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It has been over two decades since various members of the Malaysian Medical Association banded together under the Anti-Smoking and Health (ASH) Committee to repeatedly highlight the adverse effects of smoking and to call for a ban on all fronts.

I remember too, that more than 20 years ago, as a young newly-qualified physician, I was on this bandwagon for a futile crusade.

A reference to correspondence in the Letters column of The Star from 1988 to 1986 will reveal the efforts made by those of us in the profession who cared and were deeply concerned about the trends of smoking then.

But, like everything else in Malaysia, the government chose only paid lip service to the complaints. As we were continuously hitting our heads against a brick wall, most of us developed headaches and moved on.

This was about 20 years ago and we continue to see members of the Malaysian public smoke at places where they are not supposed to. As always, the law is there but the enforcement is absent or perverted for whatever excuse.

Some interesting data has emerged over the past two decades. First, health economists have realised that the cost of improving the quality and quantity of life of those with smoking-related diseases (i.e. cancer, heart and lung disease) far exceeds the proceeds raised by taxation on tobacco.

This is only the economic cost. There is the human cost the suffering and premature deaths of both active and passive smokers.

Strictly speaking, no one has shown that the pleasure derived from smoking exceeds that of the suffering the smoker (and others) may have to pay later.

Now that a proposed smoking ban in workplaces is again being discussed (only inspired by the visit of a government minister to a far away Nordic country at the taxpayer's expense) one may again hope that this will pave the way for a proposed ban in coffee shops and other public places as well.

What is tantalising and should be put to the test is litigation by workers in and visitors to restaurants, coffee shops and other public places when they contract passive smoking-related illnesses or inconveniences.

Justice has often been on their side in several Western countries as proven by court awards over the past decade or so.

Whilst this will give local solicitors' practices a boost, it will also certainly open the eyes of a lot of smokers who choose to pursue their habit in the presence of others for example, the Mad Monk .

The opposing view held by S Chang that people who get smoking-related diseases should not be treated in government hospitals merits further debate.

While I agree with some of his harsh proposals, there are also some humanitarian aspects which must be taken into consideration. The essential question here is how many of those who have smoking-related diseases were only passive smokers? These innocent bystanders should never be punished.

To conclude, the absence of data or hard evidence does not mean that authorities should not enforce a smoking ban at workplaces.

But, like all enforcement of bans (except for weapons), I remain extremely skeptical and challenge the Malaysian government to put into practice what it is proposing in real terms.

I would, however, also like propose another controversial measure - the amendment of the Penal Code to make smoking in the presence of one or more person (unless consent has been obtained) a punishable offence.

Smoking in the presence of those aged below 16 years old would also be punishable regardless of whether consent has been obtained. This, may then perhaps indeed lead to dramatic results.

Anyway, as the saying goes 'Better late than never' though it is probably too late for not only Malaysia but the whole of Asia. We have at least a century of smoking-related diseases to contend with even if the majority of smokers quit today.

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