COVID must frame new conversation on SA tobacco regulation

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The murky political history of the cigarette offers a vantage point to locate current debates on the cigarette sale ban in South Africa under lockdown, writes Dr Elijah Doro, a post-doctoral fellow in the history department at Stellenbosch University. He says it offers the opportunity to dispassionately unpack the puritanical, moral, industrial protectionist and scientific arguments that have been made by stakeholders who have sought to control the national COVID-19 narrative.

Cigarette consumer culture has revolutionised the tobacco industry and influenced global political and economic institutions for 10 decades. To date, tobacco sales have caused 100m deaths globally. It is estimated in a World Health Organisation report that 1bn more deaths will occur in the 20th century unless stringent tobacco control regulations are implemented.

Worryingly, the global epicentre of this epidemic has shifted to the developing world, where lax tobacco regulations have caused rising cigarette use among youth.

Doro writes that the COVID-19 narrative is a subtext of bigger interactions involving cigarette companies, the state, public health experts, citizens, advertising executives, smokers and non-smokers, with the very history of the cigarette as a consumer product enmeshed in the complex interactions between these role-players. It is also strongly linked to political endorsements.

The political power that the R30bn South African tobacco industry wields is palpable, while the smuggling and illicit sale of cigarettes is estimated to cost the country billions of rand annually. Doro writes that this criminal network has captured political institutions and corrupted state officials so much that despite the ban on cigarette sales there is a thriving black market. Claims by the government that the ban will reduce demand for cigarettes, cripple the illicit trade and force most smokers to quit underestimates the insidiousness of a problem that requires more pragmatism.

The industrial protectionist argument on the loss of tax revenue from cigarette sales and the impact on the economy are grossly overstated. A 2004 World Health Organisation (WHO) report on tobacco and poverty has proven that the public health burden from smoking by far outweighs the revenue accumulated from the industry. Tax revenue from most economic sectors is declining due to the lockdown.

Doro argues that the desperate attempt to frame the debate in terms of smokers’ personal choices and the ban as a violation of the social contract between the state and smokers is also misinformed.

He writes that while there is euphoria that “Big Tobacco” has lost the fight as cigarettes remain banned, this is just a pyrrhic public health victory. Throughout history the tobacco industry has always lost battles but eventually won the war. We need to use this crisis as an opportunity to frame a new national conversation on tobacco regulation and eliminate the tobacco epidemic in the post-COVID-19 era.

 

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