Sitting at an open air eatery, engineer Zharif Hamzah and his colleagues are eager to finish their meal so they can enjoy a post-lunch cigarette. But to do that, they will have to leave the area.
“The policy is well-intentioned. There’s nothing wrong with saying that during the day you cannot smoke [at places like these]. But in Malaysia, people hang out at eateries past 10pm – they could relax the restrictions at night,” he says.
The law requiring smokers in Malaysia to light up at least three metres away from open-air eateries has sparked a national debate, with many businesses complaining of fewer customers. The law, which took effect on January 1, is intended to reduce the harm caused by second-hand smoke.
In 2007, the government banned smoking in air-conditioned restaurants, schools, petrol stations, government premises and on public transport. Yet more than 10 years on, that rule has been largely ignored. Now, the new law gives authorities the power to fine smokers who flout it up to 10,000 ringgit (US$2,400).
Despite being a smoker himself, Hamzah, 25, agrees the policy will help protect non-smokers.
“It’s working. My mum and family can go to mamak [open-air food establishments] comfortably now.”
Yet despite losing his father to lung cancer, likely brought on by smoking, Hamzah says he has no inclination to quit. “I started smoking when I left school. I know I’m addicted,” he says.
According to the Kuala Lumpur-based Malaysia Singapore Coffee Shop Proprietors’ General Association, 20 to 30 per cent of customers smoke, and around half of these are staying away from places where smoking is now banned for fear of enforcement officers.
Yet despite these concerns – along with the objections of Malaysia’s Smokers Right Club, which is challenging the Ministry of Health over the new law at the High Court – public consensus appears to be that the move is timely and a step in the right direction.
In an online survey conducted by Malaysia’s New Straits Times newspaper, around 80 per cent of more than 25,000 respondents thought the policy should go even further, supporting a proposal that hotels and launderettes should be listed as smoke-free zones.
Malaysia began regulating the smoking industry decades ago. In 1976, tobacco companies were required to print health warnings on cigarette packaging; in 1994, the sale of tobacco was restricted to over-18s; and in 1995, cigarette advertising was banned.
But medical professionals like Dr Rizal Abd Rahman, a frequent panellist on the popular TV show My Doctors, are keen to stress that this latest move should not be seen as an attack on smokers.
“Rather, the government’s smoking ban is intended as an effort to protect the masses from second-hand smoke in public areas,” Rahman says.
He adds that smokers are also being offered help to quit in the form of government initiatives such as mQuit, which provides nicotine replacement therapy and health-care consultations for those wanting to kick the habit. But, he says, take up of these programmes is low. “Lack of awareness means only 3 to 5 per cent of smokers attend our quitting programmes.”
Terence Too, a social policy fellow at the Institute of Strategic and International Studies, says the current restrictions do not go far enough, and that the stipulated three-metre rule is insufficient if the goal is to protect public health.
“If you’re on the wrong side of the table, if you happen to be upwind, the smoke will still get to you,” he says.
Too also brings up a crucial distinction in Malaysia: unlike most countries in which restaurant smoking bans have been approved, in Malaysia’s mamaks, the line between indoor and outdoor sections is blurred.
“What could be a more effective solution, in terms of health, is rather to have strictly enforced indoor smoking areas,” Too says.
While Malaysia spends around 3 billion ringgit each year treating smoking-related diseases, smoking rates have remained constant for a decade, at around 25 per cent of the population. By contrast, in neighbouring Indonesia, some 35 per cent of the population smokes.
In 2016, Malaysia’s health ministry announced a new target of cutting the smoking rate to just 15 per cent. To this end, earlier this month, health minister Dzulkefly Ahmad announced that the government was drafting a Tobacco Control Act to impose further restrictions on smoking and e-cigarettes. The bill is expected to be revealed by the end of the year.
But the northern state of Penang is going even further, studying the viability of imposing a complete statewide smoking ban by 2024. To achieve this, the state government concedes that it may need to provide designated smoking areas, as well as improve education about the risks of smoking.
I’m more for harm reduction, which means you try to minimise the negative effects. It’s the idea that certain addictions can be re-routed towards less-harmful, non-lethal behaviour – Khairy Jamaluddin, Malaysia’s shadow finance minister
State executive councillor Afif Bahardin says the move is not meant to punish smokers.
“This is more about changing the attitude of society and their tolerance to smoking,” Bahardin says.
When the state was confronted with a debate on vaping, Bahardin and fellow state policymakers agreed that it would be best to implement a blanket ban, fearing it would be too complicated to legislate on differences between conventional cigarettes and smoking alternatives.
Bahardin says that “less harmful is still harmful”, and that allowing alternatives such as e-cigarettes would defeat the purpose of eradicating tolerance towards smoking.
But Khairy Jamaluddin, Malaysia’s shadow finance minister and former minister of youth and sports, says that less harmful alternatives to cigarettes should not be cast aside completely.
“I’m more for harm reduction, which means you try to minimise the negative effects. It’s the idea that certain addictions can be re-routed towards less-harmful, non-lethal behaviour,” Jamaluddin says.
Alternatives to conventional cigarettes are growing in popularity, with e-cigarettes, vaping, heat-not-burn products and smokeless tobacco sparking a debate on whether these options are less harmful and whether they really help smokers quit.
Jamaluddin points to the example of Sweden where, according to a 2017 European Commission report, just 5 per cent of people smoke daily – one-fifth of the European average of 24 per cent. Snus, a type of tobacco that users place in their mouths, is sold legally in Sweden and is widely credited with the low rates of cigarette smoking in the country. Snus has, however, been linked to various cancers, including oral and pancreatic cancer.
In Japan, conventional cigarette sales have fallen by 27 per cent in two years, due to the rise in popularity of heat-not-burn products. There deliver nicotine at lower temperatures which, it is claimed, produces fewer carcinogens. By 2021, such products are expected to account for around 20 to 40 per cent of Japanese tobacco sales.
When you finish eating, you smoke. When you’re stressed, you smoke. When you hang out, you smoke. To stop it takes time – Zharif Hamzah
However, Jamaluddin warns that much of the research on such products has been inconsistent.
“Most of the studies on alternatives to cigarettes have been either very short term or the participants were not randomly assigned to different methods to quit smoking. We need to conduct more research into these alternatives,” he says. “In any case, our approach must utilise many solutions. All options need to be readily available – from screening and counselling to comprehensive follow-ups.”
Back at the mamak, Hamzah says the habit is simply too ingrained in his way of life for him to quit.
“When you finish eating, you smoke. When you’re stressed, you smoke. When you hang out, you smoke. To stop it takes time.”
While the tide may have turned against smoking, kicking the habit continues to prove a huge challenge for millions. It remains to be seen whether Malaysia’s latest smoking legislation can help.
