A bill to strengthen tobacco control in South Africa is slowly making progress. Parliament’s Health Committee voted in favour of the Tobacco Products and Electronic Delivery Systems Control Bill earlier this year, allowing it to move forward for a clause by clause review. The proposed law which was meant to prohibit point-of-sale product displays, make public areas fully smoke free and regulate e-cigarettes has reportedly been watered down.  

This undermines an important public health intervention that can save lives, and affirms Big Tobacco as an industry with an insatiable drive for profit and addiction.

Smoking-related illnesses cost the country just over R49 Billion annually through both the direct expenses of medical care and the indirect costs brought on by disease and early mortality. But the tobacco industry, which spent decades concealing findings that their products were killing consumers, mobilised to protect their profits which resulted in the bill being stalled for years. This delay has protected a small circle of elite, self-serving interests rather than the public.

How industry lobbying delays regulation

Big industries have a long history of attempting to block or postpone regulation. For example, despite evidence that taxing carbon emissions is a potent lever for shifting behaviour, big businesses and their proxies delayed South Africa’s Carbon Tax and continue to lobby for its suspension. And misusing data to oppose the Health Promotion Levy, more commonly referred to as the Sugar Tax which despite the failure to increase it, has lowered the consumption of sugary beverages. 

These tactics form part of a foundational corporate playbook pioneered by Big Tobacco that aims to “delay, dilute, and obfuscate” regulatory efforts. This requires a range of actors, including front groups, business proxies, and/or third-party lobbyists. One such example is the Thompson Trust, which describes itself as “empower[ing] government agencies, NGOs, and multinational corporations to achieve their legislative goals”. 

According to a presentation made by the Trust to Business Unity South Africa in 2024, it successfully acted for its client to ensure “…that the process [was] delayed in order for the Tobacco Products and Electronic Delivery Systems Control bill to lapse when Parliament rose for the 2019 Elections”. The client in question is the now disbanded Tobacco Institute of South Africa (TISA), which reportedly relied on questionable information and social media influencers and media to shape public opinion on the bill. 

On behalf of its other client Philip Morris, the Thompson Trust also boasts among its successes, “harm reduction/healthy lifestyle text was adopted at ANC Elective Conference December 2022”. This happened despite evidence that a decline in smoking prevalence resulted in the industry maintaining its profits by investing in the diversification of its portfolio, alongside co-opting harm reduction narratives used to market these products. Philip Morris International more specifically was found to “develop e-cigarette technology to complement, not compete with, conventional cigarettes and evade tobacco control regulations” when smoking became less socially acceptable in the ‘90s. More recently, leaked documents suggest that the tobacco giant “continues to exploit science for profit”.

While all sectors of society should be able to engage policymakers, and in fact should be encouraged to, the misuse of lobbying that enables economic interests to take center stage at the expense of the public interest is concerning. 

Questions over conflicts of interest

It is not just big business and their proxies that pose a risk to strengthening tobacco control. One of the loudest opponents of the current draft law has been Action SA member of parliament, Dr. Kgosi Letlape, who currently serves on the Portfolio Committee considering the bill. 

Dr. Letlape has a long history of tobacco industry linked relationships. For 10 years, Dr. Letlape has been a speaker at the annual tobacco-industry-funded Global Tobacco Nicotine Forum and was in 2021 appointed Commissioner for a commission funded by the Philip Morris sponsored ‘Foundation for a Smoke-Free World’. 

Dr. Letlape co-founded and currently presides over the African Harm Reduction Alliance, an alliance made possible by Health Diplomats, a consultancy working with British American Tobacco subsidiary, Nicoventures. Parliament’s Chief Legal Adviser provided the committee with a legal opinion on Dr. Letlape’s conflict of interest. The committee ultimately deemed the matter to be minor, despite our organisation amandla.mobi’s attempts to convey that it should not be considered outside of his other professional collaborations with individuals and entities that have relationships with tobacco companies.

These publicly documented relationships raise legitimate questions about professional independence and the management of actual or apparent conflicts of interest. Especially as Dr. Letlape has repeatedly publicly shared tobacco industry talking points like repeating questionable claims about e-cigarettes, despite evidence that such claims are used to obscure the industry’s role in promoting addictive products.

Of course, being a Member of Parliament does not preclude Dr. Letlape from having his own personal views. But he is more than a private person. He is a registered ophthalmologist, a former President of the Health Professions Council of South Africa, and on Parliament’s Portfolio Committee on Health. Because of his background, people are likely to see his statements as having extra medical and ethical weight. This sets his contributions apart from those of other Members of Parliament and increases the public’s expectations for accuracy, transparency, and independence. 

When medical practitioners rely on their professional qualifications in ways that could be perceived as influencing public policy, the public is entitled to expect that legislation and scientific evidence are represented fairly and accurately, and that any actual or apparent conflicts of interest are transparently managed. Especially when it involves an industry that has a long history of using doctors’ images to portray their products as safe. 

Putting public health before private interests

These examples of industry interference and conflict of interest reveal the ways private interests can quietly shape public policy to benefit their own profitability.

Regulating this is essential and should include transparency in government dealings with the private sector. This, alongside rigorous scrutiny of claims, given big business’s long history of using hidden or false evidence, as well as emphasising commercially advantageous fragments of evidence rather than the parts that go against its interest. And most importantly, addressing the public consultation gaps that enable those vast resources to control influence, as well as manipulate public opinion.

Unless this happens, the public interest will continue to be sacrificed to the ambitions of those whose only interest is profit, no matter the cost.