Experts Urge South Africa to Adopt Science-Based Vape Policies
A leading Italian physician and tobacco harm reduction expert, Professor Riccardo Polosa, has called on the South African parliament to adopt science-based policies as it considers the new Control of Tobacco Products and Electronic Delivery Systems Bill. Speaking to the parliamentary portfolio committee on health, Polosa, who leads the Centre of Excellence for Harm Reduction at the University of Catania, urged policymakers to seriously consider evidence-based harm reduction strategies, emphasizing the role of e-cigarettes in helping smokers quit.
“Triangulation of systematic reviews and real-world evidence shows that e-cigarettes help smokers quit,” Polosa stated. “The Cochrane Library, the highest level of evidence, concludes that people are more likely to stop smoking using nicotine e-cigarettes than with nicotine replacement therapy such as patches and gums.” He pointed to real-world data from the US, where a sharp decrease in smoking has coincided with an increase in vaping, suggesting that vaping is effectively replacing smoking, particularly among young people.
Polosa highlighted the significant reduction in harm from non-combustible nicotine products. “Quitting smoking is not easy, but combustion-free nicotine products reduce toxic emissions and exposure, making it very likely that they lead to reduced harm,” he said. He cited a large international replication study showing that while cigarette smoke kills about 75% of cells in cultures, tobacco harm reduction devices show little effect, with some cells even continuing to grow. “These products are about 80% less toxic than tobacco cigarettes and about 99% less genotoxic,” he added.
He also pointed to Sweden, where the widespread use of snus (a non-combustible nicotine product) has contributed to the lowest long-term mortality and cardiovascular disease rates in Europe, as a real-world example of harm reduction success. Clinical data, he noted, shows rapid health improvements after switching, including restored sense of taste and smell, and improved lung function and quality of life for patients with Chronic Obstructive Pulmonary Disease (COPD).
Addressing concerns about vaping among non-smokers, Polosa mentioned a 3.5-year study of people who vape but have never smoked, which observed “no long-term health concerns.”
South African adjunct professor and independent healthcare consultant, Professor Praneet Valodia, echoed these sentiments. He told the committee that the combustion of tobacco produces 6,000-7,000 chemicals, with about 100 being harmful. “Non-combustible nicotine-containing products produce no combustion and 60% to 99% fewer harmful chemicals,” he stated, referencing independent evaluations by the US FDA. “Nicotine levels are the same but nicotine is not the harmful substance. It’s the other chemicals… which cause disease.”
Both experts argued that pretending combustible cigarettes and non-combustible nicotine products are the same undermines public health. They called for a smarter regulatory framework that differentiates based on risk, supports smokers with safer options, and embraces the overwhelming scientific evidence for tobacco harm reduction.
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