There’s neither rhyme nor reason behind South Africa’s inconsistent tobacco control policies.
In the United Kingdom, the public health authorities actively encourage vaping as a safer alternative to smoking, and as an aid to quitting smoking.
So much so that they recently conducted a trial. Almost 500 smokers who attended hospital emergency departments were given a vaping starter pack and referred to ‘stop smoking’ services. A control group of similar size was just given information on how to access ‘stop smoking’ services.
A year later, those given vaping kits were 76% more likely to have quit smoking. In both cases, quitting rates were low: 7.2% compared to 4.1%. After all, even with all the assistance in the world, quitting is extremely hard for most smokers.
Still, it adds up over a population. Dr Ian Pope from the University of East Anglia’s Norwich Medical School told the BBC: ‘Swapping to e-cigarettes could save thousands of lives. We believe that if this intervention was widely implemented it could result in more than 22 000 extra people quitting smoking each year.’
Vaping saves lives
I can personally attest to the effectiveness of vaping to help with quitting. I tried numerous other methods over decades, and only vaping made it tolerable to quit. The transition to a vape was hard, but I immediately felt the difference.
My cough went away. I breathed much easier. I didn’t smell like an ashtray anymore. After a few enjoyable months of steadily decreasing nicotine concentrations in the vaping liquid, I quit the vape too, without much trouble.
And I am not alone. Vaping saves lives.
Rabid anti-smokers, however, are not interested in harm reduction. They’re not interested in making it easier for smokers to quit.
Their proposals, most prominently expressed in the World Health Organisation’s Framework Convention on Tobacco Control (FCTC), which in turn gets subsumed in national legislation like South Africa’s Tobacco Products and Electronic Delivery Systems Control Bill, is punitive and prohibitive.
They understand only bans and fines, and somehow believe that brute force and prohibition are sensible public health policy which smokers will have no choice but to obey.
They are motivated not by reason, or science, but by their disdain for smokers and their hatred of tobacco companies. They seek their gratification in public whippings for both.
Scientific evidence
Public Health England bases its recommendations upon periodic reviews of the scientific evidence, concluding that although vaping is not risk-free, it poses only ‘a small fraction of the risk of smoking’.
It also found ‘significantly lower exposure to harmful substances from vaping compared with smoking, as shown by biomarkers associated with the risk of cancer, respiratory and cardiovascular conditions,’ and, importantly for innocent bystanders, ‘no significant increase of toxicant biomarkers after short-term secondhand exposure to vaping among people who do not smoke or vape’.
There is no evidence in the literature that suggests non-smokers take up vaping in significant numbers as a gateway to using tobacco products. Only two-thirds of one percent of British adults who have never smoked have taken up vaping.
That said, if people are going to acquire habits that are pleasurable but pose some health risk – which, of course, is their right – vaping is considerably less risky than smoking would be.
The largest independent review of the science to date concurs. Says Dr Debbie Robson, who co-authored a report for the Institute of Psychiatry, Psychology & Neuroscience at King’s College London: ‘The levels of exposure to cancer causing and other toxicants are drastically lower in people who vape compared with those who smoke. Helping people switch from smoking to vaping should be considered a priority if the Government is to achieve a smoke-free 2030 in England.’
Misinformed
The public has been told, falsely, by doctors, academics, the media and anti-smoking lobbyists, that vaping is dangerous – perhaps as dangerous or even worse than smoking – and that it causes awful things like ‘popcorn lung’ or EVALI, which stands for ‘e-cigarette or vaping use-associated lung injury’.
Let me quote Cancer Research UK: ‘E-cigarettes don’t cause the lung condition known as popcorn lung. There have been no confirmed cases of popcorn lung reported in people who use e-cigarettes. E-cigarettes are one of the tools that can help people who smoke to stop.’
Popcorn lung, the common name for bronchiolitis obliterans, is a condition caused by the inhalation of diacetyl. It is a flavourant in butter-flavoured popcorn, and the disease was named for workers in a popcorn factory who were exposed to large quantities of diacetyl fumes over long periods of time.
It has been banned from vaping liquids in many countries, and no reputable vaping liquids contain diacetyl these days. Even the rare few that still do have nothing on cigarettes themselves, which can contain up to 40 times more diacetyl than vaping liquid.
EVALI is misnamed. It was coined after a single outbreak of lung disease, caused by a batch of black-market cannabis vapes in the US in 2019 that contained Vitamin E acetate. It has not been reported before or since, and Vitamin E acetate does not occur in any ordinary vaping liquids.
So, the lung disease in question is caused solely by Vitamin E acetate, and not by ‘e-cigarette or vaping use’ in general.
People who think vaping is dangerous have been misinformed. It is nothing more than fear-mongering by authoritarian busybodies trying to dig up propaganda against vaping.
As Public Health England says: vaping is not risk free, but it is far, far less risky than smoking tobacco.
Tax versus public health
Yet while the UK (and other countries, like Sweden) actively promote vaping to smokers, here we are in South Africa with a Bill that is about to become law that treats electronic delivery systems of nicotine, and even non-nicotine, vapes as if they were tobacco products.
I have written about this before. I believe vaping should be regulated like coffee. I think the FCTC actively harms smokers. I believe that South Africa’s tobacco legislation ignores science, and will backfire. And I’ve written about the Swedish example, which, like the British case, is an anti-smoking strategy worth copying.
Clearly, the government cares more about its ability to tax vaping than about public health. I posted this clever insight on X.
Yet if only it were that simple. That would suggest some sort of conscious policy that, while not benefiting smokers or public health, at least benefits the country’s tax coffers. If not acceptable, it would at least be comprehensible.
Scaling down
But then I got a press release from British American Tobacco South Africa (BATSA), that said the company was scaling down its delivery supply chain as illicit combustible tobacco sales continued to increase, now making up – in BATSA’s estimation – more than 70% of South Africa’s total cigarette market.
Around 20 jobs at BATSA and more than 500 third-party jobs in the logistics and security supply chain will come under the axe.
This is, of course, a predictable consequence of the pandemic-era’s irrational ban on tobacco. It was a dismal failure, and I said so at the time. By locking the legitimate tobacco companies out of the market for a time, and the refusal of 90% of smokers to obey the ban, the government essentially surrendered the market to illicit, non-taxed products.
Whereas legitimate companies accounted for 70% to 80% of the market before that ban, the tables have now turned, and the illicit market now reportedly owns anywhere from nearly 60% to more than 70% of the market, depending on who you believe.
If the government was consistent, and cared only about tax revenue, then its tobacco ban was a shotgun blast to the foot.
Lost revenue
According to a study by the University of Cape Town’s Research Unit on the Economics of Excisable Products (which fully supports South Africa’s draconian tobacco bill), the government has lost R119 billion in excise revenue to the illicit tobacco market between 2002 and 2022.
In 2022 alone, the South African Revenue Service lost R15 billion in excise revenue and R3 billion in VAT to untaxed cigarettes. You could run a lot of anti-smoking programmes with that kind of money, or fix a lot of power stations, for that matter.
So now my clever observation about the government’s preference for tax revenue over public health doesn’t sound so clever anymore, and the government’s policy decisions just look confused and contradictory.
More restrictive tobacco control laws won’t mean anything if most of the market is illicit anyway, so not only does the government’s short-sighted policy not reduce harm and offer smokers the needed encouragement and assistance to quit by promoting vaping, but it won’t bring in a ton of tax revenue either.
It’s just stupid law, made by stupid people who care only about authoritarian power, pet hobby-horses and political expediency.
It is so easy to copy well-considered anti-smoking policies from countries like Sweden and Britain, but the South African government isn’t even capable of doing that.
[Image: A sign prohibiting smoking and vaping. Photo by Mike Mozart, used under CC-BY 2.0 licence]
The views of the writer are not necessarily the views of the Daily Friend or the IRR.
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