A life gone up in smoke

Tobacco is the only legally available product that kills people when it is used entirely as intended. According to the World Health Organisation (WHO), somebody dies from tobacco-related causes every six seconds.

The Cancer Association of South Africa (Cansa) says there are seven million smokers in South Africa and more than one billion worldwide, and in poorer countries smoking is on the rise, although it is decreasing in high-income societies.

South Africa has led the way with tobacco control in Africa. In 1999 the government banned all tobacco advertising and also prohibited smoking in public places.
But, according to the South African Medical Research Council, it still causes 44 400 deaths every year.

Tobacco has had a devastating effect on the life of Johannesburg-based journalist Samantha Perry. She started smoking when she was just 13 and continued for another 19 years. At one point she was smoking 40 cigarettes a day. And then she quit.

“My father was a heavy smoker and he was diagnosed with emphysema,” she says. “He was admitted to hospital with a collapsed lung.” Six weeks later he was dead. Not long after, another of Perry’s close relatives died from the illness. Emphysema begins with shortness of breath. Eventually the disease destroys the tissues that support the physical shape and function of the lungs.

The death of her father from tobacco-related causes was a “big deterrent” for Perry and she decided to stop smoking immediately. She knew it would not be easy—and it was not. “The first three days are the worst. It’s physically and emotionally tough to kick the habit,” she says.

World No Tobacco Day, which is commemorated annually on May 31, aims to raise awareness about the ill effects of smoking and tobacco consumption. This year’s theme was the WHO Framework Convention on Tobacco Control, an attempt to reverse horrifying statistics: 5.4-­million deaths a year from tobacco, with the death rate ­estimated to double in the next two decades.

Enforced in 2005, the convention has been ratified by more than 170 of the WHO’s 195 member states, making it one of the most ­rapidly embraced international ­treaties of all time.

Tobacco accounts for one in 10 adult deaths worldwide. Department of health spokesperson Fidel Hadebe says there has been a decrease in tobacco use in South Africa, but there is still much cause for concern.

“If you have low-income groups taking the little money they have to buy cigarettes, it can only contribute towards poverty. It’s a social problem that we find very worrying,” he said.

“Our approach is that of primary healthcare, getting schools to participate in our anti-tobacco programmes.” The government has also targeted existing smokers, ensuring that cigarette packs contain health warnings and information about how to stop smoking.

Now it plans to follow the example of countries such as Thailand, where cigarette packs are embellished with “shock” photographs showing the effects of diseased lungs and mouth cancer.

According to the Medical Research Council, R2 is spent on treating illnesses related to tobacco use for every R1 collected in cigarette taxes. It also points out that tobacco is not only found in cigarettes: water pipe or “hookah” smokers are also at risk.

A Cansa fact sheet says that hookah smoking is not harmless because “the water in water pipes does not ‘clean’ the chemicals but carries them into your lungs.” This makes the increasingly popular hookah “even more addictive and dangerous than regular cigarettes”.

Meanwhile, anti-tobacco legislation has had some positive results. Following the 1993 Tobacco Products Control Act, the number of packs of cigarettes sold in South Africa fell from 1.7-billion in 1995 to 1.2-billion in 2009. Smoking prevalence has declined since the early 1990s from 37% to 23% in adults (15+ years).

In 2009 the government introduced a set of even tougher amendments, several of which focused on the need to protect children from the effects of passive smoking. It is now illegal to smoke in a car with a passenger younger than 12 years and smoking is not allowed on premises that are used for childcare purposes.

Today, according to the National Council against Smoking (NCAS), about 36% of South African men and 10% of women are smokers.

Julie Mabandu (not her real name) is one of them. Mabandu (26) started smoking when she was 13. She knows it is unhealthy and managed to give it up for a while, but started again before long. Mabandu believes there is not enough information or support for smokers who want to kick the habit. “Why don’t we have Smokers Anonymous, like Alcoholics Anonymous?” she asks. “I think I need some kind of therapy or counselling to help me quit.”

NCAS spokesperson Linah Ledwaba says there is. “The NCAS offers free counselling through our quit line,” she says. The council also shares advice on Facebook and Twitter about medication that can help smokers to quit. But Mabandu says information alone is not enough: what she really wants is a little understanding.

Good enough reasons to quit

  • Non-smokers exposed to second-hand smoke increase their risk of developing heart disease by 25% to 30% and lung cancer by 20% to 30%.—United States Centers for Disease Control and Prevention

  • The most effective method to reduce tobacco consumption is to raise the price of tobacco products through tax increases. Higher tobacco prices encourage smokers to quit and prevent the youth from taking up smoking.—National Council against Smoking

  • Almost half of the world’s children breathe air polluted by tobacco smoke. Tobacco kills up to half of all users.—Cancer Association of South Africa

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