Dr Derek Yach, an international wellness expert and newly-appointed senior vice president of the Vitality Group in the United States. During a recent visit to South Africa, Yach – who has a lifetime’€™s experience in public health and has worked for opposing stakeholders such as the World Health Organisation and soft drink giant, PepsiCo ‘€“ spoke to the media about wellness and public health trends around the world and what South Africa can expect for the future.

Yach praised ANC stalwarts Nelson Mandela, Trevor Manuel, Dr Nkosasana Dlamini-Zuma and even the controversial Dr Manto Tshabalala-Msimang for their progressive stance on tobacco control, even under threat from external pressures.

These politicians implemented measures that cut the rate of smoking, and smoking uptake at a time when smoking trends where steadily climbing upwards.

‘€œRaising tax is the single most powerful tool of driving down the rate of smoking, and that was the first thing Trevor Manuel did ‘€“ he increased the price of cigarettes to more than inflation in every budget,’€ said Yach.

Other measures included Dlamini-Zuma’€™s ban on tobacco advertising, and laws requiring cigarettes to be sold in packs, and Tshabalala-Msimang’€™s implementation of smoking restrictions in public places.

‘€œTobacco is embedded in society, and they wouldn’€™t have had much success trying to introduce total bans, or other draconian measures,’€ said Yach. ‘€œThey were able to manipulate people’€™s smoking behaviour [and health outcomes] without the consumer even being aware of it.’€

According to Yach, although trends show an overall decrease in smoking in South Africa, lately there has been a slight increase in tobacco use among young women. ‘€œA couple of years ago, smoking among men and boys used to be a lot higher than women and girls in this country. Now the gap is getting a lot narrower, and we are waiting for it to become equal,’€ he said.

‘€œYou can see from the data that there is a continuous glamorisation of smoking in the minds of people, particularly teens and young women. They think it makes them more desirable, and it is part of their inspirational goals,’€ argued Yach. ‘€œWomen’€™s movement should be tackling this issue and show that smoking is not a sign of individuality or independence.’€

The next logical step then in the country’€™s struggle against tobacco is to eliminate the marketing and branding that attracts young people, Yach suggested.      

‘€œAlthough all advertising on billboards, radio, television, etc. are gone, there are still two outlets for marketing: point-of-sale and branding on packaging,’€ he said. In many parts of the world there are bans on point-of-sale marketing and tobacco products are supposed to be kept behind shop counters and shouldn’€™t even be visible to consumers. ‘€œBut it will be very difficult in the South African setting given the sales in the informal sector.’€

Minister of Health, Dr Aaron Motsoaledi, is currently reviewing new legislation that will limit the size and number of tobacco product displays at retailers. The law is expected to come into effect before the end of the year.  

Although plain packaging – which will require all tobacco products to be sold in drab brown packaging with graphic pictures of smoking-related disease and the brand name displayed in a small, plain font ‘€“ is not yet in the pipeline for South Africa, when congratulating Australia for being the first country to implement the measure Motsoaledi said it is on the cards for this country.

The future for tobacco in this country, as well as other areas in the world, Yach believes lies in nicotine-replacement products. ‘€œWe need to understand that many smokers will need to be given a greater push to get off the habit, and will require nicotine-replacement therapy, and help to stop smoking should be available free of charge.’€

According to Yach, electorinic cigarettes, or e-cigarettes could possibly be the next big thing. ‘€œIn the US it developed from being non-existent to a half-a-billion dollar industry in three or four years, and it is projected to be a multi-billion dollar industry in the next four to five years,’€ he said.