Malaysia is facing an increasingly concerning pattern of nicotine consumption among adolescents.
The National Health and Morbidity Survey (NHMS) 2022 reported that current e-cigarette use among adolescents aged 13 to 17 increased from 9.8 per cent in 2017 to 14.9 per cent in 2022. Sabah was among the states with particularly high prevalence of adolescent e-cigarette use.
These figures represent more than statistical changes. They reflect young people who may be exposed to addiction during a critical period of physical, neurological, and psychological development.
Nicotine is a highly addictive substance. Adolescents are particularly vulnerable to nicotine dependence, and exposure during brain development can adversely affect attention, learning, mood, and impulse control.
The concern is not simply about the vaping device itself. It is about the addictive substance it delivers, the circumstances in which it is consumed, and the possibility that experimentation may develop into long-term dependence.
For health care professionals, prevention must always be preferable to treating the consequences of addiction.
The Regulatory Question Cannot Be Separated From Public Health
The reported endorsement by the Poisons Board comes at a particularly significant time.
In May 2026, the High Court nullified the 2023 exemption order that had removed liquid and gel nicotine used in vaping products from the Poisons List. The government subsequently withdrew its appeal against that judgement in August 2026.
On November 2, 2026, CodeBlue reported that the Poisons Board had endorsed a new
proposal to exempt liquid nicotine from the Poisons List. However, the endorsement itself does not constitute a gazetted exemption order.
These developments have understandably raised questions about the government’s broader policy direction.
Malaysia has previously indicated its intention to move towards a nationwide vaping ban. The proposed exemption therefore warrants a clear explanation of how it fits within the government’s stated public health objectives.
Regulation Alone May Not Be Enough
APPS recognises the importance of effective regulation, enforcement, and responsible governance.
The Control of Smoking Products for Public Health Act 2024 (Act 852) provides Malaysia with a legislative framework to control smoking products, including vaping products.
Nevertheless, legislation must be evaluated not merely by whether it regulates the market, but by whether it achieves meaningful public health outcomes.
If nicotine products remain widely accessible, attractive to young people and socially normalised, the challenge of preventing nicotine initiation will persist.
The experience of tobacco control demonstrates that reducing the burden of addiction requires more than regulatory compliance. It requires sustained prevention, public education, enforcement, cessation support, and a consistent commitment to reducing consumption.
The objective must not simply be to manage the nicotine market. It must be to reduce nicotine dependence in the population.
Commercial Considerations Must Not Override Health Protection
The regulation of nicotine products alsoi nvolves commercial interests, taxation, and industry considerations.
These are legitimate matters of public administration. However, they must not overshadow the fundamental responsibility of the Ministry of Health (MOH) to protect population health.
APPS believes that public confidence in health policy depends on transparency, consistency and the clear communication of scientific evidence.
The public deserves to understand why a particular regulatory decision is being taken, what evidence supports it, and how it will contribute to reducing nicotine-related harm.
Where significant policy changes are contemplated, the health implications for children, adolescents, non-users, and existing nicotine consumers must be carefully considered.
The long-term consequences of nicotine dependence cannot be adequately assessed through commercial or fiscal considerations alone.
What Should Malaysia Do?
As health care professionals, our responsibility extends beyond the treatment of disease. We have an obligation to prevent avoidable illness, advocate for healthier communities and protect those who are most vulnerable.
Nicotine addiction is not merely an individual behavioural concern. It has implications for families, educational attainment, mental well-being, long-term health and the sustainability of our health care system.
For Sabah, where adolescent vaping remains a significant concern, the need for decisive and consistent public health action is particularly important.
APPS believes that Malaysia must approach nicotine policy with a clear sense of responsibility and long-term vision.
Therefore, APPS respectfully calls upon the government and the MOH to consider the following priorities:
- Clarify Malaysia’s national vaping policy: The government should clearly explain whether its commitment to a nationwide vaping ban remains in place and how the proposed liquid nicotine exemption aligns with that objective.
- Prioritise the prevention of nicotine addiction among young people: Prevention programmes should be strengthened in schools, communities, and health care settings,
with particular attention to the growing vulnerability of adolescents. - Ensure transparency in regulatory decision-making: The scientific and public health rationale supporting the proposed exemption should be communicated clearly to healthcare professionals and the public.
- Strengthen enforcement of Act 852: Particular attention should be given to preventing sales to minors, illegal online sales, non-compliant products, and the misuse of vaping devices for substances other than nicotine.
- Expand evidence-based cessation services: Health care facilities, including private medical practices, should be supported in providing accessible counselling and treatment for individuals seeking to overcome nicotine dependence.
- Adopt a consistent long-term public health strategy: Malaysia should pursue a coherent strategy that prioritises the prevention of nicotine initiation, reduction of addiction, and protection of future generations.
The question before us is not simply whether liquid nicotine should be exempted from the Poisons List. It is whether our national nicotine policy is genuinely moving towards a healthier, addiction-free future for our children.
Our position is clear: protecting a generation from nicotine addiction must remain a national priority.
Malaysia must ensure that every regulatory decision concerning nicotine is guided by scientific evidence, public accountability, and the best interests of public health.
The health of our future generation must never become the price of regulatory compromise.
Dr Devadas Pathiyil Ramankutty is president of the Association of Private Practitioners Sabah (APPS).
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
