There have recently been misleading calls for South Africa to adopt the Swedish model of regulating e-cigarettes, a model positioned by tobacco-industry supported organisations as making alternative products widely available, instead of regulating or restricting the sale and marketing of these products.

Articles and a full-page advert in the Sunday Times of 30 April 2023 link back to SmokeFreeSweden.org. In fact, Sweden strictly regulates e-cigarettes and the country’s laudable progress in becoming smoke-free is attributable to a long history of strong tobacco control measures starting in 1975. 

The misguided calls should be seen for what they are, a tactic to derail the Control of Tobacco Products and Electronic Delivery Systems Bill, which is now before Parliament, to serve the interests of the tobacco and e-cigarette industry.

The Swedish Act on Tobacco and Similar Products regulates both e-cigarettes and cigarettes under a single piece of legislation:

• Swedish smoke-free regulations treat e-cigarettes and cigarettes identically. One cannot vape where it is prohibited to smoke traditional cigarettes, for instance. Under their law, smoking and vaping in common areas of residential buildings is banned;
• Sponsorship of events or activities by both the e-cigarette and tobacco industries is prohibited, as this is a form of advertisement and promotion;
• Swedish law requires health warnings for both cigarettes and e-cigarettes;
• Swedish laws require registration and detailed reporting on e-cigarette product design, sales and marketing. Rigorous monitoring to track all suspected harmful effects of e-cigarettes is in place;
• Sweden strictly regulates the labelling of e-cigarettes; labelling must not be misleading and must contain prescribed health warnings;
• The Swedish regulations require a toxicological report, a list of all ingredients included in e-cigarettes and the emissions resulting from their use, broken down by brand and type, with information on volumes, and a description of the manufacturing process;
• Sweden controls the levels of nicotine allowed in e-cigarettes, the size of the refill containers and requires that the containers be child-proof to prevent nicotine poisoning for children; and
• Ingredients and additives that give the impression that e-cigarettes entail a health benefit or reduced health risks are banned in Sweden.

What is intentionally omitted is the fact that Sweden has had a long history of tobacco control dating back to 1975. Sweden’s success is attributable to a range of measures.

As far back as 1994, Sweden had increased taxes on cigarettes, restricted marketing and implemented picture health warnings. Smoking in Swedish bars and restaurants has been banned since 2005, a ban which was extended to playgrounds, train platforms and within a 20-metre radius of no-smoking areas for both cigarettes and e-cigarettes in 2019.

The South African Tobacco Control Bill does not intend to ban e-cigarettes. By using a balanced regulatory approach, it ensures that adults can still access e-cigarettes while minimising the demand for e-cigarettes by adolescents.

The blanket statement that every aspect of this proposed law will treat the different products identically is also premature and false. The bill only empowers the minister of health to issue regulations detailing and prescribing how e-cigarettes, cigarettes and similar products will be controlled. It is expected that the regulations will take a nuanced approach.

Who is SmokeFreeSweden.org? It is definitely not the Swedish government or its representative. A simple Google search reveals that SmokeFreeSweden.org has strong links to tobacco companies, including British American Tobacco (BAT). It is a group or campaign by the “health diplomats”, an organisation whose founders have a long history of collaborating with British American Tobacco.

With the absence of regulations in South Africa, e-cigarette use is increasing among youths, perpetuating nicotine addiction and leading some of them to start smoking traditional cigarettes.

South Africa would do well to get on with passing the Control of Tobacco Products and Electronic Delivery Systems Bill. A smoke-free Mzansi starts with the Tobacco Control Bill. DM