Cosmetic industry is growing rapidly around the globe.1 Among the countries in Asia-Pacific region, its market value was the second highest after the European market.2-3 Notably, the expenditure for cosmetics and toiletries among Malaysian reached USD 407 million in 2013.2 The Malaysia government enacted the Control of Drugs and Cosmetics Regulations 1984 (CDCR’84) to regulate the manufacture, sell, supply, import, possess or administer of cosmetics.4 Under regulation 18A(1) of the CDCR’84, “No person shall manufacture, sell, supply, import, possess or administer any cosmetic unless (a) the cosmetic is a notified cosmetic; (b) unless he is the person responsible for placing the notified cosmetic in the market or a person authorized in accordance with the notification note which is issued by the Director of Pharmaceutical Services”. The authority which regulates the cosmetic is the National Pharmaceutical Regulatory Agency (NPRA) under the Ministry of Health, Malaysia (MOH). All cosmetics industry players who intend to manufacture or import any cosmetic, must apply the notification of cosmetics (NOC) through NPRA. For those who locally purchase the cosmetic for resale purpose, possess or administer any cosmetic, have the responsibility to ensure the cosmetics are notified. In particular, a user-friendly platform Quest 3+ created by MOH has been available for the cosmetic industry players to verify the notification status of cosmetics.5
On the other hand, the authority which enforces the Regulation is the Pharmacy Enforcement Division (PED) under the MOH. Between 2015 and early 2017, PED had confiscated cosmetics without notification (CWN) which worth RM 8.5 million.6 Moreover, some CWN were banned as found to contain mercury, hydroquinone and tretinoin.7 In Malaysia, beauty salons (BS) are the major points of access and referrals to cosmetics and aesthetic services.8 However, it was found that some of the BS failed to comply with the cosmetics Regulations by purchasing and supplying CWN to their customers.6 Hence, it is crucial for the beauty salon owners (BSO) to have sufficient knowledge and appropriate practices pertinent to the sell, supply, import, possess or administer of any cosmetic. However, to the best of our knowledge, there wasn’t any published literature that provided evidences on the knowledge and practices of BSO towards the NOC. Hence, this study aimed to bridge the gap by investigating the knowledge and practices of BSO in Sarawak (Malaysia) towards the NOC.
MATERIALS AND METHODS
This was a cross-sectional study conducted from 13th March to 31th May 2016. The approval from Malaysian Medical Research and Ethics Committee (ref. no.: (5) KKM/NIHSEC/P17-13) was obtained prior to the study. Only BS located in the four major cities of Sarawak (Kuching, Sibu, Bintulu and Miri) were included in this study. As no exhaustive list of beauty salons in Sarawak existed, Google search with key terms (“beauty salon” OR “beauty saloon” OR “pusat kecantikan” OR “beauty treatment centre” OR “beauty spa”) AND (“Sarawak” OR “Kuching” OR “Sibu” OR “Bintulu” OR “Miri”) was employed to identify the BS located in the four major cities of Sarawak. Firstly, a total of 252 search results were produced. Secondly, 68 search results which found to be duplicates were excluded. Thirdly, 102 search results which were specifically remarked as hair salon, nail salon, bridal shop, massage parlour or other irrelevant premises were also excluded. Fourthly, 24 franchises of BS (having same company name) were excluded, and only their headquarters (identified through browsing the profile of the company) were included. As such, a total of 58 BS (17 from Kuching, 10 from Sibu, 12 from Bintulu and 19 from Miri) were listed. Due to the small sampling frame, the BSO of all 58 BS were included in the study.
The regulation 18A(1) of the CDCR’84 was firstly reviewed and content-analysed to generate items related to study objectives.4 The items were incorporated into a structured and self-administered questionnaire, which comprised of two sections. The instrument consisted of four questions on knowledge and three questions on practices. Each question representing a unidimensional measurement on different perspectives of cosmetic regulations. The answers to each question are binary, either “yes” or “no”. The content validity of the questionnaire was ensured by three senior PED officers.9 Lastly, training for the interviewers was done to ensure they would get written informed consent before the interview, and explained the purpose of the study, the right of the participants to withdraw, and confidentiality of the study, in accordance to the data collection manual.
During the field visits, enumerators faced difficulties in obtaining the consent to participate from BSO as some of them considered the data to be acquired were sensitive and confidential. Such difficulties were also due to the fact that the enumerators were representing Sarawak PED. Hence, only 31 BSO (53.4%) agreed to participate in this study, with 11 from Miri, 7 from Kuching and Bintulu, and 6 from Sibu. Descriptive statistics frequency and percentage were used to report the answers toward every unidimensional measurement with binary outcomes on knowledge and practices of BSO. The analyses were carried out by using SPSS version 21.0.10
Majority of the BSO who participated were female (71.0%), Chinese (61.3%) and had been practising for an average of 11.3 years (Table 1). Most of the BS were located in Miri (35.5%).
In terms of knowledge towards NOC (Table 2), although majority of BSO knew that every cosmetic sold in Malaysia needed to have notification number issued by MOH, little of them knew what the notification number looked like (19.4%), how to verify the NOC through QUEST 3+ (6.4%) and how to apply notification number (3.2%).
MOH = Ministry of Health, Malaysia.
In terms of the practices towards NOC (Table 3), only 6.4% of BSO applied for the notification number whenever they imported cosmetics. Such problems are particularly immense in Bintulu and Sibu where none of the BSO did so. Furthermore, less than half of BSO made sure the cosmetics purchased from their suppliers were notified with MOH (38.7%) and would advise customers to make sure every cosmetic they bought must be notified with MOH (48.4%).
To the best of our knowledge, this is the first study conducted in Malaysia to explore the knowledge and practice of beauty salon owners towards notification of cosmetics. Although majority of the BSO (71%) knew that all cosmetics sold in Malaysia needed to have notification number issued by MOH, little of them knew what the notification number looked like and how to verify the notification status of cosmetics (6.4%). Inarguably, knowing how to verify the legitimacy of the products sold to customers against forgery is an important component of business ethics.11 Further-more, such knowledge gap would weaken the mechanism of safeguarding the legitimacy of the cosmetics in the supply chain.12 This argument is supported by the fact that majority of the BSO (61.3%) did not verify the cosmetics that they purchased from their suppliers were notified. Hence, the Quest 3+ product search platform created by MOH to check for the notification status of cosmetics, should be intensively promoted to and fully utilized by BSO.
On the other hand, although majority of them (71%) knew that all cosmetics needed to have notification number issued by MOH, little of them (3.2%) actually knew how to apply for it whenever they imported cosmetics. This could be the main reason for only 6.4% of them applied notification number whenever they purchased cosmetics from overseas. This implies a disadvantaged position to the BSO as they are prone to supply CWN to their customers, which would face legal consequences. This is reflected by the incidences where local BSO were charged for possession for sale of CWN.13 Nonetheless, due to the knowledge gap and inappropriate practices mentioned, the consumers are highly exposed to CWN, which are often unsafe to be used.8 To address the rampant CWN in local market, relevant authorities should strengthen their collaboration in regulating the rapid-growing cosmetics industry.2 In specific, local authorities who approve the operation of beauty salons, could refer the existing and new applicants of beauty salons to PED for vetting and subsequent compulsory training course on the regulations of cosmetics as stipulated in CDCR’84. Notably, the procedures of applying notification for the cosmetics and verifying legitimacy of cosmetics addressed during the training course should be facilitated through hands-on and simulation rather than one-way communication for better learning outcome.14
Besides, it was found that less than half (48.9%) of the BSO advised customers to make sure every cosmetic they bought must be notified with MOH. Although it is not a legal requirement for them to do so, such practice could serve as an additional preventive measure to BSO from purchase and sell of CWN. From the perspective of business ethic, such practice is highly encouraged as it could empower the consumers to play the role as a guardian in combating the illegitimate cosmetics.15
Down the line, the BSO which practice as such, could gain more trust from the consumers, become a role model in the cosmetic industry and enjoy sustainable development due to their strict compliance with the laws and regulations.16-17
The findings of this descriptive study were limited due to substantial numbers of BSO who were unwilling to participate (46.6%), and thus incur nonresponse bias.18 Future studies should employ enumerators who are not the representatives from relevant authorities to enhance the response rate. Furthermore, the samples included in this study were selected from the four major cities of Sarawak, hence limited the general-izability of the results to all BSO in the State. Nonetheless, the instrument to measure knowledge and practices did not undergo comprehensive validation process to evaluate its psychometric properties. One of the reason is because each item representing a unidimensional measurement on different perspectives of cosmetic regulations, which aims to provide managerial implications rather than to develop an instrument. Future studies with remedial interventions to improve the knowledge and to promote correct practices among BSO towards NOC are recommended.