00:00hello and good evening i'm melissa idris welcome to consider this this is the show where we want
00:15you to consider and then reconsider what you know of the news of the day after the collapse of the
00:21generational end game bill the geg malaysia is once again debating how to regulate nicotine
00:28products health minister dr zokifle ahma recently announced that malaysia is moving towards a
00:34nationwide ban of the sale and use of vapes by mid-2026 and that the government consultations
00:41are now underway on the legal economic and enforcement aspects of enforcing this ban now
00:48will this be another public health breakthrough towards a nicotine free malaysia or could it be
00:55another policy that may be may prove difficult to implement and enforce joining me on the show
01:03to discuss this further is dr noor amani ahmad tajuddin who is an associate professor in the
01:07department of primary care medicine at university malaysia's faculty of medicine she is also the
01:12deputy coordinator of um's nicotine addiction research and collaborating group dr amani it's
01:18good of you to join me on the show today so with the nationwide ban that's been announced that will
01:23take place or will happen by mid next year i'm just wondering whether um what are your thoughts are
01:30whether this kind of phased approach to implementing a ban is the right way to go what what do you think
01:36from a public health perspective is it the right method the right approach all right hi hi melissa
01:41thank you for um having me um well if you ask me because i'm from primary care medicine uh i am pro for
01:49health so i would say that it is the right approach um having this um vape ban um this faced a ban in
01:57malaysia that um we are seeing now um especially when we see that on the 1st of of october that you
02:05know um when there is a ban of point of sale so that is one of the initiative that is uh being taken by
02:13our ministry of health which uh must be applaud so i think the practicality of this faced approach
02:20it allows the regulators businesses and consumers to adapt rather than face sudden disruption for them
02:29and also making enforcement more realistic but in the perspective of public health priority the ban
02:36actually aligns with uh malaysia's tobacco and game strategy that we are moving towards 2040
02:41uh where the prevalence should be less than five percent of smokers in malaysia so what we are trying
02:46to do is to reduce the exposure to nicotine addiction particularly among youth and also children and also
02:54when we talk about youth protection we're trying to gradually remove um aggressive marketing towards
03:01teenagers and also prevent new generation uh from becoming nicotine dependent so that's uh my take on this
03:08um face back then can i ask you about vapes let's um zoom out a little bit and talk about um
03:16the narratives around vapes some people some quarters argue that vape is being used as a tool to quit
03:23smoking and then on the other side there are those who say well actually that narrative is is tobacco
03:29industry driven what does independent science actually say about this okay i think when we talk about
03:36independent science is um the evidence based based on studies done from researchers especially in the
03:44medical fraternity so if we look at a study done in 2013 actually so this was more than 10 years but
03:51it has been proven from 2013 this was a study done by prof chris bullen in new zealand where they had
03:58650 smokers who wanted to quit and they were divided into different groups there was three groups number one
04:05people using nicotine um e-cigarettes number two is nicotine patches and the third group was non-nicotine
04:12e-cigarettes so what um it shows here was that this e-cigarette whether it contains nicotine or non-nicotine
04:21is not more effective than these patches why is this because after six months the quit rates for all these
04:29groups were about the same only like seven percent out of 100 um quit with nicotine e-cigarettes only
04:37six out of 100 quit with nicotine patches and only four out of 100 quit with non-nicotine e-cigarettes i
04:43would like to highlight another um another important thing in this study is that they found that these um
04:51people who were the participants in this study they actually became dual user which means that um instead
04:58from switching from cigarette to um e-cigarette they were actually using both at the same time during
05:04this um study duration so um it doesn't help in people to quit um actually another study that looks
05:13into this is um a systematic review and meta-analysis which was published in 2016 in the lancet respiratory
05:20medicine so um it the the summary of this is that um people who use e-cigarettes were actually 28
05:28likely to successfully quit smoking a regular cigarette so this has been proven and there are
05:35so many many other studies to show that e-cigarette is not an effective tool to quit conventional cigarette
05:42okay then having said that then should we should governments treat cigarette vapes like cigarettes because
05:50if we think about cigarettes they're not banned they're still legal but just tightly regulated
05:55while vapes may be banned altogether so if we see cigarettes and vapes and e-cigarettes in the same
06:02category should we be treating them similarly with um vaping with strict controls um or do you think
06:08there is still a case for complete prohibition okay so the question here is uh why not and why can't we
06:16um have a complete prohibition um of e-cigarettes because we are seeing um um reports you know case reports
06:25cases when they are admitted to the hospital with um e-liquid uh being contaminated or manipulated with
06:35um illicit drugs so um talking about this when by by reading observing and analyzing the evidence you know
06:42um we should have we can have strict control on vape and also the vaping habit itself um if you ask me
06:51personally complete prohibition would be the way to go actually to save our young young people the young
06:58generation however we are seeing that if there is complete prohibition of this there will be a lot of
07:04repercussion on this so yes for now strict control very strict control control on vape uh vaping um habit
07:13um is a must uh tight uh and street enforcement must uh be done from now onwards um when either either
07:21street control or complete prohibition there will be people in the industry talking about oh then it will be
07:28sold in the black market people can still get it from the black market um yes they can still get it from
07:34the black market similarly with the conventional cigarette however if we do not start now it will
07:40get worse and worse now now um you know the vape juice is easily modifiable um when they say about this
07:47they said that the open system is easily modifiable they can add on other materials into the e-liquid however
07:55when we talk to people who are actually vape users or vapor they even say that the closed system can actually
08:02be manipulated so other illicit substances can still be inserted into the e-juice under the closed
08:09system so um yeah we have got to be um you know stakeholders have got to come in and put in their
08:17ideas on how to solve this problem but we have got to have for now strict control but uh moving forward
08:23because we are aiming for uh smoke-free malaysia 2040 complete prohibition would be the way forward
08:29well dr money you're a family medicine specialist um and i do i do wonder for the parents who are
08:36watching right now for the um school leaders the community health um service providers what do we do to
08:45ensure that um we prevent initiation of young people to vaping in the lead up to the ban uh in 2026.
08:56okay so number one is um everybody who has the knowledge or if you do not have the knowledge
09:03go read up about it listen to talks on the danger of vape and also still you have to talk about
09:09cigarette also make noises but smart and educated noises not just team kosong you know so um you know we
09:17have to prevent new vapors and smokers by continuous education and awareness program so at every level of the
09:24community in our society everybody must actually realize that vape is dangerous and damaging not
09:31just to the physical or mental health but to our financial health country economy and environmental
09:37health so what university malaya is doing we are having this um henti elak basini asap tembakau or we
09:43call it hebat program so we have been collaborating with multiple government agencies uh we are a partner of
09:49m quick program um and also we partner with public and private universities to actually educate um
09:55school and also the people in the university so that they can go out um to educate more um in the
10:03society on the um on how you you know to prevent the uptake of cigarette on how to stop smoking and also how
10:11to stop vaping so we also do it with the ngos and interest industry so um education knowledge and helping
10:19people in this vape um area is a long battle to fight for but parents teachers ourselves you know um
10:29anybody who's listening now we should help them to keep so now the important thing is that um if you
10:36will notice that children or teenagers they are being penalized they are undergoing harsh punishment
10:43if they are found to be vaping in their school however um for my opinion i think they are the victim of
10:52the industry so what it should be done for them is for us to help them to quit make them realize that yes
11:00their action was not correct however there are available help out there but parents please
11:05realize that if you find that your children or teenagers are vaping please help them do not
11:12punish them you they need help and you do not want them to run away from you so seek help for them
11:18because they need your support so yeah um and also another thing is that um you know um the uh
11:25marketing of this we have got to control the marketing of vape products in the social media
11:30especially and also the marketing of these uh products by influencers and celebrities in
11:35malaysia that is among the way that we can curb the use of vape in malaysia thank you so much
11:43dr amani for giving us some food of food for thought today appreciate your time that was associate
11:48professor dr noor amani ahmad tajuddin from um's faculty of medicine there we're going to take a quick
11:54break here and consider this we'll be back with more stay tuned
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