Time to join the global move­ment to stub out the to­bacco epi­demic

Bill tar­gets not smok­ers but an in­dus­try tap­ping new forms of ad­dic­tion

Sunday Times - - Opinion - By PA­TRI­CIA LAMBERT Lambert, an ad­vo­cate, is the for­mer spe­cial ad­viser to the US health min­istry and the di­rec­tor of the In­ter­na­tional Le­gal Con­sor­tium, part of the Cam­paign for To­bacco-Free Kids, in Wash­ing­ton, D.C.

● The new Con­trol of To­bacco Prod­ucts and Elec­tronic De­liv­ery Sys­tems Bill is all about reg­u­lat­ing a vo­ra­cious in­dus­try to pro­tect young peo­ple, work­ers and non­smok­ers from the deadly harm of to­bacco and nico­tine prod­ucts.

Any claims that the bill is tar­get­ing the choices of smok­ers and e-cig­a­rette users miss the point.

The to­bacco in­dus­try is los­ing ground in high­in­come na­tions, with smok­ing rates and cig­a­rette sales fall­ing. To­bacco com­pa­nies have shifted their sights for fu­ture prof­its to lower- and mid­dlein­come coun­tries and see African coun­tries as es­pe­cially ripe for ex­ploita­tion.

The World Health Or­gan­i­sa­tion (WHO) has said: “Africa is poised to ex­pe­ri­ence a to­bacco epi­demic. The ex­is­tence of an at­trac­tive, un­der­tapped mar­ket and the tar­geted tac­tics of the to­bacco in­dus­try have cre­ated a ‘per­fect storm’.”

The best way to pro­tect peo­ple, es­pe­cially young peo­ple, is through strin­gent reg­u­la­tion — the kind in the pro­posed new law.

Since the in­tro­duc­tion of pre­vi­ous to­bacco con­trol laws, smok­ing rates have fallen. When SA’s first to­bacco con­trol law was in­tro­duced in 1993, 32% of adults smoked. Thanks to pro­gres­sive amend­ments to the law that rate dropped to just over 18% by 2012. But now rates are lev­el­ling off and smok­ing still claims 42,000 South African lives ev­ery year.

The hu­man and eco­nomic costs are sig­nif­i­cant and en­tirely avoid­able. Ur­gent ac­tion is needed to bring smok­ing rates down fur­ther and to pre­vent the up­take of new to­bacco and nico­tine prod­ucts, all of which are harm­ful to health to some de­gree.

The bill treats elec­tronic nico­tine de­liv­ery sys­tems (e-cig­a­rettes or va­p­ing prod­ucts) and the new heated to­bacco prod­ucts for the most part in the same way as tra­di­tional to­bacco prod­ucts in or­der to pre­vent multi­na­tional com­pa­nies from at­tract­ing young peo­ple and non­smok­ers to a new gen­er­a­tion of to­bacco and nico­tine prod­ucts.

SA was once a leader in to­bacco con­trol, but that is no longer the case and that means peo­ple in SA are at risk. Uganda, Mau­ri­tius, Kenya, Burk­ina

Faso, Bu­rundi, Chad, Sey­chelles, Mada­gas­car and Gam­bia and more than 50 other coun­tries have com­pre­hen­sive smoke-free laws, with no ex­cep­tions for the smok­ing ar­eas al­lowed in SA. Stud­ies show that no safe level of sec­ond-hand smoke ex­po­sure ex­ists and even low lev­els of to­bacco smoke can cause se­ri­ous health risks.

Sim­i­larly, some sci­en­tific stud­ies indi­cate that e-cig­a­rettes, which con­tain nico­tine and other tox­ins, can also pose risks to non-users. The health of work­ers, non­smok­ers and young peo­ple must be prop­erly pro­tected.

It has also been proved, beyond any doubt, that pro­hibit­ing ad­ver­tis­ing of to­bacco prod­ucts is ef­fec­tive, sen­si­ble and nec­es­sary to de­crease use. With TV, bill­boards and print ad­ver­tise­ments no longer avail­able to them, to­bacco com­pa­nies have to rely on prod­uct pack­ag­ing to pro­mote sales. Pre­vi­ously se­cret in­ter­nal in­dus­try doc­u­ments re­veal a Philip Mor­ris ex­ec­u­tive say­ing: “In the ab­sence of any other mar­ket­ing mes­sages, our pack­ag­ing is the sole com­mu­ni­ca­tor of our brand essence. Put an­other way — when you don’t have any­thing else, our pack­ag­ing is our mar­ket­ing.”

For this rea­son the bill in­tro­duces plain pack­ag­ing and graphic health warn­ings for to­bacco and nico­tine prod­ucts. Plain pack­ag­ing in­creases the vis­ual im­pact of the graphic health warn­ings, help­ing to reach com­mu­ni­ties where lit­er­acy rates are low.

The bill also en­sures the pro­tec­tion of young peo­ple and non­smok­ers from mis­lead­ing to­bacco and e-cig­a­rette ad­verts via dis­plays at the point of sale. Just look to the US to see what hap­pens when e-cig­a­rettes are not reg­u­lated prop­erly.

Juul is an e-cig­a­rette that has cap­tured more than 70% of the US mar­ket in only three years. It looks like a sleek USB flash drive, can be held in a closed hand, comes in at­trac­tive flavours like mango and mint and de­liv­ers nico­tine more quickly, more ef­fec­tively and at higher doses than other e-cig­a­rettes. Rather than help­ing smok­ers quit, Juul and such prod­ucts are mak­ing ad­dicts of a new gen­er­a­tion. Use among school­child­ren in the US is rock­et­ing. The com­pany plans to ex­pand, rais­ing $1.2bn (R17.6bn) to en­ter new, global mar­kets. Thanks to the new bill, SA has the op­por­tu­nity to get ahead of these new prod­ucts and pro­tect its youth from harm­ful ad­dic­tions.

To­bacco com­pa­nies, and the front groups they use, are mount­ing ag­gres­sive cam­paigns to op­pose, de­lay or di­lute the new law. They claim the bill will in­crease the il­licit trade in to­bacco and lead to job losses — both flawed ar­gu­ments.

Ev­ery in­de­pen­dent study shows that if rates of il­licit to­bacco use are high, the only way to re­duce them is through strong polic­ing and law en­force­ment. To­bacco con­trol mea­sures such as smoke-free places, graphic warn­ing la­bels and pro­hi­bi­tions on ad­ver­tis­ing have no im­pact on the sup­ply of or de­mand for il­licit to­bacco. Re­ports from the World Bank and the WHO show that for the vast ma­jor­ity of coun­tries, im­ple­ment­ing to­bacco-con­trol mea­sures is ben­e­fi­cial for the econ­omy and does not lead to net job losses.

We should be clear. This bill is not about stop­ping peo­ple who want to smoke or use e-cig­a­rettes from do­ing so. This bill is about pro­tect­ing work­ers, young peo­ple and oth­ers from sec­ond-hand smoke and nico­tine vapour, which are harm­ful to health. It is about ef­fec­tively in­form­ing con­sumers about the dan­gers of to­bacco and nico­tine use. And it is about stop­ping the to­bacco and e-cig­a­rette in­dus­tries from pro­mot­ing ad­dic­tive and deadly prod­ucts.

Through the bill, the govern­ment is pri­ori­tis­ing pub­lic health and pro­tect­ing peo­ple, es­pe­cially work­ers and young peo­ple. It is also ful­fill­ing its obli­ga­tions in terms of the WHO frame­work con­ven­tion on to­bacco con­trol — one of the most widely rat­i­fied UN treaties, with 181 par­ties in­clud­ing SA. These mea­sures are proven to re­duce to­bacco and nico­tine use and save lives, which is why so many other coun­tries around the world have in­tro­duced them. It’s time for SA to join the global move­ment to end the to­bacco epi­demic and nico­tine ad­dic­tion.

Pic­ture: Bloomberg via Getty Im­ages/Ja­son Alden

Smok­ing claims 42,000 South African lives ev­ery year.

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