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During the most recent tax hike, prices for a pack of 20 cigarettes rose from RM17 (US$4.02) to RM21.50 (US$5.08). Illicit cigarette trade filled up the gap left by legal sales. Its penetration rate increased from 36.3% in 2011 to 51% in 2016. This resulted in an estimated loss of RM4.4 billion (US$1.06 billion) in government revenue last year. From the year 2011 to 2015, average cigarette prices went up by more than 30% . If the price hikes do deter consumers, there should have been a corresponding decrease in total cigarette consumption. The Malaysian government needs to relook at its future strategies Attempts to minimise the prevalence of smoking failed due to the absence of policies to restrict black market activities. The government had oversimplified the problem by assuming price hikes would decrease the cigarette consumption in lower income families. However, with cheaper alternatives available, the citizens turned to illegal cigarettes with price tags of RM3 – RM8 (US$0.71 – US$1.89).

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Published this week in the American Journal of Public Health (AJPH), the study titled "Tobacco Industry Research on Nicotine Replacement Therapy: 'If Anyone Is Going to Take Away Our Business It Should Be Us'" found that in 1987, three years after FDA first approved nicotine gum as a quitting aid, the tide had turned on the public perception of nicotine; and that by 1992, the tobacco industry had determined that patches and gum by themselves do not help smokers quit. For more than a decade, the companies did not act on this knowledge out of fear of FDA regulation. But once the federal agency started regulating cigarettes in 2009, they went all out in their bid to develop and sell NRT. The Tobacco Papers reveal that companies conjectured that their new nicotine products could successfully compete with pharmaceutical NRT and they set the goal of gaining market control of all products containing nicotine. "It was surprising to discover the industry came to view NRT as just another product," Dorie Apollonio, associate professor in clinical pharmacy and lead author of the study, was quoted as saying in a UCSF news release. "The tobacco companies want people to get nicotine - and they're open-minded about how they get it." Smoking is responsible for more than 480,000 deaths every year in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC), and another 16 million Americans live with a smoking-related disease. The costs of such illnesses total more than 300 billion U.S. dollars each year, when including both costs of direct medical care and lost productivity due to secondhand smoke exposure. Clinical trials show that NRT can help people quit smoking, but only if used in conjunction with counseling and in tapering doses. Over-the-counter availability of NRT made it easy for smokers to get a nicotine fix in non-smoking environments like offices and inside airplanes, with the net result that they were less likely to quit.

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Drug and Alcohol Dependence Much less is known about the effects of smoking on subcortical regions. We compared smokers and non-smokers on regional subcortical volumes, and predicted that smokers demonstrate greater age-related volume loss across subcortical regions than non-smokers. Non-smokers (n = 43) and smokers (n = 40), 22–70 years of age, completed a 4 T MRI study. Bilateral total subcortical lobar white matter (WM) and subcortical nuclei volumes were quantitated via FreeSurfer. In smokers, associations between smoking severity measures and subcortical volumes were examined. Smokers demonstrated greater age-related volume loss than non-smokers in the bilateral subcortical lobar WM, thalamus, and cerebellar cortex, as well as in the corpus callosum and subdivisions. In smokers, higher pack-years were associated with smaller volumes of the bilateral amygdala, nucleus accumbens, total corpus callosum and subcortical WM. Results provide novel evidence that chronic smoking in adults is associated with accelerated age-related volume loss in subcortical WM and GM nuclei. Greater cigarette quantity/exposure was related to smaller volumes in regions that also showed greater age-related volume loss in smokers.

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