GEG: A vital initiative for M’sia’s health, economy

Letter to Editor

AS a seasoned medical practitioner with over three decades of experience, I have witnessed firsthand the devastating health consequences of smoking and vaping.

I firmly believe that the Health Ministry’s (MOH) newly introduced Generational Endgame (GEG) initiative is a courageous and vital measure in safeguarding the health of upcoming generations.

In case you are not yet convinced why we should rally behind the government’s move on GEG, let me share some facts and figures.

The prevalence of smoking in Malaysia is disconcerting, as revealed by the National Health and Morbidity Survey 2019 which disclosed that 22.8% of Malaysians aged 15 and above are current smokers, thereby posing a risk to over five million individuals daily.

It’s imperative to acknowledge that smoking remains the leading cause of preventable fatalities in Malaysia, contributing to over 20,000 deaths annually. The toll of this habit is catastrophic, leading to various diseases such as cancer, heart disease, stroke and lung ailments. It imposes an estimated cost of over RM10 bil a year on the nation’s economy.

The GEG initiative aspires to gradually phase out cigarette and vape sales for those born in 2007 onwards, aiming to achieve a smoke-free generation by 2040. This visionary move aligns with the World Health Organisation’s (WHO) global strategy to reduce tobacco use, recognising its role in causing over eight million annual global deaths.

The use of tobacco, including both smoking and vaping, presents substantial public health dangers. Cigarette smoke contains more than 7,000 chemicals including 70 carcinogens, leading to serious conditions like lung cancer, heart disease and chronic obstructive pulmonary disease (COPD).

Similarly, vaping is not a harmless alternative to smoking, as many may mistakenly think.

While e-cigarettes may contain fewer toxic chemicals than traditional cigarettes, they still expose users to harmful substances such as nicotine, heavy metals and volatile organic compounds (VOCs). These substances can damage the lungs and increase the risk of respiratory illnesses.

Moreover, the vulnerability of young individuals to the health risks associated with smoking and vaping is a matter of grave concern. Their developing bodies are particularly susceptible to the detrimental effects of these substances, putting them at a higher risk of developing chronic diseases in their later years.

Besides, nicotine addiction can have profound effects on their brain development, impacting cognitive functions and raising the likelihood of substance abuse disorders.


The GEG initiative stands as a proactive measure to safeguard the health of our youth, preventing their exposure to the harmful effects of smoking and vaping. By inhibiting access to these products for the generation born in 2007 and onwards, we can significantly diminish the prevalence of tobacco-related diseases, ensuring a healthier future for our nation.

Arguments about personal choice and potential infringements on individual freedom might arise.

However, it’s vital to recognise that the government holds a responsibility to protect public health especially when it comes to safeguarding the well-being of our youth. The long-term health benefits of the GEG initiative far outweigh any perceived limitations on personal choice.

Crucially, the GEG initiative does not aim to impose an outright ban on smoking or vaping for those of legal age.

Instead, the focus is on preventing a new generation from falling into addiction, ultimately reducing the burden of tobacco-related diseases in the long run. This bold step serves as a testament to the government’s unwavering commitment to prioritising public health and protecting the well-being of our youth.

Furthermore, the GEG initiative is projected to save over one million lives by 2040 and alleviate the burden on the healthcare system while also enhancing the quality of life and productivity in Malaysia.

On this note, kudos to Malaysian health app MySejahtera for conducting a public survey on Malaysians’ support for the GEG initiative and MOH move to pass the Control of Smoking Products for Public Health Bill 2023 which will include electronic cigarettes and vaping and the GEG provision. This survey is an important step in ensuring that the voices of Malaysians are heard.

I encourage all Malaysians to take the MySejahtera survey and share their views on the GEG initiative and the Smoking Control Bill. We can no longer remain the silent majority in such a crucial development that affects our future generations.

This app had contributed significantly to the nation in disseminating information and facilitating the effective management of the COVID-19 pandemic. I am pleased to note that this app remains highly relevant for various health-related purposes.

Ultimately, the GEG initiative will boost the Malaysian economy by reducing healthcare costs and improving productivity.

Smoking-related diseases are a major driver of healthcare costs in Malaysia. By reducing tobacco use, the GEG initiative will help to reduce these costs, free up resources for other important priorities and steer the nation in today’s challenging economic landscape. – Nov 1, 2023


Dr Shaharom Nor Azian is a consultant public health medicine specialist.

The views expressed are solely of the author and do not necessarily reflect those of Focus Malaysia.


Main photo credit: The Edge Markets

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