and developing processes to ensure compliance. Inadequate forms of implementation may strongly reduce effectiveness.
Even though government agencies play the central role in implementation and enforcement efforts, enforcement should involve local authorities where they are given adequate enforcement responsibility and powers to monitor and allowed to cancel or terminate operating/business licenses and imposed fines on offenders.
Enforcement is a critical ingredient to ensure the effectiveness of any tobacco control efforts at the ground level as they have a far-reaching reach. – May 6, 2022
LK Foo is a FocusM reader.
The views expressed are solely of the author and do not necessarily reflect those of Focus Malaysia.
