TOBACCO BILL OCTOBER 2003

1. TOBACCO BILLOCTOBER 2003 Zanele Mthembu National Department of Health 14 September 2004

2. Introduction • Tobacco is one of the leading preventable causes of death in the world • It kills 4,9 million annually. This is predicted to rise to 10 million per year by 2030 • 70% of deaths will be in the developing world. • Tobacco use causes over 40 preventable diseases • A smoker with TB is 30% to 50% more likely to die than a non-smoker with TB

3. In South Africa, tobacco related diseases kill about 25 000 people a year. This is more than the deaths caused by motorcar accidents (about 10 000 annually). The WHO Framework Convention on Tobacco Control (FCTC) adopted in May 2003 sets international standards for controlling tobacco. Introduction

4. Fewer people are smoking and less tobacco is being consumed in South Africa. (25% of adults smoke). Cigarette sales have dropped by 33% in the past decade. The purpose of the Tobacco Products Control Act is to ensure that young people don't start smoking, to protect people from pollution by tobacco smoke, to help smokers quit and to reduce the risks for those who continue to smoke. Introduction - continued

5. The 1993 Act (amended 1999) contains uncertainties that makes enforcement difficult. There are also gaps in the Act that have been exploited to circumvent it. The Tobacco Products Control Amendment Bill 2003 was published for public comment on October 17 to 17 November. Over 2 000 submissions were received.  Following public comments the DOH has revised the Bill. The new Bill (Tobacco Products Control Amendment Bill 2003)

6. The main provisions of the Bill are: ·to amend the current Act so as to strengthen the sections which prohibit advertising, promotion and sponsorship, and which regulate smoking in public places; ·to introduce picture-based health warnings; ·to remove misleading package descriptors, like “light” and “mild”; ·to increase fines for breaking the law; ·to control the ingredients and emissions from cigarettes and to establish manufacturing standards; ·to prohibit sales to and by those under 18-years; and ·to restrict the location of vending machines. The Bill

7. The 1999 TPCA Act banned smoking in all enclosed public places, except in specially designated smoking areas under prescribed conditions. A survey (NC, LP and GP) in 2002 by the Free State University found that: 90% of workplaces have a smoking policy, two thirds do not allow smoking on the premises; The law is working less well in restaurants. About 30% are smoke-free but 40% allow smoking anywhere. Section 2 of the Act. Smoke-free Public Places

8. Problems with this section; young children including babies are allowed into smoking areas. Smoking near entrances of public places has resulted in continued pollution of the non-smoking areas. Sports stadia, railway platforms and other areas where people gather are not covered by the law. Section 2

9. Section 2 • Regulatory approach • The Bill strengthens the existing laws by: • increase the fine for owners of a public place that allow smoking; • increase the fine for an individual who smokes in a public place; • smoking is not allowed within a reasonable distance of the entrance to a public place; • no one under-18 is allowed into a designated smoking area; and • regulating smoking in specified outdoor areas for health and safety reasons.

10. Section 3 – Advertising, Promotion & Sponsorship • The law banned tobacco advertising, sponsorships and promotions in 1999. This ended the false portrayal of a deadly addiction as smart, glamorous and successful. • In 2002, MRC survey found that 62% of 13 to 16 year-olds had never taken even one puff on a cigarette. This is up from 53% in 1999. • New ways of telling youth that smoking is cool evolved. The manufacturers have used the Internet, SMS and personal delivery mechanisms to reach teenagers.

11. Section 3 – Advertising, Promotion & Sponsorship • Marketers go into clubs, campuses and bars and invite ‘smokers’ to exclusive events like a pop concert or a major sporting event. • The parties are supposed to be for smokers, but nonsmokers are lured into buying (and smoking) cigarettes in order to get into the ‘select’ group invited to these events. • Promotional activities also involve investment in community infrastructure such as scholarships, bursaries, etc. Such donations are not charity but are designed to create a positive business environment for the industry.

12. Section 3 – Regulatory Approach The Bill seeks to outlaw Internet advertising and close other loopholes that the industry has exploited to continue promoting tobacco.

13. Section 3 – Restriction on place of sale • Proposal:- prohibit the sale of tobacco products in certain specified locations, such as hospitals and schools. • Reason:- Certain types of institutions are seen as having the responsibility to promote a healthy lifestyle, and from this perspective the sale of tobacco products in these institutions undermines their mandates and responsibilities

14. Section 3 – Display of products – Point of sale • Rationale •  Two issues related to the retail display of tobacco products are addressed in the Bill. •   First, self-service displays, which allow customers to handle tobacco products before paying for them, leads to increased stealing, particularly by youth. • Second, the display of tobacco products at point of sale is an important vehicle of promotion for tobacco manufacturers. • R 100 000 paid to hotels to sell certain brands exclusively. • JTI filed a complaint against BAT for anti-competitive behaviour. Hiding JTI brands.

15. Section 3 – Packaging size limitation The Bill gives the Minister authority to prescribe minimum package sizes.

16. Section 3A: Product Regulation • The cigarette is not simply tobacco wrapped in paper. It is a highly engineered product. ·Ventilated filters provide cooler and more dilute smoke. This allows large amounts of smoke to be inhaled deeply into the lungs. Filters are the key to producing so called ‘lower-tar and nicotine’ products.  Up to 1500 chemicals can be introduced during the growing, curing, storage and manufacturing processes, including pesticides, anti-fungal agents and preservatives. ·The additives ensure that the cigarette does not become dry or mouldy during storage, that it burns continuously once lit and produces a white not black ash; and that it satisfies the smokers craving for nicotine.

17. ‘Light’ brands % filter ventilation = 27.27 Perforations Full flavor brands % filter ventilation = 12.65 Perforations Cigarette Filters Photographs courtesy of J Henningfield

18. Additives, such as ammonia, urea, menthol, chocolate and sugars make smoke less noxious and increase nicotine absorption. •  Flavourings by improving the taste may make it easier for youth to start smoking. • The smoke from tobacco products contains over 4000 chemicals. Some of the chemicals in tobacco leaf or smoke that contribute to disease include: ·Carbon monoxide, nitrogen oxides, hydrogen cyanide, cadmium, zinc, and tar are contributing agents for cardiovascular disease. ·Polycyclic aromatic hydrocarbons (PAHs), tobacco specific nitrosamines, 210 polonium, formaldehyde, and metals are contributing agents for lung and larynx cancer.

19. People use tobacco to get nicotine but are killed by the tar. • Tobacco products are more toxic and carcinogenic than they need to be to deliver nicotine. • WHO has recommended that countries reduce the appeal of tobacco to children, decrease its addictive qualities, and decrease harm to users by establishing manufacturing standards. • Consumers also have a right to know what chemicals are found in tobacco products and its smoke. This information can help them make more informed decisions about starting or quitting smoking.

20. Regulatory Approach • This part of the Bill seeks to regulate the tobacco product itself. It sets standards for the composition and design of tobacco products, and the disclosure of information to consumers. • The International Standards Organization (ISO) testing methods currently in use for measuring tar, nicotine, and carbon monoxide are flawed.   • There is little relationship between the machine-measured yields of cigarettes and what smokers actually absorb. This makes the regulation of tobacco products.

21. To date, no country has fully met the challenge of developing comprehensive product regulation standards.  • For these reasons, the Bill proposes providing broad legal authority to the Minister to develop standards for constituents (what is in the product), emissions (what is produced when the product is used), product design, and testing methods, once there is clear guidance for doing so.  

22. WHO’s Scientific Advisory Committee on Tobacco Product Regulation (SACTob) is developing product and testing guidelines. • The FCTC’s Conference of the Parties also will develop guidelines for product regulation and testing. Therefore, such guidance should be forthcoming.

23. Proposal to reduce fire-risks of cigarettes • The Bill also seeks to reduce deaths, injuries and property damages resulting from fires started by cigarettes. • Discarded smoking materials are a leading cause of fires in South Africa. • In 2002, there were 48 000 fires, which killed 290 people and caused damage totaling R1.2bn. • Smoking caused 5%, or 2 535, of these fires. Most of them a result of discarded cigarettes setting fire to rubbish, grass or bush.

24. Cigarettes can be designed to self-extinguish if they have not been puffed upon for a few minutes.   • This will reduce the likelihood of igniting upholstered furniture, mattresses, bedding, grass or bush.  • In July 2000, a major American cigarette manufacturer released a reduced-ignition propensity version of one of its cigarette brands in the United States.

25. On December 31, 2003, New York State became the first jurisdiction in the world to mandate a standard to reduce the ignition propensity of cigarettes. • The standard came into effect on June 28, 2004. and all cigarette brands sold in New York State now meet these standards. • In May, Canada too proposed new regulations to reduce the fire risks of cigarettes.

26. Warning ! • Reduced ignition propensity does not mean fire-safe. It is impossible to make a burning object completely fire-safe. However, the proposed regulations will save lives by significantly reducing the number of fires started by cigarettes.

27. Section 4 – Sales to and by young persons • Most people begin using tobacco products during youth or adolescence and underestimate the addictiveness of, and harm caused by, tobacco products. • This is confirmed by the 1999 and 2002 GYTS which revealedthe initiation age to be 10 years • To discourage tobacco use by the young, sales of tobacco products to anyone under the age of 16 is prohibited in South Africa.

28. Section 4 – • The tobacco industry has recommended that this age restriction be raised from 16 to 18 years. • The FCTC suggests that if young people cannot buy cigarettes they should not be allowed to sell it either. • The challenge will be to monitor and ensure compliance • Regulatory approach • Raise the minimum age for the legal purchase or sale of tobacco products to 18 years.

29. Regulatory approach • The Minister will set a ‘performance standard’ that all cigarettes sold in South Africa must meet. This will require cigarettes to self extinguish after a few minutes, if it is not puffed upon. The law will prescribe an objective but allow manufacturers the freedom to use the manufacturing process or technical design of their choosing to achieve it.

30. Section 5 – Vending machines • The rule that vending machines be placed where purchases are inaccessible to anyone under 16 has not been effective. • Restriction to permitting machines only in designated smoking areas is suggested. (TOVA proposal) • The Bill further proposes that anyone under 18 years will not be permitted to enter a designated smoking area.

31. Section 7 – Offences and Penalties Penalties have not had the desired effect. A more meaningful series of penalties, considering the extent of harm and potential loss of life that can result from contraventions of tobacco products control measures, are proposed.

32. Thank You