38 articles qualified the exclusion and inclusion criteria and were all included in the analysis. The news articles and opinion pieces came from 15 online newspapers across Africa. Half of the articles (n = 19, 50%) have a favorable tone towards e-cigarettes. Furthermore, majority of the articles were framed as a health issue (n = 22, 58%). And the most commonly used news sources were public health agencies.
Table 1
Frequency of codes and themes.
THEMES AND SUB THEMES | FREQUENCY |
Health impacts of electronic cigarettes |
Benefits of e-cigarettes | 28 |
| Smoking cessation tool | 8 |
Reduction in smoking related diseases | 8 |
Safer as compared to smoking | 24 |
Not linked to chronic illnesses | 3 |
Drawbacks of e-cigarettes | 17 |
| Not an effective smoking cessation tool | 4 |
E-cigarettes are a gateway to smoking | 2 |
E-cigarettes are harmful | 9 |
E-cigarettes are addictive | 8 |
Second hand aerosols are harmful | 2 |
Potentially harmful | 4 |
Youths and children taking up e-cigarettes | 7 |
Story tone typically used |
Neutral | 8 |
In favor of e-cigarettes | 19 |
In opposition to e-cigarettes | 11 |
Policy issue | 13 |
| Products taxation | 8 |
Product regulation | 21 |
Product ban | 11 |
Health issue | 22 |
Youth vaping | 3 |
News source |
Government officials/ lawmakers | 8 |
Public Health Agencies | 19 |
Anti-vaping advocates and CSOs | 4 |
Vaping advocates and CSOs | 11 |
Average citizen/consumer | 3 |
Industry – retailers and manufacturers | 14 |
Health experts – doctors/ nurses | 12 |
Academia | 11 |
Journals on health | 6 |
Diversity of news sources |
Only one source used | 7 |
Two or more sources used | 31 |
Other emerging themes |
LMIC issue | 11 |
Description of electronic cigarettes | 8 |
Business or economic issue | 11 |
Dominant frames |
The frame that electronic cigarettes are safer as compared to smoking was the most frequent, it appeared in 24 articles, followed by the frame which portrays electronic cigarette use as health issue where benefits and drawbacks of electronic cigarettes were discussed and appeared in 22 articles.
The third dominant frame was on regulation of electronic cigarettes, and appeared in 21 articles. The articles covered the debate on regulation in which other articles advocated for sensible regulation of the product whilst other articles took a prohibitionist approach and demanded for bans or stricter regulation:
“Preventing access to these products through bad policies robs people of their right to health. Policy should encompass issues to do with access to credible information/science and making Tobacco Harm Reduction products available” (AllAfrica, 2020).
“… e-cigarette products actually require stricter or a step up in regulation to match the sophistication and diversity of the products and ensure that other innovations the industry might come up with in the future are covered” (Daily Maverick, 2020).
The study also unveils three interesting and emerging themes which could be specific to Africa and other low-income regions. These are; LMIC issue, description of electronic cigarettes, and business or economic issue.
Electronic cigarettes were framed in the perspective of low- and middle-income countries (LMIC) where challenges facing the adoption and implementation of electronic cigarettes such as limited knowledge, affordability and access to electronic cigarettes by nicotine consumers was discussed:
“… there is lack of knowledge and limited access to THR in most LMICs and that these less harmful products are very expensive compared to the easily accessible combustible cigarettes” (Nyasa Times, 2020).
Being a novel product on the African continent, several articles gave a brief description of electronic cigarettes, its phenotypic features and how they work.
Business/economic issue also appeared as an emerging theme where electronic cigarettes were discussed in terms of product differentiation by the industry and the need for tobacco farmers to diversify their livelihood as people are shifting from smoking tobacco to electronic cigarette use:
“Evidence from tobacco industry documents shows that tobacco companies also target this age group, seeking to find “replacement” smokers to maintain their market share and profits” (Daily Maverick, 2020).
“The global decline of smoking has many positive effects but can also bring negative economic consequences for farmers, many of who are, in Africa, particularly in Malawi, Zimbabwe and South Africa. In order to address the impact of smoking cessation, our governments should focus on identifying sustainable opportunities for tobacco farmers.” (AllAfrica, 2022).
Tone typically used
The tone was the stance that had been used to describe the whole article. Classified as favorable towards electronic cigarettes, unfavorable towards electronic cigarettes and neutral, 19 articles portrayed electronic cigarettes in a favorable way where benefits of electronic cigarette use were apparent. 11 articles were in opposition of electronic cigarette use, negative attributes of electronic cigarettes were underscored. Eight articles appeared to have a balanced tone where both positive and negative attributes of electronic cigarettes were discussed.
Benefits and drawbacks of electronic cigarettes
Overall, benefits of electronic cigarette use appeared more times than drawbacks and appeared in 28 articles and 17 articles respectively. For instance, the frame that e-cigarettes are safer as compared to smoking appeared in 24 articles as compared to the frame that they are harmful which appeared nine times. Furthermore, the argument that electronic cigarettes are an effective smoking cessation tool (eight articles) outnumbered the argument that they are not an effective smoking cessation tool (four articles).
Some of the argument indicating that electronic cigarettes are safer as compared to smoking include:
“… Vapers, for example, are considered 95 percent less harmful than cigarettes.” (263Chat, 2021).
“Although vaping is not entirely risk-free, it is vastly safer than smoking tobacco” (Daily Maverick, 2019).
On drawbacks, the most common appearing frame is that electronic cigarettes are harmful and it appeared in nine articles followed by the frame that electronic cigarettes are addictive which appeared in eight articles.
Some articles argued that electronic cigarette use causes a number of non-communicable diseases including various cancers, cardiovascular diseases and pulmonary diseases:
“Electronic cigarettes and heated tobacco products are not helping to fight cancer, the World Health Organisation said on Friday, urging smokers and governments not to trust claims from cigarette manufacturers about their latest products” (The Namibian, 2019).
“Both cigarette and electronic cigarette (e-cigarette) use, damages the respiratory system, potentially increasing the risk of experiencing Covid-19-related symptoms, a positive diagnosis and exacerbated health outcomes” (Nation, 2020).
Further to that, some articles argued that electronic cigarettes can hook citizens to nicotine addiction:
“… the introduction of new products beyond e-cigarettes has led to addictions which are negatively affecting the health of citizens” (Capital Business, 2022).
Main topic
In relation to the overall story topic, the articles were categorized intro three; health issue, policy issue and youth vaping issue. Articles on health issue as the main topic appeared in 22 articles. In these articles, benefits and drawbacks of electronic cigarettes were the center of discussion. The second dominant angle was policy issues. Appearing in 13 articles, the discourse was focused on regulation of electronic cigarettes which included tax measures and whether prohibition of the product would be ideal.
Youth vaping issue came third and it was the main topic in 3 articles only. Governments were implored to protect the health and wellbeing of youths by putting in place measures that discourage them from taking up electronic cigarette use:
“In order to prevent these habits and make the liquid nicotine used in these devices less accessible to users including to school children and the youth, I propose to change the taxation regime” (Capital Business, 2022).
News sources
Public Health Agencies at national, regional and global levels were either cited or referenced most often, appearing in a total of 19 articles followed by retailers/manufacturers in 14 articles and health officials such as doctors and nurses in 12 articles. While retailers and manufacturers expressed positive attributes of electronic cigarettes, public health officials were observed to have a divided view of the technology, with others supporting the adoption of electronic cigarettes and others condemning them as harmful and addictive products.
Diversity of news sources
A total of 31 articles were observed to have two or more sources, while only seven articles used only one source. However, having two or more sources in one article did not imply a balanced tone. There were instances when all the sources mentioned in the story spoke about electronic cigarettes only from a negative perspective, and in other articles, all the sources spoke only about the positive qualities.