Energy stick nasal inhalers are becoming increasingly popular among young people in Singapore. What are they? What are the risks they pose to health?

A new type of nasal inhaler called an energy stick now has a fruit flavor and claims to increase the user's energy level


Examples of "energy bars" that can be found on Lazada.

In Singapore, a new type of nasal inhaler called the "energy stick" is becoming popular among young people. This inhaler is priced at less than 5 Singapore dollars and comes in flavors such as "energy mint" and "juicy grape". It is claimed to replenish energy and relieve nasal congestion for users.

Two Singaporean energy bar sellers revealed that most of their customers are under 25 years old, with some even as young as 12 years old.
They added that many people are also repeat customers or those who purchase in bulk and resell to their classmates.
Are these energy bars really as advertised?
Should such products be considered as electronic cigarettes, electronic atomizers, or steam cigarettes? Since then, these devices have become the focus of people's attention.
It is illegal to use these electronic devices in Singapore.

Last Monday (March 4th), Dr. Janil Puthucheary, Senior Minister of State for Health in Singapore, stated in Parliament that the Ministry of Health and the Health Sciences Agency are "closely monitoring" the use of energy bars due to their marketing on social media and various flavors targeting young people.
He added that authorities are working hard to ensure that these products do not contain harmful ingredients such as nicotine. This addictive substance is commonly found in electronic cigarettes and products used by smokers who quit smoking.
According to online reports, these energy bars are common in Malaysia and have raised concerns about young people using them as a way to smoke and vape.

What is an energy stick?
These nasal inhalers are commonly referred to as "energy bars" or "energy bars" and can be found on e-commerce platforms such as Shopee, Lazada, and Carousell, with prices ranging from approximately SGD 1.20 to SGD 4.50.
They typically come in compact, brightly colored packaging, with various inhalers available in flavors such as mint, peach, and even alcohol themed names like 'Mango Vodka'.
Experts say that given the abundance of nasal decongestants on the market over the years, nasal inhaler products are not new.
Dr. Ker Liang, the medical director of Aglow ENT (Ear, Nose and Throat) Center, said that the difference is that these energy bars have been repackaged with a "fashionable and eye-catching design" for this familiar product.
For example, the common nasal congestion medication Vicks claims on its packaging that it uses menthol and camphor as active ingredients, which can clear "nasal congestion" and make breathing "feel fresh and cool".
The advertisement for the energy bar goes further, claiming that when people feel tired in class or while driving, this device can stay alert at any time.

How safe are energy bars?
When searching for energy bars on e-commerce websites, some sellers claim that their products have multiple health benefits, including helping users quit smoking, "deeper" breathing, and controlling snoring.
However, apart from these claims, there are many similarities between these two types of nasal inhalers.

Doctors agree with this assessment and add that research on the medical benefits of traditional nasal congestion reducing agents is limited. They said that in both cases, excessive use may irritate the respiratory tract.
Dr. David Chin, an otolaryngologist at Parkway East Hospital specializing in the treatment of ear, nose, and throat diseases, said, "The concept of 'energy bars' is not much different from our traditional inhalers
Oil based chemicals, whether menthol or essential oils... are inhaled and interact with receptors in the nasal cavity.
The difference is that there are now various ingredients that can produce different odors and even different effects. The word 'energy' may be more like a marketing term rather than a description of new technology
Dr. Chin added that in terms of menthol, although studies have shown that people feel more comfortable breathing after using these products, actual airflow measurements have not shown significant improvement.
Mr. Sean Ang, a smoking cessation consultant and pharmacist at Success Alliance Enrichment, also stated that menthol activates receptors in the nasal cavity, producing a feeling of cool air, but has no effect on clearing blocked nasal airways.
Professor Eric Chan from the Department of Pharmacy at the National University of Singapore stated that the "quality control" of plant essential oils (another common inhaler ingredient) is not yet clear, so the essential oils used may contain allergenic ingredients, which could have adverse effects on "vulnerable consumers" such as pregnant women.
Professor Philip Eng, a senior respiratory consultant physician at Elizabeth Hospital, also stated that users of traditional products such as Vicks VapoPub should be cautious of excessive use.
He highlighted a study in the 2016 BMC Journal of Otolaryngology that linked an 85 year old woman with a "difficult to diagnose" pneumonia to long-term application of Vicks VapoRub to her nostrils.

How legal are these health statements?
Regardless, well-known brands such as Vickers must indicate the active ingredients on their packaging.
However, experts point out that this is not the case with energy bars, as they usually do not clearly list their components.
They added that the production and monitoring of energy rod inhalers are unregulated areas.
Dr. Kerr said, 'Buying a simple device that is affordable and claims to bring many wonderful health benefits is very tempting.'.
As consumers, we should be cautious when purchasing products with opaque ingredients, especially when claiming to have medical benefits
She added that people with persistent nasal congestion or excessive fatigue should seek medical help, as these symptoms may indicate undiagnosed rhinitis or sleep apnea, which can be easily and safely treated.

A message on Lazada shows that according to "clinical trials and reports," this nasal patch "regenerated 96.3% of lung tissue" and "cured 91.5% of respiratory infections" after four weeks.
Pharmacist Mr. Hong said that these statements are misleading and some are 'completely false'. There is no evidence to suggest that energy bars can bring such benefits, and advertising that clinical studies have been conducted does not necessarily mean that the research is done correctly, if any.
Dr. Stephen Lee, an expert and consultant at the Raffles Ear, Nose, and Throat Center, said, "These energy stick nasal inhalers are not registered. Therefore, the actual ingredients are unknown and may vary depending on the source of these energy sticks
Experts warn that due to the unknown ingredients in these inhalers, they may contain harmful substances similar to those found in cigarettes and electronic cigarette devices, which could exacerbate respiratory diseases and lead to addiction.
The Malaysian Ministry of Health stated in a statement on February 8th that it will take enforcement action to ensure that advertisements for energy bar products are removed from e-commerce websites in response to public complaints.
Since October last year, energy bars have also become popular in China, and some of these products on the Chinese online shopping website Taobao have sold over 10000 units so far.
In December last year, the Tianjin Consumers Association suggested on its official WeChat account that primary and secondary schools across the country set up health risk warning signs for energy bars on campus.
Carousell uses both automatic and manual auditing methods to detect prohibited items and encourages users to report them. We will conduct the audit within 24 hours.
It states: "We do not allow the listing of pharmaceutical and healthcare products or services that claim to treat or cure any disease that requires the attention of registered doctors or other qualified practitioners
Lazada stated that the company fully complies with the regulations set by Singapore authorities and "continuously updates" its algorithms to exclude and disable products that violate its seller market policies.
Lazada added, "Products that cannot be promoted according to local laws, regulations, and recommendations, including product lists containing false, misleading, or exaggerated statements, are also not allowed

How popular are energy bars among young people?
The energy stick seller said that most buyers are very young, usually between the ages of 12 and 25.
About three months ago, an 18-year-old student saw the product on a Chinese supplier's page and began selling it on the electronic marketplace Carousell. He only wants to reveal his surname Goh.
Since then, he has sold about 200 units per month at a price of SGD 3.50 to SGD 4.50 per unit, and many returning customers are students.
He said, "So far, sales have been getting higher and higher... to the point where it's overwhelming, and customers are booking the next batch of orders before new inventory arrives
Some buyers are middle school students who purchase 10 to 15 energy bars at a time and distribute them at school.
The teenager claimed that he would record the usernames of young repeat customers and prevent users under the age of 18 from making bulk purchases.
Pharmacist Mr. Hong pointed out that many energy bars come with free lanyards, and their taste and color are clearly targeted towards young people.
He added, "Plus it's becoming increasingly popular, hanging such a device around your neck and becoming a member of the user community may become cool

What are the risks for young people?
Dr. Chen from Baihui East Hospital said that young people who use such devices may eventually develop more harmful habits.
Even if inhalers do not contain addictive substances, experts are concerned that frequent use of such products may expose people to other substances such as electronic cigarettes.
Professor Chen from the National University of Singapore said, "From a medical perspective, if these energy bars do not contain additive ingredients, consumers may indeed not become addicted to inhalers
However, from a socio-economic perspective, this is not the case, as consumers may eventually develop a habit or lifestyle that tends to use e-cigarettes or smoke
Mr. An said that frequent hand to nose movements and other behavioral patterns may lead to physical dependence on the device.
Ultimately, if the harm becomes irreversible, our young people will face long-term respiratory diseases that may occur in their future lives. According to these claims, this risk is not worth taking because there are safer, thoroughly researched products that can provide assistance

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