Executive Summary
Vaping has emerged as a growing public health and security crisis in Malaysia. Once promoted as a safer alternative to smoking, vaping is now strongly linked to nicotine addiction, youth uptake, serious health harms, and even drug abuse. The enforcement of the Akta Kawalan Produk Merokok Demi Kesihatan Awam 2024 (Act 852), effective 1 October 2024, is a positive step but its implementation has proven difficult. The Ministry of Health (MOH) is now burdened with too many roles including policymaking, regulation, licensing, monitoring, and enforcement. With limited resources, MOH cannot manage this growing threat effectively. An immediate ban on all vape products is necessary. In the longer term, stronger measures must be taken to restrict cigarette use and move toward a smoke-free future.
Key Issues
1. Act 852 is difficult to implement
Act 852 requires comprehensive regulation of vape products, including licensing of all retailers, monitoring of product contents and marketing, control of online and physical sales, and enforcement of advertisement bans. MOH is expected to take full responsibility for these tasks while also managing other core public health functions. This regulatory and enforcement burden is unrealistic and unsustainable.
2. Vaping is not harm reduction
Peer-reviewed research in BMJ Open (2023) involving ASEAN tobacco control experts confirms that nicotine vaping products are not viewed as effective cessation tools and are instead considered a public health threat. Most adult vapers in Malaysia (75%) are dual users who continue smoking cigarettes, thus undermining the notion of risk reduction.
3. Vaping causes serious health harms
Published studies report that Malaysian vape users commonly experience dry mouth, cough, headaches, and dizziness. More severe outcomes include EVALI (e-cigarette or vaping product use-associated lung injury), which has been documented in Malaysia. Each case costs an estimated RM150,000 to treat, with a projected national healthcare burden of RM368 million annually by 2030 if left unregulated.
4. Estimated cost burden for Malaysia
With over 1 million adult daily users in Malaysia (based on 5.4% prevalence), even a 0.1% complication rate requiring hospitalisation would result in 1,000 EVALI cases annually. At RM150,000 per case, this would translate to RM150 million in direct inpatient costs alone, not accounting for outpatient care, productivity loss, or future chronic disease management. Meanwhile, vape tax revenue of RM500 million per year is unlikely to cover the rising health and enforcement costs.
5. Vaping as a vehicle for drug abuse
An increasingly alarming trend in Malaysia involves the misuse of vape devices as covert drug delivery tools. Law enforcement and the National Anti-Drugs Agency (AADK) have reported seizures of vape devices containing methamphetamine, ketamine, THC oil, and synthetic cannabinoids. These substances are often inhaled using modified pods or liquids indistinguishable from regular vape products. Students and youths are particularly vulnerable due to the discreet nature of vape use, making enforcement nearly impossible under current regulations. This trend represents both a public health emergency and a national drug control challenge.
Policy Recommendations
1. Ban all vape products immediately
Enact a full ban on the manufacture, import, sale, promotion, and possession of all vape devices and liquids. Strengthen controls on online and cross-border purchases. Declare a national public health and security emergency linked to youth vaping and drug misuse.
2. Reduce the burden on MOH
MOH should focus on public health policy, surveillance, and prevention. Licensing, inspections, and enforcement functions should be delegated to other agencies, including municipal councils and the Ministry of Domestic Trade. MOH resources should be redirected toward cessation programmes and school-based health promotion.
3. Begin long-term restrictions on cigarette sales
Malaysia should adopt a structured roadmap toward a cigarette-free society. Immediate steps include increased tobacco taxation, plain packaging, limiting retail outlets, and expanding access to evidence-based cessation support. Stronger action is also needed against illicit tobacco trade.
References
Gravely, S., Yong, H. H., Reid, J. L., et al. (2022). The prevalence of e-cigarette use in Malaysia: Findings from the 2020 ITC Malaysia Survey. Tobacco Induced Diseases, 20(42). https://doi.org/10.18332/tid/146917 Wong, L. P., Alias, H., Aghamohammadi, N., et al. (2023). Self-reported side effects, dependence, and behaviour in e-cigarette users in Malaysia. Substance Abuse Treatment, Prevention, and Policy, 18(1). https://doi.org/10.1186/s13011-023-00558-7 Hamilton, W. L., et al. (2022). E-cigarette markets and policy responses in Southeast Asia: A scoping review. International Journal of Health Policy and Management, 11(10), 2236–2246. https://doi.org/10.34172/ijhpm.2021.104 De Guia, M. C., et al. (2023). Implications of nicotine vaping products for tobacco control in ASEAN LMICs: In-depth interviews with experts. BMJ Open, 13(9): e073106. https://doi.org/10.1136/bmjopen-2023-073106 Ibrahim, N., et al. (2023). Emerging trends in drug delivery through vaping devices. Frontiers in Public Health, 11:1198763. https://doi.org/10.3389/fpubh.2023.1198763 United Nations Office on Drugs and Crime (UNODC). (2021). Synthetic Drugs and Novel Psychoactive Substances: A Global Threat. https://www.unodc.org Ministry of Health Malaysia. (2024). Cost estimation for EVALI treatment and projections. MOH official communications reported in multiple government briefings.