LETTER | Last week’s tabling and passage of the Control of Smoking Products for Public Health Bill 2023, stripped of its crucial Generational End Game (GEG) provision, has raised disquiet concerning the unity government’s true commitment to public health.
This decision, shrouded in secrecy and lacking transparency, leaves ample room for ethical concerns and threatens the future health of our nation.
As a practising dentist specialist for 18 years, I witnessed firsthand the devastating health impact of smoking and vaping daily. I have treated young patients with advanced gum disease directly linked to smoking.
The damage often starts with the teeth, manifesting as a series of visible but superficial symptoms - discolouration, persistent bad breath, and compromised enamel structure. These habits accelerate tooth decay and the onset of periodontal diseases and even increase the incidence of post-dental surgery complications.
The consequences go far beyond the mouth. Studies have shown that smoking and vaping can significantly damage the respiratory system. They irritate the delicate lining of the lungs, leading to chronic inflammation and increased susceptibility to infections and chronic obstructive pulmonary disease (COPD).
And despite a certain public figure’s wilful disregard for the link between cancer and smoking, an abundance of scientific evidence underscores that the damage from smoking and vaping extends to a deeper cellular level. It is without a shadow of a doubt that smoking and vaping harm DNA, amplifying the risk of cancer not only in the mouth and throat but also in other organs throughout the body.
The generational smoking ban was designed to serve as a progressive and proactive measure to curb the pervasive and long-term impact of tobacco and vape use by restricting access for individuals born from 2007 onward.
By opting for a weakened Bill that fails to address the root cause of smoking addiction, the government is essentially condoning the harm inflicted by cigarettes and vape products, thereby sacrificing the well-being of future generations for short-term gains.
Its abrupt removal exposes a disturbing lack of foresight among our leaders, and the public deserves full transparency regarding the rationale and ethical considerations behind this decision.
The official reason given by the government was presented in a two-paragraph statement by Attorney-General Ahmad Terrirudin Mohd Salleh who argued the unconstitutionality of GEG just days before the Bill's tabling.
The timing itself is a red flag (it denies the public the opportunity for meaningful debate and scrutiny) notwithstanding, the attorney-general's claim that the GEG provision contravenes Article 8 of the Federal Constitution rests on shaky ground.
Article 8 guarantees equality before the law, yet the GEG provision does not target any specific group. Instead, it aims to protect future generations from the harmful consequences of smoking. Legal experts have questioned the validity of this interpretation, arguing that the provision falls squarely within the government's legitimate power to regulate public health and does not infringe upon fundamental rights.
The arbitrary disregard for the 736-page report by the bipartisan Health Parliamentary Special Select Committee (PSSC) chaired by Dzulkefly Ahmad further highlights a troubling disdain of our lawmakers for evidence-based policymaking and democratic processes.
The comprehensive report was collaboratively put together by a panel involving senior officials from the Attorney-General's Chamber and health experts and had notably proposed a revised Bill that retained crucial GEG elements. Regrettably, this proposal was inexplicably excluded from parliamentary debate.
This not only represents a missed opportunity for substantive discussion but also constitutes wasteful neglect of resources and undermines the exhaustive effort invested in compiling the report.
Indeed, while this decision to exclude GEG is questionable both democratically and morally, it also presents economic sustainability concerns. Malaysia spends billions of ringgit annually treating smoking-related diseases, a staggering expense that far outweighs the revenue generated from tobacco sales.
In 2020 alone, the Malaysian government spent RM6.2 billion treating three major smoking-related diseases, a stark contrast to the RM3 billion earned from tobacco sales. One cannot help but be sceptical about the motivations and considerations that led to the abandonment of a measure to rectify this unsustainable economic pickle.
Note to health minister
Dear Dr Zaliha Mustafa, I write this with a heavy heart. Each patient I meet, struggling with the consequences of their addiction, is a stark reminder of the human cost of smoking.
They are not statistics on a page, but real people with families, hopes, and dreams. Each one faces pain, suffering, and a future cut tragically short. It breaks my heart to see them fight recurrent infections, and some battle cancers fuelled by the very same smoke that offered them temporary solace from their addiction.
I trust you, Zaliha, of all people, understand the insidious nature of addiction. You know how it often begins in the innocence of youth, a path paved with misinformation and peer pressure.
That is why the GEG holds such immense hope. It is a chance to break the cycle and protect future generations from the very struggles we all in healthcare services witness daily.
Your voice carries immense weight. It could be the catalyst for change, the ripple that sets in motion a wave of health and well-being for countless lives. Please, I implore you, in your esteemed capacity as the minister overseeing public health, to advocate within the cabinet for a reconsideration of the GEG.
PAMELA YONG is MCA deputy secretary-general and chairperson of Institute of Strategic Analysis and Policy Research and a practising dental specialist. She has been a dentist for 23 years and actively supports improvement in public healthcare.
