Where there’s smoke, there’s fire

Mark Twain said: “Giving up smoking is easy … I’ve done it hundreds of times…”. Smokers and non-smokers know that smoking is extremely addictive. However, does the electronic cigarette (“e-cigarette”) curtail the negative effects that cigarettes have on the body of a smoker and the people around them?

The differences between cigarettes and e-cigarettes include the following:

  • Cigarettes contain tar while e-cigarettes do not.
  • Cigarettes make use of a process of ignition which converts solid nicotine or other chemical smoking products into smoke. An e-cigarette provides combustion to convert liquid nicotine into water vapors.
  • Cigarettes release a continuous stream or cloud of smoke which is harmful to the smoker, people around the smoker, and the environment. e-cigarettes only release smoke when exhaled by the smoker.
  • Generally e-cigarettes are perceived to be up to 75% cheaper than cigarettes.
  • The use of cigarettes is limited in some ways whereas the use of e-cigarettes is not.

The World Health Organization (“WHO”) states that tobacco, which is contained in all regular cigarettes, causes the death of approximately 6 million people each year. Just under one fifth relates to death of non-smokers due to the exposure to second-hand smoke. There are no positive factors that can be identified with smoking regular cigarettes, there are many negatives, including decay in teeth and organs, illnesses, and possibly death.

The e-cigarette industry is a three-billion-dollar industry with approximately 466 brands on the market worldwide. The smoking of an e-cigarette causes the heating of a liquid, which consists of nicotine, tobacco-specific nitrosamines, tobacco alkaloids, aldehydes, propylene glycol and/or glycerine, metals, volatile organic compounds and flavouring agents.

The earliest e-cigarette can be traced back to Herbert A. Gilbert who patented “a smokeless non-tobacco cigarette” that involved “replacing burning tobacco and paper with heated, moist, flavoured air” in 1963. The patent was granted in 1965 for a device which produced flavoured steam without nicotine.

e-cigarettes have an inflammatory effect on the epithelial cells lining the inside of the lungs. The substances in e-cigarettes cause harm to these cells and make them susceptible to infections. The carcinogen formaldehyde contained in e-cigarettes can be up to 15 times more toxic and cancer-causing when consumed with high-voltage vapour releasing e-cigarettes.

The smoking of tobacco products, such as cigarettes, is prohibited in any public area. The smoking of e-cigarettes, however is not. There seems to be a loophole in the legislation and policies pertaining to e-cigarettes. It is arguable, but one may be of the opinion that e-cigarettes should not be excluded from legislation detailing tobacco products, as it undermines the intention of the legislature. Some individuals use e-cigarettes as a way of quitting smoking. Studies have however shown that smokers could not be cured of tobacco cravings after 6 to 12 months on e-cigarettes and were still smoking regular cigarettes. The result is therefore the creation of dual-smokers. e-cigarettes have also opened a door to minors as they too can purchase and smoke e-cigarettes as opposed to regular cigarettes due to the loophole in legislation and policies.=

There are many opposing views on e-cigarettes and the manner in which legislation and policies should cater for it. Health advocates in the US are fighting to include e-cigarettes in all “clean air and tax laws” as a tobacco product or a product derived from tobacco. Switzerland, Brazil and Singapore have banned indoor smoking altogether. Canada and France have regulated their use. On the contrary, the British welcomed the use of e-cigarettes in 2015 as a healthier and safer alternative to regular tobacco cigarettes.

In South Africa, the Medicines and Substances Related Act 101 of 1965 was amended in 2012 to state that e-cigarettes are scheduled devices that should be bought only from a pharmacy with a doctor’s prescription. e-cigarette distributors bypassed this requirement by selling e-cigarettes over the counter in shopping malls by not mentioning that e-cigarettes can be a therapeutic device, have health benefits, or help with smoking cessation. An example hereof is Twisp, the popular brand seen in many South African shopping malls. Twisp promotes their product to be available in different flavours to “tantalize all your senses”. This may be suggestive of enjoyment. Further, South Africa’s Tobacco Products Control Act 83 of 1993 does not include any specific reference to e-cigarettes.

The ongoing health debate on conventional tobacco cigarettes compared to e-cigarettes may only be resolved after a detailed study on the long-term effects of e-cigarettes has been undertaken. In the interim, e-cigarettes bear their own characteristics that are detrimental to one’s health. It is suggested that e-cigarettes should be included under “tobacco products” for legislative purposes and that the smoking of e-cigarettes be included under the regular definition of “smoking”. Irrespective of the difference in opinion and views, it is a fact that the use of e-cigarettes remains inadequately regulated and this requires legislative reform.

South Africa’s Minister of Health, Aaron Motsoaledi, has taken a firm standing against e-cigarettes and has indicated that he will push for new legislation against all forms of smoking e-cigarettes. Until then, where there’s smoke there’s fire.

Nicolé Maré – Candidate Practitioner

Kim Rademeyer – Partner