Although the Malaysian Health Ministry has promised a set of guidelines regarding the sale and distribution of e-cigarettes and vaping for almost a year now, no announcement regarding progress has been made.

Initial studies done by the Public Health England showed that vaping and e-cigarettes as an alternative to cigarettes, would reduce the bad effects of smoking on smokers' health. It stated that e-cigarettes were 95% safer compared to conventional cigarettes and that fewer people were smoking cigarettes due to the availability of these alternatives. Yet, recent studies done in the United States have proven otherwise.

Stay away from strawberry flavoured liquid nicotine

A recent study by the Roswell Park Cancer Institute in Buffalo, New York, has shown that strawberry flavoured liquid nicotine that is used for e-cigarettes, was the most toxic amongst other e-cigarette flavours - tobacco, pina colada, menthol and coffee.

The flavourings added to the liquid nicotine burned in the devices may influence how much the fumes lead to health problems such as inflammation and cell damage. The researchers tested the vapour released by the different flavoured nicotine, tobacco smoke and in smoke-free air on human lung cells in a dish.

As expected, actual cigarette smoke was more toxic than fumes from e-cigarettes, said senior study author Maciej Goniewicz, but e-cigarettes were more toxic than smoke-free air, especially when the devices which required higher power or voltage were coupled with flavoured liquid nicotine.

Cells exposed to e-cigarette vapour reacted similarly to cigarette smoke, but on a weaker scale- reduction of metabolic activity and increased output of inflammation-related chemicals were recorded.

Past research has also found that higher-voltage e-cigarettes are mainly used by individuals attempting to quit smoking as it produces a stronger nicotine jolt, but it may also increase levels of dangerous chemicals like formaldehyde.

Cinnamon-flavoured or sweet and fruity liquid nicotine not safe either

In a separate study, cinnamaldehyde that is used in cinnamon flavoured liquid nicotine was looked at. 39 refill cartridges of cinnamon flavoured and a variety of sweet and fruity concoctions of liquid nicotine were tested and 20 were found to contain high levels of cinnamaldehyde to damage cells.

Previously, the same group showed that cinnamaldehyde was extremely toxic when different types of in vitro cells were exposed to it.

"In the new study, we further showed that cinnamaldehyde is much more widely distributed in e-cigarette products than originally thought and it appears in many sweet and fruity flavours, which are among the most popular," said senior study author, Prue Talbot of the University of California, Riverside.

Which begs the question, when is the health ministry issuing a set of guidelines?

Malaysian government awaiting WHO decision?

Previously in May, Health Minister Datuk Seri Dr S. Subramaniam announced that laws to regulate the vaping industry will be ready before the end of the year. Coincidentally, this implies the time period right after the World Health Organisation (WHO) is set to make a decision in November - as public opinion is divided on the promotion, regulation and ban of these novel tobacco products.

The Malaysian laws will involve all aspects of vaping and its products and accessories as well as distribution.The European Union itself has issued regulations on e-cigarettes, compromising to ensure quality and safety for consumers.

What Malaysia has only done so far, is to take proactive steps to openly guarantee regulations instead of a total ban, after WHO recently published a report stating the potential benefits of e-cigarettes, vaping and other heat-not-burn products, and mentioned it as a "harm reduction" tool.

However, WHO shifts its stance every few years and if it changes its stance to ban e-cigarettes and vaping due to health effects, will Malaysia follow in suit?

With an estimate of five million smokers in the country at the moment, and with many looking for alternatives, perhaps the Malaysian government should hurry to set guidelines for regulations. MIMS

Read more:
The cool new toy in Malaysia: Study finds vaping improved health of smokers
Putrajaya warned for failing to comply with WHO framework convention on tobacco products
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