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Tag: South Africa

  • Differentiate and Give Smokers a Safer Alternative

    Differentiate and Give Smokers a Safer Alternative

    By Professor Praneet Valodia, Director Praneet Valodia Consulting

    I am a healthcare professional. I have chaired Drugs and Therapeutics committees, evaluated clinical trials for over two decades and been at the forefront of innovation in therapeutic technologies. With that experience comes a responsibility to speak when evidence is ignored. What I cannot do and will not do is remain silent in the face of flawed thinking, especially when it affects public health.

    South Africa is on the verge of adopting a new Tobacco Bill. In its current form, this legislation treats combustible cigarettes and non-combustible nicotine-containing products as the same. That is a serious problem. The science says they are not the same, and pretending otherwise undermines the very goals we are trying to achieve in public health.

    I have independently evaluated the vast data I recently presented to the Health Portfolio Committee using standard criteria that are applied in assessing scientific studies. I have used this same approach in evaluating new drugs and health innovations. When applying it to tobacco harm reduction, the evidence is clear: switching from combustible cigarettes to non-combustible alternatives significantly reduces harm.

    The combustion of tobacco produces between 6,000 and 7,000 chemicals. Among these, around 100 are harmful or potentially harmful. Non-combustible nicotine-containing products produce no combustion and 60 to 99 percent fewer harmful chemicals1. This is based on an independent evaluation by the United States Food and Drug Administration (U.S. FDA), a leading authority in tobacco and medicines regulation. Nicotine levels are the same but nicotine is not the harmful substance. It’s the other chemicals, nitrosamines and polycyclic aromatic hydrocarbons, etc. which cause disease.

    The U.S. FDA evaluation of a heat-not-burn technology showed reductions of 82 percent in carcinogens, 91 percent in respiratory toxicants and 94 percent in reproductive toxicants compared to combustible cigarettes. Heavy metals that are classified as carcinogenic to humans, such as nickel, chromium, cadmium and lead, were either undetectable or drastically reduced in these products1-3.

    As an example, an evaluation of an E-cigarette by the U.S. FDA showed a 65 to 100 percent reduction in harmful chemicals compared to combustible cigarettes. Abuse liability is lower, and lab studies show no mutagenic, cytotoxic or genotoxic effects4.

    The Cochrane Collaboration’s 2024 report, based on randomised trials in multiple countries, found nicotine e-cigarettes showed significantly greater efficacy than nicotine replacement therapy for smoking cessation. Safety profiles are similar between nicotine e-cigarettes and nicotine replacement therapy5. Similarly, a study by Hajek et al.6 published in the New England Journal of Medicine a randomized trial that showed 18 percent abstinence at 52 weeks for E-cigarettes versus 9.9 percent for nicotine replacement therapy.

    Risks of myocardial infarction, stroke and Chronic Obstructive Pulmonary Disease (COPD) are reduced by 52, 35, and 54 percent respectively with vaping versus smoking7.

    Sweden’s experience with snus shows dramatically lower lung cancer and cardiovascular death rates, three times lower than the European Union, where snus is banned. This is evidence that tobacco harm reduction saves lives8.

    Nicotine is addictive but not toxic at the doses used in these products. Nicotine toxicity depends on dose. It can be toxic if injected or ingested in large amounts but aerosolised nicotine in these devices is considered to be safe. Nicotine is not carcinogenic9 nor does it cause heart or lung disease, according to current evidence7,10.

    Claims that vaping acts as a gateway to smoking are also unsupported11. I have looked at numerous studies and could not find evidence that vaping is a gateway to smoking. We must base decisions on scientific evaluation of the gateway theory to smoking.

    South African youth smoking prevalence is very low at 2.08 percent12 and that should be celebrated. Smoking prevalences in youth is low in many countries although non-combustible nicotine-containing products are freely available.  This may indicate the non-combustible nicotine-containing products are not a gateway to smoking. We need to understand the addictiveness of nicotine relative to other substances, like alcohol and cannabis.

    The current tobacco bill fails to differentiate combustible cigarettes from non-combustible products despite this overwhelming evidence. I have a moral obligation to provide smokers with evidence-based options — safer alternatives.

    We must adopt a regulatory framework like the FDA’s, which weighs benefits and risks for the population, including youth and vulnerable groups, based on the net benefit to public health.

    The way forward is not to abandon regulation. It is to regulate more intelligently. We need to differentiate products based on harm, just as the FDA does.

    We need good policies and these policies need to be evidence-based. We need consistency in decision-making relative to other substances such as cannabis. We need an independent scientific committee to evaluate the evidence and the reports should be made publicly available. Given the volume of misinformation, establishing an independent scientific committee is not just important. It’s essential.

    The bill needs to be transformative and including tobacco harm reduction is a key part of that. We need penalties that are proportionate. And we must protect the autonomy of people trying to quit smoking by giving them access to safer alternatives.

    The focus of tobacco harm reduction should be on the 11.5 million smokers in South Africa. This is where the public health problem is. We need a paradigm shift. We must include tobacco harm reduction in the bill or condemn millions to preventable death and disease.

    Ignoring this evidence is unconscionable.

    References

    1. U.S. FDA: Scientific Review of Modified Risk Tobacco Product Application (MRTPA) under Section 911(d) of the FD&C Act – Technical Project Lead – 5/12/2016.
    2.  U.S. FDA Briefing document, Meeting of the Tobacco Products Scientific Advisory Committee, January 24-25, 2018.
    3. U.S. FDA: Scientific Review of Modified Risk Tobacco Product Application (MRTPA) under Section 911(d) of the FD&C Act – Technical Project Lead – 7/7/2020.
    4. U.S. FDA: Technical Project Lead (TPL) Review of PMTAs. NJOY. 2020.
    5. Lindson N, Butler AR, McRobbie H, Bullen C, Begh R, Theodoulou A, Notley C, Rigotti NA, Turner T, Livingstone-Banks J, Morris T, Hartmann-Boyce J. Electronic cigarettes for smoking cessation (Review). Cochrane Database of Systematic Reviews. 2024.
    https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub8/full.
    1. Hajek P, Phillips-Waller A, Przulj D, Pesola F, Smith KM, Bisal N, Li J, Parrott S, Sasieni P, Dawkins L, Ross L, Goniewicz M. et al. et al. A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy. N Engl J Med. 2019; 380:629 -637.
    https://www.nejm.org/doi/full/10.1056/nejmoa1808779
    1. Lee PN, Farsalinos K. Comparing smoking-related disease rates from e-cigarette use with those from tobacco cigarette use: a reanalysis of a recently-published study. Harm Reduction Journal. 2025; 22: 78. 
    2. Smoke Free Sweden. No Smoke Less Harm. 2024.
    3. International Agency for Research on Cancer. WHO. List of classifications by cancer sites with sufficient or limited evidence in humans, IARC monographs Volumes 1-139.
    4. Balfour DJK, Benowitz NL, Colby SM, et al. Balancing consideration of the risks and benefits of e-cigarettes. Am J Public Health. 2021; 111(9):1661–1672.
    5. Polosa R, Casale TB, Tashkin DP. A close look at vaping in adolescents and young adults in the United States. J Allergy Clin Immunol Pract. 2022; 10(11):2831-2842.  
    6. Van Zyl-Smit RN, Filby S, Soin G, Hoare J, Van den Bosch A. Kurten S.  Electronic cigarette usage amongst high school students in South Africa: a mixed methods approach. eClinicalMedicine. 2024; 78:102970.
  • South African Court Allows Seizures of Tobacco Smuggling Trucks

    South African Court Allows Seizures of Tobacco Smuggling Trucks

    South Africa’s Hawks (a specialized police unit) and the National Prosecuting Authority’s Asset Forfeiture Unit (AFU) secured high court orders to seize vehicles used in the smuggling of illicit cigarettes from Zimbabwe, marking a significant step in efforts to curb cross-border tobacco crime.

    The Limpopo High Court granted a forfeiture order for a Freightliner Argosy truck and two trailers, intercepted at Beitbridge border post in March while carrying Zimbabwean-made cigarettes. The vehicles, worth $48,000, were confiscated after the arrest of the driver. In a separate case, authorities also secured a forfeiture order for a VW bus valued at $9,100 in a 2023 case of transporting illicit cigarettes.

    Officials say one-third of the cigarettes in South Africa are smuggled from Zimbabwe. Smugglers reportedly buy cigarette boxes for $120 in Zimbabwe and resell them for up to $840 in South Africa. Authorities have pledged continued action against smugglers, as tobacco tax evasion and black-market sales remain a major challenge to public health and revenue collection.

  • BAT Accuses Local Manufacturers of Fueling South African Illicit Cigarette Market

    BAT Accuses Local Manufacturers of Fueling South African Illicit Cigarette Market

    British American Tobacco South Africa (BATSA) accused local cigarette manufacturers of driving the country’s booming illicit tobacco trade, which it says is costing the state an estimated R28 billion ($1.6 billion) in lost annual tax revenue. The company’s regulatory head, Johny Moloto, said the crisis has shifted from a cross-border issue to a “homegrown problem,” with 76.7% of retail outlets selling cigarettes below the Minimum Collectable Tax price for a box of cigarettes, which “should sell for above R26.22 ($1.47) a pack after accounting for levies.”

    “We have repeatedly shown who the culprits are,” Moloto said. “If SARS [South African Revenue Service] and the police wanted to act, they could. Today.”

    A study, commissioned by BAT and independently conducted by Ipsos, revealed that 14 of the 23 manufacturers involved in the illicit trade are based in South Africa, accounting for 91% of the illegal market. Gold Leaf Tobacco Company was named as the most prevalent brand in these sales, with nearly 90% of its products selling below the legal threshold. BATSA had 1.5% of its products selling below the minimum.  

    Moloto urged SARS and police to act on existing intelligence and called for stricter enforcement, including SARS’ presence at manufacturing sites and a national minimum retail price to ease policing.

  • South Africa Debating Vape’s Role in Harm Reduction

    South Africa Debating Vape’s Role in Harm Reduction

    South Africa’s Parliament is reviewing the Tobacco Products and Electronic Delivery Systems Control Bill, which proposes strict regulations on all nicotine products—treating e-cigarettes, heated tobacco, and traditional cigarettes the same. Proponents of harm-reducing products warn that treating all nicotine products equally could stifle innovation and keep safer alternatives out of reach.

    The debate comes at a critical juncture for South Africa’s public health and economy. The current bill includes plain packaging, graphic health warnings, a ban on advertising, public vaping restrictions, and limits on vape flavors. Industry leaders like Philip Morris International (PMI) argue this approach ignores scientific evidence showing reduced harm from smoke-free products, urging a differentiated regulatory framework like those in the UK and Japan.

    PMI says equal restrictions discourage smokers from switching to less harmful alternatives. But health groups and some lawmakers remain cautious, citing youth vaping risks and insufficient long-term safety data.

  • South Africa Working to “Combat Tobacco Use”

    South Africa Working to “Combat Tobacco Use”

    Through the proposed Tobacco Products and Electronic Delivery Systems Control Bill, South Africa is actively working “to combat tobacco use,” including e-cigarettes and hookahs, according to the Deputy Health Minister, Dr Joe Phaahla.  

    “We want to make sure we regulate these upcoming products because currently they’re not covered,” Phaahla said. “That is, e-cigarettes and the hubbly bubblies [hookahs]. We want to make sure they are properly regulated because currently they are everywhere.” 

    Phaahla said the proposed Bill seeks to implement significant changes to tobacco regulation, including the introduction of plain packaging, the expansion of smoke-free zones, stricter controls on emerging tobacco products, regulation of e-cigarettes, and enhanced support for tobacco cessation programs.

    The bill is expected to proceed to Parliament, with the government confident it will pass despite pushback from those pushing for harm reduction.

  • Op-Ed: The Tobacco Products and Electronic Delivery Systems Control Bill: A weapon against smokers

    Op-Ed: The Tobacco Products and Electronic Delivery Systems Control Bill: A weapon against smokers

    By Dr Kgosi Letlape, Action SA MP and Harm Reduction Activist

    A responsible government creates safe spaces for smokers, spaces that do not affect non-smokers – but it cannot legislate them out of existence.

    When Nedlac presented its findings to the health portfolio committee at the end of May, scientific input was notably absent. There was no panel, no robust exchange of evidence from both sides, no effort to seek the truth. Just the same flawed logic repeated: harm is harm.

    But the greatest harm from tobacco comes from combustion. We’ve always known that. The health risks are not simply from tobacco itself, but from how it’s consumed. Patterns of use matter, take cigars, for example. Their impact is different, and historically, even tax policy reflected that distinction. But today’s conversation on tobacco regulation is being driven by a dangerous, unscientific mantra: harm is harm.

    This phrase is not grounded in science. I will not support a document built on hatred for smokers. Yes, hatred. That’s what this feels like. A continuation of the same oppressive mentality, now executed by a black government, to isolate and vilify people who smoke. It treats them as though they are incapable of making informed choices, as if they must be saved from themselves by a nanny state.

    We are being fed misinformation. Whether it is deliberate or not, it remains misinformation.

    It’s deeply concerning. This Bill doesn’t just regulate but criminalises. It imposes sanctions harsher than those for theft. It attempts to erase smokers from public life, as if to say: if you smoke, you don’t belong in South Africa. That violates the Bill of Rights. Yes, smokers have rights.

    We cannot allow policy to be shaped by fear and ideology instead of facts. When regulation becomes punishment, and health is used as a weapon, we lose the very essence of what it means to care. If we truly believe in equity, then we must meet people where they are – not where we wish they would be. Smokers deserve science-based support, not stigma disguised as law.

    As a doctor, I always tell patients: the best option is to quit. But if you can’t, I won’t condemn you. You deserve help. You deserve access to harm reduction tools. That is the essence of healthcare. It’s how we treat people with HIV, with cancer, with any addiction. Even in palliative care, when we can’t cure, we comfort. Why then, when it comes to smoking, do we abandon this principle?

    Harm reduction is science. Nicotine replacement therapy has existed for decades. There are safer alternatives to smoking. The UK’s National Health Service endorses vaping as a smoking cessation tool. Sweden has one of the lowest smoking rates in Europe, largely thanks to its embrace of snus. Japan’s uptake of heat-not-burn products has drastically reduced cigarette sales. These are not fringe cases. They are data-backed successes.

    Yet this Bill refuses to differentiate between products. It’s as illogical as saying all transport is the same – that bicycles and taxis should be regulated the same way because movement is movement. That’s not how we govern. That’s not how healthcare works.

    I’m not defending the tobacco industry. I’m defending people , South Africans who are being stripped of choice and dignity under the guise of public health. You don’t protect people by pretending they don’t exist. You protect them by giving them better options, by respecting their agency and by building policies around real-world behaviour, not idealistic fantasy.

    You don’t reduce harm by denying its existence, you reduce harm by confronting it with science, compassion and innovation. Likewise, a government serious about public health doesn’t ban lifeboats because it dislikes the sea.

    I also caution against relying uncritically on global bodies whose past missteps remind us that consensus often lags behind science. The World Health Organization, which once classified homosexuality as a disease, now struggles to provide a nuanced stance on tobacco harm reduction. History shows us why skepticism and scrutiny are essential.

    Worse still, this Bill centralises power in the hands of the Minister. Every aspect, from regulation to communication — is to be run by the health department. No independent bodies, no specialised institutions, just committees under the ministry. That is not how a transparent, functional health system operates. Medicines and vaccines are not approved this way. Why should harm reduction products be?

    The foundation of this Bill is flawed, and so the product is flawed. The agenda? It appears rooted in moral superiority, in puritanism. Smoking has been so demonised that smokers themselves may soon need to form rights groups. Meanwhile, the societal damage of alcohol — far greater in many respects, gets a free pass.

    This is not rational. And this cannot be passed into law. Not on my watch.

    Parliament’s job is to pass laws that are practical, fair, and based on real evidence. This one does not meet any of those standards. The idea that “harm is harm” needs to be challenged now, before it becomes law, causes damage, and builds prejudice into our legal system. We need clear thinking, balanced rules and respect for the rights of all South Africans, including smokers.

    We are a democracy. And in a democracy, public health policy must be grounded in science, reason and compassion – not in hate.

    Dr Kgosi Letlape, Action SA MP and Harm Reduction Activist.

  • South Africa: Corruption and Illicit Trade Threaten Economic Stability

    South Africa: Corruption and Illicit Trade Threaten Economic Stability

    Philip Morris South Africa (Pty) Ltd (PMSA) welcomed the release of the 2025 Illicit Trade Environment Index by the Transnational Alliance to Combat Illicit Trade (TRACIT), a global benchmark report aimed at providing an update on the set of legal, regulatory and policy recommendations designed to strengthen the fight against illicit trade around the world.

    The Index ranks 158 countries based on their structural resilience to illicit trade—across sectors including tobacco, alcohol, pharmaceuticals, digital commerce, and fast-moving consumer goods—and highlights how systemic challenges such as gaps in enforcement and regulatory inconsistencies can contribute to the growth of the global black market. South Africa ranks 60th out of 158 countries, indicating moderate resistance to illicit trade, but with notable vulnerabilities in areas such as supply chain control and enforcement capacity.

    “Illicit trade is not a victimless crime. It deprives the government of critical revenue, fuels organized crime, and puts legitimate businesses at a disadvantage,” said Philippe Van Gils, Director of Illicit Trade Prevention at Philip Morris International. “The TRACIT Index reminds us that a comprehensive approach is required, one that addresses corruption, strengthens enforcement, and ensures regulatory frameworks are both appropriate and effectively implemented.”

    PMSA echoed TRACIT’s call for evidence-based and risk-proportionate regulation. “In the tobacco sector, high excise taxes and overly restrictive product policies can unintentionally incentivise consumers to turn to unregulated, illicit alternatives,” the company said.

    “Policies must be crafted with the real-world impact in mind,” Van Gils said. “Excessive taxes on cigarettes without access to scientifically substantiated less harmful, affordable, and legal alternatives merely encourage the illicit market. A risk-based taxation model, where smoke-free products like heated tobacco are taxed significantly lower than cigarettes, can encourage adults who smoke to switch to better smoke-free alternatives.”

    PMSA supports TRACIT’s multi-pronged policy roadmap to improve countries’ ability to detect, deter, and dismantle illicit trade operations. PMSA is urging the South African government and private sector stakeholders to prioritise the following:

    •             Crafting a national anti-illicit trade strategy, integrating smart tax policies, robust regulatory enforcement, and corruption safeguards;

    •             Strengthening border control and customs capacity, particularly at high-risk points such as ports and Free Trade Zones;

    •             Securing supply chains with digital track-and-trace systems and enhanced due diligence requirements for manufacturers and logistics providers;

    •             Enhancing cooperation between government, law enforcement, and the private sector, both nationally and regionally;

    •             Educating consumers on counterfeit and smuggled products.

    “Illicit trade networks are complex, well-funded, and increasingly digital,” said Van Gils. “It’s no longer enough to raise taxes or regulate products, we need modern enforcement tools, better online regulation, and a serious crackdown on corruption.”

  • Study: Students Vaping in South Africa 

    Study: Students Vaping in South Africa 

    Researchers from the University of Cape Town found that 16.8% of high school students in South Africa used e-cigarettes. The study focused on schools in major cities and included 25,000 students from 52 schools in eight of South Africa’s nine provinces. 

    Students who vaped were asked further questions about the habit, with researchers estimating 61% of the teen vapers could be seriously addicted to nicotine. They also found that household income was not a factor in the use of vape products. When asked why they began vaping, more than half cited social influences and the desire to fit in.

    Published in The Conversation, the study also found that 5% on the students used cannabis and 2% smoked cigarettes.

  • Revenue Service Loses Camera Case Appeal

    Revenue Service Loses Camera Case Appeal

    Photo: stnazkul

    The South African Revenue Service (SARS) has lost its appeal against a ruling that prohibited the agency from installing cameras in tobacco factories to monitor production and prevent tax evasion, reports The Herald.

    Earlier this year, Bozza Tobacco and the Fair-Trade Independent Tobacco Association (FITA), representing several smaller tobacco producers, won an interim interdict preventing the SARS from attempting to install cameras in tobacco facilities.

    The FITA argued that this constituted an “unjustified violation of the right to privacy and property.”

    In addition, critics fear that if the SARS is given the right to permanently surveil tobacco producers, it might then impose the same rule on other sectors of the economy, such as clothing, gold and fuel.

    In its appeal, the SARS argued that it needed 24-hour surveillance to counter the illicit trade in tobacco products that has resulted in rampant tax evasion.

    The Pretoria High Court ruled that the SARS had failed to address whether its appeal was in the interests of justice. It had previously been found that the SARS had not followed the exact prescripts of the Customs and Excise Act when formulating the rule that would allow it to install surveillance cameras.

    The main case against the SARS is still to be decided by the Pretoria High Court and may ultimately go to the Constitutional Court for a decision, given the constitutional issues raised regarding the rights to privacy, dignity and property.

  • New South Africa Urged to Tackle Illicit Trade

    New South Africa Urged to Tackle Illicit Trade

    Photo: Tobacco Reporter archive

    BAT has called on South Africa to crack down on the country’s rampant illicit tobacco trade. The multinational estimates that the government loses an estimated ZAR24 billion ($1.32 billion) in excise tax revenue to the illegal cigarette business every year.

    In a recent Ipsos study cited by BAT, 59 percent of stores sampled sold illicit cigarettes for a little as ZAR5 per pack of 20.

    The study also revealed that new manufacturers have entered the business, fueling intense competition at the bottom end of the market.

    “The entrance of new players raises some serious concerns about government’s commitment to address illicit trade. Nothing justifies licensing new manufacturers in a sector already ravaged by high levels of noncompliance without conducting proper due diligence,” said Johnny Moloto, area head of corporate and regulatory affairs for BAT Sub-Saharan Africa, in a statement.

    The Ipsos study highlights the challenge facing the new government in getting to grips with illicit trade and cross-border illicit financial flows, which are wreaking havoc with our economy and tax revenues.

    Johnny Moloto, area head of corporate and regulatory affairs, BAT Sub-Saharan Africa

    “The Ipsos study highlights the challenge facing the new government in getting to grips with illicit trade and cross-border illicit financial flows, which are wreaking havoc with our economy and tax revenues. To right the ship, authorities urgently need to prioritize the fight against illicit tobacco and secure convictions against the ring leaders,” Moloto said.

    In the past few years, the availability of cigarette packs selling below the minimum collectable tax has fluctuated in retail outlets: from 44 percent in March 2021, it dropped to 27 percent in October 2022, before surging to 59 percent in 2024. The recent Ipsos research showed a high level of cigarette packs available below ZAR25.05 in the wholesale and informal trade, at 83 percent and 72 percent respectively.

    BAT urged the Ministry of Finance to introduce a minimum retail price, which would make it illegal to sell cigarettes for less than a stated amount.