Smoking Variations : Association With Lung Function Variations in Adults, Exhaled Carbon Monoxide and Pulmonary Function among Tobacco and Nicotine Users in Klang Valley

This ongoing collaborative research funded by MSHR and the Fundamental Grant Faculty Of Medicine Universiti Kebangsaan Malaysia (UKM) aims to address key questions regarding smoking habits, clinical effects of different nicotine products, and attempts to quit smoking among adults in the Klang Valley region of Malaysia, with the ultimate goal of informing policy decisions towards achieving a smoke-free Malaysia.

Specifically, the research addresses the Ministry of Health’s (MOH) target of reducing the number of new smokers to achieve a smoke-free Malaysia via its New Bill, dubbed as the “Generational End Game,” which will ban cigarette smoking and vaping on those born after 2007. The research aims to provide crucial insights into the effectiveness of such legislation by examining the behaviour and health outcomes of different tobacco and nicotine users.
Over 650 Malaysians participated in the study, offering a robust sample for analysis. The demographics of these participants were: aged 18 to 60, 70.3% male, 87.8% Malay ethnicity and 73.4% from the below 40 (B40) income group. The findings revealed that approximately 48% of participants were users of tobacco or electronic cigarettes, while the remaining 52% were non-smokers.

Analysis of lung function and exhaled carbon monoxide levels showed evidence of significant disparities in the impact on health caused by different smoking products. 

Users of Electronic Cigarettes (E-cigarettes/ vapes) or Heat-Not-Burn Tobacco Products (HTP) exhibited normal levels of carbon monoxide chemicals in their exhaled breath compared to smokers of traditional cigarettes who exhibited high exhaled carbon monoxide levels with restrictive lung function. 

Additionally, lung function tests among HTP users demonstrated healthier outcomes, with 100% recording normal lung function, compared to 77% of E-cigarette / Vape users. Notably, smokers who consumed multiple different smoking products (i.e poly-users), displayed discernible respiratory issues, indicating potential health risks associated with such practices

More importantly, the study found a notable disparity in users attempting to quit smoking, where the majority of poly-users (86%) had attempted to quit smoking compared to only 55.9% of cigarette smokers who attempted to quit smoking.

These findings provide crucial insights into the smoking landscape in Malaysia, serving as a compass for policymakers like MOH in crafting evidence-based legislation to combat smoking prevalence, particularly among the youth. 

While the “Generational End Game” Bill represents an ambitious initiative to eradicate smoking entirely in Malaysia, targeted interventions guided by these research findings hold the potential to bring about more meaningful change in tobacco harm reduction. 

By helping people to quit smoking and adopting healthier lifestyles, these interventions can reduce smoking rates and pave the way towards a smoke-free Malaysia.