TOBACCO BILL OCTOBER 2003

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TOBACCO BILLOCTOBER 2003

• Zanele Mthembu
• National Department of Health
• 14 September 2004

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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

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Introduction

• 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.

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Introduction - continued

• 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.

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The new Bill (Tobacco Products Control
Amendment Bill 2003)

• 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.

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The Bill

• 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.

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Section 2 of the Act. Smoke-free Public Places

• 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.

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Section 2

• 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.

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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.

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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.

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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.

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

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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.

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

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Cigarette Filters
Photographs courtesy of J Henningfield
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• 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.

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• 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.

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• 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.

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• 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.  

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

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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.

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• 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.

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• 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.

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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.

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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 revealed the 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.

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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.

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• 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.

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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.

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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.
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Thank You