South Africa’s Health Minister Aaron Motsoaledi has published a new tobacco control bill which, if passed into law, will tighten the grip on how cigarettes and other tobacco products are sold, marketed and regulated in the country. Health and Medicine Editor Candice Bailey asked Catherine Egbe about what it means for tobacco control.
What’s significant about South Africa’s pending tobacco control legislation?
There are five key areas of tobacco control that the new bill seeks to address:
a smoke-free policy,
plain or standardised cigarette packaging,
points of sale marketing, and
removing cigarette vending machines.
Some are addressed in South Africa’s current tobacco control law. But the country still doesn’t fully comply with the standards set by the World Health Organisation’s Framework Convention on Tobacco Control. South Africa signed the convention in 2005.
Smoke-free public places is one example. The current law bans smoking in public places but allows for designated smoking areas in places like bars, taverns and restaurants provided that they do not take up more than 25% of the venue.
The WHO’s convention calls for 100% smoke-free public places to protect non-smokers fully.
In line with this, the new bill calls for a 100% ban on smoking in public places. It will also ban the advertising of cigarettes and other products at tills or selling them in vending machines.
The health warnings on cigarette boxes and other tobacco product packages is another example. The current law allows for text health warning on 20% of the package. But the convention calls for a minimum of 30% and encourages countries to have the more effective plain or standardised packaging with graphic and textual warnings in place.
So the new law mandates standardised packaging with graphic health warnings to make tobacco packages less attractive to new smokers and to discourage old smokers from continuing to smoke.
The bill is also significant because it attempts to regulate e-cigarettes for the first time in South Africa. To date e-cigarettes have been freely marketed and sold anywhere to anyone, including children.
Is there evidence that the planned interventions will work?
There’s a great deal of evidence from the rest of the world.
Let’s start with smoke-free policies. In countries like South Korea and the US where they are in place, research shows that they led to an overall improvement in health, particularly children’s health.
E-cigarettes are still a relatively new factor. But research is already casting doubts on various claims made about them. First introduced in China in 2004 they were initially mooted as an aid to quit smoking. But research shows that they in fact encourage young people to start smoking cigarettes. And 18 studies have shown that e-cigarettes do not reduce quit rates. Instead, the latest research shows that they do the reverse – they reduce the quit rates of smokers intending to quit by about 66%.
The advertising, promotion and sponsorship of e-cigarettes are regulated or prohibited in 62 countries.
Why is it important to have a legislation like this?
Tobacco smoking is the single most preventable cause of death in the world. Smoking also worsens TB and HIV treatment outcomes. Yet 37% of South African men and 6.8% of South African women aged 15 years and older use tobacco .
Before the WHO Framework Convention on Tobacco Control, South Africa was a leader in tobacco control in Africa and across the world because of strong tobacco control legislation it had put in place. But the laws weren’t updated according to current WHO’s standards and the country now lags behind some other African countries.
The new legislation will place South Africa on the right path. Apart from saving millions of lives, it will ensure that South Africa fulfils its obligation as a party to the WHO convention.
There are several benefits to having strong legislation.
Firstly, it will protect millions of South Africans who don’t smoke but take in secondhand smoke from those who do. They face the same health risks as active smokers.
Secondly, it will also help encourage people to quit and live healthier lives and discourage young people from starting.
And thirdly, the tobacco industry views young people as replacement smokers. Strong legislation will prevent young people from being manipulated by the tobacco industry.
What are the next steps?
Once the bill becomes law, the health minister will have to draw up several regulations to guide its implementation. These will ensure that the law is interpreted correctly and not manipulated by the tobacco industry and that the potential gains of the legislation are not watered down.
Zimbabwe will hold a general election on July 30, President Emmerson Mnangagwa said, a vote he has pledged will be free and fair with international monitoring after the ouster of 94-year-old strongman Robert Mugabe.
Mnangagwa, who took power after the November military coup against Mugabe, counts on the election to bolster his legitimacy as he pursues a promised break with Mugabe’s repressive policies while urging foreign investors to return to Zimbabwe. Missing from the July ballot for the first time in 20 years will be Zimbabwe’s foremost political gladiators, Mugabe and Morgan Tsvangirai, the longtime opposition Movement for Democratic Change (MDC) leader who died of cancer in February.
Mnangagwa has invited the Commonwealth to monitor voting in Zimbabwe for the first time since 2002 when Harare was suspended from the group over accusations of rigged elections. He has applied for Zimbabwe to rejoin the Commonwealth. Should the election be certified by international monitors, it could be a key step to a resumption of financial aid by foreign lenders for the first time in two decades.
The vote is being cast as a fight between the old guard of Zimbabwe’s 1970s independence war and a younger generation. Mnangagwa’s main challenger is 40-year-old Nelson Chamisa from the MDC, who has energised the party, drawing huge crowds at rallies in some of the ruling ZANU-PF party’s rural redoubts.
Sixty percent of the 5.4 million voters on the new register are under 50 years old, according to official data. Separately, the Constitutional Court dismissed an application by Zimbabweans living abroad to be allowed to vote. The court did not immediately give a reason.
In a brief statement in an official government gazette, Mnangagwa said that he had fixed July 30 “as the day of the election of the president, the election of members of the national assembly and election of councillors.”
Prospective candidates will be registered on June 14. A presidential run-off vote is set for Sept. 8 if no candidate gets the 50-plus-one percent mark required to win.
For the 75-year-old Mnangagwa, victory would accord him democratic legitimacy after taking power following the coup. Nicknamed “Crocodile” for his secretive and insular demeanour, Mnangagwa goes into the election with the advantage of incumbency, allowing him access to state resources for his campaign.
Crucially, Mnangagwa enjoys the backing of the army, which analysts say remains averse to a leader lacking a pedigree from the independence war against Britain. “Though the election looks like it will go to the wire, the greater likelihood, based on cold-blooded analysis, is that experience, depth and state incumbency will triumph over youthfulness,” said Eldred Masunungure, a professor of political science at the University of Zimbabwe.
Critics say Mnangagwa was Mugabe’s most loyal acolyte and blame him for a government crackdown on rebels loyal to political rival Joshua Nkomo in the mid-1980s that rights groups say killed 20,000 civilians.
Mnangagwa has denied the charges and says political freedoms have improved under his short tenure and that he is repairing frosty relations with the West.