WHO COP9: South Africa’s Stance on ENDS is Misguided and Not Scientific

The 13th of November marked the conclusion of the Ninth Session of the Conference of the Parties (COP9) to the World Health Organisation Framework Convention on Tobacco Control (WHO FCTC). Parties at the Conference, including South Africa, were afforded the opportunity to share progress in the implementation of tobacco control measures.

Parties were expected to debate and adopt appropriate regulatory approaches for novel and emerging tobacco products, including Electronic Nicotine Delivery Systems (ENDS), however, this critical discussion has been deferred to COP10 which is expected to take place in 2023. This decision, according to a COP9 report, has been influenced, in part, by the need to ensure that regulatory decisions are based on scientific evidence which will be reviewed in the build-up to COP10. Despite this admittance, the WHO has consistently called for FCTC signatories to implement stringent measures to regulate ENDS, such as restricting the manufacture, import, sales and use thereof.

For the most part, South Africa has taken direct guidance from the WHO, without question, when coming to tobacco control. The WHO, though admitting that ENDS are less harmful than cigarettes, has dismissed the role they can play in tobacco harm reduction, stating that the concept of harm reduction is being used by tobacco companies as a marketing ploy. When coming to ENDS, the WHO has chosen to nitpick evidence on the so-called harms related to ENDS. It comes as no surprise that the Department of Health (DoH) has also exhibited the same level of misguided doubt regarding ENDS. Despite proving year after year that ENDS are less harmful than combustible cigarettes, the WHO has dismissed the scientific evidence by reputable institutions such as Public Health England, which have proved that vaping is 95% less harmful than smoking.

It is also unfortunate that DoH’s misguided stance on ENDS has permeated through other government departments. In discussions on the possible introduction of a vaping tax before Parliament’s Standing Committee on Finance on 11 November, National Treasury’s head of tax and financial sector policy Ismail Momoniat, came out very strongly against the use of ENDS, claiming that they are an invention of the tobacco industry to lure young people. This is concerning, as views such as those of the National Treasury, which has to develop vaping excise regulation, are not based on any scientific data. Although youth vaping is a concern, even for the Vapour Products Association of South Africa (VPASA), its’ scourge is greatly exaggerated to suit a narrative advanced primarily by DoH.

Whilst the decision to defer the adoption of regulatory positions to COP10 is the right one, it will be meaningless if the abundance of scientific evidence in favour of ENDS is ignored. Besides the scientific evidence by Public Health England that ENDS are 95% less harmful than combustible tobacco, the Cochrane Library has also found that ENDS are more effective smoking cessation tools than other forms of Nicotine Replacement Therapy (NRTs). This evidence has consistently been ignored and met with doubt by the WHO. 

The rejection of the role ENDS can play in tobacco harm reduction and proposal for stricter control measures, will only harm millions of smokers, who will be deprived of information on less harmful alternatives. It also begs the question of “For whom does the WHO seek to regulate ENDS?”

It is critical to note that the vaping industry does not aim for non-regulation nor to dictate government policies on vaping, but instead call for open and transparent engagements on appropriate regulation of the industry based on scientific evidence. After all, South Africa prides itself on inclusive and evidence-based policymaking – now is not the time to abandon those values at the altar of WHO’s disdain for the tobacco industry.