Mass Education and Awareness Campaigns on Smoking Can Prevent Unnecessary Health and Safety Risks

In early January, there were reports of a 30-year-old man from Mafikeng, North West, who was hospitalised after he suffered complications from excessive smoking of a hookah pipe, commonly known as hubbly bubbly. Reports stated that the man suffered a stroke and was found to have a hole in his lung.

Not ones to miss the opportunity to engage in fearmongering and misinformation, the Department of Health (DoH) and anti-smoking organisations used the incident to lay the blame on the tobacco and vaping industries for allegedly promoting hubbly bubblies as less harmful than cigarettes. Anti-smoking organisations have deliberately failed to distinguish between hubbly bubblies and vapes in particular to drive a certain narrative with the aim of encouraging the South African government to implement highly restrictive regulatory measures on vaping. Unfortunately, prohibitive regulations for vaping will be much to the detriment of the vaping industry and most importantly, smokers. For the record, a hubbly bubbly involves the combustion of tobacco (usually flavoured), producing smoke that is inhaled through a water-cooled pipe. Vaping, on the other hand, typically utilises electronic devices to heat and aerosolise a liquid, usually containing nicotine, without the harmful byproducts of combustion.

This is not to say that the vaping industry is against any form of regulation. Instead, the vaping industry has called for regulation that is based on scientific evidence, and the protection of children, whilst ensuring access to smokers who are unable to quit or in search of less harmful alternatives to smoking.

The Vapour Products Association of South Africa (VPASA) is as concerned as the DoH and anti-vaping organisations on the prevalence of youth vaping in the country. To that end, the association has been running Youth Access Prevention (YAP) campaigns, aimed at ensuring that young people do not have access to vaping products. While the campaign has achieved moderate success, we believe that with joint efforts from various stakeholders, more can be achieved.

Now coming to regulation, Clive Bates in his 2024 Evidence Brief, states that the danger for policymakers is to make straightforward cause-and-effect claims about youth smoking or vaping, such as attribution of youth use to factors such as flavours, packaging, or marketing to vaping uptake. Such views often lead to the danger of designing policy based on a simplistic understanding of causes which will leave the underlying demand intact and cause users to find alternative ways to use nicotine, including switching to smoking. The public health challenge is to reduce the risks to these young people to the extent possible – including the risks arising from the unintended consequences of poorly designed policy.

The Tobacco Products and Electronic Delivery Systems Control Bill in its current form represents a poorly designed policy that will undoubtedly not achieve its intended objectives. Instead, as stated earlier in this article, will only hamper the growth of the vaping industry and restrict smokers from receiving information on less harmful alternatives to smoking.

The news of the man from Mafikeng serves to underscore the importance of mass education campaigns on the scale of the HIV/Aids campaign to create awareness amongst young people and parents on the dangers of smoking and that vaping is sorely for current smokers. Any smoking-related hospitalisation is one too many, especially if we can inform and encourage smokers to try less harmful alternatives such as vaping, as seen in the United Kingdom and New Zealand, which have noted positive results regarding declines in smoking rates.