WHO expert: ‘Nicotine salts in e-cigarettes are twice as addictive’

MSc. Dr. Nguyen Tuan Lam, representative of the World Health Organization (WHO) Office in Vietnam, at the conference to disseminate Decree 371 in Ho Chi Minh City on January 29, warned about the “trick” from nicotine salts in new generation tobacco products. Unlike cigarettes, which have a nicotine concentration of about 2%, which causes throat irritation, e-cigarettes use nicotine salts to help users smoke smoothly even though the concentration is up to 5%.

“This artificial smoothness makes users lose their guard, loading a huge amount of nicotine into the blood in a short time, leading to a much faster and more severe addiction than with cigarettes,” Mr. Lam analyzed.

The WHO identification document also points to subtle variations in the appearance of these products. Electronic and heated cigarettes are now disguised as familiar items such as milk cartons, Lego toys, cartoon character models or technological devices such as USB sticks and pens. Constantly changing designs not only stimulate the curiosity of young people but also make it difficult for parents and schools to detect and prevent them.

The health consequences of consuming high concentrations of nicotine are especially serious for the developing brains of adolescents. More dangerously, the design of the chamber or open lid of these devices creates favorable conditions for bad guys to mix synthetic drugs or “American grass”. In fact, at Bach Mai Hospital, many emergency cases of e-cigarette poisoning were recorded in which drugs were found in medical samples. Patients were hospitalized with symptoms of brain damage, agitation and multiple organ failure.

To prevent the above risks, Vietnam has applied a comprehensive ban on e-cigarettes from the beginning of 2025. Ms. Dinh Thi Thu Thuy, representative of the Ministry of Health, said that Decree 371 issued on December 31, 2025 stipulates strict sanctions covering the entire product life cycle. Accordingly, the act of use will be fined 3-5 million VND with confiscation of evidence. Owners of places such as cafes and bars that harbor smokers will be fined 5-10 million VND. Particularly, the act of trading and transporting is determined to be trading in “banned goods”, facing an administrative fine of up to one billion VND and criminal prosecution.

Strong measures initially showed positive results. Bach Mai Hospital Poison Control Center recorded a decrease in the number of severe poisoning cases from 5-6 cases per month to 1-2 cases after the ban took effect. The situation of celebrities publicly advertising this product on social networks has also ended.