Protect our children from smoking or vaping

The message from the Western Cape Department of Health and Wellness on World No Tobacco Day (31 May 2024) is that it is never too late to quit smoking and vaping. This year’s theme is, “protecting children from tobacco industry interference” which focuses on advocating for an end to the targeting of youth with harmful tobacco and related smoking products.

We are seeing an increase in the use of e-cigarettes (also known as electronic cigarettes or vapes) in especially young people, which comes with many risks, including harm to the lungs and brain. According to the World Health Organisation, vaping has been proven ineffective as a way to quit smoking. People who want to quit smoking should aim to stop all together, and not just switch one habit for another. Vaping also poses risks to non-smokers and can have harmful health effects, especially on young people whose brains are more sensitive to nicotine.

Young people who vape are three times more likely to take up smoking. The Department urges parents or caregivers to urgently address their youngster’s vaping as an important preventative step for both smoking and vaping in future.

E-cigarettes with nicotine are highly addictive and are harmful to health. Whilst long-term health effects are not fully understood, it has been established that they generate toxic substances, some of which are known to cause cancer and some that increase the risk of heart and lung disorders. Use of e-cigarettes can also affect brain development and lead to learning disorders for young people.

Pregnant women are also urged not to vape as fetal exposure to e-cigarettes can adversely affect the development of the baby. Exposure to emissions from e-cigarettes also poses risks to the fetus.

Both tobacco products and electronic nicotine delivery system (ENDS) pose risks to health. The safest approach is not to use either. The levels of risk associated with using ENDS or tobacco products are likely to depend on a range of factors, some relating to the products used and some to the individual user. Factors include product type and characteristics, how the products are used, including frequency of use, how the products are manufactured, who is using the product, user behaviour – user’s puffing style – and whether product characteristics are manipulated post-sale.

Toxicity is not the only factor in considering risk to an individual or a population from exposure to ENDS emissions. These factors may include the potential for abusing or manipulating the product, use by children and adolescents who otherwise would not have used cigarettes, simultaneous use with other tobacco products (dual or poly use) and children and adolescents going on to use smoked products following experimentation with ENDS. Dual use, which is common, is at least as dangerous and likely more dangerous than smoking conventional cigarettes or using e-cigarettes alone. Further, not all ENDS are the same and the risks to health may differ from one product to another, and from user to user.

The World Health Organisation published shocking research indicating that children between 13 and 15 years old use e-cigarettes at a higher rate than adults in WHO regions. Canada and the United Kingdom are also seeing a significant increase in the e-cigarette use under children.

Associate Professor Richard van Zyl-Smit, Professor and Consultant Pulmonologist at Groote Schuur Hospital (GSH) and University of Cape Town notes, “While vaping liquids do not contain tobacco, and there are reduced risks for tobacco-related diseases, there are still considerable numbers of toxins in vape fumes. The fumes can harm the lungs, the brain and blood vessels.”

Prof. van Zyl-Smit and others conducted a pilot study on smoking and vaping in schools in South Africa. It was the start of a bigger project, but they first looked at high income schools in Gauteng, KwaZulu Natal and the Western Cape.  They found low numbers of those smoking, but high levels of vaping even from Grade 8, up to around 25% of matric learners vaping in these schools. The project is nearing its completion, and they hope to have the full data analysed and published by mid-2024.

GSH started a smoking cessation clinic in 2012, because there was no service of any kind to help smokers in public hospitals to overcome their tobacco addiction. It is estimated that in the Western Cape that over 23% of women and 36% of men still smoke tobacco. The clinic, led by Prof. Van Zyl- Smit, today sees up to 50 patients per year. While the service at GSH is small, it regularly runs smoking cessation training courses, and has partnered with the department to equip health care providers with the necessary skills to help smokers quit. A key milestone of the clinic is that it produced the first South African smoking cessation guidelines for use around the country. In addition, outreach and education through talks and seminars continue and it offers advice telephonically or via email as needed.

Mr Roland Kuba (58) from Diep River is currently a patient in the respiratory clinic at GSH. He started smoking at age 14 and smoked about two cigarettes per day. “Ten years ago, I started to feel the negative effects of smoking. Sadly, as a result of my smoking, I am now also being treated for Chronic Obstructive Pulmonary Disease and Parkinson Disease. I just wish that I never started to smoke in the first place.”

“We do not shout and berate those that come and see us at the clinic. Most smokers know it is bad and would like to quit… we are there to help them. We will support you as much as we can. We want our patients to know that we are 100% behind you in trying to quit, and will do all we can to help,” concluded Prof. Van-Zyl-Smit.

Today is the best day to quit smoking. Quitting smoking is the best thing you can do for your health, no matter your age or how long you have smoked, and the benefits begin immediately.