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Drug and Alcohol Dependence Subcortical white matter (WM), thalamus, cerebellar cortex, and corpus callosum were most affected. Higher cigarette pack-years related to smaller volumes in several subcortical regions. Magnetic resonance imaging studies of cigarette smoking-related effects on human brain structure have primarily employed voxel-based morphometry, and the most consistently reported finding was smaller volumes or lower density in anterior frontal regions and the insula. Much less is known about the effects of smoking on subcortical regions. We compared smokers and non-smokers on regional subcortical volumes, and predicted that smokers demonstrate greater age-related volume loss across subcortical regions than non-smokers. Non-smokers (n = 43) and smokers (n = 40), 22–70 years of age, completed a 4 T MRI study. Bilateral total subcortical lobar white matter (WM) and subcortical nuclei volumes were quantitated via FreeSurfer. In smokers, associations between smoking severity measures and subcortical volumes were examined. Smokers demonstrated greater age-related volume loss than non-smokers in the bilateral subcortical lobar WM, thalamus, and cerebellar cortex, as well as in the corpus callosum and subdivisions. In smokers, higher pack-years were associated with smaller volumes of the bilateral amygdala, nucleus accumbens, total corpus callosum and subcortical WM. Results provide novel evidence that chronic smoking in adults is associated with accelerated age-related volume loss in subcortical WM and GM nuclei.

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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. The cigarette industry holds the second place in terms of total excise collection, which contributes significantly to indirect tax ( 22.9% of the 2017 Federal Governmental budget). Additionally, the government has failed to control its illegal cigarette trade. The responsibility of clamping down on illicit cigarette trade falls on the shoulders of Royal Malaysian Customs Department (RMC).

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