Claims about e-cigarettes are simply a smokescreen. Photo: Reuters/David Mercado
There has been an uptick in sponsored content from the tobacco and vaping industry claiming that the decline in smoking rates in South Africa can be attributed to “alternative tobacco-free nicotine products”. Articles state that these products are driving public health gains by providing smokers with more satisfying alternatives to traditional cessation aids. This untrue narrative is a blatant attempt to mislead the public.
The tobacco and vaping industry’s claims surrounding a decline in smoking in South Africa are an elaborate smoke-screen designed to shift blame and sell products.
Taking credit for fewer people smoking is a new industry tactic being employed globally by the e-cigarette industry, which includes big tobacco companies. What we see here is a textbook example of tobacco industry strategy. They aim to distort public health victories and take credit for trends they had nothing to do with. This is part of a broader, global strategy to rehabilitate their image by promoting “harm-reduction” narratives. Their tactics are designed to obscure the fact that these products are not reducing nicotine addiction, but perpetuating it.
Smoking decline began well before nicotine alternatives
The facts paint a very different picture. South Africa experienced its most significant decline in smoking prevalence between 1993 and 2003, well before e-cigarettes or nicotine pouches entered the market.
During that period, smoking prevalence dropped largely due to the implementation of robust tobacco control policies, such as higher taxes, advertising bans and restrictions on smoking in indoor public places. For example, smoking rates among men fell from 42% in 1998 to 35% in 2003.
Overall rates fell as low as about 16% in 2010, but this started increasing in the early 2010s to 2020s with the re-emergence of products like hookahs and the advent of e-cigarettes, which were heavily marketed to young people and not adequately covered by the law. Notably, these changes were driven by the government’s commitment to protecting public health and the efforts of public health advocates — not by tobacco companies with novel products, which were non-existent.
Contrary to the industry’s claims, evidence shows that the introduction of e-cigarettes to South Africa, which has been tracked since about 2010, did not sustain or accelerate this downward trend. If anything, there has been a concerning reversal. Since the introduction of e-cigarettes and nicotine pouches, smoking prevalence has actually increased. Gains that were painstakingly achieved over decades of tobacco control efforts are being rolled back.
While the percentage of smokers in the population has appeared to plateau, population growth has caused the actual number of smokers to rise. Alarmingly, smoking rates among young people — especially young women — have either increased or shifted towards new products like e-cigarettes and waterpipes.
Recent South African Medical Research Council research highlights the growing prevalence of smoking and dual use of cigarettes and alternative nicotine products in South Africa. Dual use — when individuals use both traditional and “alternative” nicotine products — undermines the effectiveness of existing tobacco control measures and has been shown to be more harmful than using either product.
The industry is simply finding new ways to hook people into nicotine addiction while claiming to offer solutions.
Addressing sponsored misinformation
The tobacco industry’s claim of driving the reduction in smoking is not only false but also dangerous because it misleads policymakers and the public, creating a false sense of progress.
Rather than aiding tobacco control efforts, the availability of new nicotine products has diversified addictive nicotine consumption and allowed the tobacco industry to maintain its profits while evading regulations because in many jurisdictions, such as South Africa, it takes a long time to bring these products under any legislative framework. Knowing this, markets become flooded with these products and marketing largely goes unrestricted before they can be properly regulated.
When inaccurate or misleading sponsored content is published, it has serious consequences. It undermines public trust and hampers informed decision-making for policy and public health. Credibility is crucial in shaping public perception and these deceptive tactics risk derailing years of evidence-based tobacco control advocacy. Transparency laws should be enforced to ensure that consumers and policymakers are not misled by industry-funded pseudo-science.
Keep the focus on accountability
This year’s World No Tobacco Day theme “unmasking the appeal: exposing Industry tactics on tobacco and nicotine products” focuses on revealing how the industry manipulates and misleads the public. Efforts by research organisations, public health advocates and coalitions such as Protect Our Next are essential in exposing these tactics in South Africa.
Policy measures such as increased taxation on tobacco and alternative products; comprehensive advertising bans and stringent policies to prevent youths smoking, many contained in the Tobacco Products and Electronic Delivery Systems Control Bill, must remain central to reducing smoking prevalence. It’s time to call out industry manipulation for what it is — a direct threat to public health — and hold them accountable for their role in perpetuating misinformation.
The South African Pharmacy Council’s recent move to ban the sale of e-cigarettes in all pharmacies in the country has been praised by public health advocates, including Protect Our Next. This decision highlights the growing concern over the unregulated availability of e-cigarette products and their impact on youth and public health.
Protect Our Next has further emphasised the necessity for proactive measures, such as tighter regulations and comprehensive enforcement, to curb the rise of e-cigarette use among young people and safeguard community health.
The 2025 World No Tobacco Day campaign aims to raise awareness and advocate for stricter policies — like banning flavours and digital advertising — to reduce demand, especially among the youth. By exposing these tactics, we can work towards a healthier, more informed and tobacco-free future. Let’s unmask the industry’s strategies and protect public health.
Professor Catherine Egbe is a senior specialist scientist in the Mental Health, Alcohol, Substance Use and Tobacco Research Unit at the South African Medical Research Council.
