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Using e-cigs to quit smoking?

A NEW study reveals that 95% of Malaysian vapers surveyed have either quit or cut down on smoking, while over 80% of them reported improved health.

“More than two-thirds stopped smoking all together. Among the 27% that didn’t quit, the average consumption of cigarettes dropped from 19 to four a day,” Greek cardio­logist Dr Konstantinos Farsalinos said at a recent interview in Kuala Lumpur.

Sharing the results of his latest study, the Onassis Cardiac Surgery Center and University of Patras researcher says over 7,000 adult vapers – 97% of whom were male – participated in the online survey which was in English and Malay. The average age of respondents was 30.

Over 5,500 ex-smokers and more than 1,500 smokers, who are also vapers, were asked about their experiences with e-cigarettes, and the results were consistent with those from the United States and Europe.

“Malaysian vapers, like their global counterparts, generally use advanced e-cigs and were able to reduce their nicotine consumption gradually, feel healthier and eventually quit smoking.”

This, Dr Farsalinos claims, is the largest cross-sectional survey of adult vapers in Malaysia and Asia. The survey is an extension of his 2014 study involving over 19,000 participants worldwide. While his earlier study on the characteristics, side effects and benefits of e-cigs found that 81% of those surveyed had quit smoking with e-cigs, he admits that there was little participation from Asia. The Malaysian survey, he says, fills the gap.

“The vaping community here is more organised compared with those in other countries in the region. They reached out to me early on. There are lots of questions but no data so it was important to do a study here,” he says, explaining why he decided to conduct his latest survey in Malaysia.

The lack of data, he feels, is why e-cigs are feared. While admitting that some fears are legitimate, he argues that sound policy must be based on facts and data, not fears.

The most common side effect of vaping is dry throat and mouth, he says, dismissing fears that smoking e-cigs would lead to addiction. According to his findings, tobacco cigarettes were the first nicotine product used by 92% of the respondents while 95% denied ever using e-cigs to inhale anything other than e-liquids.

The Health Ministry’s recommendation for e-cigs to be strictly regulated as a pharmaceutical product is a “big step backward”, says Dr Farsalinos, arguing that whether the e-cig is a pharmaceutical, tobacco or consumer product was dealt with in Europe three years ago.

“The e-cig is not medicinal so that argument was thrown out. The EU regulates it under its Tobacco Products Directive but there’s a sepa­rate category for the e-cig where it’s treated as a consumer product.”

He believes the devices should be regulated as a consumer product but with restrictions, like banning its sale to minors.

“Smokers aren’t stupid. They know their habit causes diseases that kill but they like it. Smoking is pleasurable. E-cigs give them the same pleasure.

“Malaysia adopts harm reduction when they tell motorists to wear a seatbelt. Why is this different?” he asks, adding, however, that e-cigs should only be the option for those who failed to quit smoking by themselves or after they’ve tried medication.

Prof Datuk Dr Abdul Razak Muttalif believes it’s better to err on the side of caution as the long-term effects of e-cigs on the body are still unknown and may take years to find out.

He is the chairman of the Health Ministry’s technical committee tasked with studying the health effects of e-cigs and shisha smoking and also a senior consultant chest physician and former director of the Kuala Lumpur Hospital Institute of Respiratory Medicine.

“Look how long it took before we knew that cigarettes cause diseases. As doctors we are very careful,” Dr Abdul Razak says when asked to comment on the Farsalinos study.

When the committee was formed in 2013, there wasn’t much data on e-cigs, he says, but some studies now show that e-cigs could have acute and long-term effects on consumers.

Worried about the nicotine in e-liquids, he warns that it could lead e-cig users to other addictions.

Universiti Malaya nicotine addiction specialist Assoc Prof Dr Amer Siddiq Amer Nordin is also concerned.

“A single survey conducted on mainly Internet users is inadequate to change the understanding of the danger or benefits of e-cigs. Besides the ongoing national study findings, there are a number of studies looking at the prevalence, mode of use, safety of e-liquids and safety to the environment. These are conducted by local universities. Let’s compare their data with Dr Farsalinos’ data.

“If e-cigs are found to be a useful quit-smoking agent in future, it should be regulated as a medicinal device. Still, abstinence is the best way to quit,” he says, adding that nicotine is governed by the Poison Act and its distribution is controlled.

Calling for a ban on e-cigs, the Consumers Association of Penang (CAP) believes that instead of helping smokers quit, e-cigs just cause them to spend more on a new habit.

CAP education officer N.V. Subbarow insists that many vapers are still smoking.

“Now we have another problem besides smoking. Worse still, teachers and parents are at a loss because kids who have never smoked are vaping now.”

CAP, he says, conducts weekly consumer education programmes in schools, addressing topics like vaping and e-cigs.

“Our survey of eight primary and secondary schools in Penang last year found 150 regular vapers among the students.”

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