Smoking and vaping: personal choice or public health hazard?

Smoking in South Africa is about to get a little more difficult, and likely more expensive, as smoking legislation is being reviewed. The biggest proposed changes include a zero-tolerance policy on indoor smoking in public places, as well as a requirement that smokers must be at least 10 metres away from public entrances. But are the changes justified?

"Although smokers may feel their rights are being infringed upon, stopping smoking is a fantastic idea," says Professor Richard van Zyl-Smit, Head of the Lung Clinical Research Unit at the UCT Lung Institute. "Statistics tell us that over 50% of smokers will die prematurely ( that is, lose about 14 years their life) from a smoking-related illness. Thus deciding not to smoke is always a good idea."

Why this doctor wants to make it even harder to smoke

Prof. van Zyl-Smit, a pulmonologist by training, has devoted years of his life to understanding why and how smoking affects your health. Having furthered his studies thanks to a grant from the Discovery Foundation, he is now internationally recognised as an expert in his field. The professor cautions, "Smoking impacts your ability to learn and your performance in sport; it yellows your teeth and ages your skin. The cost of smoking continues to rise and with a pack of cigarettes at R30 to R40 a day, the sooner you can quit, the better for you all-round."

"In addition, second-hand smoke is well recognised to cause cardiovascular disease and increase risks for cancer. It also harms those sensitive to tobacco smoke, such as asthmatics. The fact of the matter is, the harder you make it for smokers to smoke - the more likely they are to quit. This may sound pejorative, but increased taxation, restriction of smoking in public places and so on have indirect benefit to the smoker in the long run."

"Once damage is done, there is not a lot we can do to fix it"

The benefits of quitting are undeniable, the professor says. "Within 24 hours, food will taste better, you can smell better, and you yourself will smell better to others! Your blood pressure and oxygen levels will stabilise, and your risk for stroke and heart disease will drop. The longer you smoke, the higher your risks for lung and heart disease, and the harder it is to stop. Once real damage is done, there is not a lot we can do to fix it."

Are e-cigarettes any better?

A few studies have shown promising benefit in the use of electronic cigarettes in reducing the number of cigarette use by smokers. However, a recent analysis of currently available research on electronic cigarettes (e-cigarettes) presented during the 2015 American Thoracic Society International Conference found that vaping devices haven't yet been proven successful as long-term solutions for those who want to quit smoking.

"What's even more worrying is a rising trend in experimenting with vaping among the youth," says Dr Noluthando Nematswerani, Head of the Centre for Clinical Excellence at Discovery Health. An analysis of data from poison centres around the USA showed an alarming increase of over 1 400% (between 2011 and 2014) in calls relating to e-cigarette poisoning in young children, more than half of which concerned children under the age of 5.

How vaping pollutes your lungs

Vaping carries ultra-fine chemical particles into the lungs. Vapers inhale large amounts of toxic metals, including lead, in the aerosols, reports a study in Environmental Health Perspectives. These metals apparently leak from the e-cigarette coils. A few studies that have investigated what effect vaping has on lungs show that teens who vape have higher rates of asthma, more frequent asthma attacks, and more absences from school due to breathing troubles. It appears that e-cigarettes trigger similar kinds of inflammatory responses in the lungs as cigarettes do.

The American Heart Association states that although e-cigarette emissions contain fewer chemicals and lower concentrations of toxicants than conventional cigarettes, the health effects of second-hand exposure are not known. E-cigarettes have only been around for about a decade, so scientists don't yet have any long-term evidence of their risks. As of yet, there's a lack of evidence of the safety and long-term outcomes of vaping, and most communities advocate the inclusion of e-cigarettes in smoking bans.

Spare yourself and others avoidable risk

For Prof. van Zyl-Smit, the tougher the restrictions, the better for everyone - especially for smokers themselves: "A strong policy on smoking restriction protects non-smokers from unnecessary risk, and in a roundabout way, can help smokers to break a habit that could cost them their lives."

Learn more about Prof. van Zyl-Smit here.

Get an expert's advice on how to care for the health of your lungs here.

The Discovery Health Medical Scheme is an independent non-profit entity governed by the Medical Schemes Act, and regulated by the Council for Medical Schemes. It is administered by a separate company, Discovery Health (Pty) Ltd, an authorised financial services provider.