20-2-2024 (KUALA LUMPUR) As concerns grow over the popularity of ‘energy stick’ inhalers among children in Malaysia, experts are raising alarm bells about potential lung damage and the risk of these devices becoming a gateway to drug abuse. These colorful nasal inhalers, resembling Airpod cases, have gained traction among Malaysian schoolchildren, thanks to their fruity flavors such as mint, peach, grape, and bubblegum. Priced between RM2.50 (US$0.52) and RM16, these inhalers are readily available on e-commerce platforms like Lazada. However, the exact composition of the sticks remains unclear, prompting health professionals to draw parallels with the vaping epidemic and urging authorities to address the issue proactively.
The trend of children using these nasal inhalers was initially reported in China towards the end of last year. According to the South China Morning Post, these inhalers were being sold in the thousands, with secondary school students forming the majority of customers for one online store. Although the two-pronged inhalers come in various fragrances and reportedly contain essential oils, menthol, camphor, and occasionally alcohol, their precise contents remain unknown as they have not been registered with Malaysia’s National Pharmaceutical Regulatory Agency or the Ministry of Health.
Professor Amrahi Buang, President of the Malaysian Pharmacists Society, emphasized the importance of registration, stating that “everything about the product has to be mentioned in the registration process, so we know what are the precise contents and their nature, so that everyone knows – the regulatory agency, the healthcare professional as well as the public.” The lack of registration raises concerns about the safety, quality, and efficacy of these energy sticks.
Laboratory research conducted in China suggests that these products may contain harmful substances such as lead, mercury, menthol, and nicotine, which could have detrimental effects on the respiratory system and lungs. Professor Sharifa Ezat Wan Puteh, a health economist and public health specialist at Universiti Kebangsaan Malaysia, highlighted the inhalation route of these energy sticks, stating, “These energy sticks are basically inhaled because you put them inside your nostrils… it goes through your mouth, goes through your throat, and it goes into your lungs. What happens in the lungs is the thing that… a lot of us are very apprehensive about.” Inhaling synthetic camphor, a common fragrance found in these inhalers, can lead to symptoms such as nausea, vomiting, dizziness, and irritation to the eyes, skin, or mucous membrane, as per the United States’ Centers for Disease Control and Prevention.
Further concerns surrounding energy sticks mirror those associated with vapes or e-cigarettes, which have gained popularity among youths despite their harmful effects. Like vapes, these inhalers seem to target children due to their affordability and trendy packaging. Professor Amrahi highlighted that manufacturers “focus on the younger generation, trying to sell inhalers as a cool lifestyle akin to smoking and vaping. To make it even more accessible, they are available online and can be delivered in bulk. It’s challenging to control the sale of it.” The rise of vaping has resulted in cases of e-cigarette or vaping product use-associated lung injury (Evali), which has caused thousands of hospitalizations and deaths in the United States. Vitamin E acetate, an additive found in some of these energy sticks, has been strongly linked to the Evali outbreak, according to the US CDC.
Prof Sharifa Ezat warned that the use of energy sticks could serve as a gateway to other vices, similar to vapes and cigarettes. She expressed concerns that these inhalers may open the door for children to develop addictions to conventional cigarettes, e-cigarettes, and even illegal substances like cocaine, which are commonly inhaled. While vapes and cigarettes are known to contain nicotine, it is uncertain whether inhalers also contain this addictive substance. Until conclusive evidence is available, it is deemed unsafe for both children and adults to use these energy sticks.
