The electronic cigarette industry arrived in the country with lots of hype and no regulation more than a decade ago. Today, the vape industry is thriving, with no guardrails in place and a growing teenage addiction problem.
- Electronic cigarettes, or vapes, began popping up in shops across the country in about 2012. It was a wide-open market for the slick new nicotine-delivery devices, which arrived with zero regulation.
- More than 10 years have passed, and the electronic cigarette market is still completely unregulated. The Tobacco Products and Electronic Delivery Systems Control Bill , which would change that, has been before Parliament since 2018.
- University of Cape Town pulmonologist Richard van Zyl-Smit and his colleagues have spent the last three years documenting what years without regulation have meant for teens who have easy access to the devices, which come in more than 7 000 different flavours .
- In December 2024, the researchers began rolling out the first results of a survey of 25 000 high school learners across all nine provinces: roughly 17% were vaping, and of those, 61% showed signs of addiction — they couldn't get through a day without their device.
- After years of dropping numbers of traditional cigarette smokers, the research was clear: a new generation of nicotine addicts was born. Van Zyl-Smit explains what happened.
Somewhere around 2012, electronic cigarettes began popping up in shops across the country. It was a nicotine-infused Wild West: an open market for slick new delivery devices which arrived with a lot of hype and zero regulation. Apart from complying with import rules, there was no specific limit on advertising like with tobacco, no legal standard on what was used in making the product. Best of all, if you are in the tobacco and vape industry, you could sell it to anyone who asked, including minors.
More than 10 years have passed, and the electronic cigarette market continues to be unregulated, waiting for the Tobacco Products and Electronic Delivery Systems Control Bill — which has been before Parliament since 2018 — to be passed. Stalled in committee, it would ban the advertising of all tobacco products, including electronic devices such as e-cigarettes and vapes, tobacco product displays at points of sale, smoking in all public areas and the sale of single cigarettes. But it is anyone's guess on how it will finally come out, when, and if, it does finally appear.
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University of Cape Town pulmonologist Richard van Zyl-Smit and his colleagues have spent the last three years documenting what years without regulation have meant for teens. In December 2024, the researchers published the first results of a survey of 25 000 high school learners across fee-paying schools across all nine provinces: roughly 17% were vaping, and of those, 61% showed signs of addiction — they couldn't get through a day without their device.
The researchers have continued that work, with one concerning study that was released in January about teens and dual use of substances, which found that of those learners who vaped. 34% used another product, mainly cannabis, but also hookah and traditional tobacco, which, as Van Zyl-Smit says, is simply double the toxins.
After years of dropping numbers of traditional cigarette smokers , the research was clear: the next generation of nicotine addicts is getting hooked on vapes.
Van Zyl-Smit has been advocating for regulation over the industry for over a decade. The urgency to regulate the industry is not an academic exercise. He runs the only government hospital smoking cessation clinic in the country, and spends a significant part of his working life referring cancer patients, whose lungs have been destroyed by decades of smoking, to palliative care , so they are cared for in the last stages of a terminal illness.
Tanya Pampalone spoke with him about what the research shows, why vaping is more addictive than cigarettes and what the delay in regulating the industry is doing to our teens.
There are a lot of different types of e-cigarettes, some that include tobacco and nicotine and some without either. Can you explain the different products available?
All tobacco contains nicotine — there's no decaf tobacco. Most vape products contain nicotine; our data found that about 80 to 88% of high school learners who vape were using vapes containing nicotine.
Within e-cigarettes, there are standard nicotine and modified nicotine. The modified form is what they call a nicotine salt, which is far more addictive . Chemists in the United States also created synthetic nicotine to try to avoid regulation; tobacco-free nicotine that technically has nothing to do with tobacco. Now there are products called nicotine analogues : not nicotine, but a molecule that does what nicotine does without being nicotine as a way to sidestep regulation entirely. It's an industry trying to evolve to keep clients addicted for as long as possible.
Within vapes alone, there are 7 000-plus different flavours , which makes research quite tricky, because they're all different. The problem is, we can show the cherry flavour is bad. But then there are 7 000 other flavours out there to test.
Are vapes more addictive than traditional cigarettes?
Addiction is both behavioural and chemical . If you smoke a cigarette, you cough and splutter — it tastes terrible, it burns the back of your throat, you have to work hard to get it in. Vapes are completely different. The nicotine is much smoother, the flavours are much nicer. Then you have one of these modified nicotines that causes a very quick and very high dopamine response. So you've got a very addictive nicotine, plus a product that's flavourful. And vaping is seen as social and trendy.
Why has it taken so long to regulate the industry?
Initially, there wasn't much incentive, then we hit COVID, and then there has been enormous industry interference . The other problem is that the Bill is comprehensive, including plain packaging, banning single-stick sales and advertising. There's a lot of tobacco stuff alongside the vaping provisions. If they had maybe just separated the two bills — just get the under-18 ban and marketing restrictions done, then deal with the rest — that would have been better. We run the risk that the whole Bill fails because of the tobacco provisions, and then we have nothing.
Nicotine as a substance — for example, nicotine patches and gums — is regulated by Sahpra (South African Health Products Regulatory Authority) as a medicine. It's a schedule three medication , so it needs to be behind the counter in a pharmacy. Most vapes contain nicotine, so they should be scheduled and sold in a pharmacy. But the industry does not want to be regulated as a medicinal product, because then they have to go through all the separate approvals. How the industry has avoided being regulated by Sahpra is a mystery to me.
How could the Tobacco Bill help?
There's absolutely no need to have vapes, e-cigarettes or nicotine pouches in the world, as much as there's no need to have cigarettes. But they're never going to go away. So what we need to do is regulate marketing and deal with accessibility. Banning the sale of alcohol to under-eighteens doesn't stop teenage drinking, but the fact that you can't walk into your local café and buy a pint of beer is a deterrent. And we need safety standards — even cigarettes, bizarrely, have production standards .
The Bill will prevent advertising for traditional cigarettes as well as the newer products, like vapes. But how do you police social media?
Social media is difficult. But you can't post movies of animal cruelty or public violence/beatings on Instagram; there is a code of conduct and a Human Rights Commission, etc. Technically, you could apply similar standards to vaping and tobacco promotion. No one's going to be that bothered to police it unless there are clear and tangible consequences.
The other way of dealing with it — especially among adolescents — is that they watch content created to promote vaping. So if the vaping industry makes 30 videos of kids enjoying a vape on the beach, we need kids to make 40 videos of themselves enjoying the beach without a vape and additionally videos about what's so bad about it and share them. If kids watch the non-vaping TikToks more than the vaping ones, the algorithm will serve up more of those. It's not impossible to change, even if it's very difficult to regulate.
Are the tobacco industry and the vaping industry one and the same?
Yes and no. Most tobacco companies have their own vaping arms. But there are also a whole bunch of anti-tobacco vaping companies that believe they are offering a safer alternative and want nothing to do with the tobacco industry because of its history of deceit. Juul is a good example. It started as a Stanford University project , completely anti-tobacco, then the group that owns Philip Morris took a major stake in the company.
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Groups like British American Tobacco and Philip Morris are all looking for a safer alternative to smoking because killing your clients is a very bad business model. There are these new start-ups that genuinely feel that they're doing a good thing. But there's always Big Tobacco in the background, and even organisations like the Africa Harm Reduction Alliance have all sorts of connections to the industry . It's a very murky space.
Is there such a thing as a safe vape?
No. Nicotine is bad for you . It's an insecticide, it's a poison. Does it cause all the trouble that tobacco does? No. But you shouldn't be using nicotine — we use it temporarily to help people stop smoking [with nicotine patches or gums], but that's it. Vaping products have nicotine plus other chemicals: propylene glycol, vegetable glycerine, flavours, all of which can cause harm in various forms .
If your own kid were vaping, what would you do?
I would ask them why. From our data, the why question is very informative. Stress, addiction, social habit — these kids never started out thinking they were going to be addicted. It was fun, social, interesting. In our study less than a quarter said that they had no interest in stopping vaping, over 40% said they wanted to stop, many of them indicating: "I want to stop, but I can't." Some were indifferent/undecided, so support and encouragement to stop vaping is really important.
So I'd ask: why are you vaping? Is it part of a social group? Because you're addicted? Because you're stressed, anxious or depressed? If you're addicted, telling you how dangerous it is doesn't help. If it's because you're anxious, let's deal with the anxiety and then get you off vaping. If it's a social habit, we've got to deal with teenage social behaviour. Understanding the reason gives us a good insight into how to help them stop.
This story was produced by the Bhekisisa Centre for Health Journalism . Sign up for the newsletter .
