How tobacco alternatives are shifting the smoking landscape across the globe

SA ranks 23rd among the countries with the highest smoking rates in the world. Picture: Pexels

SA ranks 23rd among the countries with the highest smoking rates in the world. Picture: Pexels

Published Nov 13, 2023


Historical, cultural and marketing factors are to blame for cigarettes’s popularity. In the early to mid-20th century, tobacco companies heavily marketed cigarettes as symbols of sophistication, glamour, and social acceptance.

They employed powerful advertising campaigns that appealed to people's desires to fit in, be stylish, and feel rebellious. These marketing efforts played a significant role in making smoking socially desirable and acceptable.

Not only do cigarettes contain nicotine, but they are a highly addictive substance. When people smoke, nicotine reaches the brain quickly, resulting in feelings of pleasure and temporarily reducing stress and anxiety.

This addictive nature of nicotine contributed to the continued use and popularity of cigarettes among smokers.

For some, smoking is often considered a way to cope with stress, anxiety, and other emotional challenges.

In fact, according to a recent study conducted by UCT's Lung Institute, South African high school pupils from high-income schools are increasingly turning to vaping as a coping mechanism against stress.

The study showed that Grade 12 pupils vape the most at 26.5%, followed by Grade 11 learners (17.4%), Grade 10s (13%), Grade 9s (10.8%). Grade 8s vape the least.

However, in recent years, awareness about the harms of smoking has led to the rise of smoking alternatives, driven by a combination of factors: The number one being health concerns associated with smoking, such as lung cancer, heart disease, and respiratory issues.

These have motivated many individuals to seek alternatives to combustible tobacco.

Public health campaigns and interventions aimed at promoting smoke-free environments and helping people quit smoking have made individuals more aware of the need to reduce or eliminate their tobacco consumption.

Heated tobacco infographic. Picture: Supplied

As a result, smoking alternatives have emerged as potential tools to assist smokers in their quitting journey.

Innovative smoking alternatives, such as e-cigarettes, snus (In Norway, snus has helped cut down on smoking), vapes, nicotine patches and heated tobacco products.

These alternatives, which deliver nicotine without combustion or the production of smoke, offer potentially reduced harm compared to traditional cigarettes, making them attractive to individuals seeking alternatives.

One company that is rallying in the frontlines for tobacco harm reduction for public health in South Africa is Philips Morris

South Africa is currently ranked among the top countries in the world in terms of smoking prevalence.

Despite stringent advertising restrictions and a new bill pending, the country remains at 23 among the countries with the highest smoking rates in the world.

According to the World Population Review 2023, South Africa’s total smoking rate is at 31.4%, and of that, 46.8% of smokers are male and 16% female.

More needs to be done between government leadership and commercial entities to accelerate efforts to reduce smoking rates, according to Philip Morris South Africa.

At yesterday's press briefing, Philip Morris South Africa's managing director, Branislav Bibic, explained that it would be ideal if one billion smokers around the world stop smoking altogether, but so far, there are no indications that this number will change significantly in the near future.

It is, however, important to consider products that replace cigarettes for adults who would otherwise continue to smoke, he said.

“While we know that these products are not risk-free and are addictive, the science shows that they are a much better choice for adult smokers compared to continue smoking,” he added.

Heated tobacco products (HTPs) are designed to heat tobacco to a high enough temperature to release aerosol, without burning it or producing smoke.

They differ from e‐cigarettes, because they heat tobacco leaf/sheet rather than a liquid. Companies that make HTPs claim they produce fewer harmful chemicals than conventional cigarettes.

Some people report stopping smoking cigarettes entirely by switching to using HTPs.

The adoption of heated tobacco products is a revolutionary change, especially considering the health risks associated with smoking.

Based on data compiled by the Toll of Tobacco-Free in South Africa Campaign for Tobacco-free Kids, over 39 000 South Africans die from tobacco use each year.

Despite the harm cigarette smoking causes, Bibic maintains that many people find it hard to stop smoking because it is addictive.

By providing access to and accurate information on scientifically substantiated products, like heated tobacco and e-cigarettes which eliminate combustion, he explicitly states that the most pragmatic approach is to complement existing efforts to reduce the harm caused by smoking.

“In that same vein, at Philip Morris International, we advocate for tobacco harm reduction (THR) strategies to be applied to the known risks of smoking.

“Indeed, there is growing support for this path among public health bureaus, governments, medical groups, and others,” he added.

He further goes on to say that the best choice for any smoker is to quit tobacco and nicotine entirely.

“However, for those who don’t quit, it is also clear that scientifically substantiated smoke-free alternatives, which provide nicotine… represent a much better choice than continued smoking.

“These products and their potential to benefit public health are central to our vision of a smoke-free future. For tobacco harm reduction to help effectively eliminate smoking, adult smokers must be able to choose these lower-risk options.

“Tobacco harm reduction should be considered a complementary strategy, and not a replacement for existing efforts to encourage those who smoke to quit and those who don’t to never start,” Bibic added.