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SAMRC national university students study highlights urgent need to curb e-cigarette and hookah advertising and marketing

Publish Date:

February 15, 2024

Durban, 15 February 2024 – South Africa is faced with an alarming rise in the prevalence of e-cigarette and hookah use among university students, exacerbated by aggressive advertising and marketing. The concerning findings of a national study conducted by the South African Medical Research Council (SAMRC)’s Mental Health, Alcohol, Substance Use and Tobacco Research Unit have shed light on the urgent need for regulatory measures to curb these trends. The study was presented today at an event at the Durban University of Technology.

The study investigated university students’ exposure to e-cigarette and hookah advertising and marketing around university campuses and at other venues, exploring the association between the prevalence of product use, the students’ knowledge, attitudes and perceptions, and their exposure to this marketing.

Findings from the study reveal that about 1 in 4 university students aged 18 to 24 years (about 26%) reported current use of e-cigarettes, while almost 40% reported ever use. Almost 1 in 3 students aged 18 to 24 years (about 32%) reported current hookah smoking, while about 47% reported ever use. Hookah smoking has been increasing in prevalence nationally in South Africa as growing trends of using these products at parties and in students residences have been reported.

The study indicates significant exposure to advertising and marketing of these products among young people. Overall, 77.8% were exposed to any advertisement, marketing, and promotion of e-cigarettes. The majority of the students noticed e-cigarette advertising in stores where e-cigarettes are sold (58.7%), closely followed by tobacco-selling stores (54.5%) and the internet or social media (54.2%).

When it comes to hookah, 69.8% were exposed to advertisement, marketing, and promotion, mostly in stores where it is sold (48.3%), or online through advertising and social media (47.3%). Many of the advertisement and marketing tactics reported by participants using hookah are illegal under the current law, the report highlights, while e-cigarette marketing has yet to be regulated in the country.

“The report reveals troubling statistics about students, a demographic group particularly vulnerable to marketing tactics,” says Dr. Catherine Egbe, Senior Specialist Scientist in the MASTRU at SAMRC. “We found that those exposed to any form of advertisement, marketing and promotion were almost three times more likely to be currently using e-cigarettes or hookah compared to those not exposed, while those who noticed e-cigarette promotions specifically were almost four times more likely to be currently using e-cigarettes.”

These findings underline the urgent need for regulatory measures, says Dr. Egbe. “Aggressive marketing tactics employed by the tobacco and nicotine industries target young impressionable minds, with products like e-cigarettes and hookah being falsely marketed as less harmful alternatives to conventional cigarettes, without information about any health effects that may be associated with the use of these products.”

For example, hookah, also known as hubbly bubbly, shisha or waterpipe, has become a popular and fashionable product among young people in South Africa. However, many young people do not know that hookah is a tobacco product and that it is supposed to be regulated by the existing tobacco control policies in South Africa, explains Egbe. Others believe that hookah is a less harmful tobacco product, because its smoke passes through water before being consumed when smoking.

Some of the participants held the belief that hookah use has health implications, with many basing their opinions on personal observations says Egbe. “Health effects mentioned included the addictiveness, headaches, respiratory issues, feeling dizzy and even fainting after having smoked hookah. Students gave personal accounts of the health consequences they have experienced from smoking hookah, include coughing, respiratory issues such as breathlessness, sinus issues, a dry throat, addiction, dizziness and lung issues.”

Recommendations based on the findings include enforcing the ban on tobacco advertising, promotion and sponsorship for hookah, and urgently extending the ban to cover e-cigarettes by passing the Tobacco Products and Electronic Delivery Systems Control Bill. The study further recommends implementing graphic health warnings and plain packaging of hookah, e-cigarettes and cigarette products to communicate the health risks associated with use in an effective way. This may deter students from initiating use and encourage current users to quit, says Egbe. Furthermore, cessation and awareness programmes targeted at university students should be designed to provide information about the harmfulness of using hookah as well as e-cigarettes and support to aid quitting.

Dr. Egbe strongly advocates for the passing of the new Tobacco Products and Electronic Delivery Systems Control Bill in South Africa. “This bill will regulate the advertising, marketing, and sale of tobacco and electronic delivery systems, including e-cigarettes and hookah, and introduce measures to raise public awareness of the health risks associated with these products. It’s a vital step to protect young people from the aggressive marketing and harmful effects of tobacco and nicotine products.”

“The passing of this bill is fundamental to the health and wellbeing of our young people,” Egbe concludes. “We must act now to help inform and protect a new generation from harm and nicotine addiction.”

Read the full report here: Prevalence of Use and Exposure of Young Adults to Electronic Cigarette and Hookah Advertisement and Marketing in South Africa | SAMRC

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