Vaping data on the way

AFTER more than a year of uncertainty, local experts are finally shedding some light on the country’s hazy e-cigarette and vape industry.

Two national studies on their use among adults and adolescents are listed on the Health Ministry’s (MoH) Institute for Public Health portal’s list of 2016 projects.

The findings of the “Tobacco and E-cigarette Survey among Malaysian Adolescents” and “Prevalence and Pattern of E-cigarette and Vape Use among Malaysian Adults” are expected to be released before laws to regulate the vaping industry are tabled in Parliament.

In May, Health Minister Datuk Seri Dr S. Subramaniam announced that the laws involving all aspects of vaping and its products and accessories as well as distribution will be ready before the end of this year. The ministry defines e-cigs as those containing nicotine and vape as those without nicotine. The MoH currently regulates e-liquids with nicotine under the Poisons Act 1952.

Another recently completed study is by Assoc Prof Dr Mohamad Haniki Nik Mohamed, who is a member of the MoH’s technical committee tasked with looking into the health effects of e-cigs and shisha smoking; he is also the International Islamic University’s deputy dean of academic affairs.

Dr Mohamad Haniki is behind several recent studies on e-cigs and vaping here – including research into the safety and effectiveness of using electronic cigarettes for smoking cessation.

The study on e-cig use among adults in Kuantan and Pekan, Pahang, will be published soon, he shares. Conducted with his doctorate student, the one-year follow-up study looks at the safety and effectiveness of e-cigs for quitting tobacco smoking, and whether users eventually become nicotine-free or continue using e-cigs and vape.

“E-cig proponents – especially those from Britain – say it’s used to help tobacco smokers quit but is that happening here?

We don’t have clear guidelines on how to include e-cigs or vape into tobacco cessation intervention so there’s an urgent need for a study on safety and efficacy,” he says in a recent interview, adding that the study also found that the nicotine content of the e-liquids analysed didn’t match what was on the labels.

Quality data is crucial in helping regulators devise a policy that truly benefits the rakyat, he believes. But it takes time, he says, to do rigorous research and to ensure that the scientific process has merit. There are many stages and approval processes involved, including ethical and board clearance and institutional reviews.

“Anyone can do a quick telephone or Internet survey. But when you see the respondents face-to-face, you can better verify the information given. For example, if the husband says he doesn’t smoke or vape, you can check with the wife who may then reveal that he actually vapes.”

Until there’s evidence of the long-term benefits and safety of e-cigs and vaping, his recommendation to smokers who want to quit is to consider approved medications that have undergone rigorous clinical trials.

The pharmacist by training dis­agrees with regulating e-cigs as a consumer product because nicotine is an addictive poison.

“There are other chemicals in the e-liquids that may also have a negative impact on the lungs because of direct inhalation,” he points out, citing “popcorn lungs”, or bronchiolitis obliterans, when scarring in tiny air sacs in the lungs lead to excessive coughing and shortness of breath, could result. The condition is linked to the chemical diacetyl, which can be found in fruit and alcohol flavourings used in e-liquids.

Dismissing the pro-vaping argument that e-cigs are as harmless as steam from a hot shower, Dr Mohamad Haniki says that while food grade flavouring agents used in e-liquids are safe to be consumed, they aren’t meant to be vaporised. Vaporising them alters their chemical characteristics, thus making them potentially unsafe.

“Smoking is a chronic, relapsing addiction. You cannot simply make claims about its cure. In our Creator we trust, for all else we need data.”