E-cigarettes were initially marketed as quitting devices. They’ve been around since 2003, but in the past few years, they have become extremely popular, and not just among smokers trying to quit. Youth, never having smoked cigarettes, are now vaping.

According to the 2021 South African Global Adult Tobacco Survey, 2.2% of South Africans aged 15 and older currently use e-cigarettes. The granular data is not yet publicly available, but we can assume that the prevalence among youth is much higher than 2.2%, given that e-cigarette manufacturers target this cohort.

Most e-cigarettes contain nicotine. They don’t contain tobacco. E-cigarettes contain additives, chemicals, and flavours. Some are disposable (e.g. AirsPops, manufactured by UK company Airscream) while others can be refilled (e.g. Vuse, manufactured by multinational tobacco giant British American Tobacco). E-cigarettes are widely available across South Africa: you can buy them at major retailers such as Pick n Pay. Or if you want a tailored shopping experience, you can visit one of Vuse’s 84 South African stores.

Although it is illegal to sell e-cigarettes to children under 18 years, this law is not enforced.

Health risks

Even the tobacco industry does not claim e-cigarettes are without risk. For example, on its Vuse website, British American Tobacco states: “Vuse and Twisp electronic cigarettes may be hazardous to health and may contain nicotine which is addictive.”

What are the risks? And which sources are reliable? For the most part, research funded by the tobacco industry can be tossed out with the mouldy cauliflower in your fridge. Some tobacco-industry-funded research makes it into reputable journals, so check the funding source, given at the end of published papers. Rather rely on research from organisations without vested interests.

The world’s leading health organisations agree that e-cigarettes are dangerous. These include the World Health Organization, the US Surgeon General, and the Centers for Disease Control, to name a few.

They warn that nicotine is addictive and can harm brain development (the brain continues to develop until around age 25). Nicotine use may make it harder for youth to concentrate, learn, or control their impulses. Nicotine can even train the brain to be more easily addicted to other drugs, like methamphetamine and cocaine. Some e-cigarettes contain heavy metals, such as nickel, tin, and lead.

Scientists at Johns Hopkins University found that vaping aerosols contain thousands of unknown chemicals and substances not disclosed by manufacturers, including caffeine and industrial chemicals (such as pesticides and flavourings). These industrial chemicals may be toxic and may cause respiratory irritation.

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In an interview with Bloomberg, one of the authors said “people just need to know that they’re inhaling a very complex mixture of chemicals when they vape. And for a lot of these compounds, we have no idea what they actually are.”

Similarly, scientists in Australia concluded that e-liquids contain a wide range of potentially harmful chemicals.

E-cigarette advertising

For parents, it poses an added worry. Can your child avoid e-cigarette advertising? This is unlikely unless they are home-schooled, don’t leave home, and don’t have internet access. If this is the case, then e-cigarettes are unlikely to be your biggest problem.

However, assuming your child is part of society, they will be exposed to e-cigarette advertising. Social media influencers are paid to promote e-cigarettes. Browse the internet and e-cigarette adverts pop up.

You can’t go to a shopping mall without seeing glamorous kiosks or stores. You can trade in old devices for new ones. You can buy seven liquids and get one free. Refer your friends and you will be further rewarded.

If you sign up online, marketing will come directly to your inbox. Want to go overseas? Enter a competition sponsored by a vaping company.

Exposed to these relentless marketing strategies, it is no wonder youth are vaping. If the issue hasn’t yet come up in your home, it probably will. Parents of teenagers should be prepared for the conversations with their children. Being prepared may prevent an expensive, harmful, lifelong habit.

An open dialogue

Before you talk to your child, know the facts. Encourage an open dialogue. The conversation may happen over days or weeks. Some parents text their children useful website links as an additional way to keep the conversation alive.

If your child is immune to advice from you, then perhaps take your child to your doctor to chat about the risks of vaping. Set a positive example by being smoke-free.

Some teenagers report that they vape because it calms them down. Help them identify the source of their stress and anxiety. Offer ways to manage these emotions in a healthy way. If your child is already vaping, offer support to help them quit rather than punishing them.

Speak their language. Search TikTok and Instagram for influencers who speak openly against vaping. Encourage your child to follow pages on Instagram that provide useful information about vaping (#escapethevape, #vapingrisks, #dontvape). A TikTok influencer (@king_victober), who has over six million followers, shared her journey of quitting vaping.

Government intervention

You may ask what the government is doing to regulate the sale of e-cigarettes. How is it possible that 14-year-olds are buying e-cigarettes?

The 2018 South African Control of Tobacco Products and Electronic Delivery Systems Bill, will, among other things, provide some regulation of e-cigarettes. Although this bill is more than four years old, it has not yet become law.

The delays are due to South Africa’s long and convoluted legislative process, industry interference, Covid-19, lack of capacity, and leadership instability.

Be prepared

Don’t wait for teachers or schools to act. Don’t wait for the government to act. If the school principal calls you to tell you your child was caught vaping, know how you will broach the subject with your child.

Being prepared may prevent addictive habits that affect the health of our loved ones. DM

Nicole Vellios is a researcher at the University of Cape Town’s Research Unit on the Economics of Excisable Products.