Tobacco – A threat to development

The World No Tobacco Day which will be celebrated on 31 May has Tobacco – A threat to development and it is timely because tobacco use has posed as a scourge on the development of a country. Malaysia is not an exception because tobacco use has imposed a massive social and economic cost over the decades when the money spent could have been used for its development.

To understand the myths and fallacies that we have been fed by the tobacco industry, we have to look back into history to understand the present and the future.

On the contrary to what was believed, tobacco cultivation required heavy subsidy from the industry. Increased cultivation costs made local tobacco leaf expensive, e.g. in 1982, the price of domestically produced tobacco was RM68.25 per kg as compared with RM18.25 per kg Cost, Insurance, Freight (C.I.F.) value of imported tobacco.

The industry was required by the government to use at least 70 per cent of local leaf content in their tobacco product. Hence, the industry has to blend local leaf with imported premium ones. Despite this ruling, local tobacco production was never enough.

Since 1990s, the government tried to get local farmers to change to potential crops identified by the Malaysian Agricultural Research and Development Institute (MARDI). Since 2004 kenaf cultivation had increased from less than 1 hectare to 2,274 hectares in 2015. The number of kenaf growers increased from one to 880 over the same period.

In 2010, the National Tobacco Board was renamed National Kenaf and Tobacco Board. If tobacco farmers are able to produce 50,000 tonnes of kenaf fibre for export annually, it would worth about RM15 billion.

Malaysia’s liberal stance on tobacco in the early years had brought much social and economic losses. The first faltering steps of tobacco control in Malaysia took place in 1996 when Malaysia Airlines imposed an in-flight smoking ban.

Meanwhile, the population of smokers grew. In 2015, it was estimated that there were 4.99 million adult smokers in the country, having smoked 91 million cigarettes daily. There were 2.67 million youths aged between 13 and 15 who smoked in 2009. If they had all been in 20-stick packs, Malaysians would have smoked 4.6 million packs of cigarettes a day! Imagine the cost to their family budget as well as to the country.

The industry was perceived as having an important role in “uplifting the socio-economic status of the rural population especially in Kelantan, Terengganu, Kedah and Perlis” by the government. As such the National Tobacco Board was established under the ambit of the Ministry of Primary Industries in 1973.

Basing on 2015 statistics, it was estimated that 20,000 Malaysians die from smoking-related annually and if we assume that each victim has three members in his family, the lives of 60,000 people would be badly affected. They would have lost a breadwinner. The average cigarette expenditure for each smoker is RM178.8 per month which he could have better spend on his family.

We must, however, think of victim’s workplace which would suffered immeasurable loss in terms of:

• Man-hour loss when he had smoking-breaks and sick leave that will interfere with his work schedule.
• Medical costs. According to a 2003-2005 study, the estimated cost of treating three commonest tobacco-related diseases (lung cancer, ischaemic heart disease and chronic obstructive pulmonary disease (COPD) was RM2.92 billion. It also showed that tobacco-related diseases use up between 6 and 15% of total national health care cost.

For the government, it is loss of manpower, medical subsidy (if the person went to a public clinic or hospital for treatment), and a contribution to the economy.

With a tightened tobacco control, companies are trying to circumvent the restrictions with electronic cigarettes (or e-cigarettes) and a potentially big market.

Although proponents have argued that e-cigarettes help smokers in quitting cigarettes, it also encouraged people from taking up smoking these devices with the belief if they are less harmful. The British American Tobacco (BAT) started producing such devices in 2013, labelling them as Next Generation Products (NGPs). The industry is convincing the youths that NGPs are “less harmful” in order to replace smokers who had died and to start nicotine addiction all over again but in a different form.

On the contrary to what is claimed that propylene glycol, the main constituent of e-liquid (the liquid that will be vaporised by the device for inhalation), is listed as Generally Recognised As Safe (GRAS) but its pulmonary toxicity due to prolonged exposure is not known. According to the Centres for Disease Control (CDC) in the United States of America, it stated: “No studies of health effects in humans were found”.

We should also be aware that other chemicals are used in e-liquid and studies have shown that e-cigarette’s aerosol does contain carcinogens such as formaldehyde and acetaldehyde. Heavy metals such as cadmium, nickel and were also present. As far as CAP is concerned, we should try to minimise or eliminate toxic chemical exposure.

As for the government, it should take a strong stand against vaping by banning it completely before the addictive habit and its health concerns become entrenched like the use of tobacco products that took decades of concerted effort to reduce their use.

Similarly other means of tobacco use such as the shisha and smokeless tobacco has to be banned too because tobacco use continues to be the world’s single largest preventable cause of diseases and harms almost every organ in the body.

Individual families as well as the government stand to benefit immensely with the money saved from abstaining from tobacco use. As many smokers are poor, their families are able to spend on better food and other necessities with the money saved. The economic and societal costs of tobacco-related diseases are astronomical and cost billions of Ringgit every year which could be better utilised for nation building.

FACTSHEET ON MALAYSIAN SMOKERS

Number of adult smokers: 5 million (2015)

Adult smoking prevalence: 22.8% (2015)

Average age of smoking initiation (daily smokers): 17.2 (2011)

Total number of youth aged 13-15 who smoked (in 2009): 2.67 million

Percentage of youth aged 13-15 who smoked (in 2009):18.2%

Average number of cigarettes smoked daily by adult smokers: 18.3 (2015)

Total number of cigarettes smoked by all adult smokers daily: 91.34 million (2015)

Percentage of male smoking prevalence: 43%

Percentage of female smoking prevalence: 1.4%

Percentage of current smokers who attempted to quit in last 12 months (2015):

Male: 52.1%

Female: 59.2%

Average monthly expenditure for manufactured cigarettes among smokers aged 15 years-old and above: RM178.8 (2011)

Tobacco-related health care costs: RM2.92 billion for only 3 tobacco-related diseases (2005)

Note: Tobacco use continues to be the world’s single largest preventable cause of diseases and harms almost every organ in the body.

Annual deaths attributed to major tobacco-related diseases: 20,000 (2015)

Source: The Tobacco Control Atlas, ASEAN Region, Third Edition (November 2016) published by the Southeast Asia Tobacco Control Alliance.

Press Statement, 30 May 2017