POLICY GAP: SA’s double defeat — smoking up, vaping left unchecked

As the world marks World No Tobacco Day on May 31, South Africa continues to buck the global trend as the number of smokers increases and as many as two-thirds of high school learners may already be seriously dependent on nicotine.

Every year, on 31 May, the world observes World No Tobacco Day. It is a reminder that tobacco still causes about seven million premature deaths globally each year. Behind every one of those deaths is a family left wondering why their loved one could not stop smoking in time. The answer almost always comes back to the same thing: addiction.

Nicotine is highly addictive. Some studies suggest that it rivals heroin. Most people who have quit smoking will testify that it was very difficult to do so. Many others have tried but have been unsuccessful.

This year’s World No Tobacco Day campaign, Unmasking the Appeal, poses an uncomfortable question: How does an industry that loses millions of customers to premature death every year keep recruiting their replacements? The answer, increasingly, is by targeting young people.

The world is winning the fight against combustible tobacco. The World Health Organization (WHO) estimates that 20% of people aged 15 and older used tobacco products in 2025, down from about 30% in 2000. This is the result of concerted efforts to “denormalise” smoking. Most countries have banned tobacco advertising and sponsorship, passed laws preventing smoking in indoor public places, and substantially increased excise taxes to make cigarettes less affordable. Many have also introduced graphic pictorial health warnings on cigarette packs, and a growing number have adopted “plain packaging”, which strips all colourful branding from packs apart from the product name.

Some countries are now even considering a tobacco “endgame”, typically defined as a situation where smoking prevalence is so low (often below 5%) that addressing tobacco use is no longer regarded as an urgent public health priority.

The United Kingdom recently passed the Tobacco and Vapes Act, which stipulates that people born on or after 1 January 2009 may never legally buy tobacco products during their lifetime. In 2024, Canada became the first country to require cigarette manufacturers to print warning messages on every cigarette stick, not just on the packaging.

But this progress in many countries is being offset by an industry that has reinvented itself. E-cigarettes, nicotine pouches and other novel products are marketed as innovative and less harmful alternatives to combustible cigarettes, but their flavours, sleek designs and social media pr