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Kota Kinabalu: Experts have warned that ramping up restrictions on vaping, especially moves tantamount to a ban, could trigger unintended and potentially harmful consequences, even as more states move in that direction.

States like Johor and Kelantan, which have banned the sale of vape products since 2016 and 2015, respectively, continue to record high user numbers, with more than 150,000 users in Johor and over 30,000 in Kelantan.

The availability of illicit vape products in the two states has raised concerns not only because they point to ineffective enforcement, but also the health issues that come with illicit product use, including the possibility of drug abuse.

Malaysia is not alone in facing issues related to illicit vape use.

A similar pattern has been observed in neighbouring Singapore, the country renowned for strict enforcement, but also where a complete ban on vaping has failed to curb its usage. 

A survey by Milieu Insight found vape usage among Singaporeans rose from 3.9 per cent to 5.2 per cent between late 2021 and 2023. For context, the island republic’s vape ban has been in place since 2018.

Back in Malaysia, several states, namely Terengganu, Perlis, Pahang, and Kedah, have implemented bans or stopped issuing new licenses for vape businesses.

A health expert and economist say the trend of illicit vape use illustrates a core weakness in prohibitionist approaches: they often do not reduce demand, but instead shift it to illegal and unregulated channels.

In a perfect world, a complete ban is ideal. But realistically, it has several repercussions,” said Professor Dr Sharifa Ezat Wan Puteh, a lecturer at Universiti Kebangsaan Malaysia.

“We’re already seeing a rise in black market tobacco and vape products. These are untaxed and unregulated, making them more dangerous to users.”

Sharifa said that in countries burdened by high smoking rates and low success with traditional nicotine replacement therapies (NRT), there may be a role for tobacco harm reduction (THR) products such as e-cigarettes, heated tobacco products (HTPs), and oral nicotine pouches.

She said some recalcitrant smokers who find it hard to quit with traditional NRT may benefit from alternatives, though the effectiveness depends on product quality and enforcement capabilities.

She cited countries like Sweden and Norway, which use snus and nicotine pouches and are projected to reduce tobacco smoking rates below 5 per cent in the coming years. 

These nations also have among the lowest rates of lung cancer and cardiovascular disease in the EU. In Japan and South Korea, the use of HTPs has coincided with a decline in smoking prevalence.

In contrast, Australia's tightly regulated medical-vaping model is struggling. Under rules introduced in October 2024, vapes can only be sold via pharmacies with a prescription.

But data from The Daily Telegraph revealed that just one in every 1,686 vape sales occurred through legal channels. Meanwhile, major suppliers, including Philip Morris, have exited the market, citing unsustainable regulatory burdens.

The stricter controls have had a paradoxical impact. A month later, the same daily reported that more than one-in-10 of Australians aged 18 to 24 are now smoking cigarettes, a 36 per cent surge in less than a year.

“Policies don’t always produce the desired results,” said Dr Carmelo Ferlito, chief executive of the Centre for Market Education. 

“We’ve seen this in prohibition-era America and communist countries. Restrictions shift consumption underground rather than eliminate it.”

Ferlito argues that heavy-handed bans fail to account for economic realities and consumer behaviour.

He said that when in-demand products are banned, people would just find a way to procure them from illegal sources, and this was why “good intentions” were not enough when it came to policy-making.

“Often, policies are designed as wishlists, ignoring the ‘laws’ of economics.

“For example, I could proclaim that I could fly and jump out a window. But if I do so, ignoring the laws of gravity, I could jump out of the window, but I won’t be able to fly. That’s the reality.”

Ferlito said he believes regulation should facilitate reputable suppliers to bring in products legally, lowering the risk of counterfeit products.

This should be accompanied by education and awareness on the trade-offs involved in the consumption of alternatives to cigarettes or stopping altogether.

Sharifa said two Cochrane reviews, which are internationally recognised as the highest standard in evidence-based health care, have shown the benefits of THR in smoking cessation.

“Vaping was never intended for youth use, but weak regulation, lax enforcement, and irresponsible vendors have enabled widespread abuse.

“The situation has been further compounded by black market imports from abroad.”

As Malaysia continues to refine its tobacco control strategy, the message from experts is clear - good intentions should not override evidence and experience.