World No Tobacco Day 2024: Nicotine Vape And E-Cigarettes Join Cigarettes As Public Health Threats — Azrul Mohd Khalib

The Galen Centre for Health and Social Policy supports the Ministry of Health’s assessment of the emergence of e-cigarettes and vape as a public health threat.

Malaysia must be assertive and unapologetically aggressive in the face of the threat posed by nicotine vape and e-cigarettes, now rapidly replacing cigarette smoking among young people and teenagers.

The Galen Centre for Health and Social Policy supports the Ministry of Health’s assessment of the emergence of e-cigarettes and vape as a public health threat.

Based on data and studies conducted over the past 10 years, it is clear that more children and young people in Malaysia are increasingly at risk of acquiring life-long addiction to nicotine through vaping and e-cigarettes.

Although the National Health and Morbidity Survey (NHMS) Adolescent Health Survey 2022 has previously revealed that there has been a decline in the reported rate of smoking among teenagers and adolescents, the same report has indicated a significant increase in the prevalence of e-cigarette and vape use among this group of people.  

The overall prevalence of children aged 13 to 17 years currently vaping and using e-cigarettes rose from 9.8 per cent in 2017 to 14.9 per cent in 2022. Another local study estimated that at least 600,000 children between the ages of 11 and 18 have taken up vaping. The rates of adolescents vaping in this age range now exceeds those reported in several countries, including the United States.

With the sales and marketing of vape and e-cigarettes becoming totally unregulated and unrestricted due to the Government’s nicotine vape exemption last year, these numbers are likely to be worse today.

The regulations which will operationalise the Control of Smoking Products for Public Health Act 2024 (Act 852) gazetted on February 2, will likely be announced next month.

It must contain the following five measures:

Restrictions on nicotine content: Vape devices sold in Malaysia have among the highest nicotine levels in the world (3 to 5 per cent), which cannot be found in other countries which regulate vape devices and e-cigarettes. In the United Kingdom, often held up as a role model for Malaysian supporters of vape and e-cigarettes, it is only 2 per cent.

Impose similar tobacco restrictions on vape and e-cigarettes industry: Vape and e-cigarettes are essentially nicotine delivery devices, similar to traditional cigarettes and other tobacco products.

The vape and e-cigarette industry is currently behaving in the same way that the cigarette industry used to behave regarding marketing, promotion, advertising, and sponsorships, from the 1960s to the 1990s, before tobacco restrictions were put into place.

Vape and e-cigarettes companies are sponsoring sporting and lifestyle events (such as the Viper Challenge, Nanostix Polo Cup), using social media influencers, advertising, promoting and marketing their products openly, and providing free samples indiscriminately.

Their marketing also appears to target children and adolescents to become new users and customers, with fruity and sweet flavourings and colourful packaging, as well as selling wihtin the vicinities of schools and educational facilities. These must all be restricted or banned immediately.

Impose ban of open retail display of cigarettes, vape and e-cigarettes: The banning of open display of cigarettes at shops and plain packaging have both demonstrated effectiveness and success in countries such as the Netherlands, Australia, Singapore, Saudi Arabia, and the United Kingdom.

Point-of-sale (POS) tobacco display bans have been introduced in Thailand since 2005. Smokers themselves supported the imposition of the regulation.

Evidence from studies have shown that widespread presence of cigarette displays at the point of sale increases the likelihood that youth will start smoking, and stimulate impulse purchasing among existing smokers.

Before the POS display ban was introduced, smoking prevalence in Thailand was 31.7 percent, today it is 21 percent and declining.

Increase excise duties on cigarettes and other tobacco products: These taxes have remained unchanged since 2015. Malaysia spends an estimated RM16 billion annually treating smoking-related illnesses such as cardiovascular disease and lung cancer. Increasing the excise tax rate to RM0.77 per stick, equivalent to 61 percent excise tax of the retail price, would generate additional tax revenue of RM771.8 million.

Enforce anti-smoking regulations: Regulations banning indoor smoking should be strictly enforced. If you have to smoke, do it outside in a designated smoking area (DSA).

The DSA should be an area or shelter which is not enclosed or substantially enclosed and clearly indicated as a place where a person can smoke.

Street smoking should be banned, especially streets adjacent to shopping areas such as malls and offices. There should be no smoking while walking.

These measures are not magic bullets. They do not work in isolation. They are not cure-alls. They must work together with existing anti-smoking initiatives to work.

The Control of Smoking Products for Public Health Act now makes it possible to introduce regulations such as plain packaging, point-of-sale display bans, restrictions on e-cigarette flavours and other measures to help prevent and control nicotine addiction and reduce underage smoking and vaping. It will finally regulate nicotine vape and e-cigarettes.

Azrul Mohd Khalib is the chief executive of the Galen Centre for Health and Social Policy.

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

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