Editor’s Note: This article first appeared in the PEMANDU Associates’ website.
SINCE early 2020, the world has been living under various degrees of lockdown measures due to the coronavirus pandemic. Prolonged lockdown and various demands that the pandemic has caused are placing a tremendous strain on people’s mental health which has led to a host of other health risks.
Mental health deterioration has been reported to cause increased levels of harmful alcohol use, drug abuse, tobacco consumption, insomnia, anxiety, unhealthy eating and higher cases of domestic violence.
Among the harmful behaviours that may cause longer term health risk, tobacco use has been one of the hot topics. International research has shown that adult smokers reported higher tobacco consumption by 25% to 45% during the lockdown period compared to before the pandemic.
Experts believe that many turned to cigarettes in response to psychosocial stress, noting that people from lower income backgrounds and younger adults are among those who have been disproportionately affected by the pandemic and are more prone to tobacco use.
With the pandemic and movement restrictions, it is even more challenging to reduce the smoking prevalence, especially when there is relatively easy access for illicit cigarettes that have been flooding the market.
According to the Nielsen’s Illicit Cigarettes Study commissioned by the Confederation of Malaysian Tobacco Manufacturers, the illegal cigarette trade in the country reached an all-time monthly high of 64.5% in August 2020.
On top of the additional danger of consuming products that are non-compliant to authorities’ standards, the Oxford Economics has estimated that illicit cigarettes business is costing the Malaysian Government around RM5 bil annually in evaded tax.
Smoke free future
The World Health Organization’s (WHO) vision of creating a ‘smoke-free’ generation is certainly a noble goal that we should all work towards.
In fact, tobacco companies have already committed to that vision where a major tobacco company recently announced that they plan to stop producing combustible cigarettes by the year 2030. Ultimately, the goal is to get people to stop and eliminate smoking.
However, we all know how difficult it is to stop smoking. Research shows that annual quit smoking success rate remains low at 7% which means there is fewer than one in 10 adult smokers who succeed in quitting each year.
Today’s innovation has given us range of alternative products that are less harmful and these alternative products have undergone studies and scientific assessments which have shown that these products are over 90% safer than combustible cigarettes.
Studies have also shown that smoking quit rate is over 60% higher for those using a combination of licensed medications and non-combustible nicotine products.
Do the less harmful alternative products really work in reducing the smoking prevalence?
Japan, a good example of a progressive country, has a concept called harm reduction product (HRP) which fundamentally encourages households to choose HRP for at least 20% of household product consumption.
Japanese policy makers have incorporated policy measures which have been successful in reducing harmful behaviours. Tobacco policy and regulations has seen the sales of conventional cigarettes reducing by 34% as people shift to healthier and cheaper option of alternative products instead of continuing to smoke cigarettes.
Pragmatic regulations
Other countries such as New Zealand and the UK have also acknowledged the benefits of harm reduction in tobacco control, and accordingly they have incorporated tobacco harm reduction in their respective policy and regulations.
The advantage of such progressive policy is evident from the contrast difference between the rate of reduction in smoking prevalence of New Zealand (CAGR: -3.8%), the UK (CAGR: -4.4%) and Japan (CAGR: -5.2%) in comparison to Malaysia’s reduction (CAGR: –1.0%) within the same period.
Establishing policy encourages innovation – not only from the industry’s end but also from the consumers’ point of view.
These could be in the simple form of risk-proportionate fiscal approach in applying tax and excise to harmful products which could shift consumers’ demand – or offering tax breaks for innovative companies with new marketable inventions in less harmful products or services that would influence supply.
Ultimately, with the right measures and implementation in tobacco control, this pragmatic approach in policy and regulations would provide medium- to long-term benefit to the healthcare system and overall population.
Business-as-usual just won’t cut it to move the needle in our tobacco control approach. If we were to continue as it is, the current trajectory shows that we will only achieve our 15% smoking prevalence target in 2042, off target by 17 years.
Essentially, Malaysia should adopt progressive policy changes if we want to achieve and enjoy the vision of a smoke free future.
Datuk Seri Idris Jala is the president and CEO of PEMANDU Associates, a global consultancy firm focused on public sector transformation and business turnaround.
The views expressed are solely of the author and do not necessarily reflect those of Focus Malaysia.
