Almost a third of university students say they smoke hookah pipes and a little more than a quarter report using e-cigarettes, according to a study from the SA Medical Research Council (MRC).
Students who said they were exposed to advertising and marketing were almost three times likelier to use these products than those who were not.
“It adds to what we already know: that there is systematic targeting of young people with these products,” said Catherine Egbe, a senior specialist scientist at the MRC’s Mental Health, Alcohol, Substance Use and Tobacco Research Unit, referring to previous research by the unit that found venues selling e-cigarettes were clustered around universities.
The latest study, released on Thursday, was based on an online survey completed by more than 2,200 undergraduate students aged 18 to 24 from 15 universities. It found that 31.5% of respondents used hookah pipes, 26.3% used e-cigarettes, 22.4% smoked cigarettes, and 13.9% used all three.
The study explored the association between product use, students’ knowledge, attitudes and perceptions and their exposure to this marketing.
“Those exposed to any form of advertisement, marketing and promotion were almost three times more likely to be using e-cigarettes or hookahs compared [with] those not exposed, while those who noticed e-cigarette promotions specifically were almost four times more likely to be using e-cigarettes,” said Egbe.
Companies selling and promoting hookahs were openly flouting laws governing tobacco products, which prohibit advertising and limit their use in public venues such as restaurants to designated smoking areas, said Egbe. Hookahs use tobacco.
E-cigarettes are not regulated in SA, as they fall outside the scope of the Tobacco Products Control Act. Draft legislation that tightens existing controls and brings e-cigarettes and other new generation products firmly into the regulatory fold is now before parliament. Legislators have completed public hearings on the Tobacco Products and Electronic Delivery Systems Bill in most provinces, but have yet to do so in KwaZulu-Natal and Northern Cape, said Egbe. The next step will be to hold public hearings in parliament.
One of the most troubling aspects of the study was that many of the hookah smokers who reported side-effects such as dizziness or respiratory problems blamed themselves, said Egbe. “They said it was their fault for not eating before smoking, or switching to a different flavour,” she said.
The extent of hookah smoking among undergraduates is broadly in line with that shown in smaller studies conducted in high schools in Cape Town and Johannesburg.
Research, reported on in the SA Medical Journal in 2020, found 37% of grade 12 pupils from six state schools in Johannesburg were hookah smokers. A study, published in the SA Journal of Child Health in 2022, found 31.1% of the 270 grade 9 learners surveyed used hookahs.
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