Malaysia: vaping for harm reduction

Malaysian vapers say their health has improved since they began using e-cigarettes and stopped smoking or reduced their consumption of tobacco cigarettes.

In a major new study just released, one of the world’s leading harm-reduction experts, cardiologist Dr Konstantinos Farsalinos, interviewed more than 7,000 Malaysian e-cigarette users about different aspects of vaping, including how good they were as a means of helping smokers to quit.

Smoking cessation – giving up tobacco cigarettes – is recognised as a ‘big ask’ right across the globe, and public-health authorities are increasingly coming to the conclusion that e-cigarettes can play an important part in helping smokers move away from smoking and reduce their risk of disease and early death.

So it is hardly surprising that the vapers in Malaysia overwhelmingly report high rates of success in getting off tobacco: more than two thirds (68.5 percent) have been able to stop smoking altogether and another 27 percent have reduced their smoking with the aid of e-cigarettes.

Possibly less predictable was the improvement in physical well-being reported by the vapers in the study: 82 percent said their “general physical status” had improved since they switched to e-cigarettes. In addition:

91 percent of participants reported improved breathing

75 percent say they now sleep better

83 percent say their capacity for exercise has improved

and a large majority report their sense of smell (89 percent) and taste (88 percent) are better since they began using e-cigarettes to quit or reduce smoking

While almost everyone agrees that e-cigarettes should not be made available to youth, most vapers are concerned about the effects of any ban on their availability to adults. Asked “if e-cigarettes were banned, would you relapse to smoking (or increase tobacco cigarette consumption)”, 44 percent of participants said they were “very likely” and a further 36 percent “likely” to relapse.

The study – believed to be the most widespread such survey ever undertaken in the Asia-Pacific region – was carried out online, with a questionnaire uploaded to a survey website.

Nearly all participants were or had been daily smokers (98 percent), although current, former and never smokers were eligible to participate and were included in the analysis. Just 67 of the 7,124 surveyed said they had never previously used nicotine products before vaping, in contrast to some suggestions that e-cigarettes might in some way provide a ‘gateway’ for non-smokers.

It was available in both Malay and English and was constructed based on previous experience from the largest online survey of electronic cigarette users (Farsalinos et al., IJERPH 2014) and from the recent Eurobarometer survey of the European Union (Farsalinos et al., Addiction 2016)

Participants came from online social media, Malaysian vapers’ associations, online and physical electronic cigarette shops. The survey was anonymous – no personal details were asked or collected.

The questionnaire website was configured to accept only one participation per IP address, and anyone who responded to less than 60 percent of the questions was excluded.

Dr Farsalinos devised the study himself and organised it via crowdfunding – the study has had no input at all from commercial interests. An enthusiastic advocate for e-cigarettes as a means of helping people stop smoking and therefore improve public health – and a vaper himself – he has visited Malaysia previously and presented his findings from a large number of scientific projects he has carried out to determine the safety (in absolute and relative terms) of properly regulated e-cigarettes.

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