Kota Kinabalu: Smoking kills. Most Malaysians have heard this phrase on television or radio growing up or seen graphic warnings in schools about the dangers of smoking.
It is common knowledge that smoking is deadly, yet many continue to pick up the habit. Worse still, they light up in front of others, including their children, exposing them to harmful second-hand smoke.
Many smokers believe that the risks are personal and affect only themselves. In reality, smoking harms everyone around them. This is why the government has introduced measures like the ban on smoking in restaurants – further strengthened under the Control of Smoking Products for Public Health Act 2024.
However, enforcement remains inconsistent, as smoking in public places, including restaurants, is still a common sight.
Perhaps the most troubling contradiction is that millions of Malaysians diligently wore masks during the COVID-19 pandemic to protect against airborne viruses but remain indifferent to the dangers of cigarette smoke - one of the most toxic airborne pollutants.
The True Danger of Cigarettes Lies in Combustion
The fundamental danger of cigarettes stems from combustion - the burning of tobacco. When a cigarette is ignited, temperatures at the tip can
exceed 800°C, generating over 6,000 chemicals in cigarette smoke.
Among them, at least 100 harmful and potentially harmful constituents (HPHCs) have been identified by public health authorities as major contributors to smoking-related diseases.
The
US Food & Drug Administration (FDA) has established a list of 93 HPHCs in tobacco products and tobacco smoke.
Among the common chemical compounds known are:
- Carbon monoxide (CO) – A toxic gas that reduces oxygen levels in the blood, increasing the risk of heart disease.
- Carcinogenic organic compounds – Such as N-nitrosamines and over 500 polycyclic aromatic hydrocarbons (PAHs) linked to cancer.
- Aldehydes – Including formaldehyde, acetaldehyde, and acrolein, which facilitate tumor formation and lung damage.
These toxic byproducts are not a result of nicotine itself, but rather the combustion process.
The same harmful emissions can be found in other forms of burning, such as fossil fuels used for energy production.
The science is clear: combustion releases
Reducing Harm Through Non-Combustible Alternatives
The role of combustion in cigarette toxicity has led researchers to explore noncombustible alternatives that can reduce harm.
According to Public Health England’s 2018 Evidence Review of E-Cigarettes and Heated Tobacco Products,e-cigarettes and heated tobacco products:
• Are significantly less harmful than smoking conventional cigarettes.
• Expose users and bystanders to lower levels of harmful and potentially harmful compounds.
• Have shown effectiveness in smoking cessation efforts, particularly among those struggling to quit.
The report also acknowledges that while e-cigarettes and heated tobacco products reduce harm, they are not risk-free. The long-term health effects of these alternatives
are still being studied.
Nevertheless, Public Health England estimates that the health risks from e-cigarettes are likely to be at least 95% lower than those of smoking cigarettes.
Dr. Tom McGrath, Global Head Combustion & Product Science at PMI,has emphasized that eliminating combustion is a core principle of heat-not-burn technology.
By heating tobacco to temperatures lower than combustion, the production of harmful and potentially harmful chemicals is significantly reduced compared to cigarette smoke.
This approach aims to offer smokers an alternative that reduces exposure to toxic compounds while maintaining the experience of tobacco use.
Rethinking Tobacco Control: From Prohibition to Harm Reduction
Governments worldwide have spent billions of dollars trying to eliminate smoking through taxation, advertising bans, and restrictions.
Yet, the effectiveness of these measures remains debatable. The reality is that quitting smoking is extremely difficult, and for many, total abstinence is an
unrealistic expectation.
A more pragmatic approach is harm reduction—providing smokers who cannot quit with scientifically validated, lower-risk alternatives. Countries like the United
Kingdom, Japan, and the Philippines have implemented harm reduction strategies by integrating reduced-risk products into their tobacco control frameworks, leading
to declining smoking rates.
Malaysia can benefit from a similar approach. While smoking cessation remains the gold standard, providing access to credible information and alternatives such as heat-not-burn products, vaping, and oral nicotine can help reduce harm for millions of smokers who continue to struggle with quitting.
