Why South Africa needs evidence-based regulations for vapes

Asanda Gcoyi

There’s no question the proposed COTPENDS Bill has the best of intentions. Its primary goal is to combat tobacco use, listed among the top five risk factors contributing to South Africa’s burden of non-communicable disease (NCD).

VPASA is not opposed to regulation either. In fact, as an industry, we welcome regulation that will allow us to grow our contribution towards tobacco harm reduction.

However, the bill attempts to paint EVPs with the same brush as smoking and cigarettes. They are not the same and, to continue this legislative process as if they are, would be a terrible betrayal to former smokers who have moved to EVPs, as well as to those who could potentially switch to this harm-reduced alternative if the government would only embrace the technology and the science that backs it.

There has been a lack of scientific, context-specific research conducted to date in South Africa but that does not mean we should not consider the large volumes of reputable and peer-reviewed studies from around the world, all of which are largely in favour of the use of EVPs as a harm-reduction tool.

The bill in its current form takes into account none of the critical findings that have emerged since the first draft in 2018 was made available for public comment. These findings further support the important role EVPs play in empowering addicted smokers of combustible tobacco to choose a less harmful alternative.

Research as recent as March, which appears in the United Kingdom’s Public Health England’s (PHE) 2021 update on its 2015 review of e-cigarettes and other novel nicotine delivery systems, notes that in the UK, more than 50% of adult smokers used EVPs primarily as an aid to stop smoking. Vapes proved to be the most successful tool used in comparison with any other method.

To the same effect as the COTPENDS Bill itself, the National Department of Health’s Socio-Economic Impact Assessment System (SEIAS) on the Control of Tobacco Products and Electronic Delivery Systems Bill also creates its own form of tunnel vision with regard to EVPs. For one, it incorporates only very simplistic overviews of the arguments against EVPs – that their supposed attraction to underage smokers is a “gateway: to smoking cigarettes”. Secondly, it fails to acknowledge that EVPs do not contain tobacco.

What does the proposed tobacco bill mean for vaping in SA?

Asanda Gcoyi, Irvine Partners  22 Jan 2021

Nicotine, which is contained in most vaping liquids, is not what causes non-communicable diseases that can kill. In contrast, cigarettes produce 60+ carcinogens, including tar and carbon monoxide, and contain 30 identified metals, some of which are radioactive. It is these that contribute to diseases like lung cancer and emphysema.

Studies reported by PHE have shown that vaping is scientifically proven to be 95% less harmful than smoking. Nicotine is a mild stimulant that has not been found to contribute to non-communicable diseases and, in any event, not all e-liquids contain nicotine. Therefore, legislating EVPs the same as combustible or any other form of tobacco product is not only highly disingenuous but could also be dangerous for those looking to make the switch to a less harmful alternative.

Despite the bill’s purported good intentions, there is just not enough credence to the wide-sweeping regulations being proposed and we need to ask ourselves why.

An aspect of the bill that may help us answer this is its strict allegiance to the World Health Organisation (WHO) Framework Convention of Tobacco Control (FCTC), which is currently being challenged by the All-Party Parliamentary Group (APPG) for Vaping in the UK.

Prompted by the WHO’s encouragement and applause of bans on EVPs, the APPG launched an inquiry into the FCTC’s history, governance and evidence-based decision making. This revealed that the framework’s policy goals (and those of the WHO’s other tobacco control operations) are heavily influenced by private organisations, all largely looking to ban tobacco products outright.

The inquiry also notes that both the WHO and the FCTC refuse to engage with any individual, NGO or other organisation that does not support their principles and purpose. As is happening with the bill in South Africa, there is a reluctance to look at any new scientific evidence. Finally, the inquiry also calls into question the WHO’s reluctance to acknowledge “harm reduction” appropriately or even the vital role that risk-reduced products can play in the tobacco control fight.

As such, we urge South African legislators not to overlook the research and scientific data. In fact, during the SEIAS consultation, I called on the government, led by the Department of Health, to commission its own scientific assessment of both EVPs and ENNDS products, by a reputable, non-biased institution.

We are not the only ones who believe this – the department’s own 2018 SEIAS report states that “ENDS/ENNDS require more research to determine the impact it would have on reducing demand for the product, particularly among current smokers and the likelihood of switching to them.” In the three years since that report was first prepared, much has changed and a lot more scientific research has been conducted that cannot and should not be ignored.

For instance, we are seeing researchers and governments elsewhere in the world embracing EVPs as tools to reduce the harm of cigarettes. In France, the National Cancer Institute has launched its new anti-tobacco campaign highlighting the role of electronic vapes in reducing tobacco-related cancer deaths and in permanently stopping smoking.

Researchers from the University of East Anglia in the UK have recently launched a trial at five hospitals, where smokers attending emergency centres for any reason will be given vape starter packs upon discharge, to be used as cessation devices.

Around the world, countries, organisations and individuals are seeing vaping for what it really is: scientifically proven to be less harmful than tobacco and an effective aid to stop smoking. It is time that the South African government does the same.