By Lian Cheng
SOME countries are witnessing significant shifts in smoking habits, with the rise of alternative nicotine products, such as vaping and heated tobacco products (HTPs), playing an important role in reducing smoking rates.
New Zealand, for instance, is on track to achieve its ambitious goal of reducing daily smoking to five per cent by 2025, largely due to the increasing popularity of vaping. In contrast, the United States has seen the smoking rates in youth plummeting, yet public debate over vaping remains highly contentious.
Malaysia, on the other hand, has taken a regulated approach to vaping, legalising it and imposing excise duties to control its use and address concerns about the rising consumption in youth. However, this strategy has not been without criticism and scepticism.
These involving trends highlight both the progress being made in nicotine harm reduction and the regulatory challenges that accompany the adoption of new technologies.
New Zealand: Vaping to a smoke-free nation
With a vision to reduce daily smoking to five per cent by 2025, New Zealand has made significant strides towards becoming a smoke-free nation. The country now boasts one of the world’s most rapidly declining smoking rates.
Highlighting this progress, Ben Youdan, director of ASH (Action on Smoking and Health) New Zealand, noted that the decline in smoking has coincided with a marked rise in vaping. He attributed this to the availability of viable alternatives to traditional cigarettes.
“Disruptor, disaster, or distraction? Vaping and smokefree New Zealand” during the E-Cigarette Summit: Science, Regulation and Public Health held at the Royal College of Physicians in London on December 5, 2024, Youdan shared findings that showed the most dramatic decrease in smoking rates occurred among Maori women, whose daily smoking numbers have almost halved in just five years.
“I don’t think I’ve ever seen such a rapid rate of decline in smoking for any population group anywhere in the world,” said Youdan, who further revealed that 27 per cent of New Zealanders now live in smoke-free neighbourhoods—defined as areas with under five per cent smoking rates—compared to just three per cent five years ago.
To him, the correlation between increased vaping and reduced smoking is too significant to ignore, prompting him to question why such positive news had not been celebrated or widely publicised on a global scale.
He attributed this lack of recognition to political disruptions, the rise in youth vaping, and harm reduction policies being dismissed as tobacco industry conspiracies.
On whether New Zealand could achieve its Smoke-Free 2025, Youdan expressed optimism, but emphasised the need for policymakers to “behave themselves”.
“We can, if we behave ourselves… (but if we) focus on ideological differences rather than public good, we risk sabotaging ourselves,” said Youdan, before calling on the authorities to prioritise what truly matters—saving lives.
It’s vaping over smoking for US high school students
From the Land of Long White Cloud to the other side of the Pacific Ocean, Professor Kenneth Warner, Avedis Donabedian Distinguished University Professor Emeritus and Dean Emeritus from the School of Public Health, University of Michigan, raised a provocative question— “US kids no longer smoke. Why aren’t we celebrating?”, a question that became the central theme of his presentation.
Warner said that in the US, youth smoking had almost disappeared, with daily smoking among high school seniors dropping from 25 per cent to just 0.7 per cent. Yet, like Youdan, he expressed dismay that such remarkable public health achievement has gone unnoticed and uncelebrated.
“This is the smoke-free generation, but no one has paid any attention to it,” Warner remarked.
However, Warner pointed out that a deeper issue lies at the heart of the lack of recognition: an overarching concern about tobacco and nicotine use in any form. The widespread misconception that smokeless tobacco is as harmful as combustibles remain pervasive.
What’s worse, Warner noted, is that most Americans, including medical professionals, still believe that nicotine itself is the primary cause of smoking-related diseases. This misunderstanding, he argued, continues to overshadow one of the greatest public health successes of our time.
“Then there’s the special case of e-cigarettes. Originally there was a fear of renormalising smoking, but the opposite has happened.
“However, parents, teachers and others are still worried about the dangers of vaping, especially as vaping has been taken up by more wealthy, educated white students,” said Warner.
Amid the great success on one hand and the persistent scepticism on the other, Warner is not without his concern.
“We’ve won a major battle against combustion, but smoking could come back.”
Despite this, Warner predicted that the current generation would experience significantly lower levels of illness and death, including cancer, heart disease, and COPD (chronic obstructive pulmonary disease). Smoking, he concluded, remains a problem mostly for the adults, especially for disadvantaged groups.
Legalizing vaping in Malaysia
In Malaysia, vaping has evolved from being an alternative to smoking cigarettes to becoming a lifestyle accessory, especially popular among the youth.
While scientific research supports vaping as an effective tool for replacing cigarette smoking, public perception has turned increasingly negative due to a sharp rise in youth vaping. This surge has sparked widespread cynicism and concern towards e-cigarettes.
Despite the prevailing doubts, the Malaysian government, which is committed to Tobacco Endgame policies, opted for regulation over prohibition. Effective April 2023, an excise duty was imposed on vape liquids, with the revenues directed to the Ministry of Health (MOH).
The reasoning was pragmatic, and while vaping was previously illegal, it remained widespread. Taxation and regulation were deemed more practical and enforceable than an outright ban, given that vapes would still be easily accessible regardless of their legal status.
The shift in policy was made possible by removing liquid nicotine from the Poisons Act 1952 on March 31, 2023, enabling the taxation and legalisation of nicotine vapes and e-cigarettes.
Building on this development, the Control of Smoking Products for Public Health Act 2024 (Act 852) was enacted on October 1, 2024, introducing comprehensive restrictions on the sale and display of vaping and tobacco products.
Under the new regulations, retail displays of tobacco and vaping products are prohibited, except in specialised, licensed stores. This restriction, set to take full effect by April 1, 2025, also extends to online sales and vending machines. Vendors are required to display clear signage, and the sale of these products to individuals under 18 is strictly forbidden.
The regulations mandate a minimum price of RM12 for packets of cigarettes, cigars, and other HTPs. Additionally, all tobacco and vape products are required to display health warning images and text as prescribed by law.
Under the new guidelines, all tobacco products must adhere to strict packaging and labelling standards outlined in the Control of Smoking Products for Public Health (Packaging and Labelling) Regulations 2024.
Violations of these regulations come with severe penalties. Individuals found guilty of non-compliance face fines of up to RM20,000 or a one-year prison sentence for the first offence, increasing to RM30,000 or two years’ imprisonment for repeat violations.
For corporations, the penalties are significantly higher. First offences can result in fines of RM20,000 to RM100,000 or imprisonment of up to two years. Subsequent violations carry fines ranging from RM50,000 to RM300,000, with potential imprisonment of up to three years.
Conclusion
As countries such as New Zealand and the US witness significant declines in smoking, largely driven by the adoption of vaping, the debate over the safety and regulation of these nicotine alternatives remains unresolved.
While vaping has proven to be an effective tool in reducing smoking rates, concerns regarding its impact on youth and its potential long-term health risks continue to fuel debate. New Zealand’s success in decreasing smoking rates stands as a powerful testament to the potential of harm reduction strategies. However, political and ideological barriers have impeded global recognition of these accomplishments. In the US, despite a dramatic decline in smoking among youth, scepticism surrounding vaping continues to overshadow these public health successes.
Meanwhile, Malaysia’s pragmatic approach to vaping regulation—by taxing and legalising it—illustrates the complexities of managing its widespread use. Moving forward, evidence-based policies and balanced regulation will be crucial to ensuring that the progress made in reducing smoking is not undermined, while safeguarding public health above ideological concerns.
The journey toward a smoke-free future requires ongoing innovation, thoughtful regulation, and a steadfast commitment to harm reduction, especially for vulnerable groups such as the youth. –DayakDaily
