Doctors, Cancer Groups Back Health Minister’s Designated Smoking Areas Proposal

The Malaysian Medical Association and the National Cancer Society Malaysia support Dr Dzul’s proposal for designated smoking areas as this will denormalise smoking. Japan, which provides designated smoking areas, has lower smoking prevalence than Malaysia.

KUALA LUMPUR, Feb 21 – The Malaysian Medical Association (MMA) and the National Cancer Society Malaysia (NCSM) have lent their support to Health Minister Dzulkefly Ahmad’s proposal to establish designated smoking areas.

MMA, the largest doctors’ association in the country, said implementing designated smoking areas (DSAs) isn’t a U-turn by the Ministry of Health (MOH) in tobacco control, as it believes that the MOH remains firm in its stand against smoking.

“We agree, if properly executed, DSAs have the potential to contribute to the gradual denormalisation of smoking – a viewpoint the MMA shares with the National Cancer Society Malaysia (NCSM),” MMA president Dr Azizan Abdul Aziz said in a statement yesterday.

“Public health must remain the highest priority in these decisions, not the convenience of shop owners and smokers. DSAs should be situated outdoors and away from crowded areas to prevent exposure of non-smokers to secondhand smoke.

“Looking ahead, we recommend that the MOH examine the implementation of DSAs in countries like Singapore and Japan to gather insights and best practices.”

Dzulkefly – who first established the 3-metre rule on smoking outside dining premises when he was health minister under the Pakatan Harapan (PH) government – said last Saturday after a walkabout in Bukit Bintang that the MOH would consider providing DSAs outside eateries, especially for those located in tight spaces.

The health minister cited Singapore, Japan, and Hong Kong as examples that the MOH would look at.

NCSM, an anti-tobacco group, similarly praised Dzulkefly’s plan and dismissed allegations that creating designated smoking areas would normalise smoking.

“This cannot be further from the truth. In actuality, this is a good progression of a wider move to create more smoke-free areas in public areas and should be supported,” NCSM managing director Assoc Prof Dr M. Murallitharan said in a statement Monday.

He also stressed the difference between smoke-free premises and smoke-free areas. For restaurants and eateries that are smoke-free premises, people can smoke freely outside a 3-metre radius, whereas individuals cannot smoke at all in gazetted smoke-free areas.

“First and foremost is the clear assurance as per the law that there will be no changes to smoke-free areas. They remain off-limits to smokers,” said Dr Murallitharan said.

“Smoke-free premises in other areas, however, will now have designated smoking areas established within them. The advantage of this is very clear – instead of having cigarette butts strewn all over the place and the resultant environmental pollution, there will be a specific space which can be designated for this purpose equipped with bins to facilitate waste disposal.

“In addition, this contributes to long-term public ‘denormalisation’ of smoking, contrary to what certain quarters seem to allege. Restricting smoking in these public areas, albeit with smoke-free premises, to certain designated smoking areas, sends a visible message that smoking is not something occurring within social norms.”

A designated smoking area at the Shibuya Crossing in Tokyo, Japan. A sign on the wall of the designated smoking area, which provides seats for smokers, prohibits smoking while walking on the streets. Violations are punishable with a 2,000 yen (RM64) fine. The sign also provides a QR code for a Google Map of smoking places in Shibuya. Photo by Boo Su-Lyn, taken on December 20, 2023.

Galen Centre for Health and Social Policy chief executive Azrul Mohd Khalib similarly said establishing designated smoking areas was an acceptable compromise to denormalise smoking.

He pointed out that the United Kingdom and many European countries took many years of campaigns and smoking denormalising measures to create a culture of not smoking in restaurants and bars.

“Designating outdoor smoking areas is one such measure which has been proven to help in controlling secondhand smoke,” Azrul told the New Straits Times yesterday.

In Tokyo, Japan, designated smoking areas are available in public areas, while cigarette butt litter is minimal due to an abundance of signs prohibiting smoking while walking on the streets. A separate space for smokers is also installed in the buildings of certain restaurants.

A designated smoking area at the popular Shibuya Crossing, for example, provides seats for smokers. A sign posted on it states, “No smoking on the streets” – violations are punishable with a 2,000 yen (RM64) – besides providing a QR code to scan for a Google Map of smoking places in Shibuya.

Japan’s smoking prevalence among men was 25.4 per cent in 2022, below Malaysia’s 41 per cent male smoking prevalence in 2019, the most recent data available. According to the OECD last year, Japan’s smoking prevalence is 16.7 per cent, lower than Malaysia’s 21.3 per cent.

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