A large-scale study has revealed a sharp rise in vaping among South African high school students, highlighting growing concerns about addiction, mental health, and broader substance use patterns.
The research, led by Richard van Zyl-Smit and published in the South African Medical Journal, surveyed more than 25,000 learners across 52 fee-paying schools in eight provinces.
Vaping overtakes traditional substances
The findings show that 16.8% of students are current users of e-cigarettes, while over a third have experimented with vaping at least once. This places vaping well ahead of other substances, including cannabis, hookah, and conventional cigarettes.
Researchers noted that vaping is now the most common inhaled substance among adolescents in these school environments. The trend mirrors global patterns, where e-cigarettes have increasingly replaced traditional tobacco use among younger populations.
More concerning is the frequency of use. A significant proportion of student vapers reported daily use, with many indicating they vape multiple times a week. The majority of these products contain nicotine, suggesting a strong risk of dependency.
Addiction, mental health and ‘dual use’ risks
The study highlights clear signs of addiction. Many students reported vaping shortly after waking, while some indicated they could not get through the school day without using e-cigarettes.
Researchers also identified a strong overlap between vaping and other substances. A large percentage of cigarette smokers and cannabis users also reported vaping, pointing to a pattern of “dual use” or multi-substance consumption.
These behaviours are often linked to emotional and social factors. Students cited stress, anxiety and depression as key reasons for vaping, while others associated it with lifestyle choices such as weight management or sleep improvement.
Peer influence and accessibility also play a major role. In many cases, learners reported using e-cigarettes out of curiosity, social pressure or simple boredom, often without fully understanding the long-term health implications.
The study further found that substance use increases with age, particularly from Grade 8 through to Grade 12, as students gain more independence and exposure to older social circles.
Experts have also raised concerns about regulatory gaps. While traditional tobacco products are governed by the Tobacco Products Control Act 1993, e-cigarettes remain largely unregulated in South Africa.
Researchers are calling for the implementation of the Control of Tobacco Products and Electronic Delivery Systems Bill 2018 to address marketing practices targeting young people and to close existing loopholes.
They emphasised the need to challenge the perception that vaping is a safe alternative, warning that its widespread use among adolescents could have long-term public health consequences.
Source: South African Medical Journal study
