Abstract
BACKGROUND: The Generation End Game (GEG) policy in Malaysia aimed at establishing a smoke-free generation, and the announcement has since sparked significant public response. This study analysed Malaysian active commenters' perceptions expressed in social media comments on online news articles concerning the Generation End Game (GEG) policy, from the initial announcement of the implementation plan to its eventual removal from the Control of Smoking Products for Public Health Bill 2023. METHODS: This cross-sectional study employed qualitative and quantitative methods and used an inductive approach and thematic content analysis to analyse online commentaries on news articles published on popular online news portals from January 2022 to January 2024. Data was collected by downloading the commentaries onto Microsoft Word and importing them into NVivo. RESULTS: A total of 7450 commentaries were analysed across three distinct timeframes: the initial announcement, the official announcement and the period following the removal of the GEG provision from the Bill. The analysis revealed that support for the policy accounted for 43.0%, 70.4%, and 67.9% of commentaries across the respective timeframes, while opposition was noted with 57.0%, 29.6%, and 32.1% respectively. CONCLUSIONS: Although initial reactions to the GEG policy were largely negative, the increase in support following the official announcement and subsequent policy changes suggests that transparent communication, political developments, and public discourse significantly influence the policy's acceptance. These findings highlight the dynamic nature of active commenters' opinions in response to policy developments and underscore the importance of engaging the public early and consistently when introducing major health policies.