Higher Learning Institutions Students’ Perspective on Public Smoking Ban Legislation

Tobacco smoking continues to be a major cause of death and disability around the world and is also a main provider towards our health inequalities. The legislation of banning smoking in public can help in improving smokers’ health. Hence, this study aims to identify the students' perceptions if the legislation of public smoking at higher learning institutions has changed smokers’ attitude and habit specifically in Malaysia. This study adopted a quantitative research approach to elicit data. An online survey using Google form application is used to distribute the questionnaires. A total of 106 undergraduates participated in this study. Data were analysed via SPSS software and descriptive analysis. The findings indicated that the smoking ban has changed the undergraduate smokers' attitude. The majority of the respondents preferred the legislation on the smoking ban to be implemented to all and were against smoking at public places as this will educate all smokers especially students to reduce or quit the smoking culture. The findings also revealed that majority of the undergraduates are aware that smoking has a negative impact on the innocent second-hand smokers, as it will deteriorate their health and may lead to fatal disease. Many respondents shared that they are seriously thinking of quitting smoking, however, some are not successful as they perceive smoking to be a form of relaxation and a way to reduce their stress. This study concludes with recommendations for further studies to be carried out to encourage the students to give up smoking totally.


Introduction
The legislation of banning smoking in public can help in improving the health of smokers'. The smoking ban at all restaurants and other eateries, including open-air hawker stalls, came into effect in Malaysia on Jan 1 2019 (Buchanan, 2019). Norshidi (2019) explains that smoking is banned at any "eating place," which is defined as any premises whether inside or outside a building, where food is prepared, served or sold. The law requiring smokers in Malaysia to light up at least three meters away from open-air eateries has sparked a national debate, with many businesses complaining of fewer customers after this law. The law was intended to reduce the harm caused by second-hand smoke. Additionally, tobacco smoking remains a major cause of death and disability around the world, as well as being a major contributor to health inequalities. Therefore, with the implementation of the legislation of banning smoking in public, it is hoped that smoking will cease to be the main contributor to the many health hazards.

Legislation on Smoking in Public
Smoking cigarette is a hard habit to break because tobacco contains the very addictive chemical nicotine (Elana Pearl Ben -Joseph, 2019). Moreover, smoking can cause lung disease by damaging your lungs airways and the small air sacs found on your lungs around six million people die from long-term exposure to first-or second-hand smoke annually (WHO,2015). Meanwhile, vape or electronic cigarette is a first-generation that resembles tobacco cigarette.

Impact of Public Smoking
Based on the online survey given by Malaysia's New Straits Times newspaper, there are 80% of more than 25,000 respondents who thought that the policy of requiring smokers in Malaysia to light up at least three metres away from the open-air eateries should go even further, supporting that hotels and launderettes should also be listed as smoke-free zones. Abdul Rahman (2019) said that the policy is an effort to protect the masses from the secondhand smoke in public areas. He also stated that the smokers seeked help to quit smoking by going through some therapies and health-care consultations. However, the support for these programmes are low as smokers who are attempting to quit are at high risk of relapsing. They need continuous abstinence from cigarettes for at least 6 months and the smokers' themselves have to be given good support in the first week of the program itself (Clinical practice guidelines). Tauras (2015) stated the use of cigarette excise taxes to generate additional revenues to compensate for fiscal shortages associated with the recent downturn in the economy.

Problem Statement
The World Health Organization (WHO) (2012) concluded that environmental (secondhand) tobacco smoke causes lung cancer among non-smokers. Norshidi (2019) said the government banned smoking in air-conditioned restaurants, schools, petrol stations, government premises and on public transport. Yet more than 10 years on, that rule has been largely ignored. Now, the new law gives authorities the power to fine smokers up to RM10,000 if they flout it. However, some say the number of smokers in the United Kingdom has also decreased, with less than 15 percent of people smoking in 2019, compared to 22 percent in 2006. Whether this is due to the smoking ban is debatable. However, it is likely that the ban has contributed to the decline in the number of smokers. As of 2012, 79% of Parties reported strengthening their existing legislation or adopting new tobacco control legislation after ratifying the Convention. Additionally, over half of the Parties to the WHO FCTC reported having developed and implemented comprehensive tobacco control strategies, plans and programs as required in Article 5.1 of the Convention. Consequently, not much has been done to study this impact of legislation ban on public smoking in higher learning institutions. Hence, this study aims to find out whether public smoking ban has brought any changes among students' attitude in smoking in the campus.

1.
It is good that the government legislate public smoking ban.   Table 2 shows the smokers' attitude after the smoking ban. The first question shows that 86.9% of the respondents were aware that smoking from cigarettes will affect the nonsmoker and 3.7% are not aware. The mean for this question is 4.42 which is the highest for this part. Next, 86.8% respondents agreed that smoking will increase the disease, stroke and lung cancer and 7.6% are disagree with the mean of 4.40. 85.8% of the respondents aware the long-term effect of smoking to their health and only 3.8% disagree with the mean of 4.34.
For the fourth question, 5.7% of respondents are not aware with the ingredients in the cigarettes that can kill the brain cells which can lead to the brain damage and 80.2% are conversely. The mean for this question is 4.9%. Lee (2015) stressed that despite the harmful ingredients and eye-opening illustrations about the risks of smoking being put in cigarette packs, the smokers concern over the dangers are still low.
84.1% of the respondents aware of the effects of smoking to their health and 6.5% are not aware with it and the mean for this is 4.28. 77.7 % agreed that smoking could be harmful to them and 10.4% are not. The mean for this 4.14. Trevallion (2017) explained that smoking can increase an adult smoker's risk of lung cancer and heart disease by a quarter, and of stroke 30%. For the question number 7, most of the respondents seriously thinking of quitting smoking and 4.7% are not serious. The mean for this is 3.91. Cheseeman (2017) said that directly after legislation, more people were trying to quit smoking and more people succeeded because it is much easier to avoid those situations. Furthermore, 34.5% of the respondents agree that when they started smoking, they will crave for more cigarettes. 32.7% are disagree with this and the mean for this is 2.95. 55.4 % are not agree with the statement that when they smoke, they feel relaxed and 22.4 % agree with it. The mean for this question is 2.49. The last question is when they smoke, they can decrease their stress. 22.4% respondents agree and 54.2% disagree with the mean of 2.43. Norshidi (2019) stated that one of the respondents agreed that smoking can reduce stress and to stop that, it will take some time.
The legislation on the smoking ban must be implemented to public. Hence, we need to support the legislation implemented by the government. As for smokers, smoking at eateries 3 meters away from that place does not disturb other customers. Furthermore, most of respondents also support the new legislation on public smoking and believe that public smoking ban is enough to reduce the number of smokers.
In short, the smoking ban has changed smokers' attitude by limiting their wants to smoke and improve their health. Based on the results, the majority of the respondents agreed that smoking cigarettes could be harmful to their health as they can suffer from lung cancer, stroke and other diseases. Additionally, the smoke from cigarettes also affect secondhand-smokers such as children and pregnant women. The smoke from the ingredients of cigarettes could be more dangerous and causes death, disease and disability.

Conclusion
From the data collected most of the respondents agreed with the implementation of the legislation of the public smoking ban. They are aware that there are many negative impacts due to smoking and this might be the right time to change the smoking culture. The respondents are also alert with the fine by the authorities for not smoking in the designated area which is 3 metres away from the eateries. Some of them also disagree with the rule. They think it is okay to smoke in public if they are not disturbing others. They believe that the designated smoking areas which is 3 meters can be accepted by the smokers. Most of the respondents agreed that the smoking ban has changed smokers' attitude. They are aware of the effects of smoking to their health in the long run and the many negative effects from smoking for both the smokers and second-hand smokers. Additionally, it was found that most parents never talk about the dangers of smoking to their children as they feel that it is not important. They responded only when their children brought it up. However, this area on parental communication with their children about the topic of smoking needs more research attention.

Recommendations
The first recommendation is to have more designated areas for smoking. This is to help the smokers to smoke freely when they are in public without disturbing the others. In this way, the number of second-hand smokers can be reduced. The government and non-government organizations should undertake strong efforts to provide awareness to the smokers that the attitude of smoking in public will give bad effects to the non-smoker. This is supported by the fact that shows the non-smoker gains more side effects rather than the smokers themselves. The last recommendation is the authority should do more patrolling around public area and they also can increase the amount of fine and the punishment to the smokers who do not obey the regulations.