South Africa Should Rethink its Tobacco Control Strategies in Line with Global Trends

There is a growing wave of acceptance that current tobacco control policies as prescribed by the World Health Organisation (WHO) are not achieving their intended outcomes as the levels of smoking have not declined significantly. This realisation is slowly prompting a rethink from various countries on their tobacco control policies and strategies.

Countries such as the United Kingdom and Japan have long adopted the harm reduction approach to tobacco control. This approach has seen both countries reduce their smoking rates by promoting scientifically proven less harmful alternatives to adults who wish to find alternative ways to ingest nicotine. The United States has also adopted a more permissive stance towards Electronic Vapour Products (EVPs) and has thus far resisted calls for them to be banned outright. This was following the E-cigarette, or Vaping, product use Associated Lung Injury (EVALI) outbreak in 2019, which was later found to have been the result of illicit vaping products from a certain manufacturer. Recently, the government of Uruguay reversed the ban on the importation and sales of heated tobacco products and EVPs and noted the role the products can play a role in reducing the impact of smoking.

In South Africa, the Department of Health (DoH) has stubbornly stuck to its outdated view on the dangers of EVPs. The DoH still contends that vaping is as dangerous to people’s health as smoking. This is despite the overwhelming scientific evidence, which has proved that vaping is significantly less harmful than smoking. Public Health England recently released its updated study on vaping, which reiterated its initial finding that vaping is 95% less harmful than smoking.  An updated Cochrane evidence published in the Cochrane Library found that EVPs containing nicotine could increase the number of people who stop smoking compared to nicotine replacement therapies. These are some of the plethora of studies and evidence reviews that support the adoption of EVPs as part of tobacco harm reduction strategies.

The DoH in South Africa seems, however, intent on implementing tobacco control measures that have been proven not to have worked and are not cognisant of global developments, especially on vaping. The proposed Control of Tobacco Products and Electronic Nicotine Delivery Systems (COTPENDS) Bill seeks to introduce more stringent smoking and vaping regulations. Some of the proposed measures include plain packaging; no public place smoking or vaping; graphic health warnings on packs to name a few. The proposed measures are not based on any practical and factual evidence when coming to EVPs. It is on that basis that the vaping industry has implored the Department of Health to have vaping regulated separately from tobacco based on the fact that the two are not the same and vaping has been proven to be less harmful than smoking. South Africa is renowned for its progressive policies and the same should be true of its tobacco control policies, which should be based on scientific evidence rather than ideology and disdain for smokers and vapers.

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