Tobacco ban remains rational Dlamini-Zuma —
Minister says in her affidavit stance is backed by medical literature
Co-operative governance and traditional affairs minister Nkosazana Dlamini-Zuma says additional medical literature has bolstered the government’s controversial cigarette ban decision, and renders the first legal challenge to its rationality “clearly unsustainable”.
Dlamini-Zuma states in an affidavit filed shortly after midnight yesterday, after initially facing the prospect of being pursued for contempt of court for missing the deadline to file by the close of business on Wednesday, that there is evidence that many smokers have quit as a result of the ban.
This means that the government’s decision to impose it remains rational, she said.
While acknowledging that the ban may have resulted in economic loss, she said this needed to be weighed against the health care costs associated with treating smokers — with or without Covid-19.
“It is therefore not the case that the state only incurs costs if tobacco sales are prohibited,” Dlamini-Zuma stated.
While stating that she never claimed that the medical literature she previously relied on to justify the cigarette ban was “absolutely conclusive”, the minister remains adamant that “the available evidence does indicate that smokers are at a heightened risk of adverse Covid-19 outcomes”.
“This, I submit, renders a prohibition of the sale of tobacco products a rational and necessary measure to protect the public.”
Dlamini-Zuma has also criticised the Free-Trade and Independent
Tobacco Association (Fita) for amending its original legal challenge to the level 4 cigarette ban to also include the ban imposed on tobacco sales under level 3.
She argues that this is “irregular” and amounts to Fita seeking to “review an entirely new decision” without the court having access to the new material that may have informed that decision.
“This causes prejudice to the respondents [President Cyril Ramaphosa and Dlamini-Zuma], as they are required to answer an entirely new review, on a few days’ notice, and without having been given the opportunity to put up the record and reasons for the decision to promulgate regulation 45.”
Dlamini-Zuma has, however, included much of the evidence she says informed the decision to extend the tobacco ban, when SA went into level 3.
According to the minister, that decision was informed by “additional medical literature” and “additional views were canvassed from the SA medical fraternity”.
She has stressed that SA’s Covid-19 epidemic “has not yet peaked”.
She said the lower levels of the lockdown would not necessarily translate to less strain on the health care system.
“Instead, it is likely that there will be a significant increase in demand for ICU [intensive care unit] beds and ventilators over the coming weeks and months.”
Dlamini-Zuma says the World Health Organisation (WHO) has confirmed — after she promulgated the cigarette ban for level 4 — that “smokers are more likely to develop severe disease with Covid-19, compared to non-smokers”.
She adds that the WHO has warned that tobacco is “also a major risk factor for non-communicable diseases like cardiovascular disease, cancer, respiratory disease and diabetes, which put people with these conditions at higher risk for developing severe illness when affected by Covid-19”.
The WHO has stressed that “there is currently insufficient information to confirm any link between tobacco or nicotine in the prevention of treatment Covid-19”.
Dlamini-Zuma says the cigarette ban has also been supported by “various organisations within the SA medical fraternity ”— including the National Council Against Smoking, the SA Thoracic Society, the College of Public Health Medicine and the Heart and Stroke Foundation of SA.
That support, contained in several letters, was also expressed after the minister promulgated the regulation extending the tobacco ban under level 4.
In her response to Fita, the minister also included affidavits from local medical experts, who confirm that “developing research” shows that smoking increases the risk of serious illness and death as a consequence of Covid-19 infection.
In court papers, the minister also lists her reasons for promulgating the regulation imposing the ban during level 4 of lockdown as including:
● “The use of tobacco products leads to respiratory diseases and ailments, both in smokers and those exposed to secondhand smoke. This is the case even without Covid-19.”
● “The emerging research shows that the severity of Covid-19 outcomes is greater in smokers than non-smokers. Smokers have higher ICU admission rates, higher need for ventilators and a higher mortality rate than non-smokers.”
● “The use of tobacco products also increases behavioural risks associated with Covid-19 transmission, as people share products, thereby sharing infected saliva, and are less likely to observe social distancing when doing so.”