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Ages 18 to 21 a critical time to stave off smoking habit

KUALA LUMPUR: If a person remains tobacco-free until they reach age 21, chances are that he or she will never succumb to the habit for the rest of their lives, says medical experts.

Hence, raising the age of buying tobacco to 21 will protect teenagers and youths from the dangers of nicotine addiction, thus, reducing the number of deaths and diseases caused by tobacco usage.

Malaysian Mental Health Association deputy president Datuk Dr Andrew Mohanraj Chandrasekaran said people aged between 18 to 21 were most susceptible to the addictive effects of nicotine because their brains were developing.

“This is why most chronic smokers would have first experimented with cigarettes around this age and not later.

“Experimenting with cigarettes during this age allows the brain to ‘learn’ to be addicted compared with a more resistant ‘mature’ brain at an older age. When such an experiment is delayed, there is less likely for addiction to develop,” he told the New Straits Times.

He said the need to experiment with new things, seeking acceptance in a group or just being “cool” were some of the reasons why young people started smoking. He said some also felt that smoking was a form of social rebellion.

University Malaya Centre of Addiction Sciences addiction medicine specialist Associate Professor Dr Amer Siddiq Amer Nordin said studies had found that raising the minimum age to buy cigarettes was effective in reducing the smoking rate and increasing the quality of life.

He said a study in the United States revealed that enforcing a higher smoking age would reduce the prevalence of smoking among adults in the long term, and might even be as effective as increasing cigarette taxes by 40 per cent.

“Malaysia’s Global Adult Tobacco Survey found the age of initiation to be 17 years. Studies showed that 80 per cent of smokers started smoking before age 20, and 90 per cent of those who purchased cigarettes were below age 21.

“By increasing the age of purchase, we are essentially ensuring that those under age 21 do not start selling cigarettes and tobacco products to their peers.

“In Malaysia, we are considered mature and able to determine the fate of the country by voting at age 21. So why do we allow those below 21 to have access to cigarettes?” said Dr Amer, who is also a Malaysian Council for Tobacco Control committee member and a smoking cessation specialist.

Malaysian Medical Association president Dr Ashok Philip said tobacco was addictive because of the nicotine content that had powerful effects on receptors in the brain that cause increased alertness and a sense of well-being. However, he said prolonged exposure to nicotine would reduce the number of receptors on the nerve cells.

“If the smoker then cuts down or stops smoking, the nicotine stimulation will drop, and the subject feels irritable, fatigued and out of sorts.

“If he or she can tolerate the symptoms for a few weeks, the number of receptors will recover, and the withdrawal symptoms should be alleviated.

“However, the severity of symptoms vary widely, and in some people, it may be so severe that even nicotine replacement with chewing gum or skin patches cannot help them to quit.”

Malaysian Psychiatric Association honorary secretary Associate Professor Dr Muhammad Muhsin Ahmad Zahari said smoking cigarettes could be a gateway to other habits, such as smoking shisha or marijuana, vaping, and even the use of illicit drugs.

“In a recent finding published in Lancet Psychiatry, regular smokers were associated with a higher risk and earlier onset of developing psychosis, which is a mental illness.”

Gynaecologist and Asia Metropolitan University president and chief executive officer Professor Datuk Dr N.K.S. Tharmaseelan said teenage smoking was often an early warning sign of future problems.

For instance, teens who smoked were three times as likely as non-smokers to use alcohol, eight times as likely to use marijuana, and 22 times as likely to use cocaine.

“Studies have shown that the three-year gap (18 to 21 years) makes a ‘huge’ difference in combating smoking among the young.

“Moreover, most countries are gradually raising the age barrier. Thus, Malaysia may be joining an elite group of health conscious nations that are implementing proactive measures to curb the rising mortality and morbidity associated with smoking,” he said.

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