The World Health Organisation’s message for 2018 coincides with its range of global initiatives and opportunities aimed at addressing the tobacco epidemic and its impact on public health.
This year’s campaign highlights the links between the use of tobacco products and heart and other cardiovascular diseases.
Aware of the risks associated with each cigarette he lit, 29-year-old Tembisa resident Mhlengi* quit smoking four months ago.
“There are days that are tough, there are days that are bearable. For me to stop smoking I have to be isolated from anything that will tempt me to smoke,” he said.
Mhlengi started smoking 12 years ago, when he was 17.
“It started out of boredom after my Grade 11 end-of-year exams. My friends and I had nothing productive to do between then and the December/January holidays, so we decided to smoke,” he recalled.
“I just woke up one day, a Saturday and I said: ‘F*** it’. It was for no particular reason. I had been meaning to stop,” he added, saying he had always been aware of the dangers.
“I am in the process of quitting the filthy habit and have not had a smoke since January 25 this year. I say I am ‘in the process of quitting” because, according to an adage, smokers never quit; they take a break’. But after more than 12 years of a hazardous habit, it was time I threw out my last butt.”
A University of Cape Town study has found that there was a decline in excise tax revenue from tobacco products. This, the study found, indicated a large increase in the illicit cigarette market.
Cigarettes acquired via the illegal market are cheaper, making it easier for people to start smoking, consume more, and not quit the habit as easily.
Mhlengi said that when he first started smoking he had about four cigarettes a day, and at his peak, five years before he quit, he smoked 10 a day. He was spending about R300 a month.
The Economics of Tobacco Control Project (ETCP) at UCT, headed by Professor Corné van Walbeek, tracks tax data to monitor cigarette sales and consumption in South Africa.
The ETCP found illicit trade in cigarettes was growing in the country, and those cigarettes were being sold in our poorest communities.
Surveys in informal settlements indicate that the illicit market is thriving. In many places, cigarettes sell at 50 cents a stick or R10 a pack. As the excise tax per pack is R15.52, it is clear that the excise tax has not been paid, pointing to the prevalence of an illegal cigarette market in informal settlements.
While the tobacco industry argues that the increase in the illicit market is driven by an increase in the excise tax, Van Walbeek strongly contests this.
He argues that the emergence of the illicit cigarette market is directly related to the inflated retail prices charged by the multinational companies. For more than 15 years, between the early-1990s and 2010, British American Tobacco was able to use its near-monopoly to sell cigarettes at increasingly higher retail prices and make massive profits, despite sizeable increases in the excise tax.
This created an incentive for competitors to enter the market and undercut its prices. Since around 2010 these new entrants were able to get in at the lower end of the market and take a substantial share of business away from the multinationals.
The result is a very fragmented and near-chaotic market, as well as increased health risks for some of South Africa’s most vulnerable citizens.
Krivani Moodley said she started smoking in 2009 but was in the process of quitting. She was substituting the habit with the perceived to be safer e-cigarette (vaping) option, smoking cigarettes only on weekends at social gatherings.
Asked why she had cut down on cigarettes, she said: “I didn’t like how I smelt. I used to smell, my hair used to smell, the car used to smell.”
She said she had started the habit as a “stupid social experiment” she regretted.
“I think there’s nicotine but there’s no tar (in vaping). With vaping you choose how much nicotine you take. I feel better, now I can do physical stuff. And I feel my skin and nerves are better,” she said.
Peter Ucko from the Tobacco Alcohol and Gambling Advisory, Advocacy and Action Group (TAG) isn't convinced.
“E-cigarettes are bad. There is a lot of talk of them being safer than regular cigarettes. Maybe they are, but they are not safe. That’s the bottom line. Some people say they are less harmful. Maybe, but they are not harmless. They are harmful.
“The big problem for me is that Howard College in London, together with Cancer Research UK, did some research on young people experimenting on e-cigarettes, and found they do it because of the exotic flavours and the wonderful-sounding names.
“They then get addicted to nicotine. The study found those children and young people who started with e-cigarettes are 12 times more likely to continue smoking regular cigarettes. I think if we should at least restrict them,” he said.
He added his organisation would continue to advocate for smoke-free public spaces.
“Smoking breaks hearts. It causes heart diseases, but it does more than that - when a smoker dies, a family lose a breadwinner, children lose a father. In 1989, the first town to officially ban smoking in its buildings was Edenvale.
“That was a long time ago. I was the mayor before that and I had started a process that only finished in 1989, that said no smoking in public buildings,” he said.
This year, he said, TAG was challenging all towns and cities not to wait for laws to change, but immediately to go smoke-free.
“The mayor of Tshwane recently announced that his city was going smoke-free. We have challenged him to do it quickly,” Ucko said. “There’s a meeting of mayors from cities in Africa next month. We have challenged him, and he agrees, to take the message to all African mayors.”
* Not his real name.