Healthcare Opinion South Africa

Are we about to see SA's tobacco bill go up in flames?

Despite mounting evidence that vaping is a viable smoking cessation tool, the South African Health Department has lumped it in the same category as tobacco products within the Control of Tobacco Products and Electronic Delivery Systems Bill - likely to be submitted to parliament before the end of the year.
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This is short-sighted, seeing that the Bill supposedly seeks to reduce the incidence of tobacco-related illness, disability and death.

Here I refer to a recent study which found that smokers who vape regularly are eight times more likely to quit cigarettes (and stay stopped) than those who don't. Vaping is almost twice as effective as other smoking cessation methods such as nicotine patches, gum, lozenges, inhalers, or mouth sprays.

It’s no wonder then that vaping is being encouraged by health departments around the world as part of programmes to reduce tobacco use in their countries to 5% or less of the population. Consequently, as vaping in these countries goes up, smoking goes down.

In the United Kingdom, for instance, which strives to make the country smoke-free by 2030, the number of vape users has increased to 8.3% of the population - the highest rate ever, amounting to 4.3 million citizens, most of whom (57%) are ex-smokers.

With this in mind, here are the learnings from the UK that the South African government should consider when putting together future policies to safeguard citizens’ health:

Vaping embracement correlates with smoking cessation: Among ex-smokers, the main reason why they vape is to help them quit (29%), followed by relapse prevention (19%). Current smokers who vape say that they do so primarily to cut down on smoking (17%), and to help them quit (14%) as well.

Evidence suggests that, as the use of vaping products in quit attempts increases, so too does the likelihood of success in stopping.

In fact, it is estimated that in 2017, more than 50,000 smokers, who would otherwise have carried on smoking, managed to stop with the aid of a vaping product.

Lessons for local lawmakers: Tobacco harm reduction, based on scientific evidence, forms part of the UK’s health strategy. And, from the figures above, it is clearly working.

So convinced is the UK of vaping’s efficacy that e-cigarettes are being prescribed on the NHS to those trying to quit. "Yet, in a country where R42bn is being spent on tobacco-related illnesses,[viii] vaping is still seen as a problem, and not a solution.

With more than 44,000 South Africans dying from smoking each year, this is something our health department should be considering, instead of pushing ahead with baseless legislation.

Rather, they should be drawing from global best practices and implementing policies that not only enable smokers to make informed choices but also recognise the potential of vaping to save lives, especially as the public health system offers severely limited options and/or services to help smokers quit – there is no toll-free quit line, no smoking cessation counselling services at primary or secondary hospitals and only one smoking cessation clinic in the entire country.

While nicotine replacement therapies and pharmaceutical aids have been approved by the South African Health Products Regulatory Authority, none of these are subsidised by the State. If the health department is serious about achieving its goals, it urgently needs to relook its cessation strategy and move away from only using blunt instruments like taxes, restrictions and stigmatisation.

To this end, VSML is currently running a petition to stop the passing of the proposed Control of Tobacco Products and Electronic Nicotine Delivery Systems Bill.

In its current format, VSML does not oppose the regulations on Electronic Nicotine Delivery Systems (ENDs) products. and advocates for ENDs not to be sold to any person under the age of 18.

The advocacy group also supports that marketing of these products must be appropriate and that products containing nicotine should carry a standard nicotine warning.

However, the petition calls for a clearer distinction between combustible tobacco and ENDS based on empirical evidence as well as proportionate risk. Additionally, it argues for the use of ENDs products in public spaces to be limited to dedicated areas, much like smoking currently is.

About Kurt Yeo

Kurt Yeo is the founder of the consumer advocacy group, Vaping Saved My Life (VSML).
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