E-cigaret­tes: it’s time for some reg­u­la­tion

The Star Early Edition - - INSIDE -

THEY’VE be­come a fa­mil­iar sight in pub­lic places: a cloud of smoke bil­low­ing into the air as a shop­per, stu­dent or pedes­trian uses an e-cigarette and re­leases “smoke” into the air.

There are two rea­sons why those who use e-cigaret­tes are cur­rently able to do so in pub­lic.

Firstly, there is no leg­is­la­tion that reg­u­lates the use of e-cigaret­tes in South Africa. The cur­rent to­bacco con­trol law was in­tro­duced more than two decades ago, at a time when e-cigaret­tes were not avail­able.

This is why e-cigaret­tes are be­ing used in­side restau­rants and malls, in pub­lic trans­port and of­fice build­ings, as well as on the streets. There are no laws gov­ern­ing their use.

Sec­ondly, there are no laws gov­ern­ing the ad­ver­tis­ing, mar­ket­ing and spon­sor­ship of e-cigaret­tes. This has meant that e-cigarette man­u­fac­tur­ers have used the leg­isla­tive vac­uum to widely mar­ket and pro­mote these de­vices.

They’ve also been able to make un­sub­stan­ti­ated claims about the im­pact they have on pub­lic health as well as on their ef­fi­cacy as a quit tool.

And they’ve been able to po­si­tion e-cigaret­tes as healthy, sexy and at­trac­tive, with a par­tic­u­lar fo­cus on get­ting young peo­ple to use the product.

This is all set to change as the Depart­ment of Health has pro­posed reg­u­lat­ing the use and mar­ket­ing of e-cigaret­tes in the Draft Con­trol of To­bacco Prod­ucts and Elec­tronic De­liv­ery Sys­tems Bill, which re­stricts the use of e-cigaret­tes in pub­lic places and in all ar­eas where com­bustible cigaret­tes are not al­lowed.

Mar­ket­ing, ad­ver­tis­ing and the spon­sor­ship of e-cigaret­tes will also be banned and their sale will be re­stricted to adults over 18.

Com­ments for the bill have closed; the depart­ment has re­ceived thou­sands of sub­mis­sions. This process will con­tinue for the next eight months at least.

But as this gets un­der way, there is a de­bate rag­ing in the back­ground about the harm at­tached to e-cigaret­tes, mostly sug­gest­ing that peo­ple switch to them. Peo­ple should not be­lieve the hype. The com­mon ar­gu­ment from e-cigarette man­u­fac­tur­ers and pro­mot­ers is that they are not as harm­ful as com­bustible cigaret­tes be­cause they con­tain less nico­tine.

Yes, it’s true they con­tain less nico­tine, but this does not equate with be­ing less harm­ful than com­bustible cigaret­tes.

E-cigarette use has been linked to the de­vel­op­ment of lung dis­eases such as chronic ob­struc­tive pul­monary dis­ease (bron­chi­tis and em­ph­esyma). And, if used dur­ing preg­nancy, it can cause sud­den in­fant death syn­drome.

Stud­ies have also linked the use of e-cigaret­tes to in­creased heart rate and high blood pres­sure, which are of­ten pre­cur­sors of heart dis­ease.

The ev­i­dence shows that there can be up to 60 tox­ins in the e-liq­uid that is used to man­u­fac­ture some e-cigaret­tes.

De­spite claims from the to­bacco in­dus­try that e-cigaret­tes help smok­ers to stop us­ing com­bustible cigaret­tes, there is no data avail­able to sug­gest that e-cigaret­tes are more ef­fec­tive as a quit tool than nico­tine re­place­ment ther­apy pro­grammes, mo­ti­va­tional coun­selling and/or sup­port groups.

In­stead there is ev­i­dence to show that e-cigaret­tes are most likely to be used in com­bi­na­tion with com­bustible cigaret­tes.

Pre­lim­i­nary re­search into the use and ef­fects of e-cigaret­tes raises cause for con­cern about their use among young peo­ple.

The US sur­geon-gen­eral found that e-cigarette use among high school learn­ers in­creased by 900% be­tween 2011 and 2015.

It’s also the most com­monly used form of to­bacco among young peo­ple in the US, and has over­taken the use of com­bustible cigaret­tes, cigars, chew­ing to­bacco, and wa­ter pipes.

The re­port also noted that the pres­ence of nico­tine in many e-cigaret­tes can cause ad­dic­tion as well as harm the de­vel­op­ing ado­les­cent brain.

The re­port also noted other ef­fects on ado­les­cents, in­clud­ing ad­dic­tion, prim­ing for use of other ad­dic­tive sub­stances, re­duced im­pulse con­trol, deficits in at­ten­tion, and mood dis­or­ders.

South Africa has not yet reached the US lev­els of con­sump­tion of e-cigaret­tes. How­ever, alarm bells are ring­ing here, too. A sur­vey of high school learn­ers by the Bu­reau of Eco­nomic Re­search showed that nearly four in 10 learn­ers in the sur­vey had smoked cigaret­tes, and three out of 10 had used e-cigaret­tes.

Most had started smok­ing in their early high school years and had ex­per­i­mented with to­bacco. The data shows sim­i­lar­i­ties with find­ings from in­ter­na­tional re­search, which shows that e-cigarette use en­cour­ages young peo­ple to start smok­ing com­bustible cigaret­tes.

South Africa is not the first coun­try to in­tro­duce reg­u­la­tion of e-cigaret­tes. We will join over 60 other coun­tries.

Cur­rently, just un­der 20% of the pop­u­la­tion smokes com­bustible cigaret­tes, a fig­ure that has re­mained stag­nant for al­most a decade.

Se­fako Mak­gatho Health Sciences Uni­ver­sity es­ti­mates that be­tween 200 000 and 300 000 peo­ple cur­rently use e-cigaret­tes, and be­lieves that this num­ber will in­crease if they are not reg­u­lated.

The pro­posed reg­u­la­tion of e-cigaret­tes to limit their use in pub­lic places, to ban all mar­ket­ing, ad­ver­tis­ing and spon­sor­ship, as well as to in­tro­duce health warn­ings on pack­ag­ing, will send a clear mes­sage to South Africans that e-cigaret­tes are harm­ful to the health of both the users them­selves as well as to those around them.

They will then make their own choice not to use e-cigaret­tes, ex­actly as mil­lions of South Africans refuse to con­sume com­bustible cigaret­tes.

Just un­der 20% of South Africa smokes or­di­nary cigaret­tes

Sav­era Kalideen is ex­ec­u­tive di­rec­tor of the Na­tional Coun­cil Against Smok­ing

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