ABSTRACT
@# Tobacco induced illness remains a major contribution to premature death and global burden of diseases. The introduction of MPOWER policies by World Health Organization held the value to monitor the implementation of the anti-smoking measures in all signatory countries. This paper aimed to investigate the application of the six MPOWER indicators among Malaysia population. Methods: We utilized the data of Global Adult Tobacco Survey-Malaysia (GATS-M) which recruited 5112 nationally representative samples of Malaysians of 15 years old and above. Descriptive statistical analysis was used to illustrate the social demographic characteristic of the respondents while cross tabulation was employed to describe all elements of the MPOWER indicators. Results: About one quarter (23.1%) of Malaysian adults were current tobacco users. The SHS exposure at home (38.4%) and restaurant (42.1%) were high. Approximately eight in ten (80.2%) of the smokers intended to quit, while for those attempted to quit in past one year, 9.0% utilized pharmacotherapy and 4.4% attended counseling. The awareness about tobacco related diseases was generally excellent. The overall tax make up of the cigarettes’ retail price ranging from 41.7% up to 80%. Conclusion: Tobacco consumption remains prevalent and plateau among Malaysian adults over the last two decades with substantial proportion of the population exposed to SHS. The inadequacy in the current anti-smoking policies needs urgent improvement in order to reduce the smoking norms among Malaysians population besides to achieve the ultimate goal of tobacco control end game by year 2045.
ABSTRACT
@#Introduction: In respond to the World Health Assembly global NCD target of 30% reduction in the prevalence of adult tobacco use by 2025, Malaysian government called for lowering its smoking prevalence to 15% by 2025. In addition, moving towards the endgame target of less than 5% smoking prevalence in 2045. Methods: Malaysia Abridged SimSmoke model, a simulation model uses specific policy parameters, the most recent smoking prevalence, and population size for Malaysia is developed to estimates and access the impact of MPOWER policies in achieving the targets. Results: The 15% prevalence rate in 2025 can be achieved if the Malaysian government increase tobacco excise tax to 72% of the retail price, implement and enforce comprehensive smoke-free air policies, ban all forms of advertising/promotions and run intensive mass media campaigns. Such approach would reduce the number of smokers by about 2.6 million, averting almost 1.3 million premature deaths in the long term. The tobacco endgame target of less than 5% smoking prevalence by 2045 is achievable if the excise tax is further increased to 86.5% of the retail price while all other tobacco control policies are kept at the enhanced level. Conclusions: Both the targeted smoking prevalence are a realistic proposition if the proposed measures are fully implemented. It requires a whole government approach with the MOH as a leading agency driving the process. It is important to monitor both the compliance with the new measures and smoking prevalence to make sure that Malaysia is on track in achieving its targets.
Subject(s)
NicotianaABSTRACT
El tabaquismo es un grave problema de salud pública en Latinoamérica, cuyos países aún muestran en su estructura poblacional una amplia base piramidal formada por grupos etarios de jóvenes que han sido el blanco primordial de la industria tabacalera. Latinoamérica requiere urgentemente de estrategias de prevención y acciones sanitarias para modificar las consecuencias de fumar sobre la salud de la población a través de la cesación del tabaquismo. El tratamiento de la adicción a la nicotina requiere estrategias de intervención eficaces para disminuir la prevalencia de fumadores y evitar su recaída, brindándoles herramientas para el mantenimiento de la abstinencia. En la actualidad, poblaciones pobres y vulnerables (44 por ciento de la población latinoaméricana) están condenadas a sufrir las consecuencias sanitarias de esta enfermedad, ya que son las que presentan un mayor consumo de tabaco y las que pueden acceder menos a las intervenciones sanitarias. El Convenio Marco para el Control del Tabaco (CMCT) y el MPOWER, ambos estrategias de la Organización Mundial de la Salud para la lucha contra el tabaco, definen claras líneas de acción pero sus limitaciones están definidas por los recursos que se asignan para las mismas en cada país. La comunidad científica y técnica abocada a la lucha contra este flagelo debe considerar y poner en marcha nuevas perspectivas para lograr colocar en la agenda política la necesidad de obtener y asignar más recursos económicos y humanos para disminuir el consumo del tabaco en todos los grupos de la población. En la lucha contra el tabaco, este es el momento indicado para considerar primordialmente aspectos de equidad y justicia social en salud.
The tobacco epidemic is a huge public health problem affecting all Latin American countries. These countries have the characteristic of a wide base of the pyramidal population structure, with many young people who have been natural targets for the tobacco industry. Therefore in this region there is an urgent need to establish prevention and treatment strategies capable to reduce incidence and prevalence of tobacco smoking in the population and as a consequence modify the health effects of tobacco consumption. Treating nicotine addiction requires intervention strategies really effective to reduce the number of current smokers as well as giving them tools to avoid relapse and maintain abstinence. Currently poor and vulnerable groups, which represent 44 percent of the total population in Latin America, are the most susceptible to suffer the health consequences of smoking since they show the highest prevalence rates and have little or no access to health services. The Framework Convention on Tobacco Control (FCTC) and MPOWER, both strategies proposed by the World Health Organization against tobacco, define clear goals to achieve their purposes, nevertheless they are limited by the economic and human resources assigned by each country. The scientific community involved in the fight against tobacco must think about new ways to place this issue in the political agenda so there will be more opportunities to increase the resources and therefore to reduce tobacco consumption in all the groups of the population. In the fight against tobacco, this is the right time to consider primarily issues related to equity and social justice.