The head of the Vapour Products Association of South Africa (VPASA) says the booming sector is plagued by continual misinformation and disinformation despite scientific evidence demonstrating that vaping is less harmful than smoking.
Chief executive of VPASA, Asanda Gcoyi said vaping is the single, most effective tool which can move smokers away from the deadly addiction to cigarettes, according to a story on IOL.
“We accept that vaping is not without risk, but it is a potentially less harmful alternative to smoking. What we cannot afford to do is to unduly stymie this technological innovation that can be the single most effective tool to move smokers away from their deadly addiction to cigarettes,” she said. “We have a collective responsibility to share correct information about vaping and other less harmful alternatives to smoking so that smokers can make an informed decision for their health.”
In the ongoing efforts to shed light and demystify vaping in South Africa, VPASA is on a drive to ultimately debunk some of the most prominent vaping myths circulating, according to Gcoyi.
The first myth is that vaping is as harmful as smoking.
“Although not risk-free, vaping is a potentially less harmful alternative to combustible tobacco. There are significantly lower levels of exposure to harmful chemicals in people who switch from smoking to vaping compared with those who continue to smoke,” she says. “The science that dates back as far as 2015 says vaping is a less harmful alternative to smoking, and recent updates continue to support this.”
The second myth is that vaping causes popcorn lung.
“According to Cancer Research UK, popcorn lung (bronchiolitis obliterans) is an uncommon type of lung disease, but it is not cancer,” says Gcoyi. “It is caused by a build-up of scar tissue in the lungs, which blocks the flow of air. E-cigarettes don’t cause the lung condition known as popcorn lung.”
Gcoyi said there was also a myth that vaping causes lung cancer.
“The fact is that burning tobacco in all its forms means exposure to carcinogenic chemicals. If you are a smoker, switching to vaping will reduce your risk of cancer. Most toxins from smoking are absent in electronic nicotine and non-nicotine delivery systems aerosol, she said. “Electronic non-nicotine delivery systems (ENDS) are a tool for consuming nicotine that is less harmful than if consumed via the combustion of tobacco. Coffee is brewed for caffeine. Vaping atomizes e-liquid for nicotine. Both caffeine and nicotine would [be harmful] if burned.”
For years, anti-tobacco lobbyists have summarily and very aggressively painted electronic nicotine-delivery systems (ENDS) with the same brush they use to condemn combustible cigarettes, turning an intentional blind eye to the important role that ENDS play in tobacco harm reduction. According to Asanda Gcoyi, CEO of the Vapour Products Association of South Africa (VPASA), this is in spite of the fact that highly reputable agencies such as the Royal College of Physicians and Public Health England have published evidence that ENDS are 95 percent less harmful than smoking.
“This unscientific one-size-fits-all rhetoric by anti-smoking lobbyists has influenced certain governments around the world to pass legislation restricting the marketing and distribution of [ENDS] under the exact same legislation that applies to normal cigarettes,” Gcoyi said. “In South Africa, with the debate currently open around the impending Control of Tobacco Products and Electronic Nicotine Delivery Systems Bill (2018), we need to ensure that we do not head the same way.”
In an editorial for IOL, Gcoyi states that, besides the damage this myopic approach does to the adult smoker who is trying desperately to find a less harmful alternative (or, at the very least, cut down) by using vaping devices, the broad-brush approach creates highly contradictory misunderstandings around possible underage users. “What our organization aims to do is to bridge the gap between government and the vapor products industry. To this end, we educate and engage the former, set standards for the latter, and collaborate with both,” said Gcoyi.
This collaboration is currently specifically aimed at developing legal regulations that will ensure adult consumers continue to enjoy access to vapour products in order to use them for the purpose for which they were invented: as a harm reduction tool that may ultimately enable them to give up smoking altogether.
“This means ensuring that EVPs are recognised for what they are, and the important role they have to play in terms of adult smokers. However, where we definitely don’t have a difference of opinion with the legislators is when it comes to restricting their access to the youth.”
As a result, while waiting for the Bill to play out, VPASA launched its own youth access prevention campaign in March 2021, to institute self-regulation in the meantime. An important part of the campaign lies in training EVP retailers about the restriction of sales to young people. This also means combating the misinformation being distributed by anti-smoking lobbyists in terms of young users.
“It is alarming enough that anti-smoking lobbyists purposely draw false parallels between combustible cigarettes and vaping products,” said Gcoyi. “But even more concerning is the misinformation around vaping products and youth. It can completely obliterate what organizations such as ours are doing in trying to ensure adult access, while also restricting sales to youth.”
The hype of the past few years around nicotine delivery systems such as vapes and e-cigarettes has overshadowed the fact that it is inhaling smoke from burning tobacco, not nicotine, that causes most smoking-related cancers.
Electronic vapour products (EVPs) were developed as a tobacco harm reduction tool and offer an alternative way to consume nicotine without the smoke produced through the burning of tobacco.
Hype and ignorance about EVPs persists, however, even among those involved in public health legislation. This is despite increasing international research in support of EVPs.
A letter from the U.S. office of the attorney general in the Iowa department of justice to the U.S. Food and Drug Administration’s (FDA) director of the Center for Tobacco Products in March 2020 addressed an erroneous FDA statement suggesting that smoking and vaping posed an equal risk to users during the Covid-19 pandemic. It said: “If the FDA is able to provide candid and clear advice that puts the health of millions of Americans first, and this is based on sound behavioural and biomedical insights, then it should do so. If, however, its communications are arbitrary and ill-conceived, spreading fear and confusions with little scientific basis and with unpredictable consequences, then it would be better if the FDA and its media spokespeople did not comment further at this time.”
The letter challenging the FDA was signed by the attorney general and 12 academics and researchers in public health from across the US, Canada and the European Union. Many have acted as consultants to governments during the drafting of legislation around non-combustible nicotine delivery systems. Among them are a number from institutions in the United Kingdom, a global leader in harm reduction policy, and where innovation in the vaping sector has flourished.
The UK now stands as the gold standard for how it regulates, manufactures and sells EVPs. Organisations such as the United Kingdom Vaping Industry Association (UKVIA) are also gaining attention for its position on the critical role that regulation has to play in finding a solution that enshrines both public safety and private entrepreneurship.
South Africa would be wise to follow suit if we are seeking sensible resolutions to the debate around the regulation of EVPs in our own country – and if we are to secure the best possible outcomes in the fight against diseases such as lung cancer and emphysema.
The first steps entail raising the level of understanding among politicians and lawmakers that combustible tobacco products and EVPs are not the same. They should not even share the same legislative platform. To insist that they do will remove an option from millions of South African smokers who are seeking harm-reduced alternatives to cigarettes.
Until the Covid-19 lockdown began in South Africa, EVPs were not legislated in terms of either the Tobacco Products Control Act or the Medicines Act.
That all changed when EVPs were subjected to the same unilateral ban as tobacco products under lockdown. Now, the imminent new Control of Tobacco and Electronic Nicotine Delivery Systems Bill looks to do exactly the same thing: classify nicotine-delivery systems and combustible tobacco products identically – from packaging and the same health warnings to restrictions on all possible distribution and public awareness channels, including advertising.
The problem with such a course of action, advises UKVIA director John Dunne, is that when consumers feel their options are constrained, they look for shortcuts and loopholes. The hard lockdown was evidence of exactly that when black market cigarette sales soared.
Dunne believes the regulatory landscape is at a pivotal point now, with two opposing factions in the ring. One is bent on demonising the consumption of nicotine at all costs, while the other aims to promote vaping as a harm-reduced alternative to smoking. Speaking at a recent VPASA webinar on EVP policy and regulation, Dunne was frank in admitting that nothing we do is 100% safe, but warned that reasonable access, advertising and education are all critical in the creation of successful regulation.
South Africa’s goals are not that far from the UK’s own and, according to Dunne, “the ultimate prize would be regulations that would prevent youth access, but also allow us to reach the adult smoker”.
“It’s really difficult with existing regulations to make that connection with smokers to get them across the line to do something different. But a smoker made to feel like they have options in 2020 is really valuable,” he commented.
At the same webinar, medical doctor and president of the Philippines-based anti-smoking advocacy group Quit for Good, Dr Lorenzo Mata, outlined the role his group had played in that country, shifting the narrative from a complete ban on EVPs to pending regulation in its favour – in just six months. Mata noted that Quit for Good, comprising concerned citizens who recognise the profound damage and loss that cigarettes have brought to that country, were pursuing legislation that enabled citizens to make the best choices for their own health.
“It’s for this reason that we have been at the forefront of advocating for vaping – both in terms of educating the public and in making ongoing representations to our government,” he said.
“Collectively, with the support of other groups also concerned with public health, we have helped to shape a stable and favourable regulatory framework for EVPs, where regulators now intend to regulate EVPs, most importantly, in a risk-proportionate manner relative to cigarettes.”
To be at its most effective, legislation must first interrogate the principles of relative risk and proportionate regulation. If we can convince the South African government to ask those same questions and conduct a full review of all the harms and benefits of specific products such as EVPs, it will be possible for policymakers to reach a science-based conclusion that is in the best interests of all South Africans.
Asanda Gcoyi is the CEO of the Vapour Products Association of South Africa (VPASA). The views expressed are those of the author and do not reflect the official policy or position of Vapor Voice. This opinion first appeared in the Mail & Guardian.
