Galen Warns Of New Health Crisis From Liquid Nicotine Deregulation

The Galen Centre warns the government of potentially creating one of the biggest public health crises in Malaysia by exempting liquid nicotine as a controlled substance without existing vape regulations: a new epidemic of nicotine addiction among children and teens.

KUALA LUMPUR, April 1 – The Galen Centre for Health and Social Policy today warned the government about potentially triggering a new health crisis from the declassification of liquid nicotine as a controlled substance.

The think tank described the exemption of liquid or gel nicotine from control under the Poisons Act 1952 – amid the absence of specific legislation for tobacco and vape control – as an “exceptionally regressive move” that removes a cornerstone of Malaysia’s anti-tobacco policy.

“This decision is likely to mark the beginning of one of the biggest public health crises in Malaysia: a dramatic increase in young people and children who are addicted to nicotine, through vape,” Galen Centre chief executive Azrul Mohd Khalib said in a statement.

“We are already going through the non-communicable diseases (NCD) crisis with millions of people living with diabetes, cancer, hypertension and obesity. This will be the next one.”

Health Minister Dr Zaliha Mustafa yesterday gazetted an amendment to the Poisons List to exclude liquid or gel nicotine used for e-cigarettes and vaporisers, overriding the Poisons Board that unanimously rejected the proposal last Wednesday. Finance Minister Anwar Ibrahim gazetted an order last March 29 to impose excise duty of 40 sen per ml on e-liquids with nicotine, effective today.

“It was intended to not only legitimise the use of nicotine e-cigarettes and vape, but also allow local industry to manufacture such products, which are currently mostly imported from China, so that they could also be taxed,” Azrul said.

“While most countries around the world are moving towards curtailing and reducing the prevalence of smoking and vaping among its population, the Malaysian government appears to be going in the opposite direction, seemingly in a desperate move to collect tax revenue.

“However what it has instead potentially done is open the floodgates to existing and new problems, which are unable to be handled by the current health care and legal system.”

Citing the National Health and Morbidity Survey 2019, the Galen Centre pointed out that 1.12 million people in the country are currently using e-cigarettes. An industry survey indicated that around 68 per cent of male respondents vaped, compared to 32 per cent of women.

“At least 600,000 children between the ages of 11 and 18 have taken up vaping using disposable vape containing high concentrations of nicotine of up to 5 per cent – concentrations that are unavailable in other countries which regulate vape,” Azrul said.

“This is causing a new epidemic of nicotine addiction not only among adults but also among young people. We are already seeing teenagers who are addicted to nicotine due to vape. Why is the government ignoring its own data and evidence?”

Malaysia currently has no regulations whatsoever on vape or e-cigarettes with nicotine, such as restrictions on sale to minors under 18; restrictions on ingredients, nicotine content, or volume of e-liquids for sale; labelling requirements and warnings; or bans on advertising, promotion and sponsorship.

“Where previously nicotine was tightly controlled, this compound will now be able to be easily accessible, used and manipulated without restraint or regulation. There are now absolutely no safeguards which prevent the online sale of e-cigarettes and vape products of high nicotine concentration to anyone, including minors,” Azrul said.

“How did we get from being leaders in advocating a progressive policy which aims to produce a smoke-free generation of people, to a policy which deregulates nicotine and encourages the growth of the local nicotine vape industry? Other countries were looking forward to Malaysia’s leadership on this issue.”

Azrul pointed out that countries like the United Kingdom, Indonesia, and New Zealand have nicotine content caps at 2 per cent for vape products, including the same restrictions imposed on cigarettes for marketing, promotion, and sales.

“Why drop nicotine altogether from being a controlled substance? It does not make sense. Malaysia is likely to lose its credibility on the international stage and in places such as the World Health Assembly,” he said.

“This government decision now undermines and removes a cornerstone of anti-tobacco policy in Malaysia. Unfortunately, this country will join an exclusive group of nations which are reversing or ignoring anti-tobacco measures intended to reduce the prevalence of smoking, the number of young smokers and vapers, nicotine addiction, cancer, and premature death.”

Azrul also warned the government that nicotine would most likely be misused in drinks and food, like ice cream and sweets, as the highly addictive substance is now easier to procure.

“It will likely encourage made-to-order beverage sellers and custom vape retailers to experiment with the compound. It can and will lead to cases of nicotine poisoning. There are no safety standards for nicotine. A separate legislation or regulation will need to be developed to address this newly created loophole.”

The Galen Centre, describing the declassification of liquid nicotine as a “short-sighted” policy decision, projected that the tax revenue gained from locally produced and imported vape will “quickly be consumed by the cost of treating the diseases that they cause”.

Azrul noted that the total value of the Malaysian vape industry was estimated at RM2 billion, less than half of the estimated RM4.38 billion in annual direct health care costs of diabetes in Malaysia.

“The link between nicotine vape and diabetes? Nicotine vape increases a person’s risk of developing high blood sugar. Those who vape have a 22 per cent increased risk of developing prediabetes compared to those who do not. Encouraging vaping will increase the number of people suffering from diabetes, and increase the cost on the health care system.”

The Galen Centre expressed its solidarity with Ministry of Health (MOH) professionals, especially those in tobacco control and NCDs, who have worked on tobacco and vape control for decades across different administrations.

“There is now only one remedy: the revised Tobacco and Smoking Control Bill must be tabled in Parliament as soon as possible. No more excuses, ifs and buts. Vape should be taxed but it also needs to be regulated as strictly as tobacco. That is only possible with the provisions contained in the Bill. The government and Members of Parliament must find the moral courage and vision to step up and do the right thing,” Azrul said.

“No one wants their daughters and sons, grandchildren, and loved ones to become addicted to nicotine, suffer from chronic diseases such as cancer, and lose their lives prematurely. One day, we will look back at the harm and suffering caused by smoking and vaping, the lives lost prematurely, the billions spent, and wonder why we did not act sooner.”

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