Closing the Space

At the current rate, tobacco harm reduction is likely to remain a fantasy in South Africa.

By Asanda Gcoyi

Like other countries around the world, South Africans have taken to vaping in great numbers over the past 10 years. What started as a small community of smokers seeking out less harmful alternatives to cigarettes has now morphed into a massive industry that is growing in leaps and bounds.

Since 2013, vaping devices in South Africa have become a ubiquitous sight, with many a smoker giving up their deadly habit in favor of vaping. For the past decade, vaping has remained outside the regulatory net while tobacco has been regulated through the Tobacco Products Control Act, 83, 1993. While hailed in its initial days, the act has failed to reduce South Africa’s smoking rates successfully.

This is reflected in recent statistics, which show that South Africa’s smoking rate has increased from about 18 percent in 2018 to over 25 percent in 2022. This is a result of lax law enforcement and the proliferation of cheap illicit tobacco products that are reported to account for over 60 percent of the South African smoked tobacco market.

For a time, harm reduction advocates were hopeful that vaping would make a significant contribution toward reducing smoking in the country. There was even a faint hope that regulators would embrace the vaping industry in the spirit of reducing the harm that smokers are exposed to and hopefully also reduce the external costs of smoking, which are borne mainly by the poorly performing public health system.

Not so. Over the past two years, the South African government has succumbed to pressure from the anti-smoking lobby, which relies on misinformation and disinformation to discredit tobacco harm reduction. In part, the antipathy toward vaping has arisen out of fears that young people were taking up vaping in droves.

Except, there is minimal evidence for this contention. The research that has been done is limited in scope and reach, and its conclusions cannot be generalized to the rest of the South African youth. No doubt, young people are curious and are trying out vaping. However, there is no evidence that large numbers are regular vapers or that they are progressing to smoking cigarettes, as has been claimed by those in favor of strict regulations of vaping.

What is beyond any doubt is that a significant number of young people are smokers due to the accessibility and low prices of illicit tobacco. In its rush to be seen to be doing something about the manufactured crisis of youth vaping, the government has embarked on two processes: the introduction of a vaping tax and the amendment of the country’s tobacco control laws to include vaping.

After a two-year public consultation charade, the government started levying an excise duty on vaping liquids on June 1, 2023. This immediately made refillable vapes unaffordable for your average vaper, as the price of a 100 mL bottle more than doubled overnight. At ZAR2.90 ($0.16) per milliliter, South Africa’s rate is on the steep side and has made smoking more attractive from a price point of view.

Perversely, the excise duty has made disposable vapes much cheaper than refillable vapes. Up to the introduction of the tax, refillable vapes had been the preferred choice for smokers who were using vaping as a harm-reduced alternative to smoking. Common wisdom has it that disposable vapes are the most preferred option for young adults and teenagers.

In introducing the steep rate, the government has failed to deter the people who should not vape from doing so while forcing many former smokers and dual users to vape higher nicotine disposables and revert to smoking due to price.

Parallel to the tax’s introduction, Parliament has been processing the Tobacco Products and Electronic Delivery Systems Control Bill, which was introduced in December 2022. This anti-harm reduction draft law dismisses the possibility that vaping is less harmful than smoking and that there should be a differentiation in law between how the two are treated.

It conflates vaping and smoking and extends draconian regulations to vaping, some of which will virtually wipe out any communication about vaping as a harm-reduced alternative to smoking. In the process, it will confirm smoking’s importance as the only viable form of nicotine delivery for the millions of nicotine addicts who do not know enough about vaping or believe the disinformation that vaping is as harmful, if not more so, than smoking.

Supported by Bloomberg Foundation-funded organizations, the bill is a clear demonstration of the deep-seated disdain that the South African government has for the smoking public. In countless public hearings, the ruling party and its fellow travelers in the anti-tobacco campaign loudly proclaimed their contrived belief that harm reduction is a ruse.

They have used every opportunity to talk up the dangers of youth vaping while completely ignoring the plight of the more than 10 million smokers in South Africa. In their telling, smokers should just quit because vaping is as bad, if not worse, than smoking. In one hearing, they were even proud to display a poster showing the diseased body of a vaper, science notwithstanding.

While there is always a chance that the new government to be elected on May 29 will revisit the draft Bill submitted to Parliament, there is little hope among tobacco harm reduction experts of any change in direction. It has become clear that the South African government has lost its ability to make public health policy guided by its unique circumstances. It is content to defer to the ideological prescripts of the World Health Organization and the Framework Convention on Tobacco Control, even when it clearly goes against its own interests as a country.

This is a disheartening and anti-democratic exercise in policy capture, which, left unchecked, will prejudice South African smokers by foreclosing the possibility of switching to less harmful alternatives. At the current rate, tobacco harm reduction is likely to remain a pipe dream rather than a reality.

Asanda Gcoyi is CEO of the Vapour Products Association of South Africa.