A team of experts gathered at Unisa Graduate School of Business Leadership yesterday ahead of World No Tobacco Day 2019 on the 31st of May to discuss the myths and realities of health and the economy inherent in the tobacco debate and to unpack the draft Control of Tobacco Products and Electronic Delivery Systems Bill, which was gazetted for public comments last year and is due to be tabled before Parliament.
The focus of World No Tobacco Day 2019 falls on lung health. Deputy Director General at the National Department of Health, Yogan Pillay, says, “Tobacco exposure is a threat to lung health for everyone – not just smokers. Respiratory disease caused by tobacco is a leading killer around the world and especially in South Africa, where smoking-related TB deaths are prevalent due to a higher vulnerability of HIV-positive individuals to TB. Our National Strategic Plan for Non-Communicable Diseases has clear targets to reduce tobacco smoking. South Africa is already overburdened with entirely preventable diseases and tobacco is one of the major risk factors. The new Bill will go a long way to reducing the disease burden.”
Lynn Moeng-Mahlangu, Chief Director at the Department of Health, led a discussion on protecting the lungs of the next generation. “World No Tobacco Day is an ideal opportunity to focus on what must be done to make it easier for all South Africans to make the healthy choice and protect the majority of our population, who are non-smokers, from dangerous second-hand smoke. We need everyone to get involved and stand up for their rights to a healthy, smoke-free environment.”
Zanele Mthembu of the Campaign for Tobacco-Free Kids, a global advocacy organisation that is working with the Department of Health and other partners, led a second panel on the war on tobacco in South Africa as experts including looked at how we stem the impact of a product that, annually, kills 42,100 people, costs the country over R59 million and threatens the health of children, pregnant women and non-smokers with toxic passive smoke.
The SA Demographic and Health Survey shows that tobacco smoking is more common among men than women, with 8% of women and 37% of men age 15 and older currently smoking tobacco products. The majority of smokers are daily smokers; 6% of women and 30% of men smoke every day, and most smoke cigarettes. “In South Africa, three times more people are killed by cigarettes than in road accidents. 550 men, that’s 50 football teams, die from tobacco every week. Yet, you could fill over 100 large stadiums with the 6.1 million adults who still smoke in our country,” says Mthembu. “Legislation and taxation have been proven to be the best ways to curb this epidemic.”
According to the World Health Organisation and local reports, active changes in tobacco control laws and raising tobacco taxes have contributed to a drop from around 38% of South Africans smoking in the mid-1990s to 22% today according to the South African Demographic Health Survey. However, South Africa’s smoking rates remain the highest on the continent – and trends show that these figures will increase over the next 15 years.
“While the impact of South Africa’s leadership and political will in tobacco control can be seen in how many of us enjoy smoke-free air compared to other countries, we still have a long way to go,” says Mthembu. “Our current legislation was developed before new tobacco products including e-cigarettes, which have emerged as a toxic threat particularly targeting our youth, entered the market. The new bill addresses the loopholes and strengthens legislation to make sure we can not only stop the increase in tobacco use, but actually reduce it.”
Understanding the new Bill
Smoke-free public spaces are a well-documented strategy to reduce smoking and second-hand smoke exposure. While smoking is currently permitted in designated areas of up to 25% of the floor area in pubs and restaurants, the new Bill requires that any enclosed public area is 100% smoke-free and will make certain outdoor public places smoke-free too. This includes all enclosed public places, workplaces, public conveyances and common areas of multi-unit residences. It further bans smoking in private dwellings used for commercial childcare/education and in cars carrying children under 18.
The looming epidemic of e-cigarettes has raised public health concerns as the body of research showing they may have dangerous health impacts continues to grow. Researchers at the Harvard School of Public Health found bacterial and fungal toxins associated with a myriad of health problems including reduced lung function, asthma and inflammation in most leading e-cigarette brands.9 Unfortunately, the current legislation predates e-cigarettes and manufacturers have used the legislative vacuum to promote these devices, appeal to the youth and make unsubstantiated claims about their efficacy as a quitting tool. If the new Bill is passed, e-cigarettes will fall under the same regulations as tobacco products, with South Africa finally joining 83 other countries in controlling their use.
South Africa is also playing catch-up when it comes to restricting tobacco marketing. The new Bill introduces uniform plain packaging for all brands and pictorial warnings on all packages similar to those adopted by many countries including Australia, the United Kingdom and France, all of which have shown significant drops in consumption. The Bill also bans cigarette advertising at tills, removing the loopholes in existing provisions for advertising displayed at points of sale. To date, 33 countries have enacted POS display bans, with African countries including Burkina Faso, The Gambia, Kenya, Senegal, Seychelles, Togo and Uganda leading the way. The Bill also does not permit any cigarette vending machines, as in 54 other countries.
And the penalties? People caught smoking or vaping in no-smoking zones could face a fine and/or up to three months in prison. Furthermore, those who import illegal cigarettes could face sentences up to 10 years in prison – a firm deterrent for the illicit tobacco trade in South Africa which sees some tobacco manufacturers operating in both the legal and illicit market.
“Tobacco industry and public health interests will always be pitted against each other – but we cannot allow the wealth of a few at the expense of health of many,” says Mthembu. “Despite claims of contributing to the economy, industry profits are at the expense of addicted smokers, their families, and public health. It’s time for our people and our government to show leadership to curb the onslaught of big tobacco through campaigning for the new Bill to be passed.”
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