Increase in vaping and e-cigarette use by children in Malaysia

In Malaysia, the Consumers Association of Penang (CAP) has urged the government’s Department of Health to immediately ban all vaping devices and e-cigarettes (also known as electronic nicotine delivery systems) to prevent large numbers of children from becoming nicotine-addicted.
According to WHO data, e-cigarettes contain nicotine and other toxic materials that are harmful to both users and non-users exposed to the second-hand aerosols. Nicotine is an extremely addictive substance and there is evidence that never-smoking minors who use ENDS are twice as likely to smoke tobacco cigarettes later in life.

According to a study by CAP, Malaysian children can easily buy cheap vapes and e-cigarettes because sellers don’t ask buyers their age. Children 8 years and older (who have previously smoked cigarettes) can purchase vaping devices. Groups of children could share prices on vaping devices and e-cigarettes.

Mohideen Abdul Kader (CAP, Penang, Malaysia) said in a letter that although electronic nicotine delivery systems only became commercially available in Malaysia in early 2015, the number of people using these products in the country has increased from 600,000 in 2016 1.2 million in 2019. From 2015 to 2020, about 30 cases of vaping-related poisoning were reported by the National Poison Center (Universiti Sains Malaysia, George Town, Malaysia), most among children aged 1–4 years, who are particularly affected Danger to life after ingestion of e-cigarette liquid.
In Malaysia, the incidence of childhood cancer is nearly 77.4 per million in children under the age of 15. Several studies suggest an increased risk of cancer associated with e-cigarette use. A study published in February 2022 suggests that people who use e-cigarettes are at a higher risk of cancer than non-smokers. There is also evidence that men and women in the US aged 18 and older who have used e-cigarettes in the past have an increased risk of developing bladder and lung cancer compared to people who have never smoked. Preclinical studies in mice exposed to EC smoke showed that these animals developed lung adenocarcinoma and bladder urothelial hyperplasia.

Moon-shong Tang (New York University School of Medicine, New York, NY, USA) commented that “regardless of age, e-cigarette users have a higher risk of cancer than non-users”. To control childhood cancer, Malaysia should[ban] Selling e-cigarettes to minors,” he said The Lancet Oncology.

Boris Mravec (Comenius University, Bratislava, Slovakia) tells The Lancet Oncology, “Children’s use of nicotine-containing e-cigarettes may have an additional adverse effect in addition to an adverse effect on brain development; In particular, it can stimulate the development and progression of cancer. It is known that inhaled nicotine has a stimulating effect on the sympathoadrenal system, while noradrenaline and adrenaline released by sympathetic nerve endings and the medulla of the adrenal glands affect almost all processes associated with tumorigenesis, tumor growth and the development of metastases related.”

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However, Sharifa Ezat Wan Puteh (National University of Malaysia, Kuala Lumpur, Malaysia) commented: “[at] At the moment, the literature mentions that the risk of vaping (quality vape juice, not adulterated) is almost negligible. We need long-term data on vaping and clinical trials under real-world conditions,” she said The Lancet Oncology. Referring to childhood cancer, she added: “A better idea would be to provide better screening and access to early treatment. This requires financial and human resources [developments] which are stretched in low- and middle-income countries. Likewise, in Malaysia, we need better screening and access to better care, especially for the [people with] low incomes and living in rural areas.”

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According to Subbarow, more than 20 countries, mostly in South America, Southeast Asia and the Middle East, have banned the sale of e-cigarette products, and other countries including Australia, Norway and Canada have introduced restrictions.

A child's hand with an electronic cigarette.  Tobacco heating system in hand.  problems of child smoking.
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