Why we need total ban on e-cigarettes

THE recent announcement by the government to regulate electronic cigarettes by three ministries (Health, Domestic Trade, Co-operatives and Consumerism and Science, Technology and Innovation) is indeed of interest to the Malaysian Association for Adolescent Heath.

The e-cigarette (otherwise known as vape) is a handheld electronic device that produces liquid flavoured vapours.

Concerns have arisen after the National E-cigarettes Survey 2016 reported that the majority of the e-cigarettes used, especially by adults, contained nicotine.

A national survey among school going adolescents from 10 to 19 years age found an alarming 9.1% students to be current e-cigarette users, with 40.9% vaping once a day and 33.9% doing it two to five times per day.

While some proponents of e-cigarettes suggest that it is useful for cessation of the smoking of tobacco cigarettes, others argue that they contain harmful ingredients which are dangerous for youth.

Important strides have been made over several decades in reducing conventional cigarette smoking among youth and young adults.

We must make sure this progress is not compromised by the initiation and use of new tobacco products, such as e-cigarettes. We have more to do to help protect Malaysians from the dangers of tobacco and nicotine, especially our youth.

The use of other nicotine products, including e-cigarettes is creating a new generation who are at risk of nicotine addiction and toxicity.

The 2015 American Academy of Paediatrics policy statement provided evidence on the effects of nicotine on the developing brain. Nicotine is highly addictive and is the primary psychoactive component causing addiction in tobacco products.

It has neurotoxic effects on the developing brain of an adolescent whose executive functions and neurocognitive processes have not fully matured.

Adolescents are more likely to engage in experimentation with substances such as cigarettes and they are also physiologically more vulnerable to addiction.

Particularly in adolescence, nicotine also has an effect on the brain as a “gateway” drug for cocaine and other illicit drugs. There have also been cases of unintentional exposure and toxicity to nicotine from e-cigarettes.

Nicotine is well absorbed from the respiratory tract, mucosal surfaces, skin, and intestines; thus, nicotine exposure can occur from inhaling, ingesting or coming in physical contact with a nicotine-containing solution.

There have been reported cases of nicotine exposure from e-cigarettes which led to hospitalization and even death.

In the United States on Jan 14, a six-year-old girl was reported to require emergency medical treatment after accidentally swallowing liquid nicotine intended for her parents’ electronic cigarettes.

The 2016 report of the United States Surgeon-General on e-cigarette use among youth and young adults reiterates the fact that e-cigarettes can expose users to other chemicals, including carbonyl compounds, and volatile organic compounds, known to have adverse health effects.

The health effects and potentially harmful doses of heated and aerosolised constituents of e-cigarette liquids, including solvents, flavourants and toxicants, are not completely understood. In simple terms, the e-cigarette aerosol is not harmless “water vapor” as claimed by some.

Apart from clean air, any non-approved product inhaled into the lungs is harmful to health.

Hence, to protect young people from initiating or continuing the use of e-cigarettes, a total ban is the mainstay strategy to be adopted by the Government.

The Health Ministry must continue to take aggressive steps to protect our youth from the harmful effects of using e-cigarettes by banning manufacturing, distribution and marketing of e-cigarettes.

The Malaysian Association of Adolescent Health congratulates the ministry for their tireless efforts on tobacco control towards the end-game and a smoke-free generation, and calls for similar actions for e-cigarettes. The health and well-being of our nation’s young people depend on the actions we decide to take today.

DR MYMOON ALIAS

President

Malaysian Association of Adolescent Health