KUALA LUMPUR, Nov 11 —The public health sector has seen a drop of 3,418 smokers receiving pharmacological treatment to kick the habit, while the government refuses to ear-mark tobacco duties for quit-smoking programmes.
According to a written parliamentary reply by Health Minister Dr Adham Baba on November 3, the number of smokers receiving pharmacological treatment has reduced to 9,222 people in 2019, as compared to 12,640 people in 2018, due to an increase in current drug prices.
He said that the total expenditure for providing pharmacological treatment for smokers has gone up by RM800,000 from RM2 million in 2018 to RM2.8 million in 2019.
“Costs incurred by the Ministry of Health (MOH), specifically for quit-smoking treatment, is the cost of pharmacological treatment involving two types of medications, namely nicotine replacement therapy or nicotine replacement therapy, including nicotine patch, and nicotine gum, as well as non-nicotine substitute therapy or partial agonist for nicotinic acetylcholine receptor which is Varenicline,” Dr Adham told the Dewan Rakyat in his written parliamentary reply.
According to MOH’s clinical practice guidelines on treatment of tobacco use disorder, there are two treatment methods used for the quit-smoking programme, which is behavioural change counselling only or behavioural change counselling and pharmacological treatment.
The health minister was replying to Muar MP Syed Saddiq Abdul Rahman, who asked the minister to state the total yearly costs incurred by MOH for quit-smoking programme mQuit, and if MOH is considering an alternative source of funds, such as income from excise duty on cigarettes and tobacco, to finance smoking cessation programmes.
Dr Adham said that this proposal was presented to the Cabinet through a Cabinet Memorandum (MJM) related to the suggestion of increasing tobacco taxes periodically in 2015.
“In the MJM, the financial need to finance the cost of smoking cessation treatment using specific provisions from the collection of excise duty on cigarettes and tobacco has been proposed,” the health minister said.
However, the then-Barisan Nasional (BN) administration did not approve ear-marking tobacco taxes for specific purposes, as income from taxes are consolidated in a general fund. MOH can apply for allocations from the Ministry of Finance following the usual financial procedure and process.
“Next, MOH has also made an application to cover the cost of smoking cessation treatment under the programme of a new policy. For example, in 2020, a total of RM6.5 million has been applied for,” Dr Adham said.
However, MOH was asked to use their existing allocation under their expenditure programme.
In order to increase the allocation for the quit-smoking programme in 2020, MOH has carried out an initiative under a public-private partnership (PPP) together with professional bodies, non-governmental organisations (NGOs), and private agencies under the mQuit smoking services programme.
“mQuit smoking cessation services had started from phase one, from 2015 till 2017. Phase two was from 2017 to 2020 and will enter the third phase from 2021 to 2025 with the signing of a memorandum of understanding along with MOH.
“Financial allocation to carry out all activities in each phase is borne by professional bodies, NGOs, and private agencies involved.”
MOH has also set a policy so that the treatment of smoking cessation can be done in an integrated manner along with treatment of other chronic diseases, such as high blood pressure, heart disease, diabetes, and etc.
This is to ensure that smoking cessation treatment can be expanded not only in public health clinics, but also in all MOH hospitals.
