The New Straits Times, October 28, 2001
By Professor Dzulkifli Abdul Razak
IN advocating new smoke-free strategies, anti-tobacco activists use what they called "the scream test" to find out how effective the strategies are. In the last budget announcement, Prime Minister Datuk Seri Dr Mahathir Mohamed, who is also the Finance Minister, applied the test with impressive results when he increased the tobacco tax (NST, Oct 20).
The big boys in the tobacco industry could be heard screaming in unison. The pain they felt must have been quite considerable.
The underlying assumption is that the more effective any strategy that encourages more people to stay away or quit smoking the louder the industry people will scream.
If, on the other hand, they think it won't help they will support the strategy strongly. Take, for example, the move some years ago to prohibit youths below 18 from buying cigarettes. There was hardly any opposition from the industry. Indeed, the scream test was an accurate gauge in that instance, as smoking among youths, including girls, continues to rise.
Similarly when the Ministry of Education banned smoking in school compounds. In fact, the industry was eager to support that ban. It even sponsored a spate of media advertising and posters to launch the move. As expected, the effort was short-lived, meant more as a whitewash on the part of the industry.
For teenagers continue to be subtly targeted by the industry through slick promotion, though the industry diligently displays under-age smoking ban signs at sales outlets. In other words, the scream test can be a useful, albeit crude, indicator for what works and what doesn't in the attempt to control smoking.
Increasing the price of cigarettes has proved most effective, as recommended even by the World Health Organisation in many of its documents to curb smoking.
There is now a correlation between the increase in tax on tobacco and the reduction in the numbers of people smoking. Generally, the higher the tax, the greater is the reduction.
So it is to be expected that the industry will scream loudly at such suggestions. In its desperation, a veiled threat on the possible increase in contraband or smuggled cigarette is linked to the price increase.
It implies that Government would lose even more revenue than it hopes to collect from the tax increase. Such an argument makes a lot of sense if not for one fact not well known publicly, namely, the industry is implicated in smuggling.
This has been well established from the internal documents of the industry made public recently, whereby contraband cigarettes are seen as attempts designed to undermine policies and decisions that hiked up tobacco prices (Poison Control, Apr 16, 2000).
So it is imperative for the public and policy-makers to recognise where the industry is coming from. They must keep to the stand to stamp out smoking through price increases again.
Of course, it would be better if the price is increased even more steeply. But other non-price strategies have passed the scream test and thus could be administratively implemented.
For example, the ban on indirect advertising, including the sponsorship of sporting and entertainment events. It passed the scream test with flying colours.
Easier still is stopping the sale of smaller packs, especially the sixes and sevens, for that matter the sale of loose cigarettes as well. Such scream test-validated moves will go a long way in complementing the purpose of hiking up prices as far as public health is concerned.
In a nutshell, much more needs to be done given the worrying increasing trend in cancer cases as discussed last week (Poison Control, Oct. 21).
