Presented by BAT South Africa

A unified approach to health policy is needed to achieve a smokeless future

 ·19 Jun 2024

By Dr Edward Makgotlho – Area Head of Scientific Affairs, BAT Sub-Saharan Africa

As the world focuses on smoking and vaping regulations, it is crucial that we take decisive action to realise the global goal of a smoke-free future.

South Africa has a significant role to play in this endeavour. To successfully change consumer behaviour and reduce smoking rates, South Africa must reach a national agreement on the most effective strategy – tobacco harm reduction (THR).

THR offers an unprecedented public health opportunity, providing a pathway for millions of South African smokers who would otherwise continue smoking, to transition to smokeless alternatives.

Several countries that have embraced THR, and implemented supportive policies, have experienced remarkable reductions in smoking rates.

The United States, United Kingdom and Japan currently have their lowest recorded smoking rates, while Sweden is set to achieve smoke-free status soon, 16 years ahead of the European Union’s 2040 target. ‘Smoke-free’ has been defined by the European Commission as countries that have less than 5% of their population who are daily smokers1.

Correlation between the prevalence of reduced risk2 products and the decline in smoking rate

However, the success of THR relies on the widespread accessibility and availability of smokeless products. In South Africa, the proposed Tobacco Products & Electronic Nicotine Delivery Systems (TPENDS) Control Bill proposes restricting access to these products, despite their lower risk profile and potential to reduce the health impact of smoking.

To maximise the public health benefits of THR and significantly reduce the health burden of smoking on South African society, regulators must embrace evidence-based science to drive positive public health outcomes.

This entails implementing a supportive regulatory framework that encourages adult smokers to switch, while ensuring stringent product safety standards and preventing underage use. Such a framework should start by distinguishing between combustible (i.e., smoke-producing) and smokeless products.

Further, the success of THR in South Africa depends on the government and regulators addressing the persistent misconceptions surrounding the relative harm of smokeless products, compared to cigarettes.

A recent study3 from University College London revealed that most smokers in England wrongly believe that vaping is ‘at least as harmful as smoking’, with 57% considering vaping to be ‘equally’ or ‘more harmful’. Similar trends have been observed in the US, with the perception of e-cigarettes as more harmful than cigarettes doubling annually between 2018 and 20204.

This holds true in South Africa too: a recent Ipsos study entitled ‘A Global Alert on the Misperception Epidemic in Vaping Views’5, published last month, found that 78% of tobacco users believe that vaping is ‘as or more harmful’ than smoking.

These misconceptions not only lack scientific basis, but also discourage smokers from switching to smokeless products. This ultimately undermines public health efforts. Greater efforts are needed to dispel these misconceptions in South Africa.

BAT’s THR approach is supported by a growing body of research and evidence6 that substantiates the reduced risk2 profile of these products compared to cigarettes – a view shared by many international public health organisations. We openly share our scientific findings7 to increase understanding of THR and raise awareness among stakeholders.

While the industry developing and producing these products plays a vital role, the success of THR in South Africa requires an inclusive, open, and honest dialogue among all stakeholders, including policymakers, regulators, and the healthcare and medical communities. Unfortunately, the industry is all too often excluded from these discussions.

South Africa has the opportunity to lead the way in creating a smokeless future, rooted in scientific research and an unwavering commitment to public health. The solutions are available today. What remains is for the relevant stakeholders to collaborate and prioritise THR for the well-being of millions of South Africans.

Click here to learn more about how BAT is building a better tomorrow through science.

Dr Edward Makgotlho – Area Head of Scientific Affairs, BAT Sub-Saharan Africa


  1. European Commission. Europe’s Beating Cancer Plan: Communication from the Commission to the European Parliament and the Council. 2022. Available:
  2. Based on the weight of evidence and assuming a complete switch from cigarette smoking. These products are not risk free and are addictive.
  3. Greaves, M. Most Smokers Wrongly Believe Vaping is at Least as Harmful as Smoking. University College London. 28 February 2024. Available:
  4. Bandi P, Asare S, et al. 2022. Relative Harm Perceptions of E-cigarettes versus Cigarettes, US Adults, 2018–2020. American Journal of Preventative Medicine, 63(2): 186–194. Available:
  5. Ipsos. 2024. Innovation Under Fire: a Global Alert on the Misperception Epidemic in Vaping Views, a Report by Ipsos. We Are Innovation (WAI). Available:
  6. African Harm Reduction Alliance. 2024. THR Health Policy. Available:
  7. Read more about the scientific research happening at BAT:

Connect with Dr Makgotlho on LinkedIn

Follow him on X/Twitter: @facts_not_fear

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