South Africa's New Vaping Laws: A Step Back for Public Health?

South Africa’s updated tobacco bill, set to treat e-cigarettes as traditional tobacco products, is creating growing concerns among public health experts and vaping advocates alike. By restricting public use, banning advertising, and imposing packaging controls, these regulations are meant to prevent youth from starting the habit. However, a closer examination of international research and market dynamics suggests these measures could unintentionally push people back to smoking, complicating South Africa’s fight against tobacco-related diseases.

Regulation Challenges and Cross-Price Elasticity

One core issue lies in the economics of "cross-price elasticity." When one product—like e-cigarettes—becomes more costly or harder to access, consumers may simply switch to an alternative. In this case, the alternative would be cigarettes. A range of international studies shows a clear substitution effect when vape regulations or taxes increase. For example, from 2011 to 2018, U.S. data revealed that a $1 increase in cigarette tax led people to turn to vapes. Conversely, taxing e-cigarettes pushed individuals back to smoking. When a 2020 U.S. proposal aimed to tax each milliliter of vaping liquid by $1.65, researchers projected 2.5 million additional cigarette smokers as a direct result.

Even among teens, the impact is stark. Between 2014 and 2019, a $1 vape tax saw over two-thirds of U.S. high school students who quit vaping move on to smoking. This underscores the risk that policies aimed at one addiction might worsen another.

How Will These Laws Affect South African Smokers?

South Africa’s own tobacco landscape is complex. In 2021, around 30% of South Africans over 15 used tobacco products, with e-cigarettes included. That year, tobacco-related illnesses claimed about 42,000 lives. Yet despite these statistics, vaping has been presented as a potential harm-reduction tool, especially for adults who find it challenging to quit smoking entirely.

By treating vapes as tobacco products, the bill might cut off a significant number of smokers from an alternative that could have helped them quit. While smoking involves the harmful inhalation of chemicals from burning tobacco, vaping heats a liquid, often containing nicotine but fewer other chemicals, to produce a vapor. Though not without risks, many believe vaping is less harmful than smoking.

In 2023, South Africa introduced a tax on e-cigarettes. However, its effects have been mixed. While the price of refillable e-liquids doubled, the cost of popular 3ml disposable vapes only rose by about R10. Disposable vapes, which are especially popular with young people, remain affordable relative to the price of cigarettes, which hasn’t significantly deterred underage usage. Comparing costs, a 3ml disposable vape costs around R105, close to three packs of cigarettes. This means that if vape costs rise significantly, some users may simply switch back to cigarettes instead of quitting nicotine.

Unintended Consequences of Flavor Bans and Advertising Restrictions

Some international efforts to control youth vaping have included bans on flavored vapes, which are often seen as enticing to younger users. In San Francisco, for instance, flavored tobacco restrictions led to a troubling rise in youth cigarette smoking, as teenagers turned to cigarettes when vape flavors became inaccessible. Although initial findings suggested this behavior may be temporary, long-term effects are less clear, and some adults in San Francisco also resumed smoking.

South Africa’s proposed laws may lead to similar outcomes if users find restricted vape products unappealing or if advertisements are cut off, reducing public awareness of potentially safer options. While advertising bans aim to reduce appeal to young people, they may also inadvertently limit adult smokers’ knowledge of alternatives to traditional cigarettes, especially in rural areas.

Need for Localized Research and Caution in Policy-Making

Experts argue that before implementing a blanket policy, South Africa should conduct local research to understand the specific impacts on its unique market. Most current studies on vaping regulations rely on U.S. data or focus on certain user groups, which may not reflect South African trends accurately. Furthermore, the diversity in e-cigarette products, from disposables to refillable devices, affects the outcomes of such research. Estelle Dauchy, principal research officer at the University of Cape Town, suggests that local studies could provide crucial insights into the interplay between vaping and smoking within the country.

Dauchy also highlights that the long-term impact of these policies is still uncertain. “If access to one product is blocked due to a price increase, some people may choose to quit and buy nothing, or they may switch to another product,” she explains. But the full ramifications of banning or limiting e-cigarettes are still unknown. While restrictions may initially deter youth, such laws could encourage illegal markets or black-market products that bypass age verification entirely.

A Step Back for Public Health?

E-cigarettes have emerged as valuable tools for those seeking to quit smoking. Treating them as equivalent to tobacco products undermines this potential, making it harder for adult smokers to switch to safer alternatives. Studies from other countries indicate that when access to e-cigarettes is restricted, former smokers often revert to cigarettes—a shift that could raise South Africa’s smoking rates rather than reduce them. Already, South Africa’s e-cigarette tax has made vaping more expensive without significantly affecting underage access, suggesting further restrictions might primarily hurt adult users trying to quit.

Flavors, Advertising, and Health Risks

Further regulations, such as flavor bans, could have the opposite effect of what’s intended, as people might turn to black-market products that pose greater health risks. By banning ads, adults might lack access to accurate information about safer alternatives, potentially driving them to continue smoking rather than seek harm-reduction options like vaping.

A Costly Health Impact

If policies drive adults back to cigarettes and limit access to harm-reduction alternatives, the South African healthcare system could face an influx of tobacco-related illnesses. This approach risks trapping South Africa in a cycle of increased cigarette use, worsened health outcomes, and illicit markets. A policy with more nuanced research could better target youth smoking while protecting adult vapers looking for healthier alternatives.

Long-Term Implications: Uncertain Effects on Smoking Rates

As policymakers continue to evaluate these issues, it’s crucial to acknowledge that simply restricting e-cigarette access may not solve South Africa’s public health challenges. If the goal is to reduce nicotine dependence and tobacco-related diseases, policies should be balanced to allow adult smokers access to harm-reduction alternatives while still protecting youth from addiction. Research suggests that more restrictive measures may lead to a rise in smoking rates, an outcome that contradicts the bill's public health intentions.

In the end, the question remains: will South Africa’s new tobacco bill encourage healthier choices, or will it lead to unintended consequences, driving users back to cigarettes? Only careful monitoring, along with responsive adjustments to the law, can determine whether the policy achieves its goals—or if it’s simply trading one public health challenge for another.