Study on adolescent vaping in South Africa published in The Lancet

Sam Filby was part of an author team comprising researchers from UCT, Utrecht University and the University of Cambridge, who recently published an article in The Lancet’s eClinical Medicine. The study, is titled “Electronic cigarette usage amongst high school students in South Africa: a mixed methods approach”, and seeks to investigate the burden of vaping among South African youth.

The research draws on a data-collection effort led by Professor Richard van-Zyl Smit at the UCT Lung Institute, which surveyed around 25,000 high school learners across 52 fee-paying schools in eight of South Africa’s nine provinces.

The findings reveal that nearly 17% of the surveyed students currently use e-cigarettes, a striking contrast to much lower rates of cigarette use (2%), cannabis use (5%), and hookah pipe use (3%). The study also found that vaping is more common among older youths, with 9% of Grade 8 learners reporting use, rising to an average of 30% among matric learners, and some schools seeing rates as high as 46%.

A concerning aspect of the study was the high level of vape dependence among users. Nearly 47% of current vapers reported using e-cigarettes within the first hour of waking up, and 88% said they used vapes that contain nicotine. The study also highlighted that 38% of students vape daily, with an additional 50% vaping at least four days a week. Around 12% of learners indicated that they were unable to get through the school day without vaping, and close to 30% of current vape users in the sample reported feeling anxious or angry if they had to wait too long before vaping.

The research also explored the reasons behind why students start and continue vaping. While over 50% of students cited social influences like family, friends, and peer pressure as reasons for starting, nearly 20% began vaping to cope with stress and anxiety. Reasons for continued vaping were primarily linked to stress relief and addiction, with 28% of learners using e-cigarettes to manage anxiety or depression. Around 15% admitted to being addicted to vaping.

This study emphasizes the urgent need for a coordinated public health response to address the growing vaping crisis among South African high school students and to support those young people struggling with vape dependency. REEP is proud to have been part of this important work.

The paper is available here.