“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,” Professor Amrahi Buang, president of the Malaysian Pharmacists Society, told CNA.

Without being registered, the safety, quality and efficacy of the energy sticks are in question, he said.

Based on research by laboratories in China, these products may contain lead, mercury, menthol and nicotine that could be harmful to the respiratory system and lungs, noted Professor Sharifa Ezat Wan Puteh, a health economist and public health specialist with Universiti Kebangsaan Malaysia.

“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,” she said. “What happens in the lungs is the thing that … a lot of us are very apprehensive about.”

According to the United States’ Centers for Disease Control and Prevention, inhaling synthetic camphor – a common fragrance in the inhalers – can cause nausea, vomiting, dizziness, and irritation to the eyes, skin, or mucous membrane.

Some of the sticks may contain vitamin E acetate, an additive also found in e-cigarettes, said Prof Sharifa Ezat.


The concerns around energy sticks echo that for vapes or e-cigarettes, which have become popular among youths despite the harm they can cause.

Like vapes, the inhalers appear targeted at children, given their affordability and trendy packaging, noted Prof Amrahi.

“(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,” he added. 

Vaping has given rise to e-cigarette or vaping product use-associated lung injury, or Evali, which has caused thousands of people to be hospitalised in the US, as well as deaths, noted Prof Sharifa Ezat.

According to the US CDC, vitamin E acetate is strongly linked to the Evali outbreak.


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