What’s better - to vape or not?
TO vape or to continue smoking combustible cigarettes? Is that even the question?
For Dr Kgosi Letlape, president of the Health Professions Council of South Africa, it shouldn’t be.
“It shouldn’t even be a contest. To me, it’s about alternatives to combustible cigarettes which have the highest degree of harm. It is about harm reduction in general and we need to get to a space where people have a choice”, Letlape said at a panel briefing in Rosebank about vaping versus cigarettes.
A vape, short for vaporiser, is an electronic atomisation or “cigarette”. While it’s gaining considerable traction in the country, with many smokers opting to use the electronic cigarettes, it is still subject to controversy as Health Minister Aaron Motsoaledi has adopted a tough stance against them, saying they should be regulated as regular tobacco.
Last year the minister said the e-cigarettes were as bad as tobacco, adding that some still had nicotine.
Also last year, a New York judge ruled that vaping was not smoking in the People vs Thomas case, defining smoking as the “burning of a lighted cigar, cigarette, pipe or another matter or substance which contains tobacco”.
Further, in 2015 an evidence review by Public Health England showed that vaping was up to 95% safer than traditional cigarettes.
But some of the panellists at the discussion were still not convinced, such as Professor Richard van Zyl-Smit, head of the Lung Clinical Research Unit, who said there simply was not enough reliable data in the South African context to project that vaping would also be 95% safer, as was found in the UK.
To which Letlape argued: “We’re not advocating people start smoking. It’s not about saying start vaping (to non-smokers), it’s about those who do. It’s about reduction of harm and not the extermination of harm.
“We know that in relation to combustible cigarettes, they are safer. And there may be a lot we don’t know yet, but there’s a lot we can do with what we do know.”
And on the subject of health ministries and governments toughening their stance on vaping, health activist, Clive Bates said: “There’s a lot of tough talk on policy but beware - if you over-regulate e-cigarettes, you’re essentially protecting the cigarette trade.”
On legislation and regulation, Dr Delon Human, co-founder of the Africa Harm Reduction Alliance and president of Health Diplomats, added that South African legislation needed to resolve four critical areas in marketing, labelling, regulation and taxation.
While there was consensus that vaping should not target children or non-smokers, “guidelines should not prevent vaping from becoming an attractive and effective alternative to the smoking of tobacco cigarettes”.
This also had implications for labelling and advertising. Legislation should not be so onerous that it limits the availability or increased the cost of vaping products. This, he said, would detract from the effectiveness of vaping products as affordable, accessible and attractive alternatives to the smoking of tobacco cigarettes.
“This would compromise the ability of vaping to truly disrupt tobacco’s hold on South Africa,” he said.
Despite the efficacy of vaping as a healthier substitute for tobacco, vaping advocates have made a decision not to seek to promote it as a medically registered nicotine replacement therapy .
This would dramatically increase the costs of producing, marketing and distributing vaping products, Bates said.