As the focus falls on the youth this Africa Youth Month, health organisations partnering in the #protectournext initiative are focusing on the challenge e-cigarettes or vape products are posing to protecting youth and reducing tobacco use. These products may create a new generation of young nicotine and tobacco users, undermining decades of progress in reducing tobacco use and nicotine addiction, say the National Council Against Smoking (NCAS), CANSA, the SA Medical Research Council (SAMRC) and the Heart & Stroke Foundation of SA. “We are calling for government to take e-cigarettes seriously, act quickly, and regulate them appropriately by passing the Control of Tobacco and Electronic Delivery Systems Bill in South Africa into law before a new generation is addicted to nicotine,” says Dr. Sharon Nyatsanza of NCAS.
E-cigarette or vape products brands are seeking new markets in countries around the globe and all of the major multinational tobacco companies are either launching their own e-cigarette and tobacco alternative products or buying established brands. A research report by Prescient & Strategic Intelligence predicts that the South African e-cigarette market will reach $62.0 million by 2024, growing from 2018 when it generated $20.7 million revenue.
Dr Catherine Egbe, specialist scientist at the South African Medical Research Council, says the South African market expansion is fuelled by misinformation on the health risks. “While research may still shed light on further health risks, we know enough for it to be very clear that these products are harmful. We must take the opportunity to try and avoid what happened with tobacco products over the years, while the health research catches up. We only have a small window of opportunity to try and prevent a new generation from becoming addicted to nicotine.”
Professor Anthony Westwood, paediatric and child health specialist at School of Child and Adolescent Health at the University of Cape Town, explains: “The longer we wait to pass the Bill, the more we risk that children become addicted to nicotine. For the vast majority of people who smoke, addiction happened before the age of twenty.”
Westwood emphasises the use of nicotine in any form causes addiction and can harm adolescent brain development. “The highly addictive properties in nicotine have the ability to alter the function of young brains permanently. And while the toxicity of the fumes from these products is still unclear, there is increasing evidence showing that both nicotine and the aerosols from these products result in significant health harm. This includes pulmonary inflammation, impaired immunity and reduced lung function,” says Westwood. E-cigarettes can also expose youth to harmful and carcinogenic chemicals. “Our children cannot afford to find out in 20 years that they’ve got cancer because of e-cigarettes.”
According to the World Health Organization (WHO) Report on the Global Tobacco Epidemic 2019 , e-cigarettes or vapes are not harmless and must be regulated as they pose risks to users and non-users. The global health body argues that there is, as yet, no harmless tobacco product, and research on e-cigarette or vape product use has provided enough data to show that these products cause significant health harm, necessitating regulation.
E-cigarettes or vape products are currently unregulated in South Africa and are being sold as consumer products, resulting in easy availability to youth at retail outlets, kiosks, and shopping malls, says Lorraine Govender of CANSA. “We’re very concerned that e-cigarette marketing uses many of the same strategies effectively used by the tobacco industry to reach kids, and South Africa is no exception. The tobacco industry’s flavoured products that taste like fruit, mint and candy have long been known to be appealing to kids, and now e-cigarettes are available in these flavours. Tobacco and e-cigarette companies are also using social media marketing to advertise e-cigarettes in ways that appeal to the youth. The bottom line is we need to close the legislative gap, and close it fast.”
Of the primary approaches available to governments acting to regulate e-cigarettes or vape products, South Africa proposes to regulate e-cigarettes using tobacco control measures. “South Africa’s Tobacco Control Bill will regulate e-cigarettes in the same way as tobacco cigarettes. Some of the regulations applicable to both combustible and e-cigarette products include new advertising restrictions at point of sale, the requirement for plain or standardised packaging and the banning of smoking or vaping areas in restaurants and public buildings.
When the Bill is passed, South Africa will join more than 90 other countries that regulate e-cigarettes. Some countries have taken the approach of completely banning e-cigarettes, or regulating e-cigarettes as medicinal or therapeutic products available only on prescription. In September 2020, Australia made an interim decision to classify e-cigarettes (and other products) as a prescription-only product from June 2021 as a measure to limit the rapid growth of youth uptake in vaping, with the Therapeutic Goods Administration highlighting that between 2015 and 2019, e-cigarette use by young people increased by 72% in the US, 150% in Canada and 96% in Australia.
Nyatsanza says the South African government must take e-cigarettes or vape products seriously as they have real potential to hinder national health goals. “For the youth, these products can be the start of nicotine addiction, with all the health harms that come with it. We must protect our public health policy from the commercial interests of the tobacco and e-cigarette industries and pass the Bill now.”
Presentation by Professor Anthony Westwood:
(webinar + slides)
WHO e-cigarette Q&A
E-cigarette use among youth and young adults, A report of the Surgeon General
Campaign for Tobacco Free Kids (CTFK):
INFO ON SOUTH AFRICA MARKET:
INFO FROM #PROTECTOURNEXT PARTNERS:
Heart and Stroke Foundation South Africa
National Council Against Smoking: