KUALA LUMPUR: The Dewan Rakyat will vote on the Control of Tobacco Product and Smoking Bill, otherwise known as the tobacco generational endgame (GEG), this week.
The bill, that was tabled for the first reading on July 27, seeks to ban those born in 2007 onwards from smoking, purchasing or possessing tobacco and vaping products.
All eyes are on the country's members of parliament to see if they will pass the legislation.
Former Human Rights Commission of Malaysia children's commissioner Professor Datuk Noor Aziah Mohd Awal wants them to make the historic move.
"Children have the right to lead a healthy life. Therefore, our lawmakers must pass the GEG to uphold our children's fundamental rights.
"Currently, smoking prevalence is very high among teenagers, who are on the cusp of adulthood.
"The National Morbidity Survey in 2019 found that 24.49 per cent of teenagers aged 18 were smoking. By contrast, only 7.7 per cent of teenagers aged between 15 and 17 were smoking.
"This shows that more teenagers start lighting up when they turn 18.
"If the GEG comes into effect, those born in and after 2007 will not have a legal leeway to smoke. This could greatly reduce the number of new smokers," she told the New Straits Times.
The Universiti Kebangsaan Malaysia law professor also noted the concerns of several parliamentary special select committees on certain provisions of the GEG bill.
However, she said the bill should still be passed after some tweaks to address their concerns.
"For example, a child caught buying cigarettes or vape should not be prosecuted or fined.
"Instead, the child should be required to carry out community service under a diversion programme.
"Furthermore, Health Minister Khairy Jamaluddin, on July 30, gave an assurance that there will be no criminal record or jail term for GEG offenders. This is welcome news.
"Once these assurances are included in the GEG bill, I don't see any need for MPs to oppose it," she said.
Malaysia became the second country to table a GEG bill after New Zealand presented a similar draft law for first reading on Tuesday.
The New Zealand bill received near-universal cross-party support in its parliament and will now be reviewed by the health select committee.
The bill, which is expected to take effect in 2023, is part of New Zealand's plan to reduce daily smoking rates to less than 5.0 per cent across all population groups by 2025.
In Malaysia, Khairy has been pushing for the GEG, with the aim of making Malaysia a tobacco-free country by 2040.
LESSER HARM OPTIONS A MYTH
Tobacco and vape industry players have been pushing for the government to remove e-cigarettes and vapes from the law's ambit as they claim these products are "harm reduction options".
However, Dr Mohd Afiq Md Noor, a medical emergency and trauma specialist at the University of Malaya Medical Centre (UMMC), said e-cigarettes were not lesser evils.
"There is no safe threshold for smoking, and e-cigarettes and vapes are certainly not safer than conventional cigarettes.
"That is like saying that jumping from a 10-storey building is safer than jumping from a 20-storey building. Both will kill you.
"Vape liquids contain thousands of harmful chemicals, some of which are carcinogenic, that could increase the risk of cancer in vapers.
"These non-tobacco smoking options have also contributed to the emergence of a new illness, known as e-cigarettes and vaping products associated lung injury (EVALI).
"I have seen many heavy smokers in their early 30s brought to the emergency department for severe heart attacks.
"Some patients died on arrival, and others did not survive even after resuscitation.
"They had no comorbidities except being chain smokers.
"So, I call on all MPs to vote for the bill and protect our next generation.
"Please do not politicise this," he said.
Dr Wong Chee Kuan, a consultant respiratory physician and lecturer at UMMC, said EVALI could be misdiagnosed because its symptoms, such as fever, cough and shortness of breath, could be mistaken for lung infection.
Dr Wong said the Centers for Disease Control and Prevention had reported 2,807 EVALI cases, with 68 deaths, up to Feb 18, 2020.
"Apart from EVALI, we also found that the use of e-cigarettes could increase the risk of getting pneumonia and asthma.
"Besides respiratory conditions, tobacco smoking also triggers chronic obstructive pulmonary disease, lung cancers, tuberculosis, lung fibrosis and several cardiovascular diseases.
"The cost of treating these diseases is high, leading to expensive health insurance cover and a non-productive nation.
"Passing the GEG will produce a healthier future generation, and reduce the country's healthcare burden," he said.
Last week, Khairy said more than 400 people die every week in Malaysia due to smoking .
An EVALI patient, he said, spent more than RM150,000 for 12 days of treatment in hospital.
Khairy had warned that two million Malaysians could die due to smoking by 2040 without the GEG.
AN END TO ILLICIT TOBACCO
Detractors have also argued that the GEG would boost the illegal cigarette trade.
But Associate Professor Dr Norashidah Mohamed Nor said the bill could eradicate counterfeit cigarettes.
The deputy dean (academic) of Universiti Putra Malaysia's School of Business and Economics said a two-pronged approach was needed to eliminate contraband cigarettes from Malaysia, of which GEG was a crucial component.
"The GEG aims to ban cigarettes, e-cigarettes and vapes for those born from 2007.
"If we implement this successfully, the GEG would stem new demand for cigarettes in generations after 2007.
"This will phase out demand for cheaper counterfeits as well.
"The government's next important agenda should be to ratify the Illicit Tobacco Trade Protocol and reduce existing demand for contraband cigarettes.
"The protocol is an international treaty that will provide a framework of measures for countries to stamp out the illicit tobacco trade.
"The ratification will boost enforcement and could see higher penalties imposed on smugglers, sellers and buyers of contraband cigarettes.
"With the GEG and the Illicit Tobacco Trade Protocol, I am confident that Malaysia can reduce smoking prevalence to five per cent by 2040 and resolve the illicit tobacco trade.
"Without the GEG, Malaysia would lose RM8.77 billion to treat three major smoking-related diseases and another RM360 million to treat EVALI cases in 2030.
"Additionally, the country will also suffer RM275.3 billion in loss of productivity.
"In other words, there is plenty to gain and nothing to lose by passing the GEG," she said.
Khairy, on Friday, said the Health Ministry estimated that it would cost the government RM8.8 billion by 2030 to treat three major smoking-related diseases — lung cancer, heart disease and chronic obstructive pulmonary disease.
He said this was almost three times the estimated RM3 billion in tax from the sale of tobacco products.
'THE RIGHT SIDE OF HISTORY'
When the GEG is put to a vote this week, parents and teachers want parliamentarians to "be on the right side of history" to nurture a nicotine-free generation.
Mohammad Hazeem Azemi, a teacher at SMK Kuala Krau, Pahang, said the GEG would ramp up enforcement on the sale of cigarettes and vape, and ensure the products did not reach students.
"Students are openly smoking and vaping now because adults have normalised the habit.
"Furthermore, the products are widely sold near schools and residential areas, and some irresponsible traders sell them to underage children.
"Health officers must make sure that shops selling cigarettes and vape are further away from schools and residential areas.
"Smoking must be stamped out among youngsters because in most cases, this habit pushes them to drugs," he said.
Similarly, Mohdan Amran, the former SMK Shah Alam parent-teacher association president, also called on MPs to put the people's interest first and vote for the bill.
"In the past, the government tried to ban cigarette sales to children below 18. And recently, it enforced a ban on smoking in public places.
"However, these efforts have fallen short of snuffing out smoking in the younger generation. The GEG could be the final solution.
"Similar to the concerted efforts to fight the Covid-19 pandemic, we need a robust mechanism to battle the 'smoking epidemic' in our country.
"The whole world is moving towards becoming smoking-free, and we must follow suit," he said.
Aisyah Rozi, who has two daughters, said the GEG would also have environmental benefits for the country.
"A generational tobacco ban will significantly reduce the amount of cigarette butts, the most littered item in the world.
"The GEG will be the final nail in the coffin for all smoking-related problems and make the country tobacco-free in 20 years.
"The new law will strengthen regulatory oversight and bolster enforcement to prevent tobacco products from reaching those born in and after 2007.
"We will no longer have to deal with smoking in the decades to come.
"Each one of us deserves to breathe clean air," she said.
Anti-smoking non-governmental organisation, Ayah Jangan Merokok, has also joined the chorus urging lawmakers to pass the GEG.
Its president, Norman Naim, said the GEG complements the NGO's awareness and outreach campaigns for primary school pupils since 2019.
"Our association encourages children to chide parents who smoke. Throughout their formative years, these children have been taught the harmful effects of smoking.
"So, when the GEG comes into effect, these children will not be tempted to buy cigarettes or vapes when they turn 18.
"At the same time, concerns expressed by the children have also encouraged many parents to enrol in smoking cessation programmes to kick the habit," he said.
Norman said the GEG was also important to protect chain smokers who use vape as a tool to quit smoking.
Khairy, on Friday, said the government had missed out on RM500 million in taxes annually since the sale of e-cigarettes began a decade ago because the industry was unregulated.
The GEG will be tabled for the second reading today.
If it is passed into law, the GEG is expected to take effect in 2025.