The Role of Cigarette Policies in Reducing Cigarette Consumption and the Occurrences of Chronic Obstructive Pulmonary Disease and Lung Cancer in Malaysia

Abstract

In Malaysia, smoking is the third risk factor with the most disease burden and it was hugely associated with diseases of the heart and lungs. In response to the tobacco epidemic, WHO had adopted the Framework Convention on Tobacco Control (FCTC) on 21 st May 2003 but despite ratifying to FCTC in 2005 and enforcing various types of policies in the country, consumption of cigarette remains widespread in Malaysia. Hence the objective of this study which is to determine the role of cigarette policies in reducing cigarette consumption and the occurrences of chronic obstructive pulmonary disease (COPD) and lung cancer in Malaysia. This is a time series study with cigarette consumption and COPD and lung cancer occurrences as the dependent variables while the independent variable was all policies related to cigarette smoking in Malaysia between the years 1995 until 2017. Data analyses were done using Microsoft Excel Version 16.12, and IBM SPSS Statistics Version 23. Descriptive statistics were conducted to describe the variables using mean and standard deviation or as median and interquartile range. Time series scatter plot was utilized to plot the data on a monthly basis. The mean for cigarette consumption was 1,268.34 million cigarettes (standard deviation (SD) 669.31 million). The median for minimum cigarette price was RM0.35 per cigarette (interquartile range (IQR) RM0.10 per cigarette). Import duty showed a median of RM0.20 (IQR RM0.06) while excise duty's median and IQR was RM0.12 and RM0.19 respectively. The median for COPD was 962 cases (IQR 381), while the mean for lung cancer cases was 231 cases (SD 55). Cigarette consumption showed a fluctuating pattern followed by a down going trend from year 2012 until 2017. This coincides with the introduction of more cigarette related policies and the introduction of minimum cigarette price policy with increasing excise tax rates. However, COPD and lung cancer cases showed an increasing trend despite the decreasing cigarette consumption, more policies implementation and increasing tax rates. In conclusion, cigarette policies have played a major role in reducing cigarette consumption but not the number of COPD and lung cancer occurrences in Malaysia from year 1995 until 2017.