What Smokers Need To Know
Smoking is a habit and like any other habit we know that it is hard to give up. Nearly most smokers are aware of the negative impacts on health. Over decades, the dangers of tobacco smoking have been actively campaigned on social media, local newspapers, health forums and many other platforms. Educating smokers to quit tobacco smoking seems to be meeting a status quo state and protecting the non-smokers from breathing secondhand tobacco smoke (SHS) will be the next vital move to reduce the public health risk from the harmful effects of SHS.
What Is Second-Hand Tobacco Smoke?
The term Second-hand tobacco smoke (SHS) or environmental tobacco smoke (ETS) refersto tobacco smokes diluted with the surrounding ambient air that released from a smoking activity. It comes from a mainstream smoke exhaled by a smoker, and a side stream smoke from the lighted of tobacco product. The side stream smoke is more dangerous because it has higher concentrations of cancer-causing agents (carcinogens) and it also has smaller particles that can easily make their way into the lungs and the cells of the body. Hence, the effect of SHS is more on the non-smoker when he or she inhaled the smokes from the smoking activity and these people are also known as involuntary or passive smokers.
How much exposure is considered dangerous?
There is no risk free level of exposure to SHS. Research has been conducted and it is proven that SHS has adverse health effects to passive smokers. Back to the question on why SHS is a public health risk that is because SHS not only causes many health problems for the smoker, but it can also affect infants and children, such as more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome (SIDS). Adults that inhaled SHS might also suffer from nasal irritation, lung cancer, and has reproductive effects in women- low birth weight. There is also a study that shows SHS is linked to mental and emotional changes and depression when non-smoker is exposed to SHS.
Current Situation in Malaysia
Why SHS is one of the major public health threat? The exposure of SHS is extensive, it is affecting not just the immediate family members but also the general population. From the Global Adult Tobacco Survey (GATS) Malaysia that been conducted by Ministry of Health Malaysia in 2011 shows that 4 out of every 10 adults were exposed to SHS at home, 4 in 10 were exposed to SHS in indoor workplaces and more than 8 in 10 adults were exposed to SHS when visiting cafes/coffee shops/bistros and almost 8 in every 10 adults were exposed when visiting bars/nightclubs, 7 in 10 adults were exposed to SHS when visiting restaurants, which equates to 42% of the entire adult population, 20% of adults were exposed to SHS when visiting government buildings and 28% of adults were exposed to SHS when using public transportation and sadly almost 9% of adults were exposed to SHS when visiting health-care facilities. This survey might be just the tip of iceberg, but is significant enough to enlighten us that SHS do pose a public health risk to anyone of us.
Smoking Room, a false sense of security
Can smoking rooms prevent the SHS? The answer is No. That is because the SHS consists of Fine Particulates Matters (PM2.5) that easily escape through the tiny spaces available in smoking rooms such as door slits and ceilings. The situation is exacerbated if the specification of ventilation of the said room does not meet the standard requirement. Furthermore, the cost of maintaining the smoking rooms at times render the owner for proper maintenance of the smoking room. Not to mention the attitude of the users where the door is not properly close.. The only way to entirely eliminate the exposure SHS in indoor environment is by banning any smoking activity in indoor environments including providing smoking rooms. It was the only science-based measures that had been proven adequately to protect people’s health from the dangerous effects of SHS in any indoor environment.
Regulation in Malaysia
The Control of Tobacco Product Regulations 2004 is one of the most enforceable legislation to protect the public from the detrimental effects of tobacco products. The regulations are in line with the Framework Convention on Tobacco Control (FCTC) planned by the WHO in addressing the problem of tobacco products. The regulations cover from tobacco advertising, promotion and sponsorship, tobacco packaging and labeling and the smoke free environment under Regulation 11 (1). Some of the noticeable activities under the regulation in our country include gazetting non-smoking area in premises and the latest has been extended to public park. Recently,
the gazettment of smoke-free zones at open air eateries was announced under the Control of Tobacco Product (Amendment) Regulations 2017 at Dewan Negara on Wednesday, 5 September. Effectively starting from 1 January 2019 the contravention of this regulation liable to be fine not exceeding Rm10,000.00 for those caught smoking in prohibited areas and Rm 2,500 will be imposed on owners of restaurants and hawker stalls who fail to enforce the ban.
Source: Kementerian Kesihatan Malaysia
Smokers’ rights vs Non-smokers’ rights
The efforts taken by the Ministry of Health in enforcing smoke-free legislation protects the non-smokers rights to breathe clean air because smoke-free environment is the only proven way to protect public health. Allowing smoking in designated areas or installing ventilation systems do not protect health and only by creating a 100% smoke-free environments that we can achieve such objective. What about smoker rights to smoke at any time and place they choose? This is often a debatable topic but as solid evidence from the researches had proven the negative effect of side-stream smoke to the people surrounding the smoker the authorities have the responsibility to protect non-smoker rights. Furthermore, quit smoking is not only beneficial to the non smoker, but also protecting and reduces the risk of the health impact of tobacco smoke on the smokers such as cancers, cardiovascular diseases, respiratory diseases and etc.
In conclusionSHS undeniable is a one of the major public health threat and with the continuous effort on health education, health promotion, quit-tobacco smoking programs and the recent changes in regulation on tobacco smoking we hope to see positive changes in our society.
References 1. Öberg, M. et al, Second-hand smoke, Assessing the burden of disease at national and local levels, WHO Environmental Burden of Disease Series, No. 18, 2010.
- Frank, C. Amanda. K, et al, Secondhand Smoke Exposure and Mental Health Among Children and Adolescents. National Institute of Health(NIH), Arch Pediatr Adolesc Med. 2011 April; 165(4): 332–338. doi:10.1001/archpediatrics.2011.30.
3. Asomaning, K. Miller, D.P. et al. Second hand smoke, age of exposure and lung cancer risk, National Institute Of Health (NIH), 2008 July; 61(1): 13–20.
- Siti, M, Kahirul, M. Mohammad, I, Avoidance of environmental tobacco smoke among non-smoking pregnant women in Malaysia Asian J Agri & Biol. 2018; Special Issue:13-22.
5. Institute for Public Health (IPH). Report of the Global Adult Tobacco Survey (GATS) Malaysia, 2011, Ministry of Health Malaysia, 2012. 6. Cao S, Yang C, Gan Y, Lu Z (2015) The Health Effects of Passive Smoking: An Overview of Systematic Reviews Based on Observational Epidemiological Evidence. PLoS ONE 10(10): e0139907. doi: 10.1371/journal.pone.0139907.
7. Government of Malaysia. Food Act 1983, Control of Tobacco Product Regulations 2004.