NATIONAL DEPARTMENT OF HEALTH

1. NATIONAL DEPARTMENT OF HEALTH • Presentation • Tobacco Control in South Africa • Ms N Matsau • Date:

2. FRAMEWORK CONVENTION ON TOBACCO CONTROL (FCTC) • The WHO FCTC is an international treaty for controlling tobacco marketing and use. • SA is among 147 countries that have ratified the treaty. • The country has legal obligations under the treaty.

3. TOBACCO PRODUCTS CONTROL LEGISLATION Tobacco ProductsControl Act, Act no. 83 OF 1993 as amended by Act no. 12 of 1999,no 23 of 2007 and no 63 of 2008 • The purpose of the Act is to: • Ensure that young people don't start smoking; • Protect people from harm caused by tobacco smoke pollution; • Help smokers to quit and • reduce the risks for those who continue to smoke.

4. PROGRESS MADE ON THE LEGISLATION Existing Regulations • Regulation No R 975 of 2000 Smoking in Public Places • Regulation No R 974 of 2000 Tar & Nicotine content • Regulation No 976 Point of Sale of Tobacco Products • Regulation No GN R1148 IN GG16588 4 August • 1995 Labelling, Advertising and sale of Tobacco Products

5. NEW REGULATIONS FOR THE AMMENDED ACT • Regulations No 429 Reduced Ignition Propensity (RIP) Cigarettes 16 May 2011 • Regulations No R 264 Smoking in Public Places and Certain Outdoor Public Places 30 March 2012 for public comments • Regulations No R634 Display of Tobacco Products at the Point of Sale 24 August 2012 for public comments • Draft Regulations underway : Regulations relating to Graphic Health Warnings

6. NEW REGULATIONS FOR THE AMMENDED ACT 1. Reduced Ignition Propensity (RIP) – gazetted on 16 May 2011 , with effect from 16 Nov 2012 Main Purpose • to reduce fires – protect human life, flora & fauna and prevent hardship to rebuild homes and settlements that are destroyed by fires • Testing of tobacco products – to be sent to ISO/IEC guide 17025:2005 accredited laboratories, available internationally.

7. NEW REGULATIONS FOR THE AMMENDED ACT 2. Display of Tobacco Products at Wholesale & Retails (points of sale) – republished for public comment on 24 Aug 2012 - 24 Nov 2012 • Research shows: tobacco displays at retail stores - important form of advertising and promotion & increase tobacco sales. •  Large, attractive tobacco displays in convenience stores, supermarkets, and gas stations - designed to create an awareness & interest in tobacco brands and to prompt impulse purchases by consumers. (Ex-smokers complaint on seeing favourite brand attractively displayed in shops -trigger craving ). •  Displays banned: Iceland – 2001,Canada - 2002-2010, Thailand – 2005, British Virgin Islands – 2007, Ireland – 2009, England, Wales & Northern Ireland - 2010-2011

8. NEW REGULATIONS FOR THE AMMENDED ACT 3. Graphic Health Warnings – Focus Group Survey Graphic Health Warnings: currently only text messages are printed on tobacco products Testing Pictorials and health messages • Gauteng – Focus Group discussions • Western Cape - Focus group discussions • Reports to be completed by Dec 2012 • Draft regulations to be finalised for public comment by March 2013

9. NEW REGULATIONS FOR THE AMMENDED ACT Tobacco Control Protection from exposure to tobacco smoke( Article 8) 4. Regulations relating to Smoking in Public Places and certain Outdoor places – published for public comment 30 March 2012 – 30 Jun 2012. • Currently reviewing comments for finalisation • Key areas of concern: entrances to public places; outdoor eating or drinking areas; health facilities, schools, child care facilities, covered walkways, stadia

10. NEW REGULATIONS FOR THE AMMENDED ACT • Tobacco Control Protection from exposure to tobacco smoke( Article 8) • SMOKING IN PUBLIC PLACES. Policy goals • 1. The reasons for enacting legislation to control smoking in public places are to: • (a) ensure that a clean and healthy environment is maintained; and • (b) ensure that the smoking of others does not impair the health of non-smokers. •  2. To guarantee the constitutional right of South Africans to an environment that is not harmful to health or well-being”. • 3. To meet with the governments commitments under the WHO FCTC. Article 8 requires Parties to provide for “protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places and, as appropriate, other public places.“

11. NEW REGULATIONS FOR THE AMMENDED ACT • Background • Tobacco smoke is one of the largest sources of indoor air pollution. • There is no safe level of exposure to tobacco smoke and both short-term and long-term exposure can cause harm. As little as 30 minutes of exposure to secondhand smoke can significantly increase the risk of a heart attack in those with heart problems. It can also trigger off an asthma attack. Longer term exposure can cause SIDS, respiratory disease, lung cancer and heart disease.

12. NEW REGULATIONS FOR THE AMMENDED ACT • Background continued • . A total ban on smoking in indoor public places has several advantages. It would: • • be more effective than a partial ban in reducing tobacco smoke pollution and in improving health; • • be fairer as it would protect all workers. Currently, those who work in areas set aside for smoking are still exposed to harm; and • • be simpler, more consistent and easier to enforce. • A number of countries have now banned smoking completely in indoor public areas, including Ireland, Norway, Bhutan, New Zealand, Scotland and England & Wales.

13. NEW REGULATIONS FOR THE AMMENDED ACT • Background continued • . A total ban on smoking in indoor public places has several advantages. It would: • be more effective than a partial ban in reducing tobacco smoke pollution and in improving health; • be fairer as it would protect all workers. Currently, those who work in areas set aside for smoking are still exposed to harm; and • be simpler, more consistent and easier to enforce. • A number of countries have now banned smoking completely in indoor public areas, including Ireland, Norway, Bhutan, New Zealand, Scotland and England & Wales.

14. NEW REGULATIONS FOR THE AMMENDED ACT • Evolution of Tobacco Control Policies in South Africa • Local authorities had prohibited smoking in cinemas, museums etc since the 1960 as safety measure – to reduce the risks of fires. No national legislation. • The first tobacco control law was passed in 1993. The Tobacco Products Control Act No 83 of 1993 allowed for: • - Health warnings on tobacco packaging, • - Regulation of smoking in public places in consultation with local government; • - No sales to children under age 16. • Some local authorities (Johannesburg, Cape Town) restricted smoking in public transport, local government buidings.

15. NEW REGULATIONS FOR THE AMMENDED ACT • Major revision of the law occurred in 1999. TheTobacco Products Control Amendment Act, Act No 12 of 1999 established the principle that smoking is not allowed in all indoor public places, workplaces and public transport. • However, the health minister could allow for indoor smoking areas under defined conditions. The smoking area must: • - not be more than 25% of the area of the public place; • - be physically separated from the rest of the public place; • - be separately ventilated; and • - carry prescribed signs. • The fine for non-compliance was R200 (US$ 35) for both smokers and the person in charge of a public place. Regulations under the Act were published in September 2000. The 2000 Regulations were a significant step in protecting the public from secondhand smoke. It prohibited smoking in all enclosed public places and workplaces, except for designated areas set aside for smokers.

16. NEW REGULATIONS FOR THE AMMENDED ACT • Surveys find that most people do not want to be exposed to tobacco smoke. • However, many are afraid to assert their right to smoke-free air in the workplace because of the fear of upsetting their employers. • They instead phone local authorities, the health department and non-governmental organizations seeking help while wishing to remain anonymous. • By allowing smoking and non-smoking areas the current law is obviously not protecting them fully.

17. NEW REGULATIONS FOR THE AMMENDED ACT • A 2010 survey by the HSRC found that 80 to 85% of all adults (both smokers and non smokers) think it is important that workplaces and eating places should be 100% smoke-free. • In 2007 the Act was again amended to strengthen the no-smoking provisions. The new Legislation: • ¨Prohibits smoking in cars if a child under 12 years is a passenger and in private dwellings if they are used for commercial childcare activities, e.g. crèches, after-school centers; • ¨Prohibits smoking within a prescribed distance of the entrance to a public place; • ¨Prohibits anyone under 18 years from being present in an area where smoking is permitted; • ¨ Regulates smoking in selected outdoor areas; and • The penalty for an individual smoking in a nonsmoking area has been increased from R200 to R500 (maximum). • For employers and those in control of a public place do not comply with the law the fine is increased from R200 to a maximum of R 50 000.

18. NEW REGULATIONS FOR THE AMMENDED ACT • Enforcement of the law • The smoke free laws are one of the best examples of primary health care and health promotion in action. • The law empowers people by making clear rules about where you may or may not smoke • Active citizenry -demand the right to clean air. (citizens - not the police - make shopping malls, workplaces, public transport smoke free. • Majority of smokers and nonsmokers support the regulations. • Complaints are handled by EHPs and the Quit Line.

19. NEW REGULATIONS FOR THE AMMENDED ACT • Impact on business • There were claims that restaurants would lose business because smokers would stop dining out or going to bars. • Research shows that the law did not affect restaurant sales.

20. NEW REGULATIONS FOR THE AMMENDED ACT • The same study also found that the new legislation was well received by non-smokers as well as smokers. • Another UCT study that looked at the actual turnover of restaurants for the same period found no evidence that restaurant turnover decreased after the imposition of the clean indoor air legislation in 2001. “Therefore, based on international and South African research there is no reason to believe that the proposed regulations will have a detrimental impact on the restaurant industry,” said Van Walbeeck.

21. NEW REGULATIONS FOR THE AMMENDED ACT Restrictions on smoking near entrances to enclosed public places: • The draft regulations will move smokers away from the entrances and air inlets to buildings. Tobacco smoke can enter and pollute buildings though open doors, windows and ventilation inlets. People entering and exiting the building are also exposed to this pollution. This can be particularly problematic for those with asthma or heart conditions, for whom even short exposures to smoke can trigger an attack. • The problem can be fairly easily resolved by prohibiting smoking within 5/10 metres of any non-domestic building. Experience in other countries shows that the policy can be enforced through signage at entrances and moving ashtrays away from doorways.

22. NEW REGULATIONS FOR THE AMMENDED ACT • Almost overnight, the social norms regarding secondhand smoking (SHS) changed. The public has embraced the law and shopping malls, public transport and workplaces rapidly restricted smoking. • However, this reduced but did not eliminate exposure to SHS. Almost one in five nonsmokers say they are still exposed to smoke at work and one in three that they are forced to breathe SHS in other public places. • The reasons for this could be (a)that smoke drifts from the smoking to the nonsmoking areas and (b) poor compliance from the hospitality industry particularly bars.

23. NEW REGULATIONS FOR THE AMMENDED ACT Smoke free laws • Best examples of primary health care and health promotion in action. • Empower people by making clear rules about where you may or may not smoke • Active citizenry -demand the right to clean air. (citizens - not the police - make shopping malls, workplaces, public transport smoke free. • Majority of smokers and nonsmokers support the regulations. • Many nonsmokers feel that existing laws do not protect them adequately and they are still being exposed to tobacco smoke. - - therefore want 100% smoke fee areas indoors. The new regulations also conforms to best practice as recommended by the guidelines of the FCTC.

24. NEW REGULATIONS FOR THE AMMENDED ACT • SOUTH AFRICA MANAGED TO HOST A SMOKE FREE SOCCER 2010 • THANK YOU • THANK YOU