By Karen Bong
KUCHING, April 25: Regulating and controlling vape or e-cigarette products in Malaysia offers smokers a safer alternative compared to blanket prohibition, which experts warn could backfire by driving users toward cheaper, more harmful illicit cigarettes while allowing the black market to flourish.
Speaking at Sarawak’s Illicit Trade: Drivers, Risks & the Cost of Prohibition Dialogue organised by DayakDaily held at a hotel here on Saturday (April 25), Public Health Specialist at Universiti Kebangsaan Malaysia Medical Centre, Professor Dr Sharifa Ezat Wan Puteh, and criminologist Dr P. Sundramoorthy of Universiti Sains Malaysia underscored the need for a balanced, evidence-based approach, especially one that prioritises harm reduction, public health, and realistic enforcement.
Understanding the real health risks
Dr Sharifa stressed that addiction, whether to drugs or tobacco, is already a significant issue in Malaysia, but misconceptions persist about what makes smoking harmful.
“Tobacco leaves are natural, but cigarettes are not. When tobacco is processed into cigarettes, it is mixed with thousands of chemicals, between 4,000 to 8,000. It is the burning of these chemicals that produces carcinogenic smoke, which damages the lungs and causes cancer. So cigarettes clearly cause health problems,” she explained.
She clarified that nicotine, often blamed as the main culprit, is not the primary cause of cancer. Instead, it is the combustion of tobacco and inhalation of toxic smoke that leads to serious health conditions, including lung cancer, cardiovascular disease, and chronic respiratory illnesses.
“Burning is one of the main dangers. It’s similar to food, like satay or kebab, if parts are charred black, we should avoid eating them. That burnt portion (charcoal) is harmful,” she said.
Malaysia records around 2,500 lung cancer cases annually, with smoking contributing significantly to non-communicable diseases such as hypertension, diabetes, stroke, and heart disease.
“Studies show that smoking is a major contributor to disease, up to 86 per cent of non-communicable diseases are linked to smoking. This alone shows how dangerous it is,” she added.
Harm reduction: A practical public health strategy
Rather than adopting an outright prohibition, Dr Sharifa advocated for a harm reduction approach by helping smokers transition away from combustible cigarettes to less harmful alternatives.
Countries such as the United Kingdom, Japan, and Sweden have implemented such strategies. In the UK, smokers are encouraged to switch to regulated e-cigarettes. Japan promotes heated tobacco and smoke-free products like IQOS, while Sweden has seen success with snus and nicotine pouches.
“These alternatives do not involve combustion, which significantly reduces exposure to harmful chemicals,” she said.
However, she noted cost remains a barrier for some alternatives.
“In Japan, such products are widely used because people can afford them. However, they are expensive, so not many Malaysians use them. In contrast, vaping is relatively cheaper,” she said.
Scientific studies, including systematic reviews conducted in 2022 and 2025, have shown that e-cigarettes can be more effective than traditional nicotine replacement therapy (NRT) methods, such as patches and gum, in helping smokers quit.
“This is because vaping mimics the act of smoking, the hand-to-mouth movement and smiliar sensation, which makes it easier for users to transition,” she added.
While Malaysia offers smoking cessation clinics, she noted their effectiveness can be limited as some users discontinue follow-ups or are dissatisfied with NRT options.
“Sometimes they have to buy these products themselves, and often they don’t because it is cheaper to buy vape or e-cigarette products instead. If a ban is implemented, what alternatives will smokers turn to?” she asked, noting many youths are already using e-cigarettes as a way to quit smoking.
Malaysia’s regulatory gap: A growing concern
However, Dr Sharifa warned that Malaysia’s regulatory framework for vape products remains inadequate compared to developed countries.
“In countries with strict regulations, vape liquids are lab-tested to ensure they are free from harmful substances like diacetyl or drugs. In Malaysia, many products, especially those sold online or at night markets, are not tested at all. They do not undergo laboratory testing, and there are no toxicology or safety reports,” she emphasised.
Unregulated vape products may contain dangerous substances, including drugs such as mushroom extracts and more recently fentanyl, which is far more potent than morphine and can be rapidly absorbed into the bloodstream through inhalation.
“When substances are mixed in, users may experience effects like intoxication or hallucinations.
“This is where the real danger lies, not in regulated products, but in illicit ones where we don’t know what users are inhaling,” she stressed.
She added that many illicit vape products do not clearly label nicotine concentrations, raising further risks including fatality, especially at high doses. Many are also supplied through unregulated channels.
The risk of prohibition and ban: Turning to illicit markets
Both experts cautioned that banning vape or e-cigarette products outright could have unintended consequences.
“If we prohibit vape or e-cigarette, people will not simply stop. They may return to smoking illicit cigarettes, which are cheaper and potentially more harmful due to lack of quality control,” Dr Sharifa added.
Illicit cigarettes in Malaysia can cost as little as RM3 to RM5 per pack, compared to over RM18 for legal products. These illegal alternatives often lack filters, contain unknown levels of nicotine, and may include unregulated or contaminated materials.
“Even if authorities try to ban or restrict methods, those addicted will still seek them. When they can’t afford legal cigarettes, they turn to illicit ones because they are cheaper and easily available,” she added.
Her research at Universiti Kebangsaan Malaysia found that illicit cigarettes are, in fact, more harmful than legally manufactured ones due to the absence of quality assurance.
“In Malaysia, we may need a different strategy, such as promoting safer alternatives. Personally, I consider ‘safer cigarettes’ to be e-cigarettes, but they must be legal. With illicit products, we don’t know what’s inside,” she said.
Crime, enforcement and limits of prohibition
From a criminological perspective, Dr Sundramoorthy reinforced the argument that prohibition is ineffective and often counterproductive.
“Malaysia loses around RM5 billion annually in tax revenue due to illicit tobacco trade, and at the same time spends another RM5 billion on enforcement. Yet about 60 per cent of the market consists of untaxed products,” he shared.
He pointed out that enforcement agencies, including police, customs, and immigration, operate with limited resources, making it unrealistic to expect complete eradication of illicit trade.
“Smuggling happens across land and sea. You cannot police everything. This creates a major challenge,” he said.
Prohibition fuels the black market
Sundramoorthy warned that banning vape or e-cigarette products would likely expand the underground market and criminalise ordinary users.
“When you prohibit something, it doesn’t disappear, it goes underground. You create more criminals unncessarily and encourage corruption,” he said.
He cited examples such as the continued availability of illegal 4D gambling in states where it has been banned, as well as the persistence of illicit cigarettes despite existing restrictions.
“Do you think states like Kelantan, Terengganu or Kedah no longer have 4D? From my observation, illegal 4D is still easily available,” he said.
“Do you think people in Singapore don’t vape just because it is banned? Prohibition often makes things worse, not better.”
Dr Sharifa agreed, noting that despite Singapore’s strict ban, illicit products continue to circulate.
“Where do they come from? Possibly through transit routes like Malaysia. Does this solve the problem? I don’t think so,” she said.
Sundramoorthy pointed out that a lack of clear understanding and facts about illicit tobacco trade and the prohibition of vape will only allow the black market to grow.
“Prohibition will fail, and we are likely to fail if we attempt to ban e-cigarettes and vaping,” he added.
Human behaviour and policy reality
Sundramoorthy stressed that policymaking must reflect real human behaviour.
“You cannot impose blanket prohibition and expect compliance. Even censorship doesn’t stop people, it often increases curiosity and demand,” he said.
He cautioned against overly punitive approaches, noting that harsh measures could lead to unnecessary criminalisation without addressing the root causes of behaviour.
“There are people who want harsh punishments like death for mat rempit, or to imprison them. Do we really want to label so many Malaysians as criminals because of such behaviours? Is that practical? This is why it is important to understand the broader philosophy of crime and punishment,” he said.
“Harsh measures often backfire. We must carefully consider the consequences before acting,” he added.
The case for regulation and stronger enforcement
Both experts agreed that the solution lies in regulation, not prohibition.
“Regulation and control are more effective approaches, especially since illicit products are already widely available. We cannot ignore that reality,” Sundramoorthy said.
He also highlighted inconsistent enforcement, noting that banned practices such as the sale of loose cigarettes still persist in some areas.
“For years, loose cigarettes have not been allowed to be sold. Yet even in places like Penang, they are still available in certain areas. Not only that, even young children from nearby neighbourhoods can go to these shops and buy them.
“Enforcement must be strengthened, whether it is customs, the police, or domestic trade authorities. All of them have a role to play,” he said.
Dr Sharifa echoed this, highlighting the importance of ensuring vape or e-cigarette products are tested, labelled, and sold through legitimate channels.
“The cost of treating smoking-related diseases, along with healthcare interventions and enforcement, runs into hundreds of millions of ringgit.
“The best approach is to discourage smoking, but since quitting is difficult, we should allow smokers to transition to safer alternatives while helping them quit. This is harm reduction,” she said.
A balanced path forward
Ultimately, the speakers called for a pragmatic approach that balances public health goals with enforcement realities.
For smokers, the best option remains quitting entirely, with support from smoking cessation clinics and nicotine replacement therapies. However, for those unable to quit, safer, regulated alternatives may play a role in reducing harm.
“If you don’t smoke, don’t start. If you smoke, try to quit. But if quitting is not possible, we need safer options, not unregulated or illicit products,” Dr Sharifa stressed.
As Malaysia grapples with rising illicit trade and evolving nicotine consumption patterns, the message from experts is clear: prohibition alone is unlikely to succeed. Instead, a well-regulated, evidence-based framework may offer a more effective path toward safeguarding public health while curbing illegal markets. — DayakDaily
