KUALA LUMPUR — As Malaysia debates how to regulate nicotine products after tabling its 2026 budget, one question lingers: why the rush to ban vapes, but not cigarettes?
Dr Thirunavukarasu Rajoo, president of the Malaysian Medical Association (MMA), says the answer lies in history — and in the country’s ongoing struggle to balance public health and addiction control.
“Do we want to create another tobacco-like vaping? Don’t we want to learn from our past mistakes?” he told Scoop Insight by PodaBoom in an interview recorded shortly after Budget 2026 was unveiled.
Health groups including the MMA and the Galen Centre have long called on the government to abolish its current sugar subsidy, which costs about RM500 million annually, and redirect those funds to strengthen the public healthcare system.
Although Malaysia ended direct sugar subsidies in 2013, a new subsidy of RM1.00 per kilogram for sugar manufacturers was introduced in November 2023 to keep retail prices low.
Advocates argue that removing it again could free up funds to improve hospital services and increase on-call allowances for medical officers and specialists.
At the same time, the government stopped short of implementing a proposal to raise excise duty on vape liquids by 900% — from 40 sen to RM4 per millilitre — a move that public health authorities said was needed to curb usage among young people.
That decision has reignited debate over Malaysia’s regulatory inconsistencies on nicotine products, particularly when conventional cigarettes — which kill tens of thousands annually — remain legal.
During the podcast, Scoop news editor A. Azim Idris noted that cigarette use reportedly kills about 27,000 people in Malaysia every year, compared to only a handful of vape-related deaths reported so far — at least within a year.
Dr Thirunavukarasu responded: “All the statistics you mentioned — there’s somebody behind that. That could be one of the loved ones. When it’s one of your loved ones, statistics don’t matter anymore.”
While acknowledging that vape-related deaths remain few and inconclusive, the MMA president argued that vaping’s rapid spread among youth represents a new form of addiction — one the country is ill-prepared to control.
“We’ve seen school children getting addicted, not even knowing what’s in the vape liquid. Some reports found chemicals like fentanyl in other countries,” he said. “Do we want our children to be exposed to that?”
Vaping advocates have argued it serves as a harm-reduction tool for adult smokers, but Dr Thirunavukarasu dismissed the notion that switching to e-cigarettes is a meaningful public health compromise.
“You cannot substitute one harm with another harm. Harm is harm,” he said.
Azim, meanwhile, cited Australia’s model — which allows vaping only with a doctor’s prescription and restricts sales to pharmacies — as an example of how strict regulation might balance health and personal freedom.
Dr Thirunavukarasu agreed the approach was sound in principle, but questioned whether Malaysia’s enforcement capacity could match that level of control.
“In Australia, enforcement is very good. The public respects the law,” he said. “Here, we still see people smoking even in no-smoking zones. So are we ready?”
For the MMA, the answer lies not in punishing adult users but in preventing a new generation from developing lifelong addictions.
“Addiction is still addiction,” he said. “Today it’s vape. Tomorrow, what’s next?” — October 28, 2025