With the parliament having recently revived the Tobacco Products and Electronic Delivery Systems Control Bill, South Africa is not far from having some of the stringent smoking and vaping laws in the world. As the Vapour Products Association of South Africa (VPASA) has been arguing, the passing of the bill in its current form will be a regressive development for South Africa’s bid to reduce the number of smokers in the country. There is ample research and evidence that the quit or die approach to smoking does not yield the desired outcomes.
Instead of accepting the proven scientific and evidential facts about vaping, the Department of Health is intent of pushing through its flawed bill based on some paranoia about tobacco companies using vaping to keep its customers.
The latest research from Action on Smoking and Health (ASH) in the United Kingdom (UK) found that among 5 million people who stopped smoking in the last five years, just over half report they used a vape to quit equating to 2.7 million people. Of those a third have also stopped vaping and the average duration of their vaping was a year. If ever there was doubt that vaping does aid in quitting smoking, there is now well-established evidence, which should make a government that claims to care about the health of smokers, reconsider its stance on vaping.
This incredible feat by the UK is not by chance, it is a result of a deliberate action by the UK government informed by scientific evidence. New Zealand is also on the cusp of being declared a smoke-free nation, with smoking rates among adults now at 6.8% and expected to fall below 5% by 2025. The latest New Zealand Health Survey results show the rate of daily smoking was 6.8% in 2022/23, down from 8.6% the previous year and 16.4% in 2011/12. This achievement is largely credited to the country’s progressive stance on vaping as a smoking cessation tool. Since the legalisation and regulation of vaping in 2020, New Zealand has seen a remarkable decline in daily adult smoking rates, highlighting the effectiveness of vaping in reducing the harm associated with tobacco use.
Sweden offers another compelling example of how an effective tobacco harm reduction strategy can lead to significant public health gains. The country has the lowest smoking rate in Europe, thanks to the widespread use of snus, a smokeless tobacco product that provides nicotine without the harmful effects of combustion. Sweden’s success shows that when safer alternatives to smoking are made accessible and socially acceptable, smoking rates can decline dramatically, leading to fewer tobacco-related illnesses and deaths.
The UK, New Zealand, and Sweden’s approaches are rooted in a pragmatic understanding of nicotine use. Rather than focusing solely on abstinence, the countries have embraced the idea that providing less harmful alternatives to combustible cigarettes can lead to better public health outcomes. This strategy has not only reduced smoking rates but has also lowered healthcare costs and improved the overall quality of life for their citizens.
Lessons for South Africa
South Africa’s tobacco-related health burden is persistently high, with 2021 GATS Study Report showing that 25.8% (11.1 million adults), 41.2% of whom are men, and 11.5% women currently smoked tobacco. The need for tighter smoking regulations and regulation of vaping is accepted and supported, particularly to protect young people from easily accessing these products that are made for adult smokers. However, as stated, the proposed bill in its current form will not achieve its intended objectives and is ignorant of scientific evidence when it comes to vaping. It is tantamount to killing an ant with a sledgehammer and may have severe unintended consequences. With a new Portfolio Committee on Health in place, we hope that sanity will prevail and there will be calls for its significant revision, guided by the principle of tobacco harm reduction, which has shown to achieve the results, as we are currently witnessing from the UK, New Zealand and Sweden to name a few.