Smoking Cessation

1st January 2020 marked an important day in Malaysia.

Starting January, smokers are not allowed to take a puff in any of the 150,000 eateries in Malaysia. The smoking ban comes in full effect.

The ban applies to all food outlets from restaurants to food courts, both indoors and outdoors as smokers and vapers have to be at least 3 metres away from restaurants if they want to light up.


First-time offenders can be fined RM250 but they can appeal to reduce it to RM150 . However, second-time offenders cannot reduce their fines and must pay in full. If smokers are caught three or more times, they can be fined up to RM350. Those who fail to pay within two months from the notice date will face court action and if found guilty, face up to RM10,000 in fines or be behind bars for up to two years. The majority of Malaysians were happy with this change. The smokers were not. Some even went as far as to challenge the smoking ban in court citing that it was unconstitutional.

Before we go any further, let me hit you with some facts and numbers:

  • Smoking accounts for one in every five deaths in Malaysia 
  • About 20,000 Malaysians die each year as a result of smoking. 
  • Today, there are about five million smokers (aged 15-year-old and above) in Malaysia, each consuming an average of 14 cigarettes per day. (NHMS 2016) 
  • 4 out 10 or 7.6 million adults are exposed to second-hand smoke inside their houses, 4 of 10 or 2.3 million adults at workplaces, and 7 out 10 or 8.6 million adults at public places like restaurants.
  • 600,000 people die every year from exposure to second-hand or passive smoking according to the World Health Organisation.

Smoking causes:

  • Decreased oxygen to the heart and to other tissues in the body
  • Decreased exercise tolerance
  • Decreased HDL (good) cholesterol
  • Increased blood pressure and heart rate
  • Damage to cells that line coronary arteries and other blood vessels
  • Increased risk of developing coronary artery disease and heart attack
  • Increased risk of developing peripheral artery disease and stroke
  • Increased risk of developing lung cancer, throat cancer, chronic asthma, chronic bronchitis and emphysema
  • Increased risk of developing diabetes
  • Increased risk of developing a variety of other conditions including gum disease and ulcers
  • Increase tendency for blood clotting
  • Increased risk of recurrent coronary artery disease after bypass surgery
  • Increased risk of becoming sick (especially among children: respiratory infections are more common among children exposed to second-hand smoke)


Smoking is both a physical addiction and a psychological habit. The nicotine from cigarettes provides a temporary and addictive high. Eliminating that regular fix of nicotine causes your body to experience physical withdrawal symptoms and cravings. Because of nicotine’s “feel good” effect on the brain, you may turn to cigarettes as a quick and reliable way to boost your outlook, relieve stress, and unwind. Smoking can also be a way of coping with depression, anxiety, or even boredom. Quitting means finding different, healthier ways to cope with those feelings.

Smoking is also ingrained as a daily ritual. It may be an automatic response for you to smoke a cigarette with your morning coffee, while taking a break at work or school, or while at the neighbourhood mamak stall. Or maybe your friends, family, or colleagues smoke, and it becomes an integral part of the way you relate with them.


Along with thousands of other chemicals, cigarette smoke contains tar, carbon monoxide and nicotine, a super-addictive stimulant drug that speeds up the messages sent to and from your brain. Like any drug, nicotine affects people differently, but most people who smoke for any length of time have a chance of becoming addicted. Even though quitting can be really hard, it’s not impossible.


To successfully stop smoking, you’ll need to address both the addiction and the habits and routines that go along with it. But it can be done. With the right support and quit plan, any smoker can kick the addiction even if you’ve tried and failed multiple times before

Let’s look at the different methods available for smoking cessation:

  1. Cold turkey (no outside help). About 90% of people who try to quit smoking do it without outside support — no aids, therapy, or medicine. Although most people try to quit this way, it’s not the most successful method. Only about 5% to 7% are able to quit on their own.
  2. Behavioural therapy. This involves working with a counsellor to find ways not to smoke. Together, you’ll find your triggers (such as emotions or situations that make you want to smoke) and make a plan to get through the cravings.
  3. Nicotine replacement therapy. There are several types, including nicotine gum, patches, inhalers, sprays, and lozenges. They work by giving you nicotine without the use of tobacco. You may be more likely to quit with nicotine replacement therapy, but it works best when you use it with behavioural therapy. Remember that the goal is to end your addiction to nicotine, not simply to quit using tobacco.
  4. Medication. Varenicline (Champix) are prescription medicines that can help with your cravings and withdrawal symptoms.
  5. Combo treatments. You might be more likely to quit for good if you use a mix of different methods. For example, using both a nicotine patch and gum may be better than a patch alone. Other helpful combinations include behavioural therapy and nicotine replacement therapy; prescription medication with a nicotine replacement therapy patch; and a nicotine replacement therapy patch and nicotine spray.


Once you stop smoking, you’ll likely experience a number of physical symptoms as your body withdraws from nicotine. Nicotine withdrawal begins quickly, usually starting within an hour of the last cigarette and peaking two to three days later. Withdrawal symptoms can last for a few days to several weeks and differ from person to person.

Common nicotine withdrawal symptoms include:

  1. Cigarette cravings
  2. Irritability, frustration, or anger
  3. Anxiety or nervousness
  4. Difficulty concentrating
  5. Restlessness
  6. Increased appetite
  7. Headaches
  8. Insomnia
  9. Tremors
  10. Increased coughing
  11. Fatigue
  12. Constipation or upset stomach
  13. Depression
  14. Decreased heart rate

As unpleasant as these withdrawal symptoms may be, it’s important to remember that they are only temporary. They will get better in a few weeks as the toxins are flushed from your body.


Every time you light up a cigarette, you are saying your life isn’t worth living.

If you’ve made the decision to quit, you’re clearly on the road to a better life. Giving up an addiction is hard, but people have successfully quit smoking, so there’s no reason why you can’t too.

A famous American Psychiatrist once said,

 “Quitting smoking can be a very good test of one’s character. Pass the test and you will have accomplished so much more than just get rid of one bad habit”

Consult a medical professional now and take control of your health.

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