BHEKISISA CENTRE FOR HEALTH JOURNALISM
Smoke and mirrors: What you need to know about the hazy world of the proposed vaping tax
In the coming months, we’ll be publishing a series of analyses that plunge into the two sides’ (the vaping industry and the tobacco industry) arguments as they rally to fight for the nation’s lungs. Here, we take a look at the tobacco-control players in South Africa.
A vaping storm’s a-brewing. In December, the Treasury released a 32-page document in which it outlines that it’s considering taxing e-cigarettes and vapour products.
But the vaping industry isn’t happy with how things are unfolding. It claims that the tax might discourage smokers from switching from tobacco to products that they argue are less harmful than traditional cigarettes.
Governments around the world use excise tax as a way to earn a steady income stream and to deter people from buying products that could harm their health or the environment. In South Africa, the government levies excise tax on fuel, tobacco, liquor, sugary drinks, electronics, cars and cosmetics – goods people buy often or that come with a luxury price tag.
And now the state has e-cigarettes and vapour products in their sights, too.
The thinking is that although excise taxes are paid by the product manufacturers, consumers often absorb part of the price hike, and so taxing these products could make people think twice before buying. So, in the long run, taxing sugary drinks or tobacco products can help people to lead healthier lives. This is what happened when the government started taxing conventional tobacco products in 1994: in the decade that followed, the number of smokers in South Africa dropped by a third.
Although it’s still early days for the vaping tax policy, it’s off to a rocky start. The initial deadline for comment on the discussion paper was 25 January but was extended to 7 February. Yet it got the vaping lobby’s hackles up because, Asanda Gcoyi says, they were not officially informed and had to learn about it through the news media. She’s the chief executive officer of the Vapour Products Association of South Africa (VPASA), an industry body that represents manufacturers, sellers and importers.
The proposed taxing of vapour products and the way it’s been introduced are just more fuel on a fire that has long raged between the public health lobby – the health department, nonprofit organisations, advocates and researchers – and the pro-vaping group – vapour product companies and some harm reduction advocates, a number of whom have ties to the tobacco industry.
At the heart of this historic tug of war is the draft Control of Tobacco Products and Electronic Delivery Systems Bill, which has been stuck, untabled, for four years. This legislation proposes that heated-tobacco products (HTPs), electronic delivery devices such as vapes and old-fashioned cigarettes should all be treated the same.
HTPs claim to “heat, not burn” tobacco, just enough to release nicotine vapour. E-cigarettes are hand-held devices that heat a glycerine-based liquid to turn it into a vapour, which is why smoking e-cigarettes is often called “vaping”. The liquid usually contains nicotine and other chemicals that allow it to vaporise easily.
Because the bad effects of tobacco are linked mostly to smoke, vaping supporters argue that smokeless products are less harmful. But the jury is still out and a recent study published in the journal Chemical Research in Toxicology showed that there are a number of known toxins in e-cigarette vapours, and a bunch of other chemicals about which we don’t know the health effects.
If the stalled tobacco control bill is passed, any kind of smoking in public will be banned and rule-breakers could face a three-month jail sentence. Advertising bans and plain-packaging rules could also be on the cards.
Plain packaging means all cigarette and vape boxes will show the brand in plain text only (so no branding will be allowed) and carry a health warning.
All advertisements and sports sponsorships for tobacco have been banned in South Africa since 2001, but the new rules could mean cigarettes and “next-generation products” (such as vapes) can’t be sold in vending machines and will not be displayed in shops. Customers over the age of 18 will have to ask the shopkeeper directly if they’re looking for smokes or vapes.
Good guys, bad guys, and those in between
Tobacco control is a very particular game. It’s a world of betrayals and deep distrust where there are “good guys”, “bad guys” and industry spies.
Traditionally, the line between the pro-health and pro-smoke sides has been very clear. But recently, as more e-cigarette and vapour products have entered the market, the distinction has become blurred. Suddenly it’s not so apparent who’s who any more, especially as next-generation products are completely unregulated in South Africa.
The pro-vaping lobby positions itself as advocating for harm reduction.
Harm reduction refers to evidence-based stuff people can do to limit the danger they’re exposed to from certain behaviour. For example, giving methadone to people who regularly take opioids such as heroin helps them avoid painful withdrawals without getting high because methadone tricks the body into thinking it’s getting its fix, but without producing the harmful side effects. This method is called opioid substitution therapy and is included in South Africa’s plan to fight HIV (injecting-drug users are more likely to contract HIV than those who don’t inject drugs, mainly because of the sharing of needles).
This vaping group is made up of vapour products companies, tobacco businesses, public health experts and doctors who argue that vapour products offer people a way out of smoking traditional tobacco products.
Those who are still firmly in the traditional public health team do not buy that next-generation devices aren’t a way to hook new users. Especially since researchers found that Philip Morris International began developing vapes in 1990 to substitute sales when many smokers were switching to quitting aids.
And although not all vaping and e-cigarette companies have ties to the tobacco industry, all the biggest tobacco businesses have a stake in new-generation products. For example, British American Tobacco owns several smaller e-cigarette brands including Twisp and has its own “heat-not-burn” products called “Glo” and “i-fuse”.
And, Marlboro manufacturer Altria has a 35% stake in vapour products company JUUL.
‘You can’t sit with us’
The public health lobby doesn’t mix with anybody from the tobacco industry, for any reason. That’s because of Article 5.1 of the World Health Organization’s (WHO’s) Framework Convention on Tobacco Control (FCTC), a treaty that commits countries to stamp out the ill-health caused by tobacco use.
The rules of the FCTC say that because the tobacco industry’s products are lethal, their agenda cannot be aligned with that of health authorities and that they shouldn’t have any wiggle room to further their business interests.
‘But we’re not tobacco’
But the pro-vaping lobby argues that next-generation products should not be lumped together with cigarettes, because they are not traditional tobacco-based products and, they believe, don’t carry the same harm.
So when the vaping industry was not invited to the WHO’s ninth Conference of the Parties in November, a meeting of all the nations which have signed the WHO’s tobacco control commitments, the international health body was criticised for undermining its own goals to reduce tobacco harm.
The vaping industry is likely to remain locked out of these discussions, though. This is not only because the WHO (and also the South African government) deems all smokes to be the same – whether tobacco-based or not – but also because the FCTC rules say that public health officials should not accept or endorse activities that the tobacco industry describes as “socially responsible” or that are part of corporate social responsibility.
Lies and spies
There is a good reason for all the rules and treaties that now exist around tobacco control: the industry has proven itself to be untrustworthy over the years.
Examples of tobacco companies deliberately undermining evidence of the harms of smoking date back to the 1950s.
Leaked industry documents published in the American Journal of Public Health in 2001, for instance, showed that Big Tobacco set up nonprofit organisations to produce “evidence” with which to flood academic conferences, in the form of sponsored studies that seemed to debunk smoking risks.
More recently, Bhekisisa reported that the now-defunct industry body the Tobacco Institute of Southern Africa (which represented tobacco multinationals, local farmers and manufacturers) paid social media celebrities to support a campaign that opposed the regulations proposed in the Tobacco Control and Electronic Delivery Systems Bill.
Not to mention that tobacco giant Philip Morris International (PMI) funded a local media personality’s travel to Europe to live-stream an industry event to Instagram followers.
And in 2019, we reported that representatives from PMI were thrown out of a public health meeting about e-cigarettes hosted at the University of the Witwatersrand because the tobacco industry is banned from participating in public health debates.
Some tobacco companies claim vaping holds the key to ending tobacco for good. For example, the Foundation for a Smoke-Free World (a nonprofit funded solely by PMI, the foundation’s 2020 tax returns show) supports research to help people stop smoking by using “less harmful” products. The foundation also attempted to set up a research unit at the University of Cape Town in 2019. Mere rumours of such a close affiliation with the tobacco industry threatened the funding of the institution’s long-standing Research Unit on the Economics of Excisable Products, which researches tax policy, and the planned tobacco-funded research group never got off the ground.
New dog, old tricks
And now there are signs that the vaping industry, whether or not it’s linked to Big Tobacco, is using old tactics. For instance, by advertising vapour products to young people online by paying them to broadcast events about the products to their followers.
In September the International Commission to Reignite the Fight Against Smoking (funded by the Foundation for a Smoke-Free World) hosted a webinar to launch its report on how vaping can help to end smoking. At the webinar, South African doctor, Kgosi Letlape (a past president of the Health Professions Council of South Africa, the HPCSA) argued in favour of an educational course on the devices for doctors, which could earn attendees continuing professional development points. Doctors must collect these points as a requirement of the HPCSA.
This harkens back to the days when tobacco companies used doctors to back claims that certain brands of cigarettes caused less irritation in the throat.
When public hearings begin for either Treasury’s excise tax policy or the health department’s Control of Tobacco Products and Electronic Delivery Systems Bill, it will be up to citizens to decide whether vaping’s proposed benefits are strong enough to risk losing the gains the country has made over tobacco for nearly three decades. DM/MC
In this article, we’ve touched on just a fraction of the issues at hand. That’s why, in the coming months, we’ll be publishing a series of analyses that plunge into the two sides’ arguments as they rally to fight for the nation’s lungs.
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