Rise in vaping cases this year involving etomidate, a fast-acting anaesthetic, says HSA

CNA

a day ago

SINGAPORE: The Health Sciences Authority (HSA) is closely monitoring the use of e-vaporisers, or vapes, to consume etomidate, a fast-acting anaesthetic used in medical procedures.
More than 20 cases involving etomidate have been detected so far this year, compared to 5 cases for the whole of last year, according to the statutory board.
Vape products laced with etomidate are often called "kpods", 'zombie vapes' and 'space oil'.
HSA warned that inhaling it directly into the lungs can cause side effects like spasms, breathing issues and seizures.
The statutory board added that the sedative is meant to be used under supervision in hospitals for medical procedures.
Etomidate is classified as a poison and those found possessing or using pods containing it are liable upon conviction to a maximum penalty of imprisonment for up to two years and/or fine up to S$10,000 (US$7,747) under the Poisons Act.
DRASTIC IMPACT ON YOUTH HEALTH
But even without etomidate, doctors said vaping can lead to more drastic health outcomes for those who take up the habit.
Between January 2024 and March 2025, about 2,600 students from schools and Institutes of Higher Learning were referred to HSA for vaping, and nearly 1,800 youths received counselling during this period, according to the agency.
HSA added that there were over 800 repeat offenders under 18 years old between 2019 to 2023 who bought, used or were in possession of a vape.
Dr Loh told CNA that teenagers are also more sensitive to addictive effects of vaping, so they might find it more difficult to eventually kick the habit, compared to adults.
Vapes contain chemicals including nicotine – an addictive substance commonly found in cigarettes, cancer-causing agents like formaldehyde, and metal nanoparticles such as tin, lead or nickel.
Adjunct Associate Professor Puah Ser Hon, head of Tan Tock Seng Hospital's Department of Respiratory and Critical Care Medicine, said that the growing number of youths vaping is a concern.
'They're still developing, their lungs are growing, their brain(s) are growing, but all the chemicals that they inhale through the vapes actually stunt them,' he added.
Assoc Prof Puah said that users of vapes also face potential illnesses such as cancer and chronic lung diseases.
One such lung condition caused by vaping is a condition called bronchiolitis obliterans, which experts believe is caused by diacetyl, a chemical widely found in vapes.
It is commonly added by manufacturers to complement the flavours of vape liquids. When inhaled, it can cause the tiny air sacs in the lungs to scar.
Over time, the scarring builds up, causing a narrowing of the airway, which can lead to coughing, wheezing or even respiratory failure.
The condition can be treated but not cured, said Dr Loh.
In extreme cases, patients may require a lung transplant but the procedure does not guarantee survival and quality of life will be reduced, she added.
Both doctors debunked the belief that vaping is a healthier alternative to smoking cigarettes.
Dr Loh said that despite e-vaporisers being a relatively new product, its harms are already well-documented, and Assoc Prof Puah said it is not true that secondhand vapour is less disruptive than secondhand smoke.
He added that smoke particles, which are exhaled through vaping, could land on clothing or the environment and be inhaled by other people as a form of third-hand smoke.
ENFORCEMENT AND EDUCATION
Ms Jessica Teo, assistant group director at HSA's Vigilance, Compliance and Enforcement Cluster, said that the statutory board has intensified its operations, both physically and online, to disrupt vape distribution networks.
'We have also strengthened border controls with the Immigrations and Checkpoints Authority, and we have increased our enforcement presence in places, in public spaces where vaping is prevalent,' said Ms Teo.
"Definitely it is of concern, and we are … monitoring this very closely. Now it is etomidate. Tomorrow it could be another substance,' she added.
HSA said its officers are scanning through online platform s looking for illegal sellers of vaping devices and signs of other offences.
Specialised systems automatically scan the internet 24/7 for suspicious listings, up to 10 advertisements per minute, according to HSA, adding that authorities then work with online platforms to take down listings.
More than 6,800 online listings of vapes and related components were removed from January 2024 to March 2025, more than double the 3,100 listings removed in 2023, said HSA.
The Health Promotion Board (HPB) and Ministry of Education said they will launch a year-long online counselling programme in all secondary schools in July, aimed at helping students quit smoking and vaping.
Private venues are also doing their part.
Zouk Group said anyone caught with illegal products, including vapes, will be referred to the authorities.
'It's just something that we don't tolerate at all. We want to make sure that, within the environment that we provide for our customers, that none of that is present in our venues,' said the nightclub's group marketing director Mr Roman Kibe.
HELP IS AVAILABLE
Authorities said that help is available for those addicted to vaping and they will not get in trouble for seeking it.
Programmes like HPB's I Quit offer support, and any personal admissions made during counselling stay confidential.
Assoc Prof Puah said that professional medical help is also available for anyone seeking help with nicotine addiction and withdrawal symptoms.
'(At) all the hospitals, the polyclinics … There are people out there ready to help. In the National Healthcare Group … you can just walk in and seek consultation, and somebody will guide you through the process,' he added.