Sex, vape and nicotine - is it really the antidote to smoking?

FOCUS Cafe owner Kok Jit Kiang could very well be the poster child of vaping.

Once a chain smoker, the forty-something father swears by it as a means to quit the habit.

Beyond that, Kok is also walking advertisement of how vaping is the path to a healthy life. A mere three months after taking his first vape hit, he feels neither the need to smoke nor vape.

He admitted that when he first started vaping last August he “vaped with a vengeance”.

It was also not as light on the pocket as claimed, he said. A starter pack cost RM180, while the juices ranged from RM40 to RM80 with each bottle lasting about three days.

When he started vaping, he said, “everything tasted better”.

“I felt healthier and all food tasted better. (Also), my kids didn’t get skin problems with vape,” he said.

But vaping was not as easy as going to the nearest convenience store for a pack of cigarettes.

“I quit because of the time taken to indulge in it. I don’t have a lot of time anymore.”

‘You can eat flour, but you can’t inhale it’

Stories like Kok’s are common within the growing community of vapers which industry players now number a whopping one million nationwide.

The Health Ministry was thus accused of being anti-health, when it started raiding vape retailers for selling nicotine-laced vape juices which make up the bulk of juices sold.

Like the physicians who run the ministry, Malaysian Medical Association president Dr Ashok Zachariah Philip (photo) has an uncompromising stand on vaping.

Inhaling chemicals into the lungs is never a good idea, he said.

“It is likely to irritate your lung tissue in the short term and the long-term effects have not been studied,” he told Malaysiakini.

Kok, like many other vapers, believe that vape juices have far less toxins than cigarettes and fewer side effects.

“If you clean your coil, you won’t be smoking the chemicals,” he claimed.

But Malaysian Thoracic Society council representative for tobacco control Dr Helmy Haja Mydin said vapers should pay attention to the fact that not everything in vape juices is safe to inhale.

“Food colouring is not necessarily safe. It may be safe to swallow, but it may not be safe to inhale. For example, you can swallow flour but it doesn't mean you should inhale it,” he said.

Vape juice is usually made up of flavouring and nicotine solutions. A flavouring solution typically contains either propylene glycol or vegetable glycerine.

Propylene glycol is considered safe by the US Food and Drug Administration (FDA) and is used in foods. Vegetable glycerine on the other hand is used as a substitute to sugar.

'We just don’t know enough'

Dr Helmy said the regulatory vacuum on vape juices should be a cause for alarm.

“There is no way to say for sure that the juice contains what it says on the bottle, that it contains the stated amount of nicotine, for example.

“It could be contaminated, it could contain excess nicotine. Users assume that makers know what they're doing but that is not always the case,” he said.

Experts also believe there has not been quite enough research conducted on the effects of vaping to conclusively prove that it can aid smokers to quit.

One oft-cited research is the one by Public Health England which claims that vaping is 95 per cent “safer” than smoking cigarettes.

However, Dr Ashok said not many can cite research showing how many of those who swap cigarettes for vaping eventually end up ‘smoke-free’.

He believes that more randomised double blind trials on smoking cessation using e-cigarettes needs to be done before it could be decided that vaping does indeed provide any advantages over other forms of smoking cessation therapy.

“Even if they are a good way to stop smoking, they should be used under medical supervision, with the eventual aim being to stop both smoking and vaping,” he said.

Malaysian Pharmaceutical Society president Nancy Ho pointed out how there were already many registered products that can be used for smoking cessation.

“The vape juice’s usefulness as a smoking cessation aid has not been established,” she said.

“Besides nicotine, there could be other additives which may spike the solution and the untested juice can pose a danger to health."

Help smokers quit

Studies conducted in Italy and New Zealand into the role of e-cigarettes in helping smokers to quit smoking have found that the quit rates at six months is the same as nicotine replacement therapy (NRT) using nicotine patches, gum as well as psychological support.

Dr Helmy (photo) therefore is of the belief that the government should support and also promote smoking cessation services that have been proven to work in a more aggressive fashion.

“The vapers who want to quit resort to e-cigarettes because they feel they do not have any other option, so we must support them as much as we can.

“Otherwise we are substituting one form of nicotine addiction for another,” he stressed.

Dr Ashok added that the public health hazards of vaping goes beyond the toxins in the juices or whether it can help smokers quit.

Fruity flavours of vape juices and low-end mods make vaping an attractive habit for young people, resulting in exposure to nicotine addiction from a much younger age.

“Young people, having less money to spend, may buy low-end vaping devices, which may be of poorer quality and therefore more prone to explode or catch fire.

“If many young people take up vaping, we will actually be increasing rather than reducing the number of people dependent on nicotine, and some of them may move from vaping to normal cigarettes,” he said.

Sexy women and ‘nenen’ flavour

Dr Helmy said the marketing of electronic cigarettes today is reminiscent to how cigarettes were marketed by big tobacco companies in the early to mid 20th century.

“(Utilising) bright colours, sexualisation of the product where sexy women are used on magazines or posters as well as flavourings like 'nenen' (breast milk) and 'taste of a virgin'…

“This is not in keeping with the argument that e-cigarettes are for smokers who want to quit.

“The marketing suggests otherwise. Vaping or smoking is becoming sexy again, an 'in' thing,” he lamented.

Vaping is also carving a new demographic of smokers – those who would not otherwise pick up a cigarette, cigar or any other tobacco product.

Twenty-something urban professional Cheryl describes herself as an occasional vaper.

She said she started vaping out of curiosity, but also because she believes is is less harmful than cigarettes.

But she admits that vaping has addictive qualities, and the reason she is not an addict is because she does not own her own vaping device.

“When you do it often, you will get hooked on to the act of vaping.

“I personally don't own my tank, I only vape when I’m out with my friends. If I have my own tank I can say for certain that I will vape everywhere,” said the woman who declined to be identified by her full name.

Cheryl is quite certain that she will not resort to smoking. Unlike the saccharine smoothness of vape, the taste and the smell of cigarettes put her off.

Sacrificing a generation

In Dr Helmy’s utopia, both cigarettes and vaping will be illegal, but the specialist concedes that tobacco has cemented itself in consumer consciousness for centuries.

“It’s practically next to impossible (to ban cigarettes). It would make more sense to spend money and time to decrease users and make it more difficult for more new users to start,” he said.

This is why health professionals are agitating for a ban on vaping, while it is still at its infancy and before too many people get hooked.

“An item should be proven to be effective and safe before it is allowed in society, not released to everyone until it is proven dangerous,” he stressed.

Dr Ashok is also of the opinion that the sale of vape devices and liquids should be regulated.

“Indeed, if the government chooses not to ban e-cigarettes, controls on manufacturers and distributors should be made much tighter.

“There is no guarantee that the effects on the gut and the lung will be the same. It is best to do more extensive studies before allowing free access to e-cigarettes. If studies prove there is no long term harm, deregulation can be done then.

“We do not want to sacrifice the younger generation in order to add one more way for smokers to stop smoking.” -Mkini