| |
 |

 
  | |
` usually thought of as chronic conditions that
do not result from an acute infectious process.
` These conditions cause death, dysfunction, or
impairment in the quality of life, and they
usually develop over relatively long
` result from prolonged exposure to causative
agents, many associated with personal
behaviours and environmental factors.

- Malaysian Family, Physician, 2010

 
` To create awareness among population about
the healthy lifestyles and adverse lifestyle-
related diseases in the community.
` To restore and maintain high quality of the
health of the individual and community
   

` 


 !
„dentify public health NCD and their
magnitude
„dentify high risk populations amenable to
intervention
Monitor health of the population

` To instill healthy lifestyles in order to reduce

the risk of NCD through education, mass
media, health campaign and support groups.
 

!
` Communicable disease are slowly being
replaced by noncommunicable.
` 6 major NCD in Malaysia are:
„ D
Mental „llness
Stroke
Road Traffic Accident
Cancer
Asthma
Diabetes Mellitus
 ‰ 
" |
` This epidemiological change accounted for 47%
of the global burden of disease and 60% of all
deaths.
` From a projected total of 58 million deaths from
all causes in 2005,
- it was estimated that chronic diseases accounted
for 35 million, which is double the number of
deaths from all infectious diseases, maternal and
perinatal conditions and nutritional deficiencies
combined.
- Malaysian Family, Physician, 2010
` about 80% of chronic disease deaths :
occurred in the low and middle income
countries
` and 50% of these deaths : occurred
prematurely in people under 70 years of age.

- Malaysian Family, Physician, 2010

 ‰ 
` The W
has proposed a global goal with a
target of an additional 2% annual reduction in
projected chronic disease death rates
between 2005 and 2015.2,3

- Malaysian Family, Physician, 2010

 "" |
 |
` The NCD team has developed a comprehensive approach to
chronic disease care.
` NCD Program in Ampangan ealth Clinic which represents
many typical government health clinics in Malaysia and the
processes by which it was developed. „ncluded are specific
examples of the tools and how they can be used by individual
clinicians in caring for patients.
` The integration of Chronic Disease Management Services into
health care systems is the direction being undertaken to
tackle the burden of chronic disease.
` Disease management supports the shift in healthcare from an
emphasis on managing the acute episode to managing the
entire disease course, highlighting both prevention and
maintenance of wellbeing for patients with chronic diseases.
 [ [

|
#

` Ninth Malaysia plan (2006-2010);

- RM2.0 billion-spent on developing rural health
services, an increase of more than 150% from
2001-2005.
- R&D, that saw only RM28.9 million in the last
five years, receive RM250.0 million.
- Allocation for training has tripled.
 ^

$
%

!

$
[%&
!
' [

())*
 ^ 

Septicaemia 16.87
. eart Diseases & Diseases of Pulmonary 15.70
Circulation
Malignant Neoplasms 10.59
Cerebrovascular Diseases 8.49
Pneumonia . 5.81
Accidents 5.59
. Diseases of the Digestive System 4.47
. Certain Conditions
riginating in The 4.20
Perinatal Period
Nephritis, Nephrotic Syndrrome & 3.83
Nephrosis
„ll-define conditions 3.03
 |+ 



[%

'|[
` %

: is to provide leadership and the
evidence base for international action on
surveillance, prevention and control of
noncommunicable diseases, mental health
disorders, malnutrition, violence and injuries
 ,
$
%
%
!
^
()--
()-.
,
%
[%!
$!
 
` The campaign, which emphasises healthy
eating, physical activity, anti-smoking and
mental health, will specifically target school
children, adolescents, women and the elderly
to ensure better health outcomes; and
  
%%!


$!
` Sports and recreational activities will be promoted to
enable people to adopt a healthy and active lifestyle.
` Existing sports and recreational amenities will be
upgraded and the private sector will be encouraged to
build new facilities in accessible locations.
` To instill the active lifestyle culture amongst children,
participation in at least one sports activity will be made
compulsory for students in schools beginning in 2011.
 ^!


` Prevention, control and management of

Cardiovascular Disease and Diabetes will be
made accessible for all population with
participation in partnership with various
stakeholders and integrated into the social,
economic and environmental systems to
establish a robust platform for effective
reduction of these diseases.
 |[

` The results of the National ealth Morbidity
Survey „„„ (N MS „„„) in 2006 showed that
prevalence of ypertension and Diabetes has
increased significantly i.e. prevalence of
known diabetes and hypertension among
adult above 30 years old was 14.9% and 42.6%
respectively.5,6
- Malaysian Family, Physician, 2010
"" |
[ [
^"  
|

#
Ë


[

/
  | |0
` 
 refers to the class of diseases
that involve the heart or blood vessels (arteries and
veins)*

` The No. 1 Fatal Disease in MALAYS„A and W
LE

world

` Mainly eart Failure- „nability of cardiac output to

meet the demand of the body

*http://en.wikipedia.org/wiki/Cardiovascular_disease
   ‰#
` 1) eart attack - damaged heart muscle =
ËM
 M
M
 M 


` 2) Prolonged pumping against a chronically

increased afterload ʹ eg: during hypertension
and stenotic valves
` eart diseases are on the rise in Malaysia despite
improvement in health services and facilities.
` They were the second leading cause of death in 2006,
accounting for 15.5 per cent of those who died in
government hospitals.
` According to the Malaysia Noncommunicable Disease
Surveillance 2005/2006, the prevalence of risk factors
such as physical inactivity was 60.1 per cent, smoking
25.5 per cent, obesity 16.3 per cent, obesity 48.6 per
cent, hypertension 25.7 per cent, raised blood glucose
11 per cent and hypercholesterolemia 53.5 per cent.
` National eart of Association of Malaysia
 |

+

'|
1
` „s a service supported by the Ministry of ealth (M
)
` to collect information about cardiovascular disease in
Malaysia,
- which will enable us to know the incidence of
cardiovascular disease,
- and to evaluate its risk factors and treatment in the
country.
` This information is useful in assisting the M
, Non-
Governmental
rganizations, private healthcare
providers and industry in program planning and
evaluation, leading to cardiovascular disease
prevention and control.
 %
+2
$
%
|

` Determine the number and the time trend of acute coronary

syndromes in Malaysia.
` Determine the socio demographic profiles of these patients to
better identify the high-risk group in our Malaysian population.
` Determine the efficiency of, and adherence to current guidelines
of treatment guidelines
` Determine the number, evaluate and monitor the outcomes of
percutaneous coronary intervention (PC„) based on selected
performance indicators.
` Determine the cost to the nation by cardiovascular disease and the
cost-effectiveness of treatment and prevention programs
` Stimulate and facilitate research of cardiovascular disease using
this database.

-National Cardiovascular database

The theme *3
* is the
overarching topic of World eart Day 2010,(26
September) with the aim to promote the
workplace as the ideal setting to adopt
healthy behaviours in order to prevent heart
disease and stroke. World eart Day will call
on individuals to take their first of
10 Steps to eart ealth.
The eart Foundation Malaysia
 "* ‰[
|
 #
 $
$
4 %

+!

à
à

 

à 
  
`
 à Y à 
`

à 
`   à !"#
` ëhambalia and Seen (2010) reviewed the
overweight and obesity trends in Malaysian adult
from 1996 to 2009.
` The risk for overweight and obesity was higher in
women than men and the levels of overweight
and obesity were highest among adults 40-59 y.
`
verweight levels were highest among „ndians,
followed by Malays, Chinese and Aboriginals,
while the prevalence of obesity by ethnicity was
less consistent.
 "* ‰[
|
 
 |‰


 "* ‰[
 
|
[|
' ^
)*
` Two studies undertaken in 2002 and 2008 among
primary school children found that overweight rose
from 11.0% to 12.8% within a period of 6 years, and
obesity rose from 9.7% to 13.7% over the same period.
` The scenario among adults is even more alarming. The
prevalence of overweight and obesity amongst
Malaysian adults had tripled within the last ten years.
`
besity rose from 4.4% in 1996 to 14.0% in 2006. The
same trend was observed for the prevalence of
overweight which rose from 16.6% in 1996 to 29.1% in
2006.
` This means that 2 in 5 adults are now either
overweight or obese.
[#^ " | |
 [#^ " | |
` ypertension is an increasingly important
medical and public health issue globally.
` The prevalence of hypertension increases with
advancing age to the point where more than
half of people 60ʹ69 years of age and
approximately three-fourths of those 70 years
of age and older are affected.
|
*
 ‰ "#
|
5
 ‰ "#

SBP/DBP

PT„MAL <120/80 N
RMAL

N
RMAL 120ʹ129/80ʹ84
PRE YPERTENS„
N
B
ARDERL„NE 130ʹ139/85ʹ89

YPERTENS„
N >140/90 YPERTENS„
N

Stage 1 140ʹ159/90ʹ99 STAGE 1

Stage 2 160ʹ179/100ʹ109 STAGE 2

Stage 3 >180/110
` This new designation is intended to identify
those individuals in whom early intervention
by adoption of healthy lifestyles could reduce
BP, decrease the rate of progression of BP to
hypertensive levels with age, or prevent
hypertension entirely.
` ypertension can be classified as either primary (or
essential) hypertension and/or secondary hypertension.
` Primary hypertension has no specific origin but is
strongly associated with lifestyle.
` „t is responsible for 90 to 95 percent of diagnosed
hypertension and is treated with stress management,
changes in diet, increased physical activity, and
medication(if needed).
` Secondary hypertension is responsible for 5 to 10 percent
of diagnosed hypertension. „t is caused by a preexisting
medical condition such as congestive heart failure, kidney
failure, liver failure, or damage to the endocrine
(hormone) system.
` Evidence showed that greater SBP is a major risk factor
for Cardiovascular Diseases.
` The prevalence of systolic hypertension increases with
age, and above 50 years of age, systolic hypertension
represents the most common form of hypertension.
` DBP is a more potent cardiovascular risk factor than
SBP until age 50; After that, SBP is more important.
` Clinical trials have demonstrated that low systolic
hypertension reduces total mortality, cardiovascular
mortality, and stroke.
` „n February 2009, Malaysian ealth Minister YB
Dato͛ Sri Liow Tiong Lai reiterated that as
Malaysia approaches a developed nation status
by 2020, the prevalence of chronic lifestyle
diseases such as hypertension is unfortunately
bound to increase.
` According to his report at the 7th AS„AN-PAC„F„C
C
NGRESS
F YPERTENS„
N 2009 the latest
National ealth and Morbidity Survey in 2006
showed that the prevalence of hypertension
among Malaysian adults 30 years old and above
was 43%, a shock 10 point leap from the 33%
recorded 10 years earlier.
` A separate survey conducted by the Ministry͛s „nstitute
for ealth Management on the outpatient
management of hypertension in government clinics.
That survey found that only 28.5% of patients treated
for hypertension in government clinics achieved the
target blood pressure.
` With these figures, it is now estimated that there are
4.8 million individuals with hypertension in Malaysia.
` The estimated figure worldwide is a staggering 1 billion
individuals. „t is also alarming to note that close to two
thirds of individuals with hypertension in Malaysia
were not aware that they have hypertension.
` There were more „ndian (12.2%) and Chinese
(11.5%) hypertensives whose blood pressure was
controlled when compared to Malays (7.0%).
` There were slight improvement in the awareness
of hypertension (33% vs 36%), and overall control
rates (6% vs 8%).
` owever, there was no difference in control rates
among those treated (26%).
| "

` The National Cancer Registry of Malaysia (NCR) records 21,773

Malaysians being diagnosed with cancer but estimates that almost
10,000 cases are unregistered every year.
` „t is estimated that one in four Malaysians (1:4) will develop cancer
by 75 years old.
` „ncreasing population and longer life spans contributes to rise of
cancer. Less than 10% of cancers happen in children compared to
over 50% in men and 35% in women aged 50 and above.
` Cancer occurs more in females than males with a ratio of male to
female 1:1.2
` The cancer incidence out of 100,000 people are:
4,058 Malay males and 4,753 Malay females are diagnosed with
cancer
4,078 Chinese males and 4,422 Chinese females are diagnosed with
cancer
629 „ndian males and 1065 „ndian females are diagnosed with cancer
` Although considered the 3rd leading cause of premature death in
Malaysia, only 30-40% of all deaths from cancer are medically
certified, meaning there is no exact figure of people dying from
cancer.
` Findings show that 10.3% of Malaysians risk dying from the disease
before 75 years old. (Globocan, 2008)
` Cancer is becoming a leading cause of death due to avoidable risk
factors like smoking and tobacco exposure, poor diet, alcohol,
inadequate exercise or being overweight.
` „t is estimated that nearly 40% of all cancers are preventable,
including colorectal, lung and cervical cancers, with smaller effects
in breast and nasopharyngeal cancer.
` „mprovement in early detection and treatment leads to better
survival rates for people with cancer.
 6|
'2 6 | 

%
|


` is a not-for-profit social enterprise
` mainly tasked to pool and utilise every effort,
expertise and financial aid from every faction of
society, and to fight cancer and reduce the
related pain, suffering and morbidity that cancer
patients and their families often experience.
` registered under the Register of Societies on 10th
November 1994 and officially launched on 30th
March 1995.
` MAëNA was founded by Dato͛Mohd Farid Ariffin.
 
` To mobilise resources in order to provide
curative, preventive, research and support
services to cancer patients and their families,
high-risk groups and the general public, in
Malaysia and the World.
 

` To keep abreast of the latest $  information, technology and development
in the cure for cancer.
` To provide consistent 
4 and 
  to educate
and promote an understanding of a healthy lifestyle.
` To raise $$
$ for cancer-related services to the community.
` To have a pool of well-trained and equipped staff to provide the best care and
 to cancer patients.
` To provide  and !
 
$ to enable early detection of
cancer.
` To source, collate and disseminate information effectively to all levels of society.
` To encourage, support and conduct % in basic sciences and clinical
research on cancer, which could lead to innovative treatment approaches.
` To manage a +!
  that provides financial assistance to cancer
patients unable to meet the cost of treatment.
` A total of 21,773 cancer cases were diagnosed
among Malaysians in Peninsular Malaysia in the
year 2006 and registered in the National Cancer
Registry.
` „t comprises of 9,974 males and 11,799 females.
` The Age standardised „ncidence Rate (ASR) for all
cancers in the year 2006 regardless of sex was
131.3 per 100,000.
` The five most common cancer among population
of Peninsular Malaysia in 2006 were breast,
colorectal, lung, cervix and nasopharynx.
National Cancer Registry,2006
 [
‰4


‰
 

 

'
` The objective : to help the poor cancer patients, to
conduct cancer research and to enhance cancer
awareness.
` „t's a home grown project supported by Bank Negara
Malaysia for the purpose of bringing back the velocity of
these coins - which we can do as a national service.
` MAëNA collects loose change such as 5 sen, 10 sen, 20
sen and 50 sen through this nationwide campaign.
` Small, medium and giant donation boxes will be
distributed and displayed at high traffic locations
throughout the country.
 
+

^ 
'^
` MAëNA fundraising solution that provides the
organisation with a regular and predictable
flow of funds.
` This sustainable source of income allows
MAëNA to plan for the future and is
invaluable in the fulfilment of its mission to
help as many cancer patients as possible.
 ^!
‰
'^‰
` For a monthly donation of as little as "-7))
or more, you can give relief and hope to
cancer patients throughout Malaysia.
` Through Payroll Giving Programme, donation
is deducted directly from payroll, making
donation giving more convenient and easy.

% 
 
'

` first launched in the year

2003 as ëempen 1 sen (
ne
Cent Campaign) with the
participation of primary
schools and was extended
to secondary schools in
2004.
` With the elimination of 1
sen, now the campaign
collectively collects all loose
change and the campaign is
renamed as ëempen
ëutipan Syiling (Loose
Change Campaign).
 
` 
6|
["#

"
^" ‰"

 ^

` 8

` F„R Wellness @ Dataran 32
^
9 +
()-- will be running a campaign
` *

! to raise funds for NCSM
from January to March
2011.
` National cancer society Malaysia

` 

%
9
!
()--
  
|
#
   
 
` „n Malaysia, diabetes is a growing concern.
` Through the Ministry of ealth's six year thematic
ealthy Lifestyle Campaign which began in 1991,
diabetes mellitus was the theme for the year 1995.
` ere, the promotion of adopting healthy lifestyle
practices relating to the prevention of diabetes namely
creating awareness and balance diet, maintain ideal
body weight and physical activities were encouraged.
` The campaign also emphasised on creating, awareness
of the disease and its complications to the public.
` Guidelines on management of diabetes and patient
education to the diabetes were also developed.
 %



9 *[


` |
Fasting <7.0 mmol/L
2 h after glucose <7.8 mmol/L
` 



Fasting <7.0 mmol/L

2 h after glucose 7.8ʹ11.0 mmol/L
` +

Fasting >7.0 mmol/L
2 h after glucose ш11.1 mmol/L
` From the survey, the national prevalence of
known diabetes in Malaysia was found to be
5.7% (5.4% - 6.1%).
` owever, through the 2 hour- post- glucose
load test, the national prevalence of
undiagnosed diabetes was 2.5% (2.3-2. 7%).
` Taking into account these 2 categories of
diabetes, hence the prevalence of diabetes in
Malaysia would be 8.3% (7.8% - 8.7%).
` The survey revealed geographical variations in the
observed prevalence of diabetes by states.
` The highest observed prevalence of known diabetes
occurred in the more developed states like Selangor (7.3%,
6.1 - 8.4%) and Penang (7.3%, 5.3 - 9.4%).
` Similarly, the prevalence of undiagnosed diabetes was
highest in the more developed states like Negeri Sembilan
(4. 1%, 2.8 - 5.401o), Penang (3, 5%, 2.4 - 4.5%) and Melaka
( 1%, 1.9% - 4.2%).
` The same findings were found among „GT. States like
Melaka (6.6%, 4.6 - 8.6%), Wilayah Persekutuan ëuala
Lumpur (5.3%, 3.8-6.9%) and Johor (5.4%, 4.1%-6.7%)
recorded highest prevalence of „GT.
` The prevalence was significantly higher among urban
compared to rural areas ( 12.1% vs 10.5%).
` No gender difference in the prevalence was observed.
` Based on ethnicity, the „ndians had the highest
prevalence of diabetes (19.9%), followed by Malays
(11.9%) and Chinese (11.4%).
` Those with primary education or less, have a higher
prevalence of diabetes.
` There was no difference in prevalence of diabetes by
income status.
` The prevalence of diabetes is increasing.
ͻ Surveys in 1960͛s & 1970͛s showed prevalence of 1-2%
ͻ National ealth and Morbidity Survey (N MS) is a
nationwide population survey of Malaysian adults done
every 10 years
-:;*
|[

*7<=
'
>
<)
!
-::*
|[

;7(=
'
>
<)
!
())*
|[


>
-)=
ͻ Malaysian population 2006 : 26.64 million ш 18 yrs :
12,923,504 ( ш 18 ʹ < 30 = 3,496,060, ш 30 = 9,424,769)
 |[


  
‰
+2
0
` To determine the prevalence of diabetes in the
` general population of Malaysia
$
+2
0


1) The prevalence of people with :
- known diabetes
- undiagnosed diabetes
- impaired fasting glucose („FG)
2) The health seeking behaviour among people with diabetes
3) The proportion of people with known diabetes with specific
complications
4) The association of risk factors with diabetes
 "
[%
^
ͻ A National Programme on ͚Staying ealthy Together͛ with
involvement of multiple stakeholders (multiple ministries, local
councils and NG
s͛) with the purpose of enhancing or inducing
change of public behaviour.
^

ͻ For purposes of population screening, both fasting and post prandial
lucose levels should be used.
+
!

ͻ 

4



%%




%

$
regular eye examination among diabetics.
- This is best performed at the primary healthcare level with the use of
a fundus camera.

^
‰
ͻ All health care providers should comply to CPG recommendations on
screening and management of diabetes and its complications
|
+

'|

` To be a National Education Resource Centre for the country
` To create and maintain a National Diabetes Registry.
` To establish and run a comprehensive health facility
(National Diabetes ospital) for the management of
diabetes and its complications.
` To coordinate and conduct research in diabetes and related
conditions.
` To be the national reference as well as the National
Coordinating Centre for Diabetes in Malaysia in respect to
statistics, education, management, research, policy and
planning on diabetes and associated diseases.
STROKE
` Stroke is the third largest cause of death in
Malaysia.
`
nly heart diseases and cancer kill more.
` „t is considered to be the single most common
cause of severe disability, and every year, an
estimated 40,000 people in Malaysia suffer
from stroke.
` Anyone can have a stroke, including children,
but the vast majority of the cases affect
adults.
National Stroke Association of Malaysia (NASAM)
 *%


31
`
` A stroke is a brain attack and occurs when
the blood supply to the brain is disrupted.
` The brain is the nerve center of the body,
controlling every thing we do or think, as
well as controlling automatic functions like
breathing.

National Stroke Association of Malaysia (NASAM)

 *%


31
` mntreated % %
+

'%!
` 
0
A diet high in salt is linked to high blood pressure,
while a diet high in fatty, sugary foods is linked to furring
and narrowing of the arteries.
` +.
` A previous .
`  $+
0
increases the risk of blood clots forming
in the heart, which may then dislodge and travel to the
brain.
` 3 .
` Regular %!
3 0 raises blood pressures
` Certain types of 

: raise blood
pressure.
National Stroke Association of Malaysia (NASAM)
 *%

%
!1
` Sudden 43 or + on one side of
the body. Signs of this may be a drooping face, a
dribbling mouth, weakness in the arm or leg.
` Sudden +
 of one eye or both eyes.
` Difficulty in 3 or  speech,
or slurred speech.
` ??, loss of balance, confusion
` Sudden severe %%
` | or vomiting
© National Stroke Association of Malaysia (NASAM).
"3
$
%

+


`  .
- more common in people over 55, and the
incidence continues to rise with age.
- because atherosclerosis takes a long time to
develop and arteries become less elastic with
age, increasing the risk of high blood pressure.
` ‰
:Men are at a higher risk of stroke than
women, especially under the age of 65.
` !
%!0 aving a close relative with a
stroke increases the risk
National Stroke Association of Malaysia (NASAM)
 3
"%+

` Early rehabilitation is crucial.

` Every stoke survivor must seek rehabilitation
treatment as soon as possible.
- Physiotherapy
-
ccupational therapy
- Speech therapy
- Counselling

National Stroke Association of Malaysia (NASAM)

"%+
` The goals :
- are to improve function
and gain as much
independence as
possible.
` „ncludes a range of
services including speech,
physical, occupational
and recreational
therapies and group
activities.
© National Stroke Association of
Malaysia (NASAM).
 |
‰ 
- to restore the stroke survivor's ability to communicate
accurately, by treating the following areas:
` % - a stroke survivor with speech problems has
difficulty producing sounds so that others can understand
him or her.
`    - is the use of symbols, such as words, numbers
of gestures that have meaning
`  , or thinking skills - a stroke survivor must be able
to pay attention, concentrate and use various thinking
skills.
` 44 - a stroke survivor may have difficulty
controlling tongue and swallowing. Therefore, therapy that
helps speech can also help swallowing.
© National Stroke Association of Malaysia (NASAM).
^%!%!

` conducted by
physiotherapists
` helps a person return to
the highest possible
level of physical
function.
` Concentrating primarily
on controlled and
balanced movement,
increased strength and
stamina for greater
mobility
National Stroke Association of Malaysia (NASAM)

%!
` focuses in improving the ability
to perform activities of daily
living, self-care and
independence at work and
leisure.
` involves an assessment of the
stroke survivor's cognitive and
perceptual functioning, the
ability to perform daily tasks
such as walking, bathing,
dressing, feeding and
housework

National Stroke Association of Malaysia (NASAM)

%
%!
` provided by a speech
pathologist
` helps a person improve his
or her ability to
communicate
` this includes speech, which
is how sounds are made,
and language, which
involves understanding and
choosing the correct word
to use.
© National Stroke Association of Malaysia
(NASAM).
 |

` function as places for stroke survivors to help
themselves in their rehabilitation process, to interact
with fellow survivors, and to get information and group
support for themselves as well as for their carers.
` NASAM's two main objectives are:
- To provide rehab services to enable stroke survivors to
return to as normal a life as possible within the limits of
their disabilities.
- To promote the concept of stroke prevention by raising
public awareness on the risk of stroke.
` NASAM operates seven centres: in Petaling Jaya,
Ampang, Penang, Perak, Malacca, Sabah and Johor.

© National Stroke Association of Malaysia (NASAM).

3
4
*3
` a nation-wide week-long
campaign,
` to raise public awareness on the
risk of stroke and to encourage the
public to take positive steps to
adopt a healthier lifestyle to
reduce the risk of stroke.
` The programme includes a public
launch event to encourage the
public to be more physically active,
forums held in various town
centres, chat shows on TV and
radio, and open day at NASAM
centres

© National Stroke Association of Malaysia

(NASAM).
 6|‰

  6|‰
#
` About half of all Malaysian men smoke.
` Every day about 50 teenagers below the age of 18 start smoking
` Studies show about 30% of adolescent boys (aged 12 to 18) smoke.
` Smoking among female teens is rising. According to two studies on
teens conducted in 1996 and 1999, the numbers of female teens
smoking rose from 4.8% to 8%.
verall, the 1999 study found nearly
one in five teens smokes.
` Some studies have shown that lung cancer is rising at a rate of 17%
a year.
` Smoking is estimated to have caused more than half a million
coronary events.
` Smoking rates are highest in rural ëelantan and lowest in urban
Penang and Sarawak.
` Although there are restrictions on advertising, tobacco
companies have found ways to bypass these laws through using
brand names and remain the top advertisers.
` eavily advertised products include the Benson and edges
bistro, Dunhill accessories, Marlboro clothing, ëent orizon
Tours and Salem Cool Planet concerts.
` Malaysia has been dubbed the "indirect advertising capital" of
the world.
` Some of the tobacco industry's most blatant efforts to target
young people can be seen here.
` Spending on tobacco advertising is extremely high.
` „n 1997, the industry spent about $90 million, while in the year
2000, two tobacco firms alone reportedly spent more than
mS$40 million.
` At least two tobacco companies were among the top 10
advertisers in recent years.
` Among those who reported ever having smoked, the
quit rate was substantially higher among females
(29.7%) than among males (17.3%).
` Women (29.6%) were more likely to smoke ͚rokok
daun͛ (hand-rolled cigarettes wrapped in a corn leaf).
` The national prevalence for smoking such cigarettes,
common in rural areas, was 14%. The proportion of
heavy smokers (>20 sticks daily) was higher among
males (33.7%) than among females (17.7%) [(„nstitut
ëesihatan mmum, 1997), pp. 120ʹ124].
  | |
` Malaysia's strong dedication to adequately funding its
Ministry of ealth will likely prevent the disease from
becoming widespread.
` The healthcare provisions in Malaysia's Ñ


program, put in place in an effort to become a developed
nation by the year 2020, add further support for the
country's likelihood of successfully curbing the spread of
disease over the next 10-15 years.
` „t is also likely Malaysia will continue its technological
expansion in the healthcare sector and expand its
healthcare coverage to include more rural and poverty-
stricken areas by building modern facilities and increasing
its mobile care capacities.
` ë AW J„NN
` SAëS ALEN„ RAJEND„RAN
` TAN C „A

NG
` C

ë ER W

„
` AR„ëR„S NAN