The tobacco industry has set its sights on Africa, exploiting regulatory loopholes and targeting a rapidly growing youth population with new nicotine products.
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This warning was issued by Professor Lekan Ayo-Yusuf, head of the School of Health Systems and Public Health at the University of Pretoria (UP), during his inaugural address, titled ‘Turning the Tide on Tobacco and Industry’s Product Innovation Gambit’.
Prof. Ayo-Yusuf said the industry is aggressively marketing products such as e-cigarettes, heated tobacco products (HTPs), snuff and other smokeless tobacco alternatives to young people in Africa as ‘safer’ options, despite mounting evidence of their health risks. “Africa’s demographic dividend – a projected increase in the 15- to 24-year-old age group – makes it a prime target for these products,” he said.
During his address, he discussed his recent research, which revealed how the industry’s shift towards electronic nicotine delivery systems, including e-cigarettes and HTPs, is not the solution it claims to be, but rather a new front in the battle against tobacco-related diseases.
False narrative around ‘safer’ alternatives
Prof. Ayo-Yusuf’s research shows that despite being marketed as harm-reducing, many of the emerging tobacco products still pose considerable health risks. “Smoking even one cigarette a day generates more than 50% of the risk of coronary heart disease. Low toxic exposure does not mean no harm,” he explained.
He also cited recently published research that shows that South Africa’s heated tobacco products contain even higher levels of carcinogens (cancer-causing substances) than similar products sold elsewhere, suggesting regulatory gaps that allow for more harmful formulations.
More concerning for South Africa is the widespread use of snuff, a smokeless tobacco product that is often perceived as a safer alternative to smoking. “In South Africa,local snuff contained more cancer-causing substances than many other smokeless tobacco products we tested,” Prof. Ayo-Yusuf said.
Unlike cigarettes, which primarily cause lung cancer, snuff has been linked to significantly higher risks of oral, oesophageal and pancreatic cancers. Despite these risks, it remains widely used, particularly among women and older populations, due to cultural and social norms.
Prof. Ayo-Yusuf’s research also shows that, rather than helping South African smokers quit, e-cigarettes may actually reduce long-term quit rates and increase nicotine dependence.
“E-cigarette use reduces long-term quitting [and] quit intentions, [and] increases smoking relapse and nicotine dependence. Dual use, where individuals smoke both conventional cigarettes and e-cigarettes,is becoming more common. Rather than fully replacing cigarettes, many users remain addicted to both products.”
Prof. Loretta Feris, Prof. Lekan Ayo-Yusuf and Prof. Tiaan de Jager at Prof. Ayo-Yusuf’s inaugural address, where he advocated for stronger policies to protect Africa’s youth from harmful nicotine products.
The African target
Prof. Ayo-Yusuf emphasised that Africa’s youth population is increasingly vulnerable to the industry’s aggressive marketing tactics. A South African study he co-authored found that vape shops are strategically placed near higher education institutions rather than in communities with traditionally high smoking rates. “This so-called harm reduction should ideally target communities with high smoking rates, if it were genuinely driven by public health as opposed to profits,” he said.
He also debunked the claim that tobacco harm-reduction strategies using electronic nicotine delivery systems are effective, saying that countries that have effectively regulated access, such as Australia, or banned e-cigarettes, such as Uganda and Brazil, have achieved better public health outcomes than those that have embraced them with fewer restrictions, such as England. “It is clear that the industry’s so-called ‘harm reduction’ narrative in South Africa is a business strategy rather than a public health strategy.”
Industry interference and policy reform
Prof. Lekan Ayo-Yusuf
A major theme in Prof. Ayo-Yusuf’s address was the persistent interference of the tobacco industry in public health policy. Drawing from global case studies, he illustrated how industries that profit from health-harming products – including tobacco, sugar-sweetened beverages and ultra-processed foods – use similar tactics to stall regulation and maintain market control.
In South Africa, industry-funded reports have been used to challenge measures such as tobacco taxation and plain packaging laws. “Raising tobacco taxes is the most effective policy to reduce tobacco use and save lives, while bringing in significant government revenue. Yet, raising taxes continues to be the least implemented measure,” he noted.
He called for stronger international co-operation and governance to counter industry influence, particularly in light of impending trade agreements that could be leveraged by tobacco companies to bypass national regulations.
The road to a tobacco-free Africa
Prof. Ayo-Yusuf called for more robust policy interventions, increased taxes on tobacco products while also addressing the criminality associated with illicit tobacco trade, and comprehensive monitoring of new and emerging nicotine delivery systems.
His research hasled to the establishment of the Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM) at UP. The centre serves as a hub for transdisciplinary research and advocacy and provides policymakers with the evidence needed to strengthen tobacco control efforts across the continent.
“The battle against the tobacco epidemic is not just about regulating cigarettes,” Prof. Ayo-Yusuf concluded. “It’s about exposing industry tactics, closing regulatory loopholes and ensuring that public health policies are based on science, not corporate interests.”
