Do flavours used in vapes cause more harm than cigarettes? Expert weighs in

There is no evidence e-liquids or flavours used in vapes and other e-cigarettes cause more harm than cigarettes, a cardiologist and renowned expert in the field of tobacco harm reduction says. 

According to Dr Konstantinos Farsalinos, mounting research suggests the use of flavours in tobacco harm-reduction products has led to a decrease in the number of global tobacco users. 

This has resulted in some countries being able to get closer to reaching their commitments to the World Health Organisation’s (WHO) framework convention on tobacco control which was developed as a response to the global tobacco epidemic, said Farsalinos. 

He said the flavours used in vapes and other e-cigarettes are composed of food-approved flavours. 

“What needs to be clarified, especially for the regulators who have very limited studies on the products and the ways they are produced, is that no ingredient was invented specifically to be used for e-liquid. All the ingredients used in e-liquids come mainly from the food industry,” said Farsalinos. 

“I think the concept is very simple. People smoke because they like smoking. They perceive some sort of pleasure from smoking. Other smokers use or smoke because it relieves their stress.

“To substitute for smoking, e-cigarettes should provide some sort of positive experience. It can’t be blunt and flavourless. It must be something interesting, otherwise no one is going to be motivated to quit smoking and use electronic cigarettes. It is extremely important to provide products in the market that are appealing to the smoker.”

Over the past few years, e-liquids have earned a bad reputation, with many blaming the bright packaging as reasons why teenagers have been driven to take up vaping. 

Johannesburg-based pulmonologist Dr Anton Meyberg told Sunday Times he treated 50 patients aged 12 to 18 with respiratory problems linked to vaping from January to May, compared to 10 over the same period last year.

The Association of Public Boys’ Schools of South Africa, representing 40 schools, said according to anecdotal evidence received, some parents were buying their children vapes and vaping products as birthday gifts.

“We have certainly seen experimentation among young people, but when you look at the surveys, flavours are not the main motivation to use electronic cigarettes. Peer pressure from friends and family or parents who smoke or vape were the main motivation for them to initiate or take up vaping,” said Farsalinos.

The Vapour Products Association of South Africa (VPASA) said suggestions flavours should be banned was a move that could have serious consequences, including people relapsing to smoking and the creation of a black market.

South Africa is no stranger to the black market, having experienced a surge in illicit cigarettes in 2020 during the Covid-19 pandemic lockdown. 

“VPASA understands the concerns around youth and flavoured vapes and other e-cigarettes and has therefore implemented actions, including the vaping advertising code of conduct and packaging guidelines to local manufacturers to ensure youth are discouraged from using these products,” said VPASA CEO Asanda Gcoyi. 

“We look forward to supporting regulators in enforcing risk-proportionate, balanced legislation that prioritises public health and protects minors while not alienating adult smokers.”

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