Policymakers must tell smokers the truth — vaping is a safer alternative if they can’t quit

As a former smoker, I often get asked how I kicked the habit after 20 years and 40 cigarettes a day. It wasn’t easy.

My father’s passing from a smoking-induced heart attack in his early 50s was the biggest catalyst in my journey to become smoke-free. What finally helped me reach my goal was an innovation I stumbled across more than 10 years ago — vaping.

I had tried electronic cigarettes twice before, but the early-generation products were prone to leaking, had poor battery life, and were too weak to replace the “fix” I got from a combustible cigarette. The third attempt, with a more advanced product, got me off cigarettes within three days. This experience taught me an important lesson in becoming a tobacco harm reduction activist — one size does not fit all; variety and choice matter.

At the time, I knew little about the science behind vaping. It wasn’t until scientific reviews from the UK and US were released between 2015 and 2018 that I fully understood tobacco harm reduction.

Though complete abstinence should be the goal, we need to acknowledge that for the 67% of South Africans who smoke and want to quit, it’s a challenge. Research shows that for every person who quits smoking without assistance, 24 will fail. While support and pharmaceutical aids slightly increase success rates, most smokers remain on a life-threatening trajectory. Unfortunately, smoking cessation support is absent in the government health system, leaving most to a wholly unsuccessful “cold turkey” approach.

There are 11.1-million South Africans over 15 who smoke regularly. It’s unrealistic to think they will all quit overnight. Perhaps that’s what government policymakers believe when they formulate draconian anti-tobacco laws and increase excise duties. The reality is that these measures only push the majority into the growing and potentially more harmful illicit market. These are the unintended yet predictable consequences of irrational lawmaking, as seen during the 2020 tobacco sales ban in the heart of the Covid lockdown.

To motivate people to stop smoking, we need people-centric cessation strategies and tobacco harm reduction — policies, programmes and practices that minimise the negative effects of risky behaviours. 

Publicly available statistics show a significant increase in smoking rates across all age groups in the country over the last decade. As smoking rates increase, so does trade in illicit cigarettes, which poses a greater challenge to public health but circumvents tobacco regulations.

Figures released in 2022 show that 2.2% of South Africans used vaping products. While it’s been proven that vaping is a less harmful alternative to combustible tobacco that could help reduce smoking, there is a misconception out there that the activity is equally or more harmful than smoking. Nothing could be further from the truth. Vaping is not only the most popular way to quit smoking but has been proven through population studies and randomised control trials to be the most successful method of achieving smoking cessation. 

However, the Tobacco Products and Electronic Delivery Systems Control Bill, currently before parliament, is a poorly conceived piece of proposed legislation. It doesn’t recognise the significant difference in risk profiles between combustible tobacco and vaping products. It treats both products as equivalent, meeting the same restrictions and reinforcing the dangerous misconception around vaping. This is not to say that vaping is risk-free or should be free of regulation, but instead that legislation should be based on scientific evidence and recognise its potential to save millions of lives while limiting youth access.

The bill will prohibit, restrict, ostracise and entrench further stigma on smokers and those who have chosen a safer alternative. It does not provide solutions, and if passed in its present format will severely affect lives.

Our consumer advocacy group Vaping Saved My Life conducted a three-month trial late last year dubbed “Mzansi Make the Switch” in which smokers tried vaping as a way of either stopping or reducing smoking. The results were fascinating. Over half the participants who tried vaping gave up cigarettes entirely. Of those who continued to smoke, 79% reduced their cigarette consumption.

In a follow-up survey conducted a few weeks after the three-month challenge period ended, 41% of respondents were still not smoking. Among those who had relapsed, 46% said that though they still smoked a little, it was a small fraction of their prior consumption and they felt optimistic about their ability to successfully quit in the future using vaping products.

The results of the “Mzansi Make the Switch” social experiment illustrate that vaping may play an important role in supporting smokers’ desire to quit smoking, avoid relapse or reduce their smoking. Additionally, as participants also reported feeling significant enhancements in their health, this demonstrates that vaping should be further explored as a potentially feasible method for harm reduction in South Africa.

In 2022, the UK Office for Health Improvement and Disparities reiterated its assessment, contained in a report it released in 2015, that vaping posed only a small fraction of the risk of smoking and the statement that it is “95% less harmful” was broadly accurate. According to their findings, smoking is at least 20 times more harmful to users than vaping. These findings, coupled with the results from the Cochrane Systematic Review proving the effectiveness of vaping in helping smokers quit, prompted the UK government to introduce the “Swap to Stop” initiative in 2023. The first of its kind will see 1-million UK smokers provided with a vaping kit and support.

The New Zealand health ministry acknowledged that while quitting smoking may be difficult, vaping offers a way to quit cigarettes by providing nicotine with fewer toxins that come from burning tobacco. This sudden course of correction in 2019 has not only seen the island nation experience accelerated declines in smoking rates but has put them on a path to becoming the second country behind Sweden to be deemed smoke-free.

These facts alone should make South African lawmakers rethink their approach to regulating vaping products. In 2021 it was estimated that 82-million people worldwide had switched from smoking to a safer alternative in vaping. Smokers in South Africa are being left behind.

If the Tobacco Products and Electronic Delivery Systems Control Bill becomes law, it will restrict smokers’ rights to opt for less harmful alternatives. By making it illegal for vaping products to claim they are less harmful, this truth will be kept from smokers, leaving millions without basic knowledge of this alternative. 

Policymakers should allow consumers to make their own choices. They should adopt the message, “If you don't smoke, don't vape. If you smoke, quit. If you are unable to quit, switch to a safer alternative like vaping.” 

• Yeo is a former smoker who, after switching to vaping, co-founded the consumer advocacy group Vaping Saved My Life