University of the Free State senior lecturer Dr Phindile Shangase believes that if you want people to stop smoking, you need to present them with alternatives because the quit-or-die approach is not working.
Shangase was speaking at the ninth edition of the Global Forum on Nicotine (GFN) in Warsaw, Poland, recently and referenced research conducted by academics for the online journal Annals of Global Health, titled “Barriers to smoking cessation among drug-resistant tuberculosis patients in South Africa”. The research found there were many barriers to smokers quitting, which included personal circumstances and lack of awareness of smoking alternatives such as e-cigarettes or vaping products.
“If there are regulations forcing people to stop smoking, they will find ways to continue.
“Smoking is also a way of coping. Unemployment is high in SA so people try to cope using cigarettes. They have their own peers who don’t work and when one friend gets a pack, they share and smoke and this is a way of coping,” Shangase said.
“If you want people to stop smoking, you need to replace that with other alternatives so that behaviour needs to be modified somehow.
“This is why I say you need a transtheoretical model. You need something to help to sustain smoke reduction which will eventually lead to quitting. People do quit but at the end of the day they go back to smoking and it's not sustainable,” she said.
Meanwhile, the National Treasury is expected to introduce a tax on e-cigarettes and vaping products in the country from next year.
These are referred to as “non-combustible” devices.
Finance minister Enoch Godongwana made the announcement while delivering the 2022/2023 budget speech earlier this year.
The proposed tax bill could hit consumers in the pocket and deter smokers who wish to switch to safer alternatives.
The World Health Organisation continues to maintain that not enough is known about the health consequences of non-combustible devices.
In its discussion document released in December, the Treasury dismissed evidence produced by Public Health England and the UK Royal College of Physicians that found that vaping is 95% less harmful than smoking.
Shangase's study was aimed at identifying barriers to smoking cessation among drug-resistant tuberculosis inpatients at hospitals in KwaZulu-Natal.
She said when it came to lack of access to smoking alternatives, poorer people suffered.
“The essential medicines list for private hospitals does have nicotine replacement therapies, however, for public hospitals there isn’t any.
“Public hospitals are more burdened and the staff are more burdened... I feel when it comes to tobacco harm reduction and smoking cessation, this needs to be facilitated in one way or another.
“The quit-or-nothing approach is not working. Smokers need practical assistance. Most people who vape are the ones who can afford to.
“There will always be those discrepancies between the haves and have-nots when it comes to the burden of ill-health,” she said.
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