Tobacco control: Which is more important – liberty or safety?


“Eh doc, first you want to ban smoking. Soon you will ban alcohol.”

“If you say cigarettes are bad, what about sugar? Sugar is bad too, there are so many diabetics! Are you going to ban sugar too?”

“Don’t lah take away the right to choose!”

These are some feedback made to me by pals and acquaintances after we mentioned the Generational Endgame – the plan by the Health Ministry to disallow the sale and use of cigarettes to anybody born after the yr 2005.

ALSO READ: Preparing for the tobacco generational endgame

They are legitimate questions, reflecting issues about civil liberties and state intervention.

However, listed here are some factors to think about.

Not all the identical

Smoking is not the identical as ingesting alcohol.

Drinking alcohol is not the identical as consuming a doughnut.

A doughnut is not the identical as cocaine.

When reviewing the necessity to ban or limit substances, every product must be seen and reviewed in isolation and in context.

The “slippery slope” argument – whereby one type of a restrictive regulation will mechanically result in more stringent kinds – presupposes that healthcare policymakers view all merchandise in the same, non-scientific vogue.

Religious causes apart, alcohol and sugar will be consumed safely in the correct quantities.

This is very a lot on the alternative spectrum when in comparison with smoking – there is no degree of smoking that is deemed wholesome.

Indeed, one in two people who smoke die as a consequence of smoking once they use cigarettes within the precise method that the producers need them to.

Unlike different substances, tobacco additionally kills a lot of non- customers.

Of the eight million individuals who die from tobacco yearly, roughly 1.2 million deaths are the results of non-smokers being uncovered to secondhand smoke.

Once once more, there is no risk-free degree of publicity to secondhand smoke.

Its influence ranges from lung most cancers to killing infants through sudden toddler dying syndrome (SIDS).

Utilising the ‘slippery slope’ argument, some argue that sugar may eventually be banned too due to its negative health effects. However, unlike smoking, sugar can be consumed in moderation to no ill effect. — Photos: TNSUtilising the ‘slippery slope’ argument, some argue that sugar might finally be banned too resulting from its detrimental well being results. However, in contrast to smoking, sugar will be consumed carefully to no ailing impact. — Photos: TNS

State vs the person

Whenever a choice must be made that will limit particular person liberties, it needs to be balanced in opposition to public security and the great of the group.

For instance, a person might have the correct to devour alcohol with out worry of punishment, however that proper is eliminated if he is driving or inebriated to the purpose the place he is violent or abusive.

No honest and simply particular person will argue in opposition to this.

The state has a task to play in minimising the hurt that firms trigger customers, reminiscent of banning cancer-causing asbestos in buildings and making certain that child powder doesn’t kill kids.

With tobacco, there is a accountability to minimise the hurt of smoking to each customers who’ve been misled into being addicts, in addition to non-users.

In a really perfect world, we might ban all cigarettes yesterday, however that is not sensible.

Instead, we are able to do more to make sure that applicable restrictions are in place to minimise the variety of new people who smoke, whereas serving to current people who smoke give up (log on to for more tips about quitting smoking).

Addiction and particular person rights

If you’re feeling strongly in opposition to the function of the state in figuring out particular person affairs, it is best to really feel even more strongly about Big Tobacco deceptive people and creating lifelong nicotine addicts who’ve their freedom of selection taken away from them.

It is value remembering that nicotine is probably the most addictive substances recognized to people.

This is significantly impactful within the mind, which continues to develop till concerning the age of 25.

Those under this age are more prone to nicotine dependancy.

Nicotine may change the way in which mind synapses are shaped, inflicting hurt to the elements of the mind that management consideration and studying.

In different phrases, smoking not solely takes away one’s freedom of selection, but in addition actually modifications the mind of younger people who smoke.

An addict has no free will over the substance that he/she craves.

It is because of this that firms goal youthful clients.

Half of all present people who smoke wish to give up, and a fair increased proportion want they by no means began.

Almost all people who smoke don’t need their kids or family members to begin smoking, understanding what it is wish to have a psychosocial dependence on a product that is actively killing you.

These information aren’t unknown to the business.

To quote a cigarette firm’s report:

“Younger grownup people who smoke have been the crucial issue within the progress and decline of each main model and firm over the past 50 years.

“They will proceed to be simply as important to manufacturers/firms sooner or later for 2 easy causes: The renewal of the market stems virtually solely from 18-year-old people who smoke.

“No more than 5% of people who smoke begin after age 24.

“[And] the model loyalty of 18-year-old people who smoke far outweighs any tendency to modify with age…

“Brands/firms which fail to draw their fair proportion of youthful grownup people who smoke face an uphill battle.

“Younger grownup people who smoke are the one supply of substitute people who smoke…

“If youthful adults flip away from smoking, the business should decline.’

Nicotine addiction can literally rewire the brain, especially in young smokers, taking away their freedom to quit smoking easily.Nicotine dependancy can actually rewire the mind, particularly in younger people who smoke, taking away their freedom to give up smoking simply.

The sanctity of youth

In 2018, the world’s six largest cigarette producers made income of more than USD55 billion (RM242 billion).

It is solely pure that these firms do their finest to sow discontent and halt the event of tobacco management insurance policies that can influence their backside line.

Despite these challenges, the Malaysian authorities has made a dedication to introduce new tobacco management measures.

Moves such because the introduction of a smoking generational endgame aren’t carried out for ideological or paternalistic causes.

Smoking is a singular public enemy due to its addictive nature, the way in which youth are focused and misled into being lifelong addicts, and naturally, the a whole bunch of thousands and thousands of customers and non-users who’ve been killed by it over the previous many years.

As with all coverage issues, laws should be complemented by applicable enforcement.

It is solely then that we can not solely get hold of the outcomes that we wish, but in addition quieten the naysayers.

Editor’s notice: Health Matters will take a break subsequent month and will likely be again on-line on Aug 29 (2022).

Dr Helmy Haja Mydin is a guide respiratory doctor and Technical Advisor to the Health Ministry on tobacco management. For additional data, e mail [email protected] The data offered is for instructional and communication functions solely. The Star doesn’t give any guarantee on accuracy, completeness, performance, usefulness or different assurances as to the content material showing on this column. The Star disclaims all accountability for any losses, harm to property or private damage suffered immediately or not directly from reliance on such data.

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