KUALA LUMPUR, July 5 — Health care professionals have thrown their support behind the Malaysian Council for Tobacco Control’s (MCTC) lawsuit against Health Minister Dr Zaliha Mustafa and the government over the declassification of liquid nicotine.
The judicial review application by the anti-tobacco coalition – as well as by the Malaysian Green Lung Association (MGLA), and child rights group Voice of the Children (VoC) – was unprecedented in Malaysian anti-tobacco and public health litigation, as this was the first time that medical professionals and health advocates sued a health minister for allegedly harming public health.
In previous tobacco-related cases, it was either the tobacco industry or smokers suing the Ministry of Health (MOH) or the government.
“We hope that this matter opens up the eyes of the minister, the government, and the general public that this is a serious issue,” Medical Mythbusters Malaysia (M3), a group of health care professionals comprising doctors, medical assistants, pharmacists, physiotherapists, and nurses, said on its Facebook page last Monday.
“As a health NGO (non-governmental organisation), we support any measure that is taken to ensure that Malaysia moves towards a smoke-free country. However, the backward move in removing nicotine from the Poisons Act  not only harms society, but sends the wrong message about the dangers of nicotine addiction.
“Therefore, the move by NGOs to bring this matter to justice is appropriate.
“We hope that the government under the leadership of PMX [Anwar Ibrahim] and also YBMK Dr Zaliha will correct this matter by reinstating nicotine into the Poisons Act and by expediting the implementation of the Control of Smoking Products for Public Health Bill , including the GEG (generational end game).”
M3, which has 246,000 followers on Facebook, seeks to combat medical myths for the general public and has helped the MOH with health education on numerous issues.
The judicial review application by MCTC, MGLA, and VoC was filed last Friday in the High Court here after the government failed to secure passage of the Control of Smoking Products for Public Health Bill in the last Dewan Rakyat meeting, sending it last June 12 instead to a parliamentary special select committee (PSSC) after first reading.
The lawsuit by the anti-tobacco and child rights groups sought to challenge the order gazetted by Dr Zaliha last March 31 that exempted liquid and gel nicotine used in e-cigarettes and vaporisers from the list of scheduled poisons under the Poisons Act; the health minister had vetoed unanimous objection from the Poisons Board.
This effectively legalised the sale of e-cigarettes and vape with nicotine to anyone, including children and teenagers aged below 18, due to the absence of regulations on such nicotine products. There are no restrictions prohibiting sale to minors or other restrictions on sales; nicotine content level; advertising, promotion and sponsorship; or packaging and labelling.
The health minister has merely told parents to protect their children from vape and reminded the vape industry to practise “self-regulation” to voluntarily avoid selling its products to minors.
Former Health deputy director-general Dr Christopher Lee, in remarking last Monday on MCTC’s legal action, simply tweeted: “Unprecedented move in Malaysia…but not totally unexpected. Sad.”
MPS: Litigation Was ‘The Only Option Left’
Malaysian Pharmacists Society (MPS) Amrahi Buang said that MPS, which is a member organisation of the MCTC, supported the MCTC’s judicial review application because they were told that going to court was “the only option left”.
“We’re not taking it personally. We’re not against the minister personally or against the Cabinet personally,” Amrahi told CodeBlue yesterday.
“The only way is to have the Court have a legal interpretation.”
He stressed that the MCTC strictly follows the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC) that Malaysia became party to in 2005.
“Whatever is written under the FCTC, the government must follow. You must have a tobacco control law.”
MMA and Lung Cancer Group Also Back Lawsuit, Environmental Health Officers Association Wants Harms to Health Taken Seriously
The Malaysian Medical Association (MMA) and Lung Cancer Network Malaysia (LCNM), both of which are member organisations of the MCTC, also openly declared their support for MCTC’s judicial review application.
MMA is the largest doctors’ association in the country, while LCNM, founded by two medical specialists, is dedicated to addressing lung cancer.
“MMA strongly supports the judicial review by dedicated NGOs against the minister. MMA stands for accountability and public health. Together, let’s ensure decisions are evidence-based and prioritise the well-being of Malaysians,” MMA tweeted last Monday.
LCNM co-founder Dr Anand Sachithanandan, a cardiothoracic surgeon, told CodeBlue that LCNM also backed MCTC’s legal challenge against the declassification of liquid nicotine.
“We are members and unanimously supported the free vote within MCTC [to pursue a judicial review application].”
The Malaysian Environmental Health Officers & Assistant Officers Association (MyEnvHeat), a group of health inspectors, also commented on the legal action against the deregulation of liquid nicotine.
“What happened? Causes of disease and causes that harm health should be taken seriously and are not a matter that can be traded (diperdagangkan),” MyEnvHeat posted on its Facebook page yesterday.
Milton Lum: Reinstate Liquid Nicotine into Poisons List Without Awaiting Court Order
Dr Milton Lum, who is a former president of MMA and the Federation of Private Medical Practitioners’ Associations, Malaysia (FPMPAM), urged the government to reinstate liquid nicotine into the Poisons List instead of fighting MCTC’s lawsuit.
“Better to admit a monumental error than be instructed by a court to do so. I’m thinking more of the public interest,” Dr Lum told CodeBlue in an interview last Monday.
“If the government does it now, fewer people will take to vaping, and fewer people from those who take to vaping will start smoking. I’m not thinking of the face of the government.
“The government lost face the moment the health minister signed the gazettement. Whatever Kelvin Yii says – you cannot give an excuse. There is no excuse. All the reasons given are very pathetic. You don’t need to be a doctor to know that.”
Bandar Kuching MP Dr Yii, who is also the health minister’s special advisor, recently defended the referral of the Control of Smoking Products for Public Health Bill to the Health PSSC, saying that a review was necessary to prevent “any unintended consequences”.
For Dr Lum, the process of reinstating liquid and gel nicotine is the quickest option available to the government and Dr Zaliha, as the next Dewan Rakyat meeting is only scheduled in October.
“Alternatives can be done, but it will take time. In the meantime, what is going to happen is vape [vending] machines and devices will all be sold. A lot of people will get into vaping, and then, they will start smoking,” he said. “These are young people.”
“And then you are going to spend billions to treat their illnesses. So, the sensible thing is to put it back. The minister might have to resign, but that is too bad. She made the bungle.”
On the other hand, former FPMPAM president Dr Steven Chow held that across the tenure of three health ministers, his association has pushed for regulations to govern vape devices and e-liquids, but was met with silence.
“Now, they have put the cart before the horse. It does prove the point that politicians do think, see, hear and speak better only when they are in Opposition.”
MCTC chairman Dr M. Murallitharan yesterday urged Dr Zaliha to restore liquid nicotine into the Poisons List before July 26, the date of the first court hearing on its judicial review application, instead of opposing their suit. He also told a press conference that health and child rights groups had exhausted all avenues in the executive and the legislature before turning to the judiciary.
The health minister did not respond to media requests yesterday to her office or the MOH for comment on whether she would accede to MCTC’s request or if she would see them in court.