The following letter is signed by 30 Malaysian medical organisations. We represent the majority of the medical fraternity in Malaysia.We are writing to express our support for the Ministry of Health’s recent announcement by the Deputy Health Minister Dr Lee Boon Chye that the Ministry intends to gazette alfresco restaurants as no-smoking zones under the Control of Tobacco Products (Amendment) Regulations 2017. Dr Lee was quoted as saying “The gazettement of the new smoke-free zones under the Control ofTobacco Product Act is to protect the public, especially non-smokers, from the dangers ofsecondhand smoke”. We could not agree more with this statement. One in two smokers will die from the use of tobacco. While that is a tragedy on its own, it is an evengreater travesty that many non-smokers suffer numerous ailments as a result of secondhand smoke. Secondhand smoke contains more than 7000 chemicals, of which many cause cancer. Studies haveshown that it causes premature heart disease and lung cancer amongst non-smokers and even leadsto strokes. The effects are particularly felt by women and children, who are often at the mercy of smokers andare unable to voice out their concerns. For example, secondhand smoke leads to more frequent andsevere asthma attacks, respiratory infections and ear infections. It also increases the risk ofpremature birth, low birth weight, birth defects and sudden infant death syndrome. It is also essential to note that there is no risk-free level of exposure to secondhand smoke.With these factors in mind, many governments across the world have taken measures to protect their citizens from the harmful effects of secondhand smoke. For example, a policy making it illegal to smoke in work places in England came into force on 1 July 2007 as a consequence of the Health Act 2006. An analysis of studies found that admissions for heart attacks fell by 42 per cent among men and 43per cent among women in the five years since the ban was introduced in 2007. Rates ofhospitalisations for asthma were also reduced. In the United States, a review found a 14 per centreduction in strokes in counties which introduced a ban, compared with those which did not. These numbers translate to real lives that are saved from the physical, financial and emotionalburdens of disease. Although some will undoubtedly voice concerns regarding the negative economic impact on local restaurants, it is worth noting that even here the evidence suggest otherwise – in England, many eateries have thrived since the smoking ban as they changed their focus on more high-quality food and trying to attract families – including those with young children – who would previously have avoided smoky atmospheres. Furthermore, the government will be fulfilling their obligation to protect public health & make public places 100% smoke-free, as detailed in the World Health Organisation’s Framework Convention on Tobacco Control, which Malaysia signed and ratified. We acknowledge and congratulate the new government’s emphasis on preventive medicine andaddressing the scourge of non-communicable diseases at their infancy. We look forward to both DrLee and our Health Minister, Dr Dzulkefly Ahmad, leading the way in ensuring that the gazettement is made official. There is no greater modifiable risk factor than tobacco, and by implementing measures to reduce the impact of secondhand smoking, the government will go a long way in reducing the nation’s healthcare costs whilst increasing the well-being of the rakyat. Signed, Academy of Medicine of MalaysiaAcademy of Medicine of Malaysia – College of SurgeonsAcademy of Medicine of Malaysia – College of PhysiciansAddiction Medicine Association of MalaysiaAsthma MalaysiaFamily Medicine Specialists Association of MalaysiaFederation of Private Medical Practitioners’ Associations MalaysiaIslamic Medical Association of MalaysiaLung Foundation of MalaysiaMalaysian Association for Bronchology and Interventional PulmonologyMalaysian Association of Thoracic and Cardiovascular SurgeryMalaysian Council for Tobacco ControlMalaysian Medical AssociationMalaysian Medics InternationalMalaysian Oncological SocietyMalaysian Paediatric AssociationMalaysian Psychiatric AssociationMalaysian Society of Geriatric MedicineMalaysian Thoracic SocietyMedical Mythbusters MalaysiaMedical Practitioners Coalition Association Of MalaysiaMedical Tweet MalaysiaNational Cancer Society of MalaysiaNational Heart Association of MalaysiaObstetrical and Gynaecological Society of MalaysiaPerinatal Society of MalaysiaPersatuan Kesihatan IKRAM MalaysiaPersatuan Pakar Perubatan Kesihatan Awam MalaysiaPertubuhan Doktor-doktor Islam MalaysiaVascular Society of Malaysia