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The targeted quantity of smokers is only equivalent to 7.8% of the current smoking population, and resources allocated are evidently insufficient. Malaysia’s current minimum legal age for smoking is 18 . Countries like Singapore and Sri Lanka have made progress to raise the age requirement to 21 while Malaysia is still debating on its 2018 tobacco bill . Although the government has designated non-smoking zones , there seemed to be negligible enforcement and issuance of fines. Is Malaysia’s government just too incompetent? The government may have been aware of the possible consequences in hasty cigarette tax hikes. It decided tax hikes were necessary to meet its budget deficit target. “As per the trends of past years, there is usually a surplus to offset the deficit from the first half, in turn keeping the deficit within the target,” said Lee Heng Guie, executive director of Socio-Economic Research Centre. Malaysia achieved its budget deficit target of around 3% despite billion-dollar losses in oil revenue. Together with cost-cutting measures, sin tax made up for any shortfalls in revenue.

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For more than a decade, the companies did not act on this knowledge out of fear of FDA regulation. But once the federal agency started regulating cigarettes in 2009, they went all out in their bid to develop and sell NRT. The Tobacco Papers reveal that companies conjectured that their new nicotine products could successfully compete with pharmaceutical NRT and they set the goal of gaining market control of all products containing nicotine. "It was surprising to discover the industry came to view NRT as just another product," Dorie Apollonio, associate professor in clinical pharmacy and lead author of the study, was quoted as saying in a UCSF news release. "The tobacco companies want people to get nicotine - and they're open-minded about how they get it." Smoking is responsible for more than 480,000 deaths every year in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC), and another 16 million Americans live with a smoking-related disease. The costs of such illnesses total more than 300 billion U.S. dollars each year, when including both costs of direct medical care and lost productivity due to secondhand smoke exposure. Clinical trials show that NRT can help people quit smoking, but only if used in conjunction with counseling and in tapering doses. Over-the-counter availability of NRT made it easy for smokers to get a nicotine fix in non-smoking environments like offices and inside airplanes, with the net result that they were less likely to quit.

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