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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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This resulted in an estimated loss of RM4.4 billion (US$1.06 billion) in government revenue last year. From the year 2011 to 2015, average cigarette prices went up by more than 30% . If the price hikes do deter consumers, there should have been a corresponding decrease in total cigarette consumption. The Malaysian government needs to relook at its future strategies Attempts to minimise the prevalence of smoking failed due to the absence of policies to restrict black market activities. The government had oversimplified the problem by assuming price hikes would decrease the cigarette consumption in lower income families. However, with cheaper alternatives available, the citizens turned to illegal cigarettes with price tags of RM3 – RM8 (US$0.71 – US$1.89). Customs director-general Datuk T. Subromaniam appeared to be in denial, as he commented , “It (tax increase on cigarettes) is merely a measure to reduce the number of smokers in Malaysia and increase tax revenue. We cannot solely blame taxation for the rise in illicit cigarettes.” On a larger scale, Malaysia’s tobacco industry has taken a hit.

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