E-cigarette smokers, or “vapers” as they are sometimes called, like to make a big deal with their smoke. They are not trying to hide it. There is no cupping the cigarette in your hand, no blowing smoke out of the corner of your mouth. These smokers celebrate smoke – it looks like there’s a fire in their mouths – and would probably blow it out their ears if they could (in fact, you can – there’s a video on YouTube.)
In some of the adverts for e-cigarettes, you cannot even see the models, just the edge of their jerseys, their torsos and heads hidden inside a giant cloud of grey smoke.
While some studies argue that e-cigarettes are less harmful than “analogue” cigarettes there is no consensus. You also can’t smoke e-cigarettes on planes, and New York and Chicago among other cities last month ruled the devices were subject to the same regulations as tobacco.
In South Africa, Sanlam said this week it regards you as a smoker if you use e-cigarettes and you will still be charged smokers’ rates for your insurance.
Dr Pieter Coetzer, chief medical adviser at Sanlam, said in a release that “e-cigarettes may even contain more toxic chemicals than regular cigarettes” and that it was “probable that using e-cigarettes can still increase the user’s risk of cancer and other serious illnesses such as heart disease and stroke”.
Even if clients say they are using e-cigarettes without any nicotine, Sanlam will regard them as smokers, since insurers have no way of determining whether or not these products are always nicotine-free.
“Smoking laws have brought down the number of smokers worldwide, and we are concerned that e-cigarettes, which are often appealingly flavoured, may open a new gateway to smoking for especially the younger generation,” he said.
Twisp is the most popular “cigarette simulator” in South Africa, and reckon they have about 95% of the market. Their device, designed by Dutch company Janty, doesn’t look like a cigarette at all, and is more like a handsome silver cigar.
You unscrew the top, pour in some e-liquid (R200 for 30ml), attach the battery and start puffing away. The experience is similar to smoking. When you draw on the device, you still feel “the hit” as the vapour enters your lungs. The vapour looks almost exactly like smoke. Craving disappears.
Alexandra Ferguson, head of social media at Twisp, said the product had been in South Africa since 2008, and it was “hard to keep up with demand”.
She said the “coolness factor” was a factor in many (mainly young) people’s decision to use the device. She said her sister, who has never been a smoker, enjoyed smoking what they call their “homeopathic” range of flavours, which do not contain any nicotine.
Nathan Smith, Twisp’s marketing director, said they are signing on 10 000 new customers a month.
He said they were taking “self-regulation” steps and that he would welcome more government regulation, because the department of health often appeared uncertain about how to deal with Twisp, because it did not appear to fall under existing tobacco laws.
Twisp is marketed as a recreational device, or a “smoking alternative”, and the company does not endorse it as a smoking cessation device.
Dr Yussuf Saloojee, the executive director at the National Council Against Smoking, an NGO, said this week that, according to the Medicines and Related Substances Act 101 of 1965, nicotine is classified as a schedule three drug when its intended use is as a substitute for a tobacco product.
This means that e-cigarettes that contain nicotine need to be registered with the Medicines Control Council and can only be bought with a doctor’s prescription from pharmacies. There can also be no direct consumer advertising, and there needs to be a test case in court, Saloojee said.
According to Smith, all their flavours are made under “strict pharmaceutical conditions” in Cape Town.
Referring to the liquid made
by foreign manufacturers, however, he said “no one knows what’s in there, or where it’s made”.
The ingredients printed on the back of a bottle of Twisp’s “polar ice” state that one drop contains 0.9mg nicotine, vegetable glycerine, the preservative propylene glycol, deionised water, and flavouring.
There is an array of flavours. Twisp sell some “limited edition” ones, such as nut brittle and piña colada, and their “signature range” includes café latte, and one they call “rebel” is “extraordinarily similar to a popular energy drink, which shall remain unnamed”. There’s also a tobacco flavour, and cherry.
Smith predicted that in 10 years there will be more e-smokers, at least among upper- and middle-income earners, than smokers of ordinary cigarettes
Saloojee said e-cigarettes had the potential to “disrupt tobacco control legislation that we already have”.
“Government policy has made smoking socially unacceptable. Now, e-cigarettes threaten to make it socially acceptable.”
E-cigarettes were “potentially less harmful” than cigarettes, he said, but it was “too early in the game” to judge the effects of daily, repeated exposure to propylene glycol and glycerine.
“If smokers simply change to e-cigarettes, it might be beneficial,” he said, but added that he believed the “majority” of vapers were “dual users” who continued to smoke ordinary cigarettes.