South Africa continues to face a serious public health challenge as tuberculosis (TB) and HIV remain significant concerns.According to Professor Lekan Ayo-Yusuf, despite progress in extending the lives of people living with HIV, the rising prevalence of tobacco and nicotine use, including e-cigarettes and vapes, threatens these gains.Research shows that smoking and nicotine exposure compromise the immune system, increasing susceptibility to TB and worsening treatment outcomes.

Alarmingly, nicotine products are increasingly marketed to young people, often with high nicotine concentrations, undermining the argument that vaping reduces harm.

The Tobacco Products and Electronic Delivery Systems Control Bill, first introduced in 2018 and tabled again in 2022, seeks to regulate rather than ban nicotine products.

Proposed measures include stronger smoke-free laws, restrictions on youth-targeted advertising, and regulated packaging—steps proven effective in countries like Kenya.

Opposition to the Bill often focuses on illicit trade, jobs, and personal freedoms, yet studies indicate these are predominantly governance issues rather than reasons to delay public health protections.Smoking-related illnesses already cost South Africa tens of billions of rand annually and claim over 30 000 lives each year.

The article argues that Parliament must prioritise health over industry interests, passing the Bill to curb nicotine addiction, protect young people, and ultimately reduce TB, cancer, and heart disease burdens.