As vaping rates among South African teens surge to alarming levels, public health researchers from the University of Cape Town (UCT) are calling on the government to urgently enact the Tobacco Products & Electronic Delivery Systems Control Bill to curb what they warn could become a full-blown national epidemic.
The bill seeks to regulate vaping products and shield South African youth from a growing nicotine addiction crisis. The call comes on the heels of a landmark study – the largest of its kind in South Africa – conducted by researchers from UCT and Utrecht University in the Netherlands and recently published in The Lancet’s eClinical Medicine.
The study surveyed 25 000 pupils across 52 fee-paying high schools nationwide to assess the prevalence, drivers and addictive behaviours linked to vaping among teenagers. The researchers uncovered startling trends using a mixed-method approach combining quantitative and qualitative data.
“In South Africa, where tobacco control has made strides, the rapid rise in vaping among adolescents is a new public health challenge. As a multidisciplinary team, whose work intersects on public health matters, we wanted to quantify the burden. We were further driven by global alarm bells, like the World Health Organization’s 2023 warning about e-cigarette promotion targeting the youth, as well as local gaps in knowledge,” says co-author Samantha Filby, who is based in the Research Unit on the Economics of Exercisable Products in UCT’s School of Economics.
Until now, data on the scale of teen vaping in South Africa has been scarce. This study filled a critical knowledge gap, and the findings paint a deeply concerning picture:
Nearly 17% of surveyed learners currently use vapes.
Among them, 38,3% vape daily.
Over 50% of current users vape more than four days per week.
Alarmingly, 88% of current vapers reported using products containing nicotine.
Researchers also investigated signs of addiction:
47% of teen vapers use their device within an hour of waking – a strong indicator of dependence.
11,8% said they cannot get through the school day without vaping.
24,9% admitted feeling anxious or angry if unable to vape for a prolonged period.
“We used this information to construct a novel vape dependence score that could help us identify the proportion of vape users who are highly vape dependent. On our scoring system, 60% of the sampled adolescent vapers exhibit high vape dependence,” says Filby.
“This underscores vaping as a significant addiction for a large portion of young users and highlights the urgent need to strengthen prevention efforts.”
UCT’s Professor Richard van Zyl-Smit, lead author of the study, points out that the scale of nicotine dependence seen in this research is unprecedented – even when compared to traditional cigarette use among teens.
“The extent of use and dependence on nicotine is something researchers had never encountered with traditional cigarettes in the past,” he says.
To reverse the tide, researchers say education must start early.
“Addressing the current crisis is possible with the right interventions,” says Filby. “And it all starts with debunking the dangerous myth that vaping is safe.”
Filby emphasises the need for basic education around the harms of vaping from primary school level, with clear messaging that vaping is addictive and not safe. For those already addicted, tailored psychosocial support is essential.
However, she warns that education alone is not enough.
“What we need is regulation – to ban ads targeting youth and enforce age limits to reduce appeal and access,” she says. “Vape products are so easily accessible because you can even order them on the Checkers Sixty60 or UberEats mobile apps. The restrictions on vape marketing, which the bill provides, can aid in debunking the myth that vaping is safe and assist with deglamourising vaping among our youth.”
The researchers stress that schools, parents and healthcare professionals must be engaged to tackle the crisis.
“We want to ignite action, push lawmakers to regulate vaping, equip schools, parents and the public health community with knowledge that there is need to intervene and shift public perception towards the reality that we do have a public health crisis in the making, and we need to address it,” says Filby.
Parents and teachers must be empowered to recognise the signs of vaping and its underlying drivers – such as peer pressure, stress and mental health struggles. At the same time, healthcare providers should begin screening for vape use during routine check-ups to guide addicted teens toward recovery support.
As the research lays bare the urgency of the situation, the message is clear: South Africa cannot afford to wait. The time to act – through policy, education and community-wide engagement – is now.
Article by Niémah Davids, UCT News