ALLOW VAPING PRODUCT SALES DURING SOUTH AFRICAN COVID-19 LOCKDOWNS

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The announcement of a lockdown by President Cyril Ramaphosa is unprecedented in the history of South Africa. Although unprecedented, it is essential given the increase in the number of coronavirus infections in the country and the need to implement drastic measures to curb its rapid spread and flatten the curve.

Since the declaration of a State of National Disaster by President Cyril Ramaphosa on 15 March 2020, a shutdown has loomed large as an inevitable progression of already gazetted measures, spurred on by South Africans’ penchant for ignoring government’s health guidance and the difficulties of social distancing caused by South Africa’s spatial topography.

It is commendable that the government is willing to take the hard decisions now in order to avoid the spread of the disease. For this reason, I would urge the government to take the necessary decision to include vape products as an essential product in the country during the lockdown. Despite controversies surrounding vaping in parts of the world, the practice is indeed a much less-harmful alternative to smoking. There is ever-growing body of scientific evidence showing that vaping is far less harmful than combustible tobacco. I refer to the most recent report released by Public Health England, “Research and analysis Vaping in England: 2020 evidence update summary”, Published 4 March 2020

“This is the sixth report in a series of independent reports commissioned by Public Health England (PHE) to summarise evidence on e-cigarettes to inform policies and regulations.”

“Despite reductions in smoking prevalence, smoking remains the biggest single cause of preventable death and disease and a leading cause of health inequalities. So, alternative nicotine delivery devices that are less harmful could play a crucial role in reducing this health burden.”

“vaping regulated nicotine products has a small fraction of the risks of smoking, but this does not mean it is safe”

“smokers should be encouraged to try regulated nicotine vaping products along with smoking cessation medications and behavioural support. This will greatly increase their chances of successfully stopping smoking”

(https://www.gov.uk/government/publications/vaping-in-england-evidence-update-march-2020/vaping-in-england-2020-evidence-update-summary

It is well understood that the burning of tobacco contains harmful chemicals, which includes 77 known carcinogens. Further, it is now established beyond doubt that smokers are addicted to nicotine but die from all the other chemicals released during the process of combustion.

The danger of closing vape shops is that vapers, who are addicted to nicotine, will continue to satisfy their nicotine craving by either reverting to cigarettes or acquiring illicit homebrews that can worsen their respiratory health. Under these circumstances, it seems reasonable that government should consult all available evidence from across the world and look at what other governments are doing to ensure that measures to prevent the spread of  COVID-19 do not undermine the steady progress that is being achieved through switching nicotine addicts from combustible tobacco to vaping. Such an outcome would be entirely regressive and set back many former smokers who are unable or unwilling to quit their nicotine addiction.

The decision would, of course, be a deeply unpopular one. The National Council Against Smoking (NCAS) has, since the beginning of 2020,  advocated that vaping is as, if not more, dangerous than tobacco. In this, they have relied on discredited studies, some of which have been withdrawn from publication due to the less than robust methodological underpinnings, the most recent being:

“Retraction to: Electronic Cigarette Use and Myocardial Infarction Among Adults in the US Population Assessment of Tobacco and Health”

(https://www.ahajournals.org/doi/10.1161/JAHA.119.014519

If the South African government decides to include cigarettes as an essential item under the State of National Disaster during the lockdown, cigarettes will remain widely available at grocery shops to nicotine addicts. It would thus be counterproductive to have some nicotine products available for sale while prohibiting others. My biggest fear is to have former smokers that have decided to switch to a safer alternative be forced back into the clutches of combustible tobacco.

Our request is to have vaping products included as an essential item for an ever-growing community of former smokers who have chosen a less harmful method of nicotine delivery. These products can be bought via numerous online stores and have them delivered via door-to-door courier services. In this way, we can still provide a valuable tool in the war against smoking, and exercise social and physical distancing.

South Africa will not be alone in taking such a decision. The worst affected country, Italy, (https://filtermag.org/italy-vaping-coronavirus/ has elected to exempt vaping shops from its lockdown to prevent a relapse of vapers into smoking. Similarly, France; Greece and Switzerland (https://www.bloomberg.com/news/articles/2020-03-17/european-smokers-vapers-still-get-their-fix-during-lockdowns have also taken a similar stance, informed by the need to remain vigilant against one of the deadliest products to ever be invented by humankind: the combustible cigarette. In addition, similar requests have been made by Health Experts in Canada and New Zealand to have vape shops exempt from the Covid-19 lockdown in their respective countries. These actions have garnished support by leading Public Health experts:

Tweet by Martin Dockrell (Tobacco Control Programme Lead for Public Health England):

 “I note that France and Italy exempted vape shops from their shut down. Very sensible.

It would be very unfortunate to protect tobacco supplies and block the supplies of the most popular and effective ways to quit.”

As a final note, it would be remiss of me to not include a very recent opinion piece published 20 March 2020 on BMJ - Covid-19: The role of smoking cessation during respiratory virus epidemics

“In the meantime, we strongly recommend that public health messages focused on how to curb the spread of SARS-CoV-2 also include country specific, evidence-based smoking cessation advice (e.g. https://quitnow.smokefree.nhs.uk/

(https://blogs.bmj.com/bmj/2020/03/20/covid-19-the-role-of-smoking-cessation-during-respiratory-virus-epidemics/

It may be a difficult decision to make but it is one that ought to be made nonetheless.

Kurt Yeo is a vaping advocate who promotes the benefits of vaping as a harm-reduction tool. He writes in his personal capacity and does not represent any organisation.