by Dr Sharon Nyatsanza, Deputy Director, National Council Against Smoking

This year marks the 20th anniversary of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) coming into force. This critical milestone in global health progress has become one of the most rapidly and widely embraced treaties in United Nations history. Since its adoption in 2005, the FCTC has united countries in implementing policies to combat the tobacco epidemic, focusing on measures like tobacco advertising bans, taxation, and public smoking restrictions.

In 2003, South Africa was one of the first signatories to this Treaty.   We now stand on the cusp of passing tobacco control legislation that aligns with our FCTC commitments. 

South Africa has made significant strides in implementing the FCTC. Progress thus far includes using tobacco taxation as a tool to discourage smoking and promote public health. In recent years, the Department of Finance introduced excise taxes on Heated Tobacco Products and electronic cigarettes (e- cigarettes) respectively. Consistent increases in tobacco excise duties coupled with other strong tobacco control measures have led to a noticeable decline in smoking prevalence over the years. However, much more work remains, hence the Tobacco Products and Electronic Nicotine Delivery Systems Control Bill, which will repeal the existing Tobacco Products Control Act of 1993 as amended. When the Finance Minister delivers the budget speech on 12 March, there’s a critical opportunity to put public health first by raising tobacco taxes above inflation to make a real impact.

Sustained efforts are vital to tackling emerging challenges such as the rise of new tobacco products and persistent industry interference, which threaten progress in protecting global health. By combining robust taxation policies with comprehensive tobacco control strategies, the government continues to address both the economic and public health impacts of tobacco use.

South Africa and the FCTC 

South Africa had already implemented tobacco control legislation by the time the global community adopted the FCTC. The Tobacco Products Control Act passed in 1993, was significantly reinforced after the establishment of the democratic government in 1994.

Starting that year, South Africa introduced a comprehensive array of measures to reduce the harmful effects of tobacco use on public health. These included: 

•  banning tobacco advertising,
•  classifying nicotine as an addictive drug, 
• restricting smoking in public spaces, and 
• raising excise taxes on cigarettes. 

Alongside these measures, individual-focused initiatives were also introduced, such as incorporating health education into the national school curriculum to improve health literacy and emphasise nicotine’s addictive properties.

South Africa’s leadership and political commitment to protecting the population from the devastating effects of tobacco use earned it recognition from the international tobacco control community. As such, in 2001, South Africa received a Luther Terry award for excellence and leadership in tobacco control. 

South Africa conducted the Global Youth Tobacco Surveys (GYTSs) in 1999, 2002, 2008, and 2011 showing the positive impact of tobacco control policies on youth smoking over a 12-year period.

Data for the same period based on market surveys, such as the All Media and Products Survey shows sustained reductions in South African cigarette consumption amongst adults. At its peak in 1991, aggregate cigarette consumption decreased by 39% between 1991 and 2004. Per capita consumption decreased by 54% from 1999 to 2011. 

In 2021, South Africa conducted the Global Adult Tobacco Survey South Africa for the first time, providing critical insights into tobacco prevalence among adults aged 15 years and older. It reported that 29.4% of South African adults used tobacco products, with cigarette smoking being the most common form at 25.8%. This remains the highest of all African countries surveyed. 

While exposure to second-hand smoke in workplaces and public places has significantly reduced thanks to public smoking restrictions implemented in prior decades, exposure levels are still high. These findings reinforce the importance of ongoing policy interventions to further reduce tobacco consumption and protect public health in South Africa.

New Tobacco Control legislation aligns with FCTC 

The key measures outlined in the Tobacco Products and Electronic Delivery Systems Control Bill, align with the requirements of the FCTC. 

Firstly, the Bill incorporates stricter advertising and promotion restrictions, fulfilling Article 13 of the FCTC, which mandates comprehensive bans on tobacco advertising, promotion, and sponsorship.

Secondly, it imposes enhanced packaging and labelling regulations, including prominent health warnings, aligning with Article 11’s demand for the effective communication of health risks.

Additionally, the Bill strengthens public smoking bans, complying with Article 8, which emphasises protecting citizens from exposure to tobacco smoke.

Finally, it extends regulations to include electronic delivery systems, addressing market evolution and ensuring comprehensive compliance with FCTC recommendations. These measures collectively reinforce South Africa’s commitment to reducing tobacco use and safeguarding public health through evidence-based, global strategies.

In the seven years since the Bill was first introduced, a partnership of South Africa’s leading health, research and community organisations united under the banner of Protect our Next, has mobilised South Africans to advocate for stronger tobacco control, calling for government to pass the Bill and fulfil our FCTC commitments. Our partnership aims to build a united front against the might of the tobacco industry, conveying a clear message that the people of South Africa say yes to this bill. It’s going to save lives and reduce the immense burden tobacco-related diseases place on public health.

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Protect Our Next is a partnership including the South African Medical Research Council (SAMRC), the National Council Against Smoking (NCAS), the Cancer Association of South Africa (CANSA), the South African Tobacco Free Youth Forum (SATFYF), and the Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM).  

The views and opinions expressed in this opinion piece are those of the author, who is not employed by Health-e News. Health-e News is committed to presenting diverse perspectives to enrich public discourse on health-related issues.