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MPOWERing the world

MPOWERing the world

The Star13-07-2025
THE 'strongest possible measures' against vaping should be adopted as the devices – aimed at putting nicotine back on the agenda – are as bad as cigarettes, says Irish Prime Minister Micheál Martin.
Countries are now dealing with the same tactics and approaches the world experienced with tobacco cigarettes to a 'disgraceful degree', he said.
'We were caught off guard by the onset of vaping.
'Now there is research on the evils of vaping and Ireland has introduced substantial legislation to deal with it including banning the sale of vapes (or e-cigarettes) to those under 18,' Martin said in his opening speech at the recent World Conference on Tobacco Control (WCTC) in Dublin.
In the battle against tobacco, he stressed that a 'relentless focus' on children is critical.
'Many of my friends started smoking at ages nine and 10. We have to be extremely vigilant,' he said, adding that Ireland wants to work with other countries in keeping the global population safe from the harms of tobacco products.
'I have always been a strong opponent of vapes because there was very little due diligence done on the composition as well as the health impact of these devices.
'It's extraordinary that vapes ended up on the shelves without any real health and safety analysis (being done prior),' he said.
Concurring, World Health Organisation (WHO) director-general Dr Tedros Adhanom Ghebreyesus warned that new and emerging nicotine and tobacco products could pose serious health threats, especially to children.
'The marketing is aggressive, the appeal of their products is strong, and regulation is often weak.
'But our vigilance on new products must go hand-in-hand with intensified action on conventional tobacco products,' he said.
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'The 2025 WHO report on the global tobacco epidemic, which we are launching here, shows that the MPOWER ( see infographics ) measures introduced in 2008 to support the implementation of the Framework Convention on Tobacco Control (FCTC) international treaty, are working.
'Around the world, 155 countries have implemented at least one MPOWER measure at best-practice level but despite the rise in regulation, new tobacco products are being introduced and pushed to the youth,' he said, adding that to protect the next generation from tobacco-related diseases and death, all countries must commit to implementing at least one more MPOWER measure at best-practice level within the next year, and those that have passed laws on tobacco control must enforce them rigorously.
Researchers, he stressed, must continue building the evidence base on the health impacts of new and emerging tobacco and nicotine products.
'Legislators and regulators must ban flavours and designs in vapes that are designed to attract children and young people.
'And, to truly make a meaningful difference in tobacco control, we must embrace our youth and place them at the centre of our efforts,' he said, adding that tobacco control is central to tackling noncommunicable diseases (NCDs), an agenda at the upcoming United Nations High-Level Meeting on NCDs in September.
During the 2025 Bloomberg Philanthropies Awards for Global Tobacco Control ceremony, WHO Global Ambassador for Noncommunicable Diseases and Injuries, Michael R. Bloomberg, said for all we've accomplished, there's so much more to do.
The Bloomberg LP and Bloomberg Philanthropies founder, who announced a new US$20mil (RM84.8mil) Accelerator Fund to help advance progress in countries where tobacco control is stalled, said the work has gotten harder especially for organisations that received funding from the United States.
'I know there's a lot of concern that foundations will pull back on funding, too. So let me just say this: Global public health is a driving passion and we are not backing off. Not one inch.
'Bloomberg Philanthropies will work with partners to proactively engage governments and NGOs in several low- and middle-income countries that either lack best-practice tobacco control measures or are close to implementing all best-practice measures,' he pledged.
Bloomberg announced a new US$20mil fund to help countries where tobacco control is stalled. — Bloomberg Philanthropies
Governments and non-governmental organisations of India, Mauritius, Mexico, Montenegro, the Philippines and Ukraine, were presented with the 2025 Bloomberg Philanthropies Awards for Global Tobacco Control at the WCTC.
Where Malaysia stands
Malaysia's Control of Smoking Products for Public Health Act 2024 (Act 852) – the country's first standalone law that covers all aspects of tobacco control, including the regulation of vapes – is laudable but 'there's always room for improvement', WHO FCTC Secretariat senior lawyer Kate Lannan said.
In April, Health Minister Datuk Seri Dr Dzulkefly Ahmad acknowledged that there was a missed opportunity to ban vaping at the federal level but said the situation could always be revisited. The Generational Endgame (GEG) ban, part of Act 852, was originally intended to prohibit individuals born on or after Jan 1, 2007, from purchasing or smoking tobacco products, including vapes. However, the GEG element was removed from the final Bill due to constitutional issues.
Johor and Terengganu, however, have since enacted local government laws to halt the issuance of operating licences and prohibit the sale of vape products within their respective states.
Lannan said the WHO had been tracking the progress of the Bill as it went through the legislature and is 'pleased with various aspects of it'.
'Malaysia recently received the WHO World No Tobacco Day Award so you are definitely doing a lot of things right.
'But of course, there's always something more every nation can do to deepen and intensify the implementation of the FCTC (Framework Convention on Tobacco Control) that goes beyond the mere checking of boxes,' she said.
Commenting on the government's issuance of an interim nicotine manufacturing licence to a company, shortly after Dr Dzulkefly, the Health Ministry's Disease Control Division deputy director Dr Noraryana Hassan and Malaysian Council for Tobacco Control (MCTC) president Assoc Prof Dr Murallitharan Munisamy, were presented with the WHO award on May 19, Lannan said it is not the role of the Secretariat to take a party to task for elements not specifically covered in the FCTC.
'The Health Minister may not have known about this as there are other authorities involved but we have no doubt that Dr Dzulkefly will safeguard the public health of Malaysians,' she said.
The minister, who was among the recipients of a prestigious WHO award, had been 'carefully vetted and clearly researched' before being acknowledged for his contributions.
'The award is an important recognition of the progress Malaysia (has achieved in tobacco control). The recipients have done a great job. And, there is no doubt in our minds that the minister will protect public heath in Malaysia. We have every confidence in that,' Lannan said during a press conference at the WCTC.
According to the WHO Global Tobacco Epidemic 2025 Report, Malaysia has achieved best practice level for all MPOWER measures except two – offering help to quit tobacco use, and enforcing bans on tobacco advertising, promotion and sponsorship.
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Laos to enforce strict penalties on tobacco companies failing to comply with new graphic warning regulations
Laos to enforce strict penalties on tobacco companies failing to comply with new graphic warning regulations

The Star

time3 hours ago

  • The Star

Laos to enforce strict penalties on tobacco companies failing to comply with new graphic warning regulations

Samples of the new graphics on health warnings on cigarette packs. - Photo: Laotian Times VIENTIANE (Laotian Times): The Lao Ministry of Health is stepping up efforts to reduce smoking by strictly enforcing new rules on cigarette packaging. Starting 15 August, companies and shops that fail to use the approved graphic health warnings on cigarette packs will face serious penalties, including fines, product seizures, and possible license suspensions. These packaging rules, which officially came into effect on 13 May 2024, require all cigarette packs to display large, clear images and messages warning about the dangers of smoking. Tobacco companies were given a 180-day window to comply, but that deadline has long passed. In fact, companies have delayed the process by an additional 253 days, totaling 433 days, now it's over one year since the regulation first took effect. Authorities now say enforcement is overdue. Stores caught selling cigarette packs with incorrect or outdated warning images will have the products seized and destroyed, and damages will be charged to the manufacturers. Fines, License Suspensions Await Non-Compliant Tobacco Firms Tobacco companies that continue using the old packaging will be fined depending on the number of violations. The first offense will result in a LAK 10 million (US$462) fine, followed by a LAK 20 million (US$925) fine for the second offense. From the third offense onward, the fine increases to LAK 50 million (US$2314.81), and the matter may be referred to the relevant authorities for further legal action. In more serious cases, companies may even face suspension or revocation of their business licenses. This move is part of Laos' broader effort to align with international tobacco control measures. The country is now the third in Asean, after Thailand and Singapore, to implement mandatory graphic health warnings on cigarette packs. The regulation also bans all branding and advertising on the packaging, allowing only ten approved warning designs that focus on the harmful effects of smoking. Laos has been a signatory to the World Health Organization's Framework Convention on Tobacco Control since 2006. By enforcing these new measures, the country hopes to better protect public health, especially among young people who are most at risk of picking up smoking habits. Tobacco use remains a major public health issue in Laos. More than 800,000 people across the country smoke, and tobacco-related illnesses kill an estimated 6,800 people each year—around 18 deaths per day. The financial cost is equally high, with the government spending approximately LAK 3.6 trillion, or around US$200 million, on healthcare expenses related to smoking each year. The South-East Asia Tobacco Control Alliance (SEATCA) has previously raised concerns over slow enforcement, noting that many cigarette packs still do not meet the new standards. SEATCA has urged the Lao government to increase inspections and impose penalties to ensure full compliance. By enforcing these new rules and holding the tobacco industry accountable, Laos hopes to lower smoking rates, reduce health risks, and build a healthier future for its citizens. - Laotian Times

When ‘chubby' turns costly: The high NCD risk behind childhood obesity
When ‘chubby' turns costly: The high NCD risk behind childhood obesity

Sinar Daily

time10 hours ago

  • Sinar Daily

When ‘chubby' turns costly: The high NCD risk behind childhood obesity

KUALA LUMPUR - "So cute!' This phrase still rings out at family gatherings, often directed at chubby, round-faced children with hearty appetites - signs of them being "healthy and happy'. For generations, a little extra weight on a child was seen as a sign of well-being. But health experts warn that this mindset is outdated and increasingly risky for a child's long-term health. Childhood obesity is far from harmless. It is a serious medical condition linked to long-term health complications, including noncommunicable diseases (NCDs), most commonly type 2 diabetes, heart disease, fatty liver and even some cancers. As long as society continues to view chubbiness as cute and harmless, children will continue to pay the price with their health. MALAYSIA'S NCD BURDEN According to Dr Muhammad Yazid Jalaludin, senior consultant paediatric endocrinologist at Universiti Malaya Medical Centre (UMMC) and UM Specialist Centre (UMSC), many global organisations have recognised obesity as a disease. Dr Muhammad Yazid, Professor of paediatrics at the Faculty of Medicine, Universiti Malaya, also said obesity is not just about size or body mass index (BMI) exceeding a certain level, but is dangerous due to its association with chronic NCDs, which can severely impact health and even be fatal. According to the World Health Organisation (WHO), NCDs are caused by a combination of genetic, physiological, environmental and behavioural factors. The main types of NCDs are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes. NCDs disproportionately affect people in low- and middle-income countries, where nearly three-quarters of global NCD deaths (32 million) occur. According to a 2024 report, 'Prevention and Control of Noncommunicable Diseases in Malaysia: The Case for Investment' (jointly prepared by the Ministry of Health Malaysia [MOH], WHO and the UN Inter-Agency Task Force on NCDs), each year, NCDs in Malaysia cause 72 percent of all premature deaths. Economic analysis of data from 2021 has estimated that NCDs cause RM64.2 billion in economic losses per year, including RM12.4 billion in healthcare expenditure and disability payments, and RM 51.8 billion in productivity losses. The total social and economic losses due to NCDs is equivalent to 4.2 percent of the nation's gross domestic product. The 2024 report also highlighted another concern: Malaysia is experiencing the double burden of malnutrition and undernutrition, and overweight and obesity, causing diet-related NCDs. FATTY LIVER Dr Yazid said obese children are at risk of developing type 2 diabetes earlier than usual. "I've treated children as young as eight years old who had type 2 diabetes, which usually affects older adults. "These children (with diabetes) often also have cholesterol issues, putting them at risk of heart disease much earlier than other people. When we see people having a heart attack at age 40, we used to think they are too young to get it, but now people as young as 28 are having heart attacks due to severe obesity at a young age, plus cholesterol, hypertension and diabetes,' he said. More concerning, he added, is their research showing that even children can suffer from fatty liver disease. "If it begins too early, it can lead to fibrosis and cirrhosis, significantly raising the risk of hepatocellular carcinoma or liver cancer,' he explained. He added that excessive obesity increases the risk of other cancers, such as colon, breast and gynaecological cancers. "Obese children may also develop sleep apnoea, a condition where breathing (repeatedly) stops (and starts) while sleeping. This can cause the right side of the heart to enlarge or thicken, increase pressure in the lungs and potentially lead to death during sleep,' he said, adding children also risk developing bow legs due to the stress of supporting their excess weight. LIFELONG OBESITY RISK Childhood obesity is far from harmless. Photo for illustrative purposes only - Canva Childhood obesity is far from harmless. Photo for illustrative purposes only - Canva Childhood obesity is far from harmless. Photo for illustrative purposes only - Canva Childhood obesity is far from harmless. Photo for illustrative purposes only - Canva Childhood obesity is far from harmless. Photo for illustrative purposes only - Canva Childhood obesity is far from harmless. Photo for illustrative purposes only - Canva Childhood obesity is far from harmless. Photo for illustrative purposes only - Canva Childhood obesity is far from harmless. Photo for illustrative purposes only - Canva The 2019 National Health and Morbidity Survey (NHMS) found that 29.8 percent of children aged five to 17 fall into the categories of overweight (15 percent) and obese (14.8 percent). On May 24, Deputy Health Minister Datuk Lukanisman Awang Sauni was quoted by the media as saying that, based on NHMS data, the prevalence of overweight and obesity among children is continuing to rise. "For children under the age of five, the rate increased from 5.6 percent in 2019 to six percent in 2022. "For adolescents aged 13 to 17, the prevalence rose from 28.5 percent in 2017 to 30.5 percent in 2022, indicating that one in three children is experiencing overweight or obesity issues,' he said. Pointing to the rising number of overweight and obese children in Malaysia, Dr Yazid said if the issue is not controlled, they will add to the nation's overall obesity statistics in adulthood. "Statistics show that 70 to 80 percent of children aged six to eight who are overweight or obese will remain obese as adults. Out of 10 obese seven-year-olds, only three will achieve a normal weight in adulthood,' he said. Excess weight results from consuming more calories than needed, often due to unhealthy eating and lack of exercise and physical activity, he said, adding that sleeping late or insufficient sleep can also contribute to obesity as tired children tend to feel hungrier during the day. "When children lack sleep or have poor sleep quality, they eat more the next day due to fatigue. Like adults, they tend to choose sugary, high-calorie and fatty foods to regain energy. "Even if they know the food is unhealthy, their brain is already wired to crave such food,' he explained. SEDENTARY LIFESTYLE IMPACT While genetics plays a role, Dr Yazid noted that environment and habits matter more. He said studies show that if one parent is obese, the child's risk of obesity increases fivefold, and if both parents are obese, the risk goes up 13 times. "Only a very small number - less than two percent - of obesity cases are due to genetic syndromes. Most cases are due to the environment (they live in) as obese parents tend to eat more and exercise less, and their children follow suit. "In a study ('MyHeART') that we did, we assessed the fitness levels of teens aged 13, 15 and 17. Fewer than 10 percent were genuinely fit and less than 30 percent engaged in useful physical activities daily. "Our calorie intake far outweighs calorie burn due to our sedentary lifestyle. Food is easily accessible… just order and it's delivered to your door,' he said, adding that another study has shown that Malaysian teenagers are generally not physically active. He also pointed out a lack of awareness about the importance of Physical and Health Education (PJK) classes in schools. "PJK is often sidelined, seen as unimportant and frequently sacrificed for other academic activities. But that short session is the only chance some students have to exercise and sweat, which is vital for their health. "After school, many kids just spend time on their gadgets and (online) games, staying indoors instead of going to the park or playing football or cycling. When we talk about this issue, (parents) will raise concerns about safety, unpredictable weather and other things. "This is where local authorities and the government must play a role by providing safe and well-maintained recreational areas where local communities can exercise and participate in physical activities, thus fostering a healthier lifestyle,' he said. While the medical challenges of obesity are daunting, treatment options are available - though not without their own limitations. METFORMIN Rejecting claims that childhood obesity in Malaysia is only an urban issue caused by busy parents, financial status and access to food, Dr Yazid said the situation has changed. "In the United States, many obese persons come from low-income groups because healthy, nutritious and high-quality food is expensive. In contrast, in China, it's the wealthy who tend to be obese due to access to a wide variety of food. "In Malaysia today, those with money can afford to eat a lot, while those without money eat whatever is available, regardless of whether it's healthy, high in sugar, salt or otherwise,' he said. Regarding appropriate weight-loss medications for children, Dr Yazid said currently, no drug has been specifically approved for those under 12. He said metformin, a medicine to treat type 2 diabetes, has many side effects when given to children under 10, such as stomach ache, flatulence and discharge of oily stool. "We can't give school kids this medicine as they may have an 'accident' in school and be teased by their friends,' he said. Dr Yazid added that while metformin is "not popular for children under 12, we will consider it in certain cases'. "Metformin is used for type 2 diabetes and can be given to children aged 10 and above who show signs of insulin resistance or prediabetes. The aim is to reverse their health issues before they develop full-blown diabetes.' This medication is usually taken for up to a year for weight loss, but some patients may need to take it for more than a year to prevent extreme weight gain and their insulin resistance from worsening, he said, adding scientific data has shown that the use of metformin can reverse prediabetes in 50 to 70 percent of cases. LIRAGLUTIDE, BARIATRIC SURGERY Referring to a study conducted and co-authored by him together with several of the world's leading medical experts, titled "Liraglutide for Children 6 to Less Than 12 Years of Age with Obesity - A Randomised Trial' ( Dr Yazid said their research involved the use of liraglutide - an injectable medication suitable for obese children aged six to under 12, to help reduce their appetite. The study, published in 'The New England Journal of Medicine' in September 2024, found that treatment with liraglutide for 56 weeks, combined with lifestyle interventions, resulted in a significantly greater reduction in BMI compared to placebo combined with lifestyle interventions. "Liraglutide tends to be more effective in children and youth than adults, with fewer side effects compared to other medications. We only prescribe it after all other weight loss efforts fail,' he said, adding that liraglutide costs about RM1,900 per month, making it unaffordable for many families. As for bariatric surgery, he said it is seen as a last resort for extremely obese children at risk of developing NCDs. However, it is not recommended for children who have not reached puberty due to potential disruption to growth. "Currently, bariatric surgery is not performed on children unless under very specific conditions, usually in cases of extreme obesity where obesity-related diseases have started to develop. It can be done for adolescents who have stopped growing and entered adulthood,' he said. Bariatric surgery is performed to reduce the size of the stomach, making the patient feel full quickly even with small meals. However, it also reduces nutrient absorption, which can lead to nutritional deficiencies if not properly managed. "Post-surgery, patients must continue to consult doctors and dietitians to ensure they get the right supplements. For instance, a lack of vitamin D can lead to osteoporosis, while vitamin K deficiency can cause bleeding and bruising. In the US, (there was a case of ) a patient (who) became blind after undergoing bariatric surgery due to a lack of vitamin A,' he said. RAMPANT SALE OF JUNK FOOD Beyond hospitals and clinics, the everyday environments children are exposed to - especially at school - also play a critical role in shaping their eating habits and long-term health. Sharing their concerns over the increasingly rampant sale of sugary drinks, snacks and fast food, including outside school gates, several parents interviewed by Bernama described the situation as a "threat' to their children's health. Siti Balkis, 42, a government employee, said almost every day her children, particularly the two younger ones who are in primary school, would buy ice cream, snacks or 'jelly balls' (colourful jelly candies) after school as the street vendors are just a few steps away from the school gate. "Every time after school, they want to buy something. It's hard to stop them because the stuff is right there in front of them. Children are easily influenced, especially by the bright and attractive packaging. "Sometimes, we as parents don't even know what our children are eating because many different types of snacks are available in the market these days,' said the mother of four. Father of two Muhammad Saufi, 39, meanwhile, said the presence of vendors selling food high in sugar, salt and other additives outside school premises calls for stricter action from the authorities. "The types of food being sold also need to be monitored because most of them are unhealthy. Kids may love the taste of these snacks, but they can have serious health effects,' he said, suggesting that schools work together with Parent-Teacher Associations and local councils to more closely monitor the sale of food outside school gates and promote healthier alternatives at affordable prices. As Malaysia grapples with the long-term consequences of childhood obesity, experts stressed that treatment alone is not enough. Early prevention, public awareness and stronger enforcement of regulations are crucial to breaking the cycle before it burdens the nation further. From sugar-laden drinks sold outside school gates to inherited risks compounded by sedentary routines, this issue demands urgent, multi-pronged actions - not just to manage weight but to safeguard the future health and productivity of the nation's younger generation. Tomorrow: Behind every overweight child is a hidden struggle - not just with their health but with their confidence, emotions and sense of self. In Part Three, we uncover the silent mental toll of childhood obesity. - BERNAMA

Chikungunya might be about to break out worldwide
Chikungunya might be about to break out worldwide

The Star

time13 hours ago

  • The Star

Chikungunya might be about to break out worldwide

The A. aegypti mosquito can transmit both the dengue and chikungunya viruses. — Filepic The World Health Organization (WHO) warned on July 22 (2025) that a major chikungunya virus epidemic risks sweeping around the globe, calling for urgent action to prevent it. The United Nations health agency said it was picking up exactly the same early warning signs as in a major outbreak two decades ago and wants to prevent a repeat. Chikungunya is a mosquito- borne viral disease that causes fever and severe joint pain, which is often debilitating. In some cases, it can be deadly. 'Chikungunya is not a disease that is widely known, but it has been detected and transmitted in 119 countries globally, putting 5.6 billion people at risk,' said WHO infectious diseases epidemiologist Dr Diana Rojas Alvarez. She recalled how from 2004 to 2005, a major chikungunya epidemic swept across the Indian Ocean, hitting small island territories before spreading globally and affecting almost half a million people. 'Today, WHO is seeing the same pattern emerge; since the beginning of 2025, Reunion, Mayotte and Mauritius have all reported major chikungunya outbreaks. 'One-third of the population of Reunion is estimated to have been infected already,' she said during a press briefing in Geneva, Switzerland. The symptoms of chikungunya are similar to those of dengue fever and Zika virus disease, making it difficult to diagnose, according to the WHO. Dr Rojas Alvarez said that like 20 years ago, the virus is now spreading to other places in the region, such as Madagascar, Somalia and Kenya. 'Epidemic transmission is also occurring in south Asia,' she added. In Europe, imported cases have also been reported, linked with the outbreak in the Indian Ocean islands. Local transmission has been reported in France and suspected cases detected in Italy. 'Because these patterns of transmission were seen in the outbreak from 2004 onwards, WHO is calling for urgent action to prevent history from repeating itself,' said Dr Rojas Alvarez. She noted that the case fatality (death) rate was less than 1%, 'but when you start counting millions of cases, that 1% can be thousands' of deaths. 'We are raising the alarm early so countries can prepare early, detect and strengthen all the capacities to avoid going through very large outbreaks.' Dr Rojas Alvarez explained that in regions where populations have little or no immunity, the virus can quickly cause significant epidemics, affecting up to three-quarters of the population. Chikungunya virus is transmitted to humans by the bites of infected female mosquitoes, most commonly Aedes aegypti and Aedes albopictus mosquitoes. The latter, which is known as the tiger mosquito, is venturing farther north as the world warms because of human-driven climate change. They bite primarily during daylight hours, with peak activity often in the early morning and late afternoon. The WHO urged people to protect themselves through measures like using mosquito repellent and not leaving water to stagnate in containers such as buckets, where mosquitoes can breed. – AFP

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