The GEG has been lauded and backed by 17 international NGOs and individuals from the international tobacco control community. - NSTP/GENES GULITAH
The GEG has been lauded and backed by 17 international NGOs and individuals from the international tobacco control community. - NSTP/GENES GULITAH

KUALA LUMPUR: Malaysia's Generational End Game (GEG), undertaken through the Tobacco and Smoking Control Bill 2022, has been described as a visionary effort to strengthen tobacco control.

The GEG has been lauded and backed by 17 international non-governmental organisations (NGOs) and individuals from the international tobacco control community.

"Because prevention is always better than cure, this excellent policy will greatly enhance Malaysia's efforts to tackle the tobacco problem more effectively and join the many other countries and jurisdictions that are focusing on the tobacco end game," they said in a joint statement.

The tobacco control community includes Action on Smoking & Health (ASH), the Unites States, ASH Canada, ASH Scotland, African Tobacco Control Alliance, Asian Consultancy on Tobacco Control, Hong Kong SAR, Asthma and Respiratory Foundation New Zealand, Cambodia Movement for Health, Tobacco Campaign Director Corporate Accountability, European Network for Smoking and Tobacco Prevention and Health Justice Philippines.

The other signatories to the joint statement are Physicians for a Smoke-Free Canada, Smoke-free Cities Asia Pacific Network, Southeast Asia Tobacco Control Alliance, the Union for International Cancer Control and the World Heart Federation.

They said countries and jurisdictions that had reduced their adult smoking prevalence included Panama (5.3 per cent), New Zealand (9.4 per cent), Hong Kong (9.5 per cent), Australia (10.3 per cent), Finland (10.6 per cent), Singapore (10.1 per cent) and Canada (13 per cent).

This, they said, was done by applying stringent tobacco control measures according to the World Health Organisation Framework Convention on Tobacco Control (FCTC), to which Malaysia is a party.

"These include tax increases that reduce affordability, advertising and marketing bans, point-of-sale display bans, public smoking bans, large pictorial health warnings, standardised/plain packaging, mass media campaigns and tobacco cessation.

"Many of these countries also have specified prevalence end-game targets (usually less than five per cent) by a certain year.

"The EU Beat Cancer Plan and US Healthy People 2030 Plan also specify a tobacco end-game target."

According to the NGOs, the end game for tobacco has been pursued for more than a decade around the world, with the support of governments and the public health communities.

Notably, this success had been achieved without the use of e-cigarettes, they added.

"In fact, Panama, Hong Kong, and Singapore, despite considerable tobacco industry interference, have banned electronic smoking devices, which they consider as a clear risk of reversing the success they have achieved thus far.

"Australia allows e-cigarettes only by medical prescription for smokers who have failed other cessation therapies.

"Finland, the first country in the world to legislate a tobacco end game, includes all nicotine products (such as e-cigarettes) in its 2030 end game target."

The NGOs said e-cigarette use had not accelerated the decline of smoking prevalence in countries where e-cigarettes have been widely available, such as the US, the United Kingdom, Canada, and New Zealand and that a large proportion (often a majority) of smokers using e-cigarettes are dual users rather than quitters. There are also worrying trends of increasing vaping uptake and nicotine addiction, particularly among youth.

"Malaysia's GEG is, therefore, a sensible policy proposal to insulate youths from lifelong addiction and chronic diseases, which will also reap social and economic benefits in the long term.

"GEG is consistent with Article 16 (sales to and by minors) of the WHO FCTC, which encourages parties to implement measures beyond those required by the Convention (Article 2.1).

"The GEG will be a game-changer for tobacco control, not only for Malaysia but also globally."

They said opponents to the GEG policy had predictably been Big Tobacco and its front groups and allies, using a slew of misinformation and unsubstantiated claims about harm reduction and illicit trade. Citing an example, they said the recent calls to postpone the passage of the Tobacco and Smoking Control Bill were a trademark delay tactic of the tobacco industry.

They said tobacco products should never have been legalised in the first place, adding that the fact that cigarettes were still sold legally today was a historical abnormality that should be corrected.

Last year, more than 140 organisations around the world had called for the phasing out of cigarette sales.

"This is the bare minimum that governments should do to end the tobacco pandemic that kills more than 28,000 Malaysians and eight million people globally each year.

"Malaysia's GEG is a preventive vaccine that complements this curative approach to the tobacco pandemic," the NGOs said.

"We reiterate our full support for Malaysia' visionary approach to protect its future generations from

the tobacco scourge."

Malaysia's National Strategic Plan on Tobacco Control 2015-2020 (NSPTC) is aimed at strengthening the implementation of tobacco controls in the country. The NSPTC has a medium-term target to reduce smoking prevalence to 15 per cent by 2025, as well as a long-term target to achieve the "end game" of tobacco in Malaysia by 2045.