Resolving The Urgent Nicotine Abuse Menace The Singaporean Way — Prof Dzulkifli Abdul Razak

The national prevalence of the use of e-cigarettes and other vaping products jumped to 14.9 per cent in 2022.

The controversy about the use of vapes with nicotine is in the news again. Unfortunately, it is from Singapore, not Malaysia. Ours was early this month with the shocking news by the health minister announcing the postponement of the tabling of the Control of Smoking Products for Public Health Bill 2023.

The Bill was scheduled for early this year, but after a number of U-turns, the latest was said to be for the October Parliamentary session. But this has come to nought.

This means that nicotine in vapes, liquids, and gel forms, will continue to be available in the public space without any restriction since its delisting on April 1 this year.

This where the Singapore news article hits hard, very hard. It said: “Singapore: Eight hundred students, from primary-school age to those enrolled in Institutes of Higher Learning (IHLs), were prosecuted in 2022 for vaping offences even as concerns grow over the rising popularity of electronic cigarettes.

“The Health Sciences Authority (HSA) said the Ministry of Education (MOE) had referred the students to the authority, adding that some were fined. Those caught buying, using or owning a vaporiser can be fined up to S$2,000 per offence.

“When contacted, MOE said the students are from primary schools to autonomous universities.

“’Fewer than 50 students from schools and IHLs were referred to HSA for vaping offences before 2020,’ Second Minister for Education Maliki Osman had said informed the Parliament earlier this month. He also said the government and various health agencies are concerned about the vaping situation, not just among students but in the wider community.

“Students caught using or possessing e-vaporisers will be required to attend cessation programmes arranged by HPB and schools, while the recalcitrant offenders may also be referred by the schools to HSA for further action, such as composition fines or prosecution. The parents were notified.”

From the report alone, the difference from the Malaysian scene is rather stark. For example, the number of students arrested, what more prosecuted, has never been discussed in Parliament, even before the Covid-19 pandemic.

In reality, the national prevalence of the use of e-cigarettes and other vaping products has jumped to 14.9 per cent in 2022, marking a substantial increase from 9.8 per cent in 2017. These numbers are concerning, because nicotine harms children and adolescents, especially girls.

Unlike Singapore, the Malaysian counterpart in the education ministry has never been known to refer similar cases to the relevant authorities beyond the school to include the wider community, where the practice is endemic.

The frequency of advisories and warnings from the medical and health fraternity have also impacted directly on the youth population. Reportedly, Singaporean doctors have regularly warned of the dangers of vaping, saying it could lead to respiratory problems similar to cigarette smoking.

One Dr Aneez Ahmed said that vaping is especially harmful to adolescents whose respiratory systems are still developing. A senior consultant lung surgeon at the International Centre for Thoracic Surgery in Mount Elizabeth Novena Specialist Centre also said that vaping can lead to nicotine dependence, which may predispose the user to cigarette smoking later.

Psychotherapist Andrew Da Roza, who specialises in addictions, said that the younger the person starts using nicotine regularly, the greater his risk of dependence.

“Nicotine has a number of psychoactive effects and some of these are experienced as positive – such as improved attention, focus, short term memory, coordination, and relief from anxiety and low moods,” Da Roza added.

While we are convinced that our medical and health fraternity is equally competent and authoritative, their silence has been deafening, in light of the health minister’s unilateral and undemocratic action to bulldoze through the delisting of liquid nicotine from the Poisons List.

In fact, an attempt to have a Parliamentary debate in June on the suspected nicotine poisoning involving a two-year-old girl deemed as “urgent and of public importance” was not successful.

Instead, the health minister — in an affidavit filed in the High Court this month — claimed to only need to get “consultation” from the Poisons Board about her decision for the exemption order and “without a requirement to obtain approval from the Poisons Board”.

Economically, the health minister may have victorious in taxing e-cigarette and vape liquids with nicotine, but morally and ethically, it is an utter failure, given the endless suffering that is ongoing following the delisting of the poison.

Here, Singapore exhibits far more care and compassion in handling the issue, putting Malaysia to shame in the eyes of the world! Could this be a lesson that the Prime Minister is capable of picking up during his official visit to our neighbouring country?

Prof Dzulkifli Abdul Razak is a neuropharmacologist and recipient of Malaysia’s Tobacco Control Icon Award 2023.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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