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The huge tax loss from the illicit cigarette trade is compounded by the burden of smokers on the public healthcare system that is estimated at RM2.9 billion annually, based on a 2007 Universiti Kebangsaan Malaysia (UKM) study that is the latest research on the issue, according to the Health Ministry

The mood-altering effects of nicotine (pleasure, alertness, relaxation) are powerful and when a person begins to smoke, particularly at a young age, the risk of developing nicotine addiction is high

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It's key to look at the UK's vaping trends

Thus, comprehensive tobacco control is urgently needed in LMICs, including full implementation of the World Heath Organization MPOWER measures (see Tobacco Control) and consideration of Endgame Strategies