South Africa’s new tobacco laws need to differentiate between cigarettes and non-combusted alternatives and help people make informed choices instead of clamping down on smoking.
Regulations set out in the Tobacco Bill should also be based on scientific evidence, something a multinational tobacco company claims is not currently the case.
The Tobacco Products and Electronic Delivery Systems Control Bill, which is available for public comment until September 4, includes enhanced regulations on the sale and advertising of traditional tobacco products, as well as new regulations pertaining to the sale and advertising of electronic cigarettes.
Proposals include standardising the packaging of cigarette products, stopping sales through vending machines, and outlawing smoking in all indoor public places and certain outdoor areas.
However, tobacco company Philip Morris South Africa (PMSA), has called the bill “irrational”, and says its current approach “lacks nuance and scientific justification”. It will also not advance the public interest.
What the Portfolio Committee on Health should rather be doing, it says, is differentiating between the regulation of non-combusted alternatives and cigarettes.
Ulreich Tromp, director of external affairs Southern Africa at PMSA, says the Bill should include differing communication rules as well as different regulations for packaging, labelling, and ingredients for the two types of tobacco products. This will ensure that adult smokers understand the differences and benefits of better alternatives versus continued smoking.
“We believe in an open and transparent dialogue between policymakers, legislators, health experts, society, and industry about the future of tobacco regulation in the country.”
Amongst the issues raised in its written submission on the Bill, the company highlighted the differences between non-combusted alternatives and cigarettes, stating that they should be regulated differently based on the different risk profiles of these products as supported by the scientific evidence.
The submission also raised several other concerns regarding the Bill, which include protecting freedom of commercial speech to provide an opportunity for adult smokers to choose better alternatives to continued smoking.
“The current approach adopted in the Bill lacks nuance and scientific justification to the extent that it is irrational. The resultant proposed legislative mechanisms set out in the 2022 Bill will not advance the public interest.”
Furthermore, Buhle Binta, head of scientific engagement at PMSA, says the proposed definition of ‘smoking’ is factually wrong and should also be amended to accurately reflect its scientific meaning; it should not include non-combusted alternatives which do not burn tobacco and therefore do not generate smoke.
The company says non-combusted alternatives have led to historic declines in smoking rates in countries such as Japan and Sweden, and that the USA, UK, and New Zealand have recognised the potential of non-combusted alternatives in reducing the harm caused by smoking. However, the Bill fails to recognise that different approaches are needed to accelerate major declines in smoking and associated diseases.
Despite its opposition to the Bill in its current form, PMSA agrees that non-combusted alternatives must be regulated to minimise the risk of youth and non-smokers using these products and to ensure that adult smokers understand that these non-combusted alternatives are addictive and not risk-free.
Although there is currently no official tobacco harm reduction (THR) strategy in South Africa, non-combustible alternatives to smoking (such as vapes and e-cigarettes) have gained popularity, with statistics on use ranging from 2.2 percent to 4 percent, states the Africa Harm Reduction Alliance, which brings together leading harm reduction experts in the medical community.
Citing global statistics, it says countries where smoke-free alternatives to cigarettes are available, acceptable and affordable to adult smokers, see drastic declines in smoking rates. However, instead of using non-combustible alternatives as the foundation for a THR strategy in South Africa, the government has “demonised vaping to such an extent that smokers, medical personnel, and caregivers often believe it to be more harmful than smoking”.
“A one-size-fits-all approach to combustible tobacco products and non-combustible alternatives makes the unscientific assumption that all nicotine products are equal in terms of harm caused. Codifying this approach in the proposed Tobacco Products and Electronic Delivery Systems Control Bill will block access to less harmful smoke-free alternatives for adult smokers who are trying to quit their cigarette habit...”
However, the National Council Against Smoking (NCAS) – which partners with the Cancer Association of South Africa (CANSA), the South African Medical Research Council (SAMRC), the Heart and Stroke Foundation South Africa, and the South African Tobacco Free Youth Forum (SATFYF) as part of the ‘Protect our Next’ initiative – believes the Bill will help create a tobacco- and nicotine-free South Africa, which will change lives for the better.
NCAS and other health organisations united under the ‘Protect our Next’ initiative are hopeful the Bill can become law in 2023.
“Measures in the new Bill close loopholes and are set to reduce tobacco use, exposure to second-hand tobacco smoke, as well as the initiation of tobacco use by young people. It brings South Africa’s domestic legislation closer to full implementation of the WHO Framework Convention on Tobacco Control (FCTC), a global standard captured as sustainable development Goal (SDG) target 3.a,” says NCAS deputy director Dr Sharon Nyatsanza.
The first Global Adult Tobacco Survey conducted in South Africa (GATS-SA) conducted by the South African Medical Research Council (SAMRC) in 2021 shows high levels of tobacco use (29.4%) and second-hand smoke exposure in South Africa. The research further shows strong public support for regulations, with nine out of 10 adults supporting a ban on smoking in indoor workplaces and public places.
Survey lead investigator and specialist scientist within the SAMRC’s Alcohol Tobacco and Other Drug Research Unit, Dr Catherine Egbe says a sick nation is a poor nation, and that communities want freedom from tobacco and the damage it causes to people’s health, the environment and the country’s economy.
“The Bill includes carefully designed measures to achieve this and we need it to be urgently passed into law so we can move towards a tobacco-free, healthy nation.”
Freedom from tobacco use also gives hungry communities the freedom to spend more money on food, rather than tobacco, says Sanele Zulu, convenor of SATFYF.
“Our young people need to make the right choices, but they also deserve better protection from the targeted marketing of tobacco and e-cigarette companies. The new Bill provides this protection.”
The Bill prohibits smoking and the use of e-cigarettes in enclosed public areas, such as restaurants, and will make certain outdoor public places 100% smoke-free too, ensuring South Africans are free from exposure to second-hand smoke. It will remove smoking areas on public conveyances and apply the 100% smoking ban to common areas of multi-unit residences. It further prohibits smoking and the use of electronic cigarettes in private dwellings used for commercial child care or education, and in cars carrying children under 18, rather than under 12 as is currently the case.
The Bill also introduces uniform plain packaging for all brands and pictorial warnings on all packages. Advertising of tobacco products, heated tobacco and electronic cigarettes at points of sale (tills) and the sale of cigarettes through vending machines will be prohibited.
Electronic nicotine and non-nicotine delivery systems will also be regulated.
“Through implementing the cost-effective, proven measures in the Bill, which apply to both tobacco products and e-cigarettes, we can help free our youth from addiction to nicotine,” Zulu states.
Lorraine Govender, national manager of health promotion for CANSA, says the new Bill will help free South Africa from the crippling impact of non-communicable diseases, including cancer.
“We have long campaigned for better measures that can free South Africa from the crippling impact of non-communicable diseases, which are currently responsible for the deaths of 50.9 percent of South Africans. Tobacco use is a major risk factor and is currently estimated to cost South Africa R42-billion per year in treating illnesses and loss of productivity.
“We must take action to free our economy from further strain and we look forward to stronger legislation that will better protect our rights to freedom and health.”