South Africa: from tobacco control leader to loser

When the 17th World Conference on Tobacco or Health takes place in March 2018, the eyes of the global health community will be on the host nation South Africa. Unfortunately, although South Africa was a tobacco control leader in the 1990s and early 2000s, today the country is falling behind. Public interest in tobacco control is flagging, and the network of non-government organisations (NGOs) and public health officials so crucial to progress are lacking both financial and human resources.

South Africa’s national ban on smoking in public places came into force on 1 January 2001. It followed from the first Tobacco Products Control Act (the Act) which was published in 1993, amended in 1997 and then activated by regulations published in 2000. The first ban on smoking in public buildings was introduced 12 years earlier in the town of Edenvale in 1989. Although groundbreaking, it was not noted internationally. However, it sets the scene for public acceptance of smoke-free public places, despite the fact that adult smoking prevalence at the time was close to 40%.

There have been two further amendments to the Act, in 2007 and 2008. These amendments saw the introduction of reduced ignition propensity standards, required all exported products to comply with the importing countries’ laws, strengthened advertising, sponsorship and promotion bans, banned tobacco industry events (other than shareholder meetings), banned confectionery and toys that looked like tobacco products, banned tobacco sales in health and educational institutions, and increased penalties for breaches. Both came into force only in August 2009.

These amendments started with the publication of an Amendment Bill in 2003, which had taken 3 years to draft and then another 6 years to become law. Although they …