Research shows youths are on average nine times more likely than adults to vape. On the eve of World No Tobacco Day, the writer confronts the alarming rise of nicotine addiction among South Africa's youth. He argues that as the tobacco industry evolves, so must our response to protect future generations.
Image: Dylan Nieuwland / ANP MAG via AFP
Every year on World No Tobacco Day (31 May), the world is reminded that tobacco remains one of the leading preventable causes of death. And this year’s theme – ‘Unmasking the appeal: countering nicotine and tobacco addiction’ – could not be more relevant to South Africa’s current moment.
The tobacco and nicotine industry today no longer depends only on cigarettes. It now relies on deception, product engineering, flavours, attractive packaging, social media influencers and carefully crafted “harm reduction” narratives designed to make addiction appear modern, harmless – and even socially desirable.
Behind the glossy packaging and sleek devices lies the same business model: recruiting new users, especially young people, to sustain profits. And South Africa is increasingly becoming a target.
Research from the Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM) at the University of Pretoria (UP) shows that smoking and vaping among young South Africans aged 16–34 years have increased significantly over the past 15 years. Cigarette smoking prevalence in this age group rose from 15.3% in 2010/11 to 27.3% in 2024/25, while vaping increased dramatically from 0.3% to 11.1% over the same period.
These trends directly contradict the tobacco industry’s repeated claim that newer nicotine products are reducing smoking at population level. Instead, the evidence increasingly suggests that these products are expanding nicotine addiction and normalising smoking-like behaviours among youth.
The industry’s strategy is not accidental. Flavours such as bubble gum, mango and cotton candy are clearly not designed for long-term adult smokers trying to quit. Colour-coded packaging, glamorous retail outlets and influencer marketing are not public health interventions; they are recruitment tools, as they appeal particularly to young people, including those who have never used nicotine products.
This is precisely why this year’s World No Tobacco Day theme matters. We must expose the tactics used to make dangerous and addictive products attractive, particularly to adolescents and young adults whose brains remain vulnerable to nicotine addiction, especially before the age of 21 years.
Nicotine is not harmless. It affects brain development, attention, mood regulation and addiction pathways in young people. Increasing evidence also links vaping among adolescents to respiratory problems, impaired concentration and greater likelihood of later cigarette smoking.
Yet, while the science becomes clearer, South Africa’s regulatory response to unmask the appeal remains dangerously slow. The Tobacco Products and Electronic Delivery Systems Control Bill, first introduced in 2022, remains stalled despite years of public consultation and mounting evidence of harm at the population level. Meanwhile, the nicotine market continues to evolve faster than regulation.
This delay benefits only one group: the tobacco and nicotine industry. We have seen this playbook before. For decades, the tobacco industry denied the harms of cigarettes, manipulated nicotine delivery, and marketed products aggressively while resisting regulation at every stage. Internal industry documents later revealed deliberate strategies to sustain addiction and undermine public health measures.
Today, similar tactics are being repackaged through vaping and newer nicotine products under the language of “innovation” and “harm reduction”. But genuine harm reduction cannot mean creating a new generation addicted to nicotine.
The reality is that South Africa currently has major regulatory gaps. Many e-cigarette products are sold without standardised health warnings, ingredient disclosure, packaging restrictions or meaningful controls on nicotine levels, flavours and advertising. Social media promotion targeting youth remains widespread.
Countries such as Kenya have already moved to require graphic health warnings on e-cigarette packaging, recognising that these products are not risk-free. The tobacco companies opposing this same regulatory requirement in South Africa are complying in Kenya and elsewhere in the world. South Africa cannot afford to lag behind while youth nicotine addiction escalates.
The public also needs to understand that “smoke-free” does not mean “harmless”. Studies of heated tobacco products and e-cigarettes continue to identify toxic substances, including cancer-causing chemicals, in their emissions and aerosols. Recent international studies, including work involving South African products, found that colour-coded heated tobacco variants marketed as “lighter” or “milder” did not contain lower levels of harmful substances than supposedly stronger variants.
The appeal itself is part of the danger. This is why stronger regulation is urgently needed. South Africa should fully implement evidence-based measures aligned with the WHO Framework Convention on Tobacco Control and the WHO’s MPOWER measures aimed at assisting in the country-level implementation of effective interventions to reduce the demand for tobacco.
These measures should include comprehensive regulation of all nicotine and tobacco products; plain or standardised packaging; restrictions on flavours appealing to youth; stronger enforcement against advertising and social media promotion; higher tobacco taxation; improved actions against illicit tobacco trade; and expanded access to structured cessation support services.
Importantly, policymakers must resist efforts to weaken or delay the current Bill through industry lobbying and misinformation campaigns. Every year of delay means more young people becoming addicted before protections are in place.
World No Tobacco Day should not merely be symbolic. It should serve as a warning. South Africa stands at a crossroads. We can either act decisively to protect the next generation from nicotine addiction, or we can allow commercial interests to shape the future of public health.
The evidence is already clear. The question is whether we have the political courage to act on it before even more lives are placed at risk.
* Ayo-Yusuf is Professor of Public Health and Chairperson of the School of Health Systems and Public Health at the University of Pretoria.
** The views expressed do not necessarily reflect the views of Pretoria News, IOL or Independent Media.
On the eve of World No Tobacco Day, the writer confronts the alarming rise of nicotine addiction among South Africa's youth. He argues that as the tobacco industry evolves, so must our response to protect future generations.
Image: SUPPLIED