Ten reasons why electronic cigarettes need to be regulated in South Africa

While tobacco marketing is regulated, electronic nicotine delivery systems (ENDS) such as e-cigarettes are currently are in a legislative vacuum in South Africa as the current law predates the launch of these products. Unregulated and as yet untaxed, the vaping industry stands steadfast behind the narrative that these products offer people a way out of smoking traditional tobacco products, rather than disguising lifelong nicotine addiction in a range of candy flavours and sleek designs as the industry grows market share with young people.

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The vaping industry is facing new legislation in South Africa – firstly to regulate it, and also to impose excise taxes on these products. The draft Control of Tobacco Products and Electronic Delivery Systems Bill, now approved to go to Cabinet, will institute the same regulation rules for vapes, e-cigarettes and heated tobacco products as for traditional cigarettes.  

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New in-depth data from the first Global Adult Tobacco Survey conducted in South Africa in 2021 (GATS-SA) that shows that emerging products including e-cigarettes and hookah are mostly used by younger age groups – with the highest percentage usage of e-cigarettes is in the age 15-24 category at 3,1% (overall prevalence is 2.2%), while 7.1% of this age group are using hookah. 

Placing children at the centre of conversations on better regulation of these novel products is critical for public health, argue the Protect our Next partners, a coalition of South Africa’s leading health organisations including the National Council against Smoking (NCAS), the South African Medical Research Council (SAMRC), the South African Tobacco Free Youth Forum (SATFYF) and the Cancer Association of South Africa. (CANSA)

According to the expert partners, here are ten reasons why the Bill should be passed as soon as possible.  

  1. To ensure children will never vape, the marketing and promotion of e-cigarettes must be regulated

E-cigarette products are patently marketed to South African children and easily accessible. Sleek designs and thousands of youth-friendly flavours increase product appeal and create a perception that these products are safe, fuelling youth e-cigarette uptake.   The new Bill will prevent this kind of marketing, including point of sale. 

  1. E-cigarettes are popularised and glamourised on social media, placing young people at risk of initiating use 

A new study published by JAMA Pediatrics, the first large-scale effort linking social media content to tobacco use, reveals that people who have viewed tobacco content on social media are more than twice as likely than non-viewers to report using tobacco and, among those who have never used tobacco, more likely to be susceptible to use in the future. The abundance of tobacco and e-cigarette content on social media needs to be countered, with researchers recommending that tougher regulations should be placed on the way tobacco and related companies are permitted to promote their products online.

  1. Regulation protects our youth from being recruited as the next generation of nicotine addicts

Neurobiologically, children are even more vulnerable than adults to nicotine addiction, and those who start using nicotine at a young age have greater nicotine dependence than those who start later.  

Early exposure to nicotine paves a pathway to addiction of all kinds. The brain’s peak period for developing addiction is in adolescence. . Exposing children and adolescents to nicotine can have long-lasting, damaging effects on brain development and lead to nicotine addiction. Furthermore, there is a growing body of evidence in some countries that never-smoker adolescents who use ENDS at least double their chance of starting to smoke cigarettes later in life.

  1. Banning flavoured e-cigarettes would reduce their appeal to children

The use of flavours that appeal to youth is a well-known tactic that has been employed by tobacco companies to attract a young market and find “replacement” smokers to maintain their market share and profits – creating another generation addicted to nicotine.

  1. E-cigarettes are as addictive as tobacco and may lead to cigarette smoking

Most e-cigarettes contain nicotine. Nicotine is highly addictive. Some e-cigarettes use nicotine salts, which allow particularly high levels of nicotine to be inhaled more easily and with less irritation than the free-base nicotine used in tobacco products. E-cigarettes can contain other harmful substances besides nicotine. Using nicotine in adolescence may also increase risk for future addiction to other drugs. E-cigarettes can contain high amounts of addictive nicotine and deliver nicotine more quickly than cigarettes.  Young people are often unaware of the level of nicotine content in e-cigarettes and become rapidly addicted. For example, a study showed that approximately two-thirds of JUUL users aged 15 – 24 do not know that JUUL always contains nicotine

  1. E-cigarette use is harmful to human health; any harmful product cannot be left to be freely marketed as a safe product

E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavourings, and other chemicals that help to make the aerosol. Users inhale e-cigarette aerosol into their lungs. Bystanders can also breathe in this aerosol when the user exhales it into the air. The evidence is clear that the aerosols of the majority of e-cigarettes contain toxic chemicals, including nicotine and substances that can cause cancer. The WHO states that ENDS are undoubtedly harmful, should be strictly regulated, and, most importantly, must be kept away from children.

  1. Current evidence shows that e-cigarettes are harmful to health, use has been linked to severe health conditions, including cancers, respiratory and cardiovascular diseases, chest pains and mouth ulcers

Failure to properly regulate e-cigarettes ignores the harmful effects of these products which are linked to severe health conditions. Both tobacco products and e-cigarettes pose risks to health and the safest approach is not to consume either.

  1. Unproven claims of cessation efficacy of e-cigarettes are harmful to public health

The vaping industry, led by the Vapour Products Association of South Africa (VPASA), continues to oppose moves to regulate vapour products in the same way as traditional cigarettes, arguing that doing so will deprive millions of South African adult smokers and nicotine users of a potentially less harmful alternative.  However, while the value of e-cigarettes for adult smokers is still contested, the regulations in the Bill do not ban or prohibit adult e-cigarette use. The regulations strike a delicate balance, limiting youth initiation, while still allowing adult access.  

  1. Unregulated e-cigarettes undermine the use of medically proven cessation aids

E-cigarettes are not endorsed as cessation aids by the World Health Organization, and even South African e-cigarette companies do not officially categorise them as stop-smoking aids. They are registered as consumer products. While the industry seeks to avoid regulation, the opposite is needed; e-cigarette products actually require stricter regulation to match the sophistication and diversity of the products and ensure that other innovations the industry might come up with in the future to circumvent regulations, such as synthetic nicotine, are covered.

  1. If e-cigarettes are a cessation aid or medicine, they need approval and must be sold under a prescription

If e-cigarettes were registered as stop-smoking aids or tobacco substitutes, the Medicines Control Council classifies nicotine e-cigarettes as Schedule 3 products to be sold under a prescription, which does not suit the business objectives of the industry.

The industry says it does not target children, but instead it violates child rights by marketing and designing products which are blatantly attractive to children. If the industry is so against youth uptake, why are they so against having marketing that is clearly targeted towards a younger generation regulated? If the vaping industry is about protecting people’s health, why are they do against restricting vaping in public places, where toxic aerosols could affect others? The bottom line is that the tobacco and e-cigarette industries cannot be trusted to self-regulate and public health policy must be protected from the industry’s influence. 

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About Protect our Next

Health organisations forming part of the #protectournext partnership include the National Council Against Smoking (NCAS), the Cancer Association of South Africa (CANSA), the Heart and Stroke Foundation South Africa (HSFSA) and the South African Tobacco Free Youth Forum (SATFYF). Together, these organisations are steadfast in driving awareness of the dangers of tobacco and e-cigarettes, while campaigning for the Control of Tobacco and Electronic Delivery Systems Bill to be passed. 

About the Bill:

The Tobacco Control Bill requires that any enclosed public area is 100% smoke-free, and will make certain outdoor public places smoke-free too, providing protection for many South Africans who are often involuntarily exposed to second-hand smoke. It removes the requirement to provide for smoking areas in all enclosed public places, workplaces and on public conveyances and applies the 100% smoking ban to common areas of multi-unit residences. It further prohibits smoking in private dwellings used for commercial child care or education, and in cars carrying children under 18, rather than under 12.

The Bill introduces uniform plain packaging for all brands and pictorial warnings on all packages. Cigarette advertising at tills and the sale of cigarettes through vending machines will be prohibited. Importantly, the Bill also includes the regulation of electronic delivery systems including e-cigarettes.


Prof. Lekan Ayo-Yusuf, Director of the National Council Against Smoking (NCAS) and the Head of the School of Health Systems and Public Health at the University of Pretoria

Sharon Nyatsanza (PhD), Deputy Director, National Council Against Smoking (NCAS)

Dr Catherine Egbe, Specialist Scientist: Alcohol, Tobacco and other Drug Research Unit, South African Medical Research Council 

Sanele Zulu, Convenor: South African Tobacco Free Youth Forum

Zanele Mthembu, Public Health Policy and Development Consultant

Lorraine Govender, National Manager, Health Promotion, CANSA


Tamaryn Brown

Connect Media for CART Agency

084 3510560 / tamaryn@connectmedia.co.za

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