Before plain packages to stop smokers, look at support structures

Just yesterday, DAP lawmaker Charles Santiago wrote that the Malaysian Ministry of Health (MOH) had backtracked on their word to work towards introducing plain packaging for cigarettes.

Citing a quote back in February by the MOH’s divisional director of disease control, Dr Chong Chee Keong:

“Health Ministry plans to introduce generic packaging for tobacco products with the aim of reducing brand recognition and ultimately reducing overall consumption.”

However, a written reply to Santiago in parliament by the Health Minister pointed out that the Ministry had yet to undertake public consultation on the matter at hand.

While the Klang lawmaker is loudly quipping a backtrack in government policy on this matter, I fail to see when and where both Dr Chong or the ministry ever mentioned a timeline for the plain packaging on cigarettes.

After all, the government does have an objective to make tobacco no longer a major health problem by 2020 – some four years down the road.

Thus, I’m wondering if Santiago is clearly saying “backtrack” or just the fact that it’s not being done in a timely manner – most probably due to budget constraints. And surely, there is a need to look at the government budget.

Meanwhile, let’s raise a proper question – does plain packaging work?

Yes, it does, as proven in Australia in 2013 when they first implemented it. According to a portal report done a year after plain packaging was implemented, there was a 78 percent spike in calls to quit lines within the first month.

Other countries looking to do the same include South Africa and also the United Kingdom.

Let’s start with a few worrying facts – Southeast Asia had more than 600 million smokers in 2010. In a paper published in the Asia-Pacific Journal of Health, we had 5 million smokers back then.

Adding on to that, 1 million smokers are younger than 18 years of age – which goes to show that somehow sales control in the shops  (as well as parental control, one might think) aren’t working.

Currently, Malaysia is stuck using the graphic warnings on cigarette packages, which are also working. The earlier journal piece I highlighted points out that adolescent smoking had gone down 5 percent between 2002 – 2006.

In fact, it is a worldwide trend. The World Health Organisation in a news release confirmed a worldwide decline in the number of tobacco users as of 2015.

But let’s be frank; it is not just about the graphic images or plain packaging movement but also the support structure behind it.

Let me ask you this – what is our anti-smoking hotline? Do we even have one?

Yes, we do. We have an “Infoline” on the back of each pack of cigarettes.

Has there been any word as to measuring just how many calls this service has received? And how many followups planned, leading to how many people have actually stopped smoking?

In simple terms, what is our baseline?

In Australia, the anti-smoking campaign first established a hotline to promote quitting before plain packaging.

Even in the United Kingdom which is seeing the debate for plain packaging even now (as per the Telegraph), they’ve launch a “Stop Smoking” month during October since 2012 – called “Stoptober“.

So, where are these supporting structures before we talk about plain packaged cigarettes?

According to our Ministry of Health, we don’t have one. What we have instead is a list of so-called “Stop Smoking Clinics” that I can honestly say is perhaps underutilised if anyone had bothered to ask the minister in charge in parliament.

I’ve no sure what financial incentives doctors involved with these clinics get, nor just how much in terms of funding is spent there, but that is the next point we need to consider.

How much money do you want the Malaysian government to spend on anti-smoking campaigns?

For the UK’s Stoptober project in 2012, it cost £5.7 million ( roughly RM34.23 million today) to stop 160,000 in a population of 10 million smokers for a month.

At the same time, ever wondered how much these anti-smoking campaigns and support groups will cost to implement?

Care to promote this to the Health Minister as well?

If Santiago’s intentions is to promote better health, he should consider looking at this from a proper health standpoint. If his intent was to highlight the fact that the MOH was lagging in terms of combatting tobacco, then there should have also been a question on what has happened to the duties and taxes imposed on cigarettes?

Why wasn’t this money spent on anti-smoking campaigns? What was the money spent on, then?

Instead, his statement reads like a tirade against Big Tobacco which is far from what we need.

What we truly need is a proper plan to increase the rate of tobacco user reduction. Quite frankly, the effectiveness of the Malaysian Health Ministry regarding this has remained in a blindspot for quite some time.

Thus, perhaps it should be wise for the Health Minister to be asked to divulge and conduct a study on how effective they have been in combatting tobacco use, as well as what future campaigns they are planning to implement.

At the same time, perhaps a similar study can be done (if not done already) by the Malaysian Council for Tobacco Control (MCTC) – a local NGO with an anti-tobacco stance who should be up to date with what needs to be done rather than promote conspiracy stories of conglomerates affecting health policy.

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