WARSAW: The Malaysian government needs to improve enforcement against smuggled low-quality tobacco products and institute regulatory and quality control on vape products.
In many Low-and-Middle Income Countries (LMICs), authorities have so far failed to stamp out illicit cigarettes and Malaysia faces similar issues with illicit cigarettes which are rampant.
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The authorities seem rightfully keen to ban vape products due to the black market mixing vape liquid with drugs etc.
Importance of controlling tobacco and mitigating its harm through alternative methods was mentioned at the opening day of the 12th Global Forum on Nicotine (GFN) 2025 in a workshop on “Low-and-Middle Income Countries: Communicating the Scientific Rationale of Tobacco Harm Reduction” participated by a panel of experts that included Prof. Dr Sharifa Ezat Wan Puteh.
Dr Sharifa is the Chairman of Malaysian Society for Harm Reduction. She is also a Professor in Health Economics, Hospital & Health Management in the Department of Public Health Medicine, Faculty of Medicine and Dean of School of Liberal Science of Universiti Kebangsaan Malaysia, the National University of Malaysia.
They noted that the poorer segment of society in these LMIC countries use these low-quality tobacco products and unregulated vape products affecting their health, and as cigarette prices hike, users tend to spend less on healthcare or nutritious food, further aggravating their health, as governments are keen to impose tobacco taxes.
Consumers, particularly those in the B40 category with limited financial resources, are drawn to cheaper and widely available illegal tobacco products. Governments should adopt tiered taxation based on product risk - lower taxes on smoke free products such as heated tobacco products (HTP) and vapes (regulated ones) vs. cigarettes.
There was a conservative estimate of about 4.8 million adult male Malaysians who currently smoke. The audience heard that in any plan to get people to stop smoking, smoke-free products (SFPs) like vaping are an ally. So are heated tobacco products, snus and tobacco pouches.
In fact, using an alternative non-combustible tobacco (no pyrolysis) product is a key ally, if not the most important one. It may sound peculiar because smoking and using an alternative non-combustible tobacco product or a smoke-free product are often seen in the same light, but science tells us otherwise.
There is a lot of evidence —including two Cochrane reviews and updates in Version 1.2025 of the U.S. National Comprehensive Cancer Network (NCCN) Guidelines for Smoking Cessation from Version 2.2024 that keep growing — which shows how using an alternative non-combustible tobacco product is not only less harmful than cigarettes, but also effective in assisting people to kick the smoking habit.
In May, the NCCN updated their guidelines on smoking cessation recognizing e-cigarettes, heated tobacco products, snus and nicotine pouches as less harmful compared to continuing smoking tobacco, and also highlighting how these products can help smokers move away from cigarettes.
More effective even than Nicotine Replacement Therapy (NRT) products like nicotine patches, gum, or medication marketed by the pharmaceutical industry. In a 2022 UK research report that summarises the evidence on e-cigarettes are at least 95 per cent less harmful than smoking.
The report, originally commissioned by Public Health England (PHE) and now the Office for Health Improvement and Disparities (OHID) in the Department of Health and Social Care, stands behind the belief that regulated e-cigarettes pose only a small fraction of the risks of cigarette smoking.
Contrary to popular perception, vaping is not equivalent to smoking. Scientific evidence overwhelmingly supports its role as a harm reduction tool. Studies also show vaping is more effective than nicotine patches or gum in helping smokers quit. Despite this, outdated stigmas persist. Governments must base policies on science, not sentiment.
“Governments need to accomplish its goal of smoking cessation by looking at new evidence, with good enforcement and not allow unregulated vape adulterated with drugs into the market.
“Our policies must rely on science and data, as scientific facts and data are all around us,” the President of the Malaysian Harm Reduction Society, Prof. Dr Sharifa said in an interview with Daily Express on her thoughts on the Control of Smoking Products for Public Health Act 2024 (Act 852) which is Malaysia’s tobacco and vape control Act which she said is a positive breakthrough.
Interestingly, vaping has been the cornerstone theme of New Zealand’s ‘QuitStrong’ campaign, and is offered as a key support mechanism to help people quit smoking.
“We can improve product policing and enforcement. A lot of illicit markets come from abroad or sellers are mixing their own vape liquid, back door industry mixing it with drugs such as opioid and fentanyl and pushing them among youths in this country for easy profit. Vapes should not be sold to youths or people less than 18 years old.
“Please don’t say I advocate vaping, as vaping is not harmless. It was never meant for youths and nicotine naive lungs. It is ‘responsible vaping’ by adults that are heavily addicted to cigarettes as an alternative to tobacco.
“If rightfully adopted, medically prescribed vaping (as in Australia) is good because it is controlled by doctors, who can prescribe safe alternatives such as HTP, or e-cigarettes to recalcitrant smokers that cannot quit using the traditional method.
“If they were to buy from shops, there is no guarantee that the vape products are safe as the government has difficulty regulating the industry.
“In other developed countries; the vape liquid has to go through a lab testing for content security, toxicology and also quality control. But in Malaysia, no.
“So many, many vape liquids are not tested and are potentially not labelled properly on dose and content, risking it being mixed with drugs or other adulterants like Vitamin E Acetate (VEA) or Diacetyl. Diacetyl is the material that causes pop-corn lung which is also present in tobacco cigarettes with 10 times more in strength compared to in vape liquids.
“Vape is dangerous if the government does not control it. The government must regulate so the quality of vape sold are of sound quality,” she said, noting that information on tobacco harm reduction should not only be informative, but should also be disseminated in a responsible manner. The low-income and disadvantaged groups are at the highest risk of illicit combustible tobacco in Malaysia.
Malaysia’s nicotine makeup consists of consumers using 23.8 per cent legal cigarettes, 29.9 per cent illicit cigarettes, 25.3 per cent e-cigarettes/vapes/HTPs, and 20.4 per cent of users who use both traditional and alternative products.
According to the latest Illicit Cigarettes Study, the incidence of illicit cigarettes in Malaysia declined from 56.6 per cent in 2023 to 54.8 per cent in May 2024. Up to 80 per cent of cigarettes sold in East Malaysia remain illicit despite a steady decline in the trade nationwide since 2020, according to a study.
Geographical factors, a lack of manpower in enforcement agencies, and the relatively low-price points of illicit smokes made it harder to combat the trade of illicit cigarettes in Sabah and Sarawak.
Illicit trade is much harder to control in East Malaysia than in Peninsular Malaysia because of its multiple border entry points connecting neighbouring countries.
West Malaysia still had a higher volume of cigarette sales due to its larger population, but illicit smokes only made up 55 per cent of cigarettes in the peninsula.
The incidence of illicit cigarettes declined to 55 per cent in 2024 after peaking at 63.8 per cent in 2020, as more nicotine consumers migrated to vaping.
To combat the rampant illegal cigarette trade, it is important to effectively regulate border customs and eliminate corruption.
The majority of illicit cigarettes enter Malaysia through neighbouring borders such as the Philippines, Thailand and Indonesia.
Strengthening customs enforcement and adopting new technologies to tackle smuggling are essential steps in curbing this issue.
Besides enforcement efforts, harm reduction strategies were highlighted as a potential approach to combating the illicit tobacco trade.
There is an urgent need for less stringent regulations on smoke-free products (SFPs) and other less harmful alternatives.
Recognizing the need for a comprehensive tobacco harm reduction program, it was suggested legalizing vaping as a Nicotine Replacement Therapy (NRT) tool to provide smokers with safer alternatives.
By investing in research and development, Malaysia can foster innovation and encourage scientists and entrepreneurs to explore novel solutions that mitigate risks associated with certain products.
As Malaysia continues its battle against the illegal cigarette trade, addressing these key factors and implementing necessary measures will be vital in protecting public health, reducing revenue losses, and creating a safer environment for all citizens.
Malaysia must combat illicit tobacco and vapes through enforcement and science-backed harm reduction. By embracing responsible and medical vaping and heated tobacco products as an alternative or cessation aid to smoking, besides tightening border controls against smuggling, the government can protect public health, recover lost revenue, and offer smokers safer alternatives.
