Mixed reactions from residents emerged during the resumption of public hearings on the Tobacco Products and Electronic Delivery Systems Control Bill of 2022 in Durban on Sunday.
The Portfolio Committee on Health conducted public hearings in seven provinces, with the hearings coming to an end in KZN. The Bill seeks to strengthen public health protection measures, align South African tobacco control law with the World Health Organization Framework Convention, and repeal the Tobacco Control Act of 1993.
The proposed legislative and policy changes seek to make indoor public places and certain outdoor areas 100 per cent smoke-free; ban the sale of cigarettes through vending machines; require plain packaging with graphic health warnings and pictorials; ban the display of products at the point of sale; and regulate and control electronic nicotine delivery systems and non-nicotine delivery systems.
eThekwini residents filled the Greenwood Park Community Hall on Sunday, stepping forward to either reject or support the bill.
Professor Monique Marks, from Ward 33, who has worked in the field of substance use for more than 10 years as an advocate and practitioner in harm reduction, rejected the bill in its current form.
She stated that the bill fails to adequately understand addiction, including the substance (nicotine), methods of use including inhaling or smoking, and driving factors such as stress relief and sociability.
Marks said the bill also fails to balance individual health autonomy with public health concerns, despite some emphasis on individual rights. “I think the call for good public healthcare policy is that balance.”
She added that the bill, in its current form, does not fully recognise how to attain demand reduction for combustible cigarettes, which requires the promotion of regulated and less harmful substitutes to divert the market.
“The answer I believe is in harm reduction. Firstly, it meets users where they are at, including their drivers for smoking cigarettes and using nicotine,” she said.
Dr Mario Shonga, a general practitioner who works at Entabeni Hospital and in the harm reduction space, also rejected the bill as it does not adequately differentiate between existing and new users. “There are products that can help existing users to reduce their risk of cardiovascular disease and primary lung diseases caused by smoking.”
Shonga stated that there is scientific evidence that carbonised materials (burnt or combustible) known as paralytic means of smoking are the main cause of the disease. He said this bill would prevent him from advising his patients about using other substances other than non-combusted materials to actually avert cardiovascular and pulmonary disease.
“I think health practice needs to adopt a harm reduction process, and if we take that into consideration and use all of these vapes and non-combusted products as a means to promote better health among people who are already using large volumes,” said Shonga.
Many others rejected the bill because they believe that it would affect sales and, in turn, impact jobs and the economy. Community entrepreneurs like vendors expressed concerns that not being able to advertise their products would affect their income and families.
Malusi Ncube, from Ward 83, echoed others' sentiments that he supported the bill because while people have the right to choose whether to smoke or not, those who are inhaling second-hand smoke have no choice. “If tobacco products are attractive in appearance, it will lure young children to start smoking," he added.
A student social worker from Ward 34 stated she supports the bill, emphasising that it is not just about regulation but also about saving lives, improving the quality of life, and securing a healthier future for generations to come.