/ 28 January 2023

The tobacco bill violates human rights

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Every South African has the right to equality, the right to access information, the right to healthcare, and the right to life, according to the Bill of Rights enshrined in the constitution. This includes the 12.7 million South Africans who consume nicotine in all forms. 

The Control of Tobacco Products and Electronic Delivery Systems Bill will rob people of these rights because of the tightened restrictions around one of the most effective tools in reducing harm and achieving smoking cessation.

While the harms caused by smoking are well-known, and the bill seeks to “reduce the incidence of tobacco-related illness, disability and death” by creating further restrictions and heavy penalties on transgressors, there has been no public health strategy in place to assist people who smoke and wish to quit. 

There needs to be a more progressive and pragmatic way of achieving this aim. If we don’t, we could witness yet another missed opportunity to help millions of people and the continuation of unnecessary pain and suffering. 

Consider the country’s misguided Aids policies between 2000 and 2005, when more than 330 000 people died prematurely because of the government’s denialism and obstruction of life-saving treatment. 

Tobacco harm reduction offers another solution for smoking, which kills 44 000 people a year in South Africa. Using e-cigarettes and other harm-reducing products is a “life-saving treatment” for people who smoke. By passing this Bill, the government has denied this fact and would be obstructing known benefits.

Harm reduction refers to policies, programmes and practices that aim to minimise the adverse health, social and legal effects of risky behaviours. It was born out of the drug war and cross-pollination of the HIV/Aids epidemic in the 1980s to treat drug addiction and curb the spread of HIV and Aids. 

Harm reduction is a human right because it enables people to make choices about their bodies. It also gives people access to reliable, accurate information to educate them about their behaviour and advise them on what to do to improve their lives. 

The government is no stranger to harm reduction if you consider the broader HIV/Aids strategy and the distribution of free condoms and pre-exposure prophylaxis (PrEP) medications.

The bill, on the other hand, imposes restrictions, many of which infringe on people’s rights. For instance, the right to access information is nullified with the bill making it illegal for vaping products to claim that they are less harmful than other tobacco products. 

Additionally, smoking cessation claims will be prohibited, this knowledge could be beneficial for the person who smokes wanting to quit. Both these claims have been proven by science

At the same time, the bill will impinge on the rights of vape shop owners and their employees to freely choose their trade, occupation or profession. Overnight, 30% of the industry will face closure, largely because products will no longer be displayed or sold online. 

Many of these small businesses were hit hard by the Covid-19 lockdown restrictions. We can expect further destruction, especially as most are exclusive vape shops and don’t stock other items they could fall back on.

This will only feed the illegal trade. The knock-on effect is that the safety of vaping products will suffer as all forms of control will be circumnavigated. One only needs to look at an event in the United States late in 2019, where 2 500 people became ill, and 54 died after consuming an adulterated product. 

These tetrahydrocannabinol (THC) vaping products contain vitamin E acetate used by bad actors to reduce cost, increase their yield, and sell via informal channels. Furthermore, the illicit trade will directly affect the population the proposed Bill seeks to protect, our youth. 

Australia became a living example of a failed policy when it enacted a prescription-based model to control nicotine e-cigarettes in late 2021. Only 1% of the 130 000 Australian doctors provide nicotine prescriptions, and 12% of all e-cigarette users purchase these products under this ill-conceived policy. Resulting in an illicit vape market exploding in Australia and reports of ever-increasing youth consumption. 

It is well-documented that poorly thought-out policies drive markets underground, setting the stage for unintended yet predictable consequences.   

The bill seeks to prohibit, restrict and ostracise, entrenching further stigma on people who smoke and those who have chosen a safer alternative. It does not provide solutions, and if passed, it will be at the cost of human rights and human lives. 

To truly help them, we must implement counselling at healthcare facilities, cessation clinics, cessation training for doctors and nurses, and subsidised pharmaceuticals and nicotine replacement therapies. Additionally, we need to include harm reduction in our smoking cessation strategy and take learnings from the United Kingdom and New Zealand. 

Vaping products need to be regulated appropriately, based on proportional risk, and not simply lumped into the same category as its deadlier entrenched alternative.

Most importantly, we need empathy and acknowledgement that people who smoke derive some benefit from nicotine. Most have expressed a desire to quit based on health fears associated with combustion. Without proper support and proven tools, smoking cessation is possibly one of the hardest things to do, so we need to do more.

The views expressed are those of the author and do not necessarily reflect the official policy or position of the Mail & Guardian.