24 Sept 2024, Kuala Lumpur

The Addiction Medicine Association, Malaysia (AMAM) together with the Federation of Private Medical Practitioners’ Associations, Malaysia (FPMPAM) are urging the government to increase cigarette excise tax and minimum cigarette price as part of the upcoming national Budget 2025. AMAM points out that the last excise tax increase occurred in 2015 and since then, no further adjustments have been made in the past 9 years.

FPMPAM stresses that increasing the excise tax on cigarettes is synergistic in achieving public health objectives.

Dr Shanmuganathan Ganeson, President of FPMPAM said, “Increasing the excise tax on cigarettes is essential to achieving our nation’s public health goals. Higher taxes have been proven to reduce smoking prevalence, especially among youth and lower-income groups, who are most vulnerable to the harmful effects of tobacco. By raising the cost of cigarettes, we can effectively decrease consumption, prevent new smokers from picking up the habit, and support long-term health outcomes for the population. This measure is not just about revenue; it’s a critical public health tool in the fight against smoking-related diseases.”

“The Government should consider implementing an excise regime that increases cigarette taxes annually at a fixed rate. A structured, predictable tax increase will ensure that the cost of cigarettes keeps pace with inflation and rising incomes, maintaining its effectiveness in curbing smoking. This approach provides a long-term, sustainable method for reducing tobacco consumption and reinforcing our public health objectives, while also sending a clear message that smoking comes with significant health and financial consequences.”

In addition,FPMPAM is also calling for the Government to increase the minimum price of cigarettes, which has remained unchanged at RM12 per pack since 2020. FPMPAM said that the current minimum price of cigarettes is not reflective of the total tax and duties imposed on cigarettes.

“We urge the Government to increase the minimum price of cigarettes, which has remained stagnant at RM12 per pack since 2020. The current price no longer reflects the total excise tax, sales tax, and import duties imposed on cigarettes, creating a disconnect between the true cost of tobacco products and their impact on public health. Raising the minimum price to a more accurate level of RM13.00 or RM13.50 will help strengthen the effectiveness of tobacco control measures and further reduce smoking rates,” Dr Shanmuganathan added.

FPMPAM believes that raising both the excise tax and the minimum price will help to reduce tobacco consumption and also contribute to increase government revenue, which can be used to fund public health programmes and tobacco control initiatives.

Dr. Steven Chow, President AMAM concluded that, “We strongly urge the government to include these adjustments in Budget 2025. These measures are important steps toward reducing smoking rates and improving public health outcomes in Malaysia. These actions, combined with broader tobacco control efforts, will help protect future generations from the harmful effects of smoking and align with the nation’s commitment to safeguarding the health and well-being of its citizens,”

Prepared by

Dr Steven Chow, President, Federation of Private Medical Practitioners’ Associations, Malaysia & President, President, Addiction Medicine Association of Malaysia &

Associate Professor Dr Anne Yee, Honorary Secretary, Addiction Medicine Association of Malaysia

24^th  May 2021 (Kuala Lumpur)

The Addiction Medicine Association of Malaysia (AMAM) and the Federation of Private Medical Practitioners’ Associations, Malaysia (FPMPAM) organised the 11^th National Conference on Addiction Medicine (11^th NatCAM). The first session was held on 23^rd May 2021 (Sunday) and was attended by more than 70 practitioners.  The second session is scheduled for 30^th May 2021 (Sunday) from 1100 to 1600 hrs.

Experts and practitioners working on ground zero of the addiction disease landscape shared their concerns and reservations on the many issues  which have been neglected during this COVID-19 pandemic.

 The 11^thNatCAM specifically addressed issues related to drug addiction and its treatment in the pandemic era.  A team of experts was invited to share their knowledge and experiences with our members and frontline practitioners.

METAMPHETAMINE ABUSE UPDATE

Associate Professor Dr Anne Yee (UM) and Associate Professor Dr Suzaily Wahab (UKM), delivered the plenary lectures on how to address the issues and treat methamphetamine use disorder, especially in adolescents and young adults, in the COVID-19 period which is a worrying trend.

COVID-19 PANDEMIC ASSOCIATED DEPRESSION & SUICIDE

Dr Chee Kok Yoon, Consultant Neuropsychiatrist (HKL), talked on the burdens of depression and suicidal tendency in the era of COVID-19 pandemic and how GPs can help in early diagnosis and intervention.

TOBACCO HARM REDUCTION – VAPING/E-CIGARETTES: TO BAN OR TO REGULATE

In his address, Dr Steven Chow, reiterated that in 2015, AMAM, FPMPAM and other medical NGOs  had  called for the ban on e-cigarettes and tobacco. We are concerned that to date we have not seen any update of the proposed Control of Tobacco Products Regulations 2004 which we had hoped would have led to the  ban or at least  to seriously regulate e-cigarettes and vaping.

Dr Chow reiterated the point that “It is misleading to say that the effects of electronic cigarettes and vaping on our health and society is minimal. We must learn from the mistakes made during the war against tobacco, in which it took decades for the true cost of tobacco harm to the society to be made public.  AMAM and the FPMPAM will jointly move to support access to smoking cessation service with a programme to train general practitioners to help those wishing to quit smoking. We are aware that more than 50% of current smokers in Malaysia are keen to quit, and it is our duty as doctors to help them achieve abstinence”

To date, we have approximately 300,000 students who are e-cigarette users.

The Conference was informed that the World No-Tobacco Day on 31^st  May 2021, will seek to explore what tobacco harm reduction is and how it can help smokers in quit smoking altogether. AMAM and FPMPAM will participate in this global initiative led by the World Health Organisation (WHO).

Associate Professor Dr Amer Siddiq, a smoking cessation expert, stated that e-cigarettes are clearly being targeted at the younger geneerations of the society and this could be a gateway to lifelong nicotine addiction. Although there is evidence to suggest that e-cigarettes might be able to assist smokers to quit, however it is important that we look at all factors on harm and benefits considering the available of safer alternatives to assist in smoking cessation for fear of creating another issue such dual use (using electronic cigarettes and tobacco at the same time).

Associate Professor Dr Amer presented the updated Cochrane Review on Electronic cigarettes for smoking cessation, which looked at 50 studies from the USA, UK, Italy, Australia, New Zealand, Greece, Belgium, Canada, Poland, South Korea, South Africa, Switzerland and Turkey and the key findings were that smokers were likely to stop smoking for at least six months by switching to vape with nicotine e-liquid as compared to nicotine replacement therapy, nicotine-free vape or behavioural support.

The Conference called for more intense public and professional engagement to examine the issue of  tobacco harm reduction. The evidence supports the view that tobacco harm reduction can be a pragmatic approach to reducing the harm of smoking related diseases.

AN UPDATE ON KETUM IN MALAYSIA

Associate Professor Dr Rusdi Abdul Rashid, a  Director of University of Malaya Centre for Addiction Science Studies (UMCAS), presented his data on studies on ketum users. He explained that most of the regular ketum users were found to have opioid or stimulant dependence. They mainly used ketum to reduce the withdrawal symptoms from opioids and stimulants. He concluded that ketum could be a potential alternative as compared to existing methadone assisted therapy. However, more studies should be done on ketum to explore its use. Hence, he suggested that ketum should not be put under the Dangerous Drug Act to facilitate further research activities.

UMCAS also provided training workshops for the practitioners to equip them with knowledge and skills to treat substance use patients – ASSISST BI (The Alcohol, Smoking and Substance Involvement Screening Test plus brief intervention) is one of them.

ASSIST BI was developed for the WHO by an international group of substance abuse researchers to screen for problems or risky uses of substances and to provide a brief intervention to at-risk patients in the primary health care settings. 

CHEMSEX, the Malaysian  Scenario

The use of stimulant drugs by men who have sex with men (MSM) which facilitate and enhance sexual pleasure (chemsex) has been documented. Due to the prohibition of drug use and homosexuality in Malaysia, drug treatment services tailored to the needs of MSM are therefore non-existent in this country. Associate Professor Dr Anne Yee, the principal investigator of a project developing a community-based, online intervention to address the mental health and sexual health needs among stimulant-using MSM in Malaysia, stated that this community-based, low-threshold, online intervention will provide a safe environment where MSM could access drug screening and harm-reduction materials.

Currently this project is still actively recruiting participants for its study. She called on GPs with patients who are aged 18 years or older, having engaged in ‘chemsex’ with other men in the past 12 months (defined as taking crystal methamphetamine, GBL/GHB, or ecstasy/MDMA), to contact her by email at  annyee17@um.edu.my.

Session 2, 30^th May 2021

Among other topics,  experts will discuss the current debate on medical marijuana with a plenary on Redesigning the Policy of Medicinal Hemp by Professor Dr Mohammad Hussain Habil. There will also be an interactive forum on the Drug and Substance Abuse Act 2020.

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The Addiction Medicine Association of Malaysia (AMAM)

AMAM, a sister society of the FPMPAM, was formed in 2006 and is the first addiction medicine association to be founded in Asia. Its primary objective is to develop and promote the science of addiction medicine nationally and in the region. Members of AMAM consists of GPs, specialists in addiction medicine and allied healthcare professionals with the interest or working in managing of patients with addiction. AMAM organises the National Conference on Addiction Medicine (NatCAM) together with International Conference of Addiction Medicine (ICAM) once every two years.

Federation of Private Medical Practitioners Associations, Malaysia (FPMPAM)

Founded in 1989, it has more than 5,000 members in seven state-level associations in the country. While it is primarily committed to improving the quality of private healthcare through continuing medical education, continuing professional development of its members and ethics advocacy, it has in recent years been focusing on frontier medicine, addiction medicine and a mentoring programme for trainee doctors.

For further information please contact: Dr Steven Chow,

Tel: 019 3376703 email: secretariat@fpmpam.org

PRESS STATEMENT

Kuala Lumpur, 27.11.2019

RISING TREND IN DRUG RELATED ARRESTS, DRS URGE GOVERNMENT TO AMEND LAWS

We refer to the speech by YB Dr. Lee Bon Chye, Deputy Minister of Health Malaysia in Bangi at the opening of the Asia Pacific Society for Alcohol and Addiction Research Conference incorporating the 10^th National Conference on Addiction Medicine.

The Federation of Private Medical Associations Malaysia (FPMPAM) and the Addiction Medicine Association of Malaysia (AMAM) would like to congratulate and support this important development in the on-going battle against drug addiction.

The medical fraternity have long appealed for a compassionate approach to the management of those afflicted by drug addiction and advocated for the important role of medication assisted therapy (MAT) together with psychosocial intervention at all levels of the community. The scientific evidence of addiction as a chronic brain disorder is irrefutable.

Since 2002, the FPMPAM and the AMAM (founded in 2006) have developed a community-based MAT program. More than 900 GPs have been trained in the use of MAT and they are able to offer treatment for these patients within the community setting. To date, our nation-wide community-based MAT program have taken more than more than 24,000 patients with heroin addiction off the streets. Retention treatment rates have been more than 60% when the data was last analysed in 2014. Within 2 years following the introduction of MAT in Malaysia, important parameters like HIV-associated IV drug use death rate and drug-related arrests have been shown to fall significantly. This experience have been similar in countries that have advocated this policy.

However from 2016, statistics from the NADA have shown a worrisome reversal of the trend with an increasing number of drug related arrests. This is an indication that affirmative regulatory reform is needed for maintaining and upscaling MAT.

Amendments to relevant provisions in the Drug Dependants (Treatment and Rehabilitation) Act 1983 will enable those in addiction to legally and confidently seek medical treatment are urgently needed.

We urge that political will be focussed to ensure that this policy decision be translated into administrative action to prevent condemning another generation of young Malaysians into a lifetime of addiction. On our part as medical practitioners, we offer our services and resources to the government to achieve this goal.

The 10^th National Conference on Addiction Medicine is incorporated into the APSAAR 2019 with AMAM as a co-organiser. AMAM will specifically address issues related to drug addiction and its treatment in Malaysia at this meeting

 

Dr. Steven KW Chow
President, Addiction Medicine Association of Malaysia (AMAM)
President, Federation of Private Medical Practitioners’ Associations Malaysia.

About The Addiction Medicine Association of Malaysia (AMAM)
AMAM, a sister society of the FPMPAM was formed in 2006 and is the first addiction medicine association to be founded in Asia. Its primary objective is to develop and promote the science of addiction medicine nationally and in the region. Members of AMAM consists of GPs, specialists in addiction medicine and allied healthcare professionals with the interest or working in managing of patients with addiction. AMAM organises the National Conference on Addiction Medicine (NatCAM) together with International Conference of Addiction Medicine (ICAM) once every two years.

About the Federation of Private Medical Practitioners Associations Malaysia (FPMPAM)
Founded in1989, it has more than 5,000 members in seven state-level associations in the country. While it is primarily committed to improving the quality of private healthcare through continuing medical education, continuing professional development of its members and ethics advocacy, it has in recent years been focusing on frontier medicine, addiction medicine and a mentoring programme for trainee doctors.

For further information please contact: Dr. Steven Chow,
Tel: 019 3376703 email:secretariat@fpmpam.org