The Department of Health Should Open Itself up to Genuine Conversations on Vaping

South Africa should follow the lead of the Australian government in opening itself up to engagements on EVPs. Thus far, the South African Department of Health (DoH) has shunned attempts to engage with the EVP industry and those who hold a different view to it and anti-tobacco lobbyists and has held on to its myopic view on vaping.

In October 2020, a Select Committee on Tobacco Harm Reduction was established by the Australian government to launch an inquiry into vaping and establish clear e-cigarette laws. After months of public consultations, the Committee issued its final report in December 2020.

In the report, the Committee made a number of recommendations including amongst others: that the Australian government revise its current tobacco control measures to include harm reduction strategies with a strong focus on e-cigarettes; legalise the sale of, possession and use of nicotine e-cigarette products as a consumer product; establish a nationally consistent regulatory framework for the sale, possession and use of nicotine e-cigarette products; and that government continue to fund independent research into e-cigarette use.

This is a positive step from a country that has been hailed as a global leader by a number of countries, South Africa included, in reducing smoking and tobacco related harm. Australia is one of the countries that first introduced measures such as plain packaging and graphic health warnings for cigarette packs in its bid to reduce levels of smoking in that country. The country should be commended for realising that Electronic Vapour Products (EVPs) can play a role in its quest to further reduce smoking rates and tobacco related harm.

It should also be noted that the recommendations of the Select Committee support the position of the Vapour Products Association of South Africa (VPASA) on how the South African government should treat EVPs. South Africa should also look at the United Kingdom, which has long adopted EVPs as part of its tobacco harm reduction strategies and as a result has recorded a significant decrease in smoking rates. VPASA has been advocating for the inclusion of EVPs in tobacco harm reduction strategies in the country to assist in mitigating smoke related harm in line with South Africa’s strategy on non-communicable diseases.

South Africa should follow the lead of the Australian government in opening itself up to engagements on EVPs. Thus far, the South African Department of Health (DoH) has shunned attempts to engage with the EVP industry and those who hold a different view to it and anti-tobacco lobbyists and has held on to its myopic view on vaping.

The last published Socio-Economic Impact Assessment report released by the Department in May 2018 showed glaring gaps in the Department’s appreciation of the evolving landscape on vaping. Despite the emergence of copious amounts of new evidence showing vaping to be far less harmful than smoking, the Department, in its media pronouncements, continues to act as if its extreme caution on vaping products is justified.

The Department continues to rely on ideologically laden research, including the now discredited anti-vaping crusader Stanton Glantz whose research on the impact of vaping on cardiovascular health was found to be wanting. The study called Electronic Cigarette Use and Myocardial Infarction Among Adults was withdrawn from publication by the Journal of the American Heart Association in February 2020. According to JAMA the “article did not fully account for certain information in the Population Assessment of Tobacco and Health”, including whether the myocardial infarction started before or after the respondents in the study-initiated e-cigarette use.  

Similarly, the Department and anti-vaping lobby continue to rely on a hyperbolic reading of data on youth initiation into vaping, ignoring overwhelming evidence from the UK, which shows that in fact, youth vaping is not the crisis that it has been made out to be. The UK Action on Smoking and Health (ASH) found that “Vaping is much less common among young people who have never smoked. A large majority of never smokers aged 11-18, 93.8% in total, have either never used an e-cigarette (87.8%) or are not aware of them (6.0%). Of young people aged 11-18 years old who have never smoked, 5.5% have ever tried e-cigarettes, 0.8% are current vapers, only 0.1% vape more than once a week, and not a single never smoker reported vaping daily”. Yet, in South Africa the public is bombarded with a gateway theory which has manifestly failed to materialise in markets where the government follows a strict, but scientific approach in regulating vaping. A study published by NYU researchers from the school of Global Public Health in the Journal Nicotine & Tobacco Research in January 2020, “finds that over 80 percent of youth do not use any tobacco and over 86 percent don’t vape—and among the minority who do vape, most are not regular users. In addition, the study reveals that most youth who are vaping are also current or former smokers”. Such findings do not accord with the pre-determined posture of the Department which relies on a long standing and justified abhorrence of smoking, even if this lends itself to a misguided and overblown caution on technological advancements in nicotine delivery.

Though youth vaping should concern all sane people, it does not help to use this concern as a smokescreen to avoid engaging with the very real possibility that vaping is in fact a gateway out of smoking that should be critically and dispassionately assessed without leaning on orthodox strategies for countering smoking. Equally, it does nothing for the millions of smokers who do not have the will to quit their nicotine intake but would change to less harmful alternatives if these were widely available.

That being the case, VPASA reiterates its position that it is not against regulation, as DoH and anti-tobacco lobbyists would have people believe. VPASA has long stated that any regulation on vaping should be scientifically based and provide a conducive environment for smokers to have access to information on less harmful alternatives. It is on that basis that we have called for a separate regulatory framework from the mooted Control of Tobacco Products and Electronic Nicotine Delivery Systems Bill (COTPENDS), which treats vaping and smoking as one and the same. The risk of conflating the two habits will be carried by generations of smokers who are liable to be misinformed and disinformed about the crucial differences between the two products.