Vaping companies in South Africa called this week for separate legislation for tobacco products and electronic nicotine delivery systems, reports Independent Online. Meanwhile, research in New Zealand suggests that health messages presenting e-cigarettes as a lower risk alternative to smoking could encourage about a third of smokers to trial them.
The call for positive messaging for electronic nicotine delivery systems (ENDS) was made following University of Otago research by ASPIRE 2025, a partnership between New Zealand research groups that conducts tobacco control research – the universities of Otago and Massey, Tala Pasifika, Whakauae Research and the Health Promotion Agency. The study has just been published in the journal Tobacco Control.
Targeted health messaging needed in era of vaping, researchers say
A researcher has called on health authorities to develop targeted health messages for vaping product and e-liquid packaging to encourage smokers to switch from cigarettes to e-cigarettes and to prevent non-smokers from taking up vaping, according to University of Otago material published on 27 January 2021.
Professor Janet Hoek, a Co-Director of the university’s ASPIRE 2025 Research Centre, has led new Health Research Council-funded research analysing the impact of on-package messaging on e-liquids.
The research team found messages presenting electronic nicotine delivery systems as a lower risk alternative to smoking could encourage about a third of smokers to trial them. On the other hand, messages about the increased risks of taking up vaping appeared to strongly discourage non-smokers from trying e-cigarettes.
Researchers asked non-smokers to view e-liquid bottles featuring different statements, including: ‘If you are a non-smoker, vaping increases harms to your health’, and an addiction warning stating: ‘Vaping products that contain nicotine are highly addictive’.
Smokers were asked to consider a different set of messages and an addiction warning. Hoek says two messages, in particular, were the most effective: ‘If you are a smoker, vaping reduces harms to your health’ and: ‘If you are a smoker, vaping reduces your risk of lung disease’.
The University of Otago material continues: “Currently many countries require an addiction warning on electronic nicotine delivery system products, but our results suggest including a message to smokers about the reduced health risks of vaping could be more likely to encourage smokers to switch.
“By contrast, addiction warnings and messages about the increased health risk from using electronic nicotine delivery systems appear likely to strongly discourage uptake among susceptible non-smokers, occasional and former smokers.”
Hoek says so far no countries have introduced on-pack messaging to encourage different behaviours, with on-pack warnings typically stating that nicotine is addictive and advising non-smokers not to use electronic nicotine delivery systems.
“If policy-makers want to encourage the uptake of electronic nicotine delivery systems among smokers, yet deter it among others, a targeted messaging strategy could be more effective.”
The study is thought to be the first to examine how both reduced-risk and increased-risk messaging could affect the appeal and potential use of electronic nicotine delivery systems.
Vaping companies call for own regulations
In South Africa, vaping companies are calling for separate legislation to the Control of the Tobacco Products and Electronic Nicotine Delivery Systems Bill, wrote Amber Court for Independent Online on 31 January 2021.
Vaping companies said that they did not encourage non-smokers to vape – an issue worldwide has been whether vaping products are a gateway for non-smokers into more harmful combustible smoking, writes MedicalBrief. Vaping companies argue that their products should be used as a harm reduction alternative to smoking.
There are an estimated 350,000 vapers in South Africa, Vapour Products Association of South Africa (VPASA) Chief Executive Asanda Gcoyi told Independent Online.
“The current provisions of the tobacco control bill expects a vaping product to list that it can cause cancer which we see in tobacco products. We cannot label information that is scientifically not true,” said Gcoyi.
The industry agreed to be regulated, but not the same as tobacco products. “Let’s have separate regulations. Not a lot is known about vaping, so the labelling aspect provides a chance to educate. You need to say that nicotine is addictive, but not harmful,” she explained.
There was a need to make sure that all the ingredients used were put on the label as well as an age restriction of 18 and over, reported Independent Online.
“The main objective is to reduce the number of smokers in the country…years of research found that e-cigarettes are the number one option that helps smokers move away from smoking into less harmful substances.”
In vaping you need to advertise, because you need to educate on tobacco reduction, added Gcoyi. “We understand that the clouds people blow out are also not acceptable. It is about manners. We want designated areas. “If you are not a smoker, vaping is not for you,” she stressed.
Dr Delon Human, co-chair of the Africa Harm Reduction Alliance (AHRA), told Independent Online he was disappointed that combustible tobacco was equated with non-combustible e-cigarettes.
“It is the consumer’s right to have labelling so that they can make an informed choice. If labelling is untruthful and not science-based, or does not depict what is inside the package, then it doesn't help,” he said.
If labelling forced manufacturers to equate combustible tobacco with vaping products, this would scare off consumers. “We are in favour of a separate bill, because it is a separate product,” said Human.
Heart and Stroke Foundation of South Africa Chief Executive Professor Pamela Naidoo said: “I think that there is more evidence, to show that vaping does affect one's health, especially with respiratory disorders like COVID-19,” she told Independent Online.
“Vaping increases your risk of dying of heart disease and strokes. The argument that we are putting forward is, do we allow our people to be guinea pigs? and the answer is no.”
Dr Sharon Nyatsanza, communications manager at the National Council Against Smoking, told Amber Court of Independent Online that the bill will play a key role in reducing tobacco use in South Africa. Regarding vaping, there were no regulations and the bill would “protect the youth and allow adults to make a choice”.
Link to the full Independent Online story below.
Analysis of on-pack messages for e-liquids: A discrete choice study
Janel Hoek, Philip Grendall, Christine Eckert, Jordan Louviere, Pamela Ling and Lucy Popova
Author affiliations: University of Otago, University of Technology Sydney, Best-Worst Company in Seattle, University of California San Francisco – San Francisco – and Georgia State University.
Published in Tobacco Control in January 2021
Policymakers wishing to encourage smokers unable to quit to switch to using electronic nicotine delivery systems (ENDS) also need to consider how to deter ENDS use among non-smokers.
We examined whether reduced-risk messages could increase ENDS’ appeal among smokers and if increased-risk messages could decrease appeal among susceptible non-smokers, occasional and former smokers.
An online discrete choice experiment tested three attributes: information message, nicotine content (0 mg or 3 mg) and flavour (tobacco, menthol or fruit). The sample comprised 352 current smokers, 118 occasional and former smokers, and 216 ENDS-susceptible never smokers.
Smokers viewed reduced-risk messages that encouraged switching to ENDS, while other groups viewed increased-risk messages that discouraged ENDS use. All groups saw a typical addiction warning. We analysed the data by estimating multinomial logit regression and adjusted latent class analysis models.
Relative to no message, reduced risk-messages increased the appeal of ENDS uptake among one class of smokers (33.5%) but decreased appeal among other smokers.
However, among all smokers, reduced-risk messages increased preference more than a dissuasive addiction warning.
By contrast, among occasional or former smokers, and susceptible non-smokers, all information messages discouraging ENDS use, including an addiction warning, decreased preference relative to no message.
On-pack relative-risk messages about ENDS could make transition more attractive to smokers while increased-risk messages could deter ENDS uptake among susceptible non-smokers, occasional and former smokers.
Communicating diverse messages via discrete channels could recognise heterogeneity among and between smokers and non-smokers.
University of Otago material – Targeted health messaging needed in era of vaping, researchers say (Open access)
Independent Online story – Vaping companies call for own regulations say (Open access)
British Medical Journal article – Analysis of on-pack messages for e-liquids: a discrete choice study (Restricted access)
ASPIRE 2025 – Research for a tobacco-free Aotearoa
SEE ALSO FROM MEDICALBRIEF’S ARCHIVES
What proposed Tobacco Bill means for vaping in South Africa
Vaping reduces inflammatory biomarkers compared to smoking – American Council on Science and Health
To deliver health benefits, vaping must replace smoking – American Heart Association