In the worldwide battle to defend public health against the international tobacco industry, health advocates, however great or small their resources, need a “win” every so often, just to keep up morale. In South Africa, one of the smaller agencies has clocked up two, just by eagle eyed surveillance and the tenacity of its founder. Furthermore, the Tobacco Action Committee (TAC) won its victories in what advocates often feel are no-win areas, owing to the dominance of some of the tobacco industry’s most ardent supporters, such as the advertising industry.

First, TAC’s founder Ken Sheppard, an American born businessman resident in South Africa for many years, noticed that an advertisement for Rothmans’ Peter Stuyvesant brand was breaking the legal regulations specifying the area to be covered by health warnings. The new, small-sized advertisement was shaped so that the more colourful parts of the design, featuring the cigarette pack, were broader than the top of the ad, where the health warning has to be placed. Legal regulations specify that 10% of the total ad must be occupied by the health warning; TAC saw this was not nearly the case in the ad. Equally important, they said, by placing most of the visual content in a wider, more eye-catching lower segment, the ad had been deliberately designed so that the effects of the health warning were minimised. After protesting to the health ministry and threatening to start legal action against Rothmans, TAC received a placatory letter from the ad agency responsible, denying any intention to break the law, but saying the ad had been withdrawn.

Next, TAC spotted an ad for First National Bank, an American business establishing itself in South Africa. The bank’s ad included a play on the wording of South Africa’s tobacco health warning, a ploy common among advertisers in other countries. But TAC took the view that messing around with the wording of a vital, highly justified, and hard-won warning about the most dangerous consumer product on the market was unacceptable, for fear of softening public perception of its seriousness and thus weakening its effect. Sheppard swung into action again, at first receiving predictable rebuffs from the bank, indicating that it was too late, and alas, the multimillion rand campaign was now unstoppable.

But stopping to think about this was something thatwas possible, and led Sheppard to the realisation that when an ad agency lands such a massive new client, and if the client intervenes to ask for changes in the content of the ad, the agency does not hesitate to comply. And so with further appeals to the bank, TAC persuaded it to think again, and in due course was informed that the offending ads were being pulled. Another small victory, and another demonstration of what a small but energetic campaign can achieve.

Meanwhile, South Africa’s new legislation will almost certainly be put to the legal test by the tobacco industry, whose practically limitless resources for litigation mean that to appeal as high up the court hierarchy as possible is now the rule, not the exception. And so lawyers will continue to get richer, faster. And undertakers will not be idle, either: despite an 18% decline in smoking prevalence from 34% to 28% between 1992 and 1997, around 89 000 premature deaths each year in South Africa are predicted on the basis of current consumption.