Most Malaysian families know this conversation.
The doctor says, “Uncle, you need to stop smoking.” Uncle nods respectfully. Outside the clinic, he announces: “Doctor advised only. He didn’t say cannot.”
Auntie sighs. The children roll their eyes. Someone reminds him that changing the subject does not count as changing his lifestyle.
Malaysia’s nicotine debate raises a similar question: what happens when health advice is heard, but does not determine the decision?
Who Is Sitting At The Table?
Malaysia’s Poisons Board is not a room full of doctors. Its published 12-member roster includes these different voices:
| Voices At The Table | Seats | Share |
| Medical leadership and organisations | 3 | 25% |
| Pharmacy representatives | 2 | 16.7% |
| Chemistry, agriculture, and veterinary departments | 3 | 25% |
| Business chambers | 4 | 33.3% |
| Total | 12 | 100% |
The three medical seats are held by the Health director-general (chairperson), the Malaysian Medical Association (MMA), and the Malaysian Medical Council (MMC).
Pharmacy has two seats. Chemistry, agriculture, and veterinary services have one each. Four chambers of commerce — international, Malay, Chinese, and Indian — represent business.
These percentages describe the seats represented, not every member’s personal qualifications, and exclude the separately listed secretary.
Put simply, medical representatives have three chairs, and business representatives have four. Even medical and pharmacy representatives together have only five out of 12. Doctors have a voice, but they do not control the room.
It is a little like a family discussion about whether Grandpa should stop smoking. The doctor’s advice is on the table, but so are everyone else’s opinions.
Of course, a national regulatory board should work on evidence, not whichever relative speaks loudest over dinner.
Advice Is Not The Same As The Final Say
In 2023, the Poisons Board opposed exempting nicotine liquids and gels used in electronic cigarettes and vaping devices from the Poisons List.
Then-health minister Dr Zaliha Mustafa proceeded with the exemption anyway. This was not the removal of every form of nicotine from poison controls.
So that episode was not simply doctors being outnumbered by business representatives. The board’s collective advice did not prevail.
The board advises, while the minister holds the statutory power to amend the list after consultation.
The family version might sound like this:
“The doctor advised against it.” “Yes, we listened.”
“And?” “We decided otherwise.”
Every Malaysian grandmother knows that “I heard you” and “I followed your advice” are two very different things.
Reports of the board supporting a fresh exemption proposal in late 2026 have since prompted medical and paediatric organisations to seek explanations and supporting evidence.
However, without individual voting records, we cannot honestly say that business representatives outvoted doctors. Having more chairs does not prove how those sitting in them voted.
Parents And Grandparents Deserve A Straight Answer
For ordinary families, the concern is not who won an argument in a meeting room. It is whether health warnings receive the weight they deserve when decisions may affect their children and grandchildren.
The issue is accountability.
If policymakers take a different path from medical advice, they should explain the evidence, the risks and the safeguards, in language that makes sense at the kitchen table, not just around the boardroom table.
Doctors do not need to be treated like gods whose advice can never be questioned. But their warnings deserve more than Uncle’s usual response to stop smoking: a respectful nod, a “Yes, doctor”, and then, business as usual.
The author is a general practitioner (GP).
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
