Vaping is the less harmful alternative many smokers have been waiting for, and it’s high time the public and legislators look past the hype to the real science.
SA will soon be deciding whether to paint vaping with the same brush as all other tobacco products as legislators prepare to finalise the new Control of Tobacco and Electronic Nicotine Delivery Systems Bill (2018).
This bill will classify harm-reduction electronic nicotine-delivery systems (Ends), like vapes and e-cigarettes, identically to combustible tobacco products – from the same health warnings on packaging, to restrictions on distribution and public awareness channels. But this would do a major – and potentially deadly – disservice to all those smokers desperately seeking less-harmful alternatives to cigarettes, particularly in the fight against non-communicable diseases such as lung cancer and emphysema.
The Global Burden of Disease study estimates that smoking cigarettes directly accounted for 7.1m premature deaths in 2017, with an additional 1.2m deaths attributed to second-hand smoke. Yet, in numerous countries across the globe, Ends such as vapes are receiving an equally bad rap, more often than not because these are conflated with smoking. As a result, draconian regulators often call for both to be subject to the same regulations – a fundamentally flawed approach. This is primarily because nicotine, and not the act of smoking, has incorrectly emerged as the villain when it comes to non-communicable diseases.
While there can be no denying that nicotine is a habit-forming social drug, much like coffee, it is not carcinogenic, unlike cigarette smoking. It also does not cause major disease in adult users. In many ways, regulating Ends would be like regulating sugar-free beverages alongside their sugar-based counterparts. Ends should rather be regulated in a proportionate, risk-based manner, recognised for being the harm-reduction devices that they are.
One country that has acknowledged this is the UK, where that government’s approach has been to place more of an emphasis on assisting adults to quit combustible tobacco products, and less on nicotine addiction. The harsh description of people being “addicted” to nicotine is a stigmatisation that needs to stop. We don’t speak of people being “addicted” to caffeine.
A report by Public Health England sums it up best by concluding that Ends are 95% less harmful than smoking, and that falling smoking rates in the UK can be attributed to these. A total 2.6m current or ex-smokers are using the devices to prevent them returning to combustible cigarettes.
Despite having one of the earliest and worst outbreaks of Covid-19 outside China, and among the most stringent lockdowns in the world, Italy exempted vape shops from the list of businesses that had to close. This is due to Italian authorities following the advice – and research – of Dr Riccardo Poloso, a world-renowned scientist who is the founder of the Centre of Excellence for the Acceleration of Harm Reduction in Catania, Italy, and the publisher of dozens of studies on vaping.
The same battle is being fought in SA by the Vapour Products Association of SA (VPASA) whose goal is to protect the rights of Ends users as the country looks towards the promulgation of the new bill. To quote Asanda Gcoyi, VPASA’s CEO: “We find it quite critical that government takes a very cautious approach, which seeks to promote product safety without unduly affecting the ability of smokers in South Africa to receive the necessary information they require to take up vaping as a less harmful alternative to smoking.”
Ends, such as vapes, contribute to a decrease of disease and premature death. They can also work to decrease the tobacco-related costs of morbidity and mortality. It is incumbent on the SA government to ensure that legislation enables consumers to have adequate access to and knowledge of all their alternatives towards better public health.
• Dr Human is co-founder and chair of the African Harm Reduction Alliance (AHRA)
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