Tobacco: a threat to South Africa’s development

When South Africa first implemented tobacco control legislation in 1993, it was seen as a world leader. And as a result the past two decades has seen smoking rates reduce from unacceptably high percentages in the mid thirties to 19% this year.

Today, in South Africa just over 7.2 million people – or roughly 19% of the population — light up a cigarette each day. And in fact, they don’t only light up one cigarette. On average most of them smoke eight more cigarettes in the same day. Three out of 10 are male. One is a female. This picture has not changed significantly in the last 10 years and has rather stagnated.

Unless the government, civil society and public should work together, this will not be reduced. Reducing tobacco use is critical because tobacco consumption hinders development. It increases health-care costs and decreases productivity. And there is evidence that tobacco consumption contributes to inequality in South Africa. Poor smokers tend to spend a higher proportion of their income on tobacco products than the richer people, implying a greater opportunity cost.

One example is found in data we collected through the 2016 Human Sciences Research Council’s Social Attitudes Survey. It shows that 2.3 million smokers live in households that receive child support grants. On average, each of these smokers spend about R300 a month on cigarettes.

Collectively they spend close to R700 million on cigarettes each month. Based on research that shows how child support grants support entire households, the money spent on cigarettes could therefore be from child support grants.

This is money that could be spent on children’s development and welfare. We know from the recent statistics released by the South African Demographic Health Survey that child stunting, which is sitting g at 27% is at its highest yet. Child stunting is an effect of under-nutrition, which speaks to poor socio-economic and health condition. But instead of spending it on children, it goes up in smoke.

On the global agenda

South Africa is not alone in its efforts to reduce tobacco use. The harm of tobacco use has become a global priority and is now part of the development agenda that make up the sustainable development goals.

In total there are 17 goals with 169 targets. Tobacco control is recognised under goal three alongside TB, HIV, maternal mortality and child health with the target of strengthening the implementation of the World Health Organisation’s Framework Convention on Tobacco Control (the FCTC).

The convention is the first global treaty which guides countries on how to tackle tobacco use. IT specifies a comprehensive set of evidence-based, cost-effective, population-wide steps to tackle demand for and supply of tobacco. This includes protecting people from exposure to smoke, creating smoke free workplaces and bans on smoking in public places, and increasing the price of tobacco through taxation and cigarettes sold in plain packaging.

There’s good reason for this.

Strengthening tobacco control in turn reduces tobacco consumption. Global estimates show that in 2012 about 38 million deaths – or 65% of the deaths worldwide – were as a result of non –communicable diseases.

Closer to home, in South Africa, this figure sits at about 44 000 death from tobacco related illness each year. And there’s an increase in the number of people who have been diagnosed with high blood pressure or classified as overweight or obesity. The latest findings from South Africa’s Health and Demographic Survey show that close to 70% of South African women and a little more than 30% of South African men are now obese. In addition, one in five South African women suffer from severe obesity. In addition, close to half of the women in the country just over 40% of men have high blood pressure.

The South African National Department of Health is in the process of finalising amendments to the current tobacco control act. Its amendment will have four main goals. It will force manufacturers to remove the branding on their cigarette packs and include graphic warnings on the front and back of the back. Secondly, it will ensure that the use of electronic devices, such as e-cigarettes, are regulated in the country. The third goal is to introduce a 100% smoke-free policy in indoor public areas, and lastly, it will ban all tobacco product advertising at point of sales.

These points are critical for South Africa to reduce its smoking prevalence and to meet the 2030 sustainable development goals, which it has committed to meet.

But unless this act is finalised, South Africa will struggle to reduce tobacco use. And the innovative products from the tobacco industry which are not covered in tobacco control legislation will continue to flourish and smoking rates will stay the same.

• Professor Lekan Ayo-Yusuf is the director of the Africa Centre for Tobacco Industry Monitoring and Policy Research based at Sefako Makgatho Health Sciences University.