Tobacco Products Control Amendment Bill: briefing

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Health

13 September 2004
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Meeting Summary

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Meeting report

HEALTH PORTFOLIO COMMITTEE
14 September 2004
TOBACCO PRODUCTS CONTROL AMENDMENT BILL: BRIEFING

Chairperson:
Mr L Ngculu (ANC)

Documents handed out:
Draft Tobacco Products Control Amendment Bill (not available to public; consultations with tobacco industry plus November conference plus meeting with Cabinet need to be completed prior to draft Bill being finalised)
Department presentation on the draft Tobacco Products Control Amendment Bill
WHO Framework Convention on Tobacco Control

SUMMARY
The Committee was advised by the Department of Health and the Minister of Health's 's Legal Advisor on proposed amendments to the Tobacco Products Control Act. The officials emphasised key aspects of pending legislation and the high-profile role played by South Africa in the recent formulation of the World Health Organisation (WHO) Framework Convention on Tobacco Control. They outlined the objectives of the Department pertaining to cigarette smoking.

In the ensuing discussion, Members asked about dangers posed to workers involved in the production of tobacco products, how the age of individuals would be determined at a point of sale, and why the age restriction was being changed from 16 to 18. They also raised the health risks of smoking cigars and pipes. The Chairperson stressed the importance of legislation remaining within the confines of overall government policy, such as attracting foreign investment and the stimulation of economic growth.

MINUTES
Department briefing on the Tobacco Products Control Amendment Bill
Ms Z Mthembu (Director: Department of Health: Health Promotion) provided an overview of proposed amendments to tobacco legislation and background to the usage of tobacco products. Tobacco was described as a unique product requiring specific legislation due to the lethal nature of its properties and the high death figures associated with its usage. Studies have shown that approximately 5 million users die globally on an annual basis with an estimated 10 million predicted to die by 2030. Forty preventable diseases are connected to cigarette smoking such as cardiovascular diseases and cancer. Approximately 25 000 people die annually in South Africa due to smoking-related diseases and robust policies are needed to deal with the scale of the problem. Despite some success locally in addressing the phenomenon such as a reduction in the number of adults smoking and a drop in cigarette sales, existing policies need to be improved in order to address loopholes currently exploited by tobacco companies. Of prime concern for the Department of Health is the dramatic reduction in youth involvement in smoking. South African legislation would remain in line with the World Health Organisation Framework Convention on Tobacco Control.

Certain loopholes had arisen in existing legislation that allowed circumvention of regulations by manufacturers such as at point of sale where products were displayed in such a manner as to contravene the laws pertaining to the prevention of tobacco advertising and promotion. The Department received 2 000 submissions from stakeholders and members of the public as part of research to identify contraventions. The proposed amendments are in line with overall government policy to promote a healthy society. Issues such as the informing of the illiterate in a more effective manner and the removal of misleading statements from packaging were all considered. Increasing fines is proposed to promote compliance and act as a deterrent. Pressure would be placed on manufacturers to improve the description of products and specify all ingredients. The location of vending machines would be curtailed and co-operation had been forthcoming from the Vending Machine Association of South Africa to restrict such machines to smoking areas only.

Only 25% of public places should be designated areas for smoking and workplaces are encouraged to outlaw all smoking (currently two-thirds of workplaces do not allow smoking). The promotion of public health was incorporated into the amendments with society encouraged to engage in self-enforcement. One proposal was to increase fines for contravention of regulations, particularly for owners of public places, and to target individuals guilty of smoking in smoke-free areas. Owners had to co-operate in ensuring that rules were respected.

Section three of the proposal deals with advertising, promotions and sponsorship. South Africa had done reasonably well in this regard and most images had been removed that could act as a stimulus to the youth. A recent survey indicated a reduction in youth smoking from 23% in 2000 to 18.5% presently. However, this required further improvement. New tactics had been introduced by industry following the 1999 amendments such as the use of SMS's, the personal delivery of products and the Internet and these had to be addressed. Legislation would propose the banning of tobacco advertising on the internet and restrict the use of information technology in promoting tobacco products.

Restrictions on the place of sale were also proposed and no sales would be permitted in hospitals and schools in order to promote healthy lifestyles. The display of products was also under consideration as this promoted accessibility. Certain manufacturers were accused of product monopoly in places such as hotels where payments were made to prevent competitors from gaining access. Minimum packaging sizes were to be prescribed by the Minister and product regulation was proposed to reduce harmful additives introduced within the production process such as carbon monoxide, hydrogen cyanide and tar. Consumers had a right to be properly informed of all ingredients in cigarettes. The overriding principle was that no safe cigarettes existed with mild versions just as dangerous as stronger types.

The Bill sought to regulate the design and composition of the product and the manner in which information was conveyed to consumers. The current system utilised to test chemical absorption was machine-based and therefore flawed. The Bill proposed new methods for testing content and emission levels. The World Health Organisation was involved in developing product and testing guidelines and South Africa would adhere to these.

Proposals were also included to reduce the risks of fire associated with cigarette smoking. Recent figures suggested that cigarettes caused 2 535 fires in South Africa on an annual basis. The merits of self-extinguishing cigarettes were being considered and reduced-ignition propensity versions were a possibility. The Bill intended to discourage smoking amongst the youth and the age restriction would be extended from 16 to 18 years. Cigarettes must have a self-extinguishing component in future. Vending machines would only be placed in smoking areas to which under 18s would be refused access. Harsher penalties were proposed to encourage compliance and the courts would be encouraged to prosecute offenders, particularly in instances where the youth were involved.

Ministry Legal Advisor's briefing
Ms P Lambert reported that the tobacco industry had intentionally created products designed to harm and entrap users through addictive additives and promotional activities. Research and marketing was intended to reach the widest possible target market by means of enticing advertising and the youth market remained a primary objective. Such activities continued to reap substantial rewards through excessive profit margins. As a reaction to government initiatives to curb the dangers of smoking, the Department of Health received numerous complaints from the general public suggesting discrimination against smokers and unnecessary concentration on smoking to the detriment of other more serious concerns. The intention of the Ministry was not to discriminate but to encourage smokers to quit and prevent young people from becoming addicted. Tobacco companies did provide finance for social development programmes and bursaries at tertiary institutions but this finance was regarded by the Ministry as "blood money" garnered at the inexcusable expense of people's health. Such companies could not be regarded as good corporate citizens contributing to overall economic growth. The Ministry could never do enough to combat the dangers as these were preventable and contributed to excessive public health costs. A number of loopholes had been identified such as tobacco companies sponsoring smoking parties on university campuses and conducting marketing campaigns with new impressionable students. The relevant question was whether tobacco companies should be allowed onto campuses which the Ministry opposed.

The proposed legislation was designed to be self-enforcing and encourage greater awareness of the dangers of smoking. The Ministry was motivated by the desire to protect human life and facilitate healthy lifestyles amongst all communities by inspiring smokers to quit and prevent the youth from starting. The Minister believed that the correct path was being followed and numerous accolades were received from foreign visitors praising the situation on the ground and commending the policies in place.

South Africa played an important role in the negotiating of the Framework Convention on Tobacco Control that is the first international treaty attempted by the WHO. The 46 members of the Afro region presented one voice during the negotiation process and were united in their determination to address the dangers. The present Bill would be completed in the near future following final deliberations with the Department of Justice and forwarded to the Cabinet and Parliament for comment and approval. The tobacco industry would engage in counter-argument and media-driven publicity campaigns but the Ministry was assured of its position and would remain steadfast in its objectives centered on the protecting of citizens and the promotion of healthy lifestyles.

Discussion
Dr A Luthuli (ANC) asked what remedies the Department proposed to help smokers stop the habit as many existing remedies had suspect effectiveness and were expensive.

Mr R Coetzee (DA) questioned the ultimate objectives of the proposed legislation as being nebulous and lacking clarity. Two objectives could be discerned from the presentation. One seemed to suggest the desire to eradicate smoking and the accompanying industry from the country and the other to provide a continuing right for adults to make informed choices on whether to smoke but recommending cessation. The Committee required clarity on this to assist in the evaluation of pending legislation.

Ms Mthembu stated that the key to stopping lay with individual choice and willpower and the objective of the legislation was to provide people with sufficient information to make the correct decision. The Department wanted to inform citizens of the dangers of smoking and the ingredients within cigarettes that caused such harm. A 'Quit Line' was provided by associated NGOs and many support groups had been established in communities. The Department also had a telephonic hotline service for the public that was proving effective. Alternatives to current remedies were being considered and the Department continuously monitored the activities of NGOs and support groups.

Ms Lambert declared that the ultimate goal of the government was to protect the health of its citizens. There was no doubt that if cigarettes were created today for the first time and submitted for scientific evaluation, they would be rejected on the basis of the associated dangers. The banning of cigarettes was not an option as underground activity would begin in response to this. Reference was made to the experience in the United States with the prohibition of alcohol in the 1930s. Strong control measures would be put in place to encourage smokers to quit and prevent the youth from starting. Market forces would be allowed to intervene in altering the general economic landscape through decreasing demand and causing the tobacco industry to focus on other areas. The complete cessation of all smoking activity was unlikely and the Department would be happy with decreasing trends and increased awareness of the dangers facilitating responsible decisions by citizens. Criticisms around increased job losses were not justified as the 1999 amendments had not resulted in widespread unemployment and no related businesses were closed down. Adults did not have a right to smoke and this remained a choice that the Department sought to discourage.

Mr I Cachalia (ANC) asked about the dangers to workers involved in the production of tobacco products and how the age of individuals would be determined at a point of sale. Concern was also expressed on the high incidence of smoking during pregnancy.

Ms M Madumise (ANC) provided an anecdote of her own battle with smoking that she eventually overcame. Clarity was sought on plans to address passive smoking and smoking in prisons.

Mr Steyn (DA) suggested that the most vulnerable needed to be protected such as children and asked whether parents smoking in homes and motor vehicles could be regulated as this could be construed as a form of abuse.

Mr S Njikelana (ANC) asked why the age restriction was being changed from 16 to 18 and inquired whether any interaction had occurred with the Department of Trade and Industry on certain aspects of the proposed amendments.

Ms Mthembu responded that the age of consumers would be determined by means of identity documents should doubt exist. The onus was on sellers to confirm age as uncertainty would not serve as a defence. The incidence of smoking during pregnancy was of great concern and interventions were being developed in conjunction with the Medical Research Council to reduce this. A pilot project would soon be launched in the Western Cape. Programmes would also be launched to reduce smoking in schools and health facilities. No health facility would be allowed to sell cigarettes. The health of prisoners was being considered and discussions were taking place with the relevant authorities. The Department proposed a holistic approach to creating healthy citizens and reducing the negative impacts on society caused by irresponsible behaviour such as smoking. Numerous bilaterals had been held with Trade and Industry since 2001 and a number of submissions received from other departments including Finance and Customs. 60% of admissions to Groote Schuur hospital on an annual basis were smoking related and smoking caused a high level of disability that necessitated high maintenance grants. This scenario had to be addressed.

Ms Lambert stated that existing labour legislation and trade union involvement covered the conditions of workers in tobacco plants. Negotiations were underway with the Department of Correctional Services to improve the protection of prisoners against passive smoking. Smoking within private dwellings and motor vehicles was a sensitive legal issue that required further consideration. Attempts in the past to ban smoking in homes had been met by vigorous legal action from tobacco companies and the Constitutional position clearly established the right to privacy. However, from a policy perspective, education to change mindsets and encourage self-enforcement would continue unabated. Further legal opinion regarding motor vehicles was needed and this would be provided by the Department in the near future when the Bill returned to Parliament. Figures pertaining to the costs of smoking were available and these would be forwarded to the Chairperson within a week.

Ms F Batyi (ID) reminded the Committee of the dangers of throwing cigarette stumps out of moving vehicles and asked what provisions could be made in this regard.

Ms B Ngcobo (ANC) asked what plans were envisaged to help those who could not quit in terms of rehabilitation and the dangers of cigars and pipes.

Ms R Mashigo (ANC) mentioned the problems associated with shebeens and the lack of enforcing regulations in these establishments. A common myth existed that smoking could increase weight loss and this needed attention.

Dr Luthuli expressed confusion over the role of the Vending Machine Association in indicating a desire to help and yet the continuing problem associated with the placing and policing of machines.

Ms P Tshwete (ANC) enquired about the extent of awareness campaigns undertaken at universities and other tertiary institutions.

Ms Mthembu responded that such campaigns were already in place in conjunction with relevant civil society groups. Schools were perceived as smoke free zones and it was proposed that all workplaces would follow suit. In 2001 numerous workshops were held throughout the country explaining the gist of the previous amendments and a similar exercise would occur with the latest proposals. The Department envisaged removing vending machines from all locations in the future but presently only certain demarcated areas would receive machines. Impressions of irrelevance of legislation to shebeens were being addressed and complaints received from township residents were followed up. A number of public awareness campaigns had been conducted and a radio programme aired on SABC in all official languages. Rehabilitation of smokers required a team effort from all concerned and cigars and pipes were regarded in the same light. Advertising had created the myth of weight loss and this needed to be addressed through education.

Ms Lambert asserted that the pharmaceutical industry had a role to play in assisting people to quit and a public-private partnership was needed to reduce the costs of remedies as often prescription medicines were required to combat the chemical component of tobacco products.

Ms Mthembu acknowledged contributions made by tobacco companies towards bursaries and community development projects but the nature of the industry meant that such assistance was not sustainable. Local tobacco farmers were being removed from the economy through cheap imported products and the industry had a questionable future.

The Chairperson warned Members of the danger of ostracising certain business entities capable of making significant contributions to general government objectives of development and job creation. The tobacco industry provided much needed sponsorship to tertiary education and future investment could be forthcoming. Legislation should be sensitive to this reality and not antagonise potential financial support. The Chairperson recognised the informal nature of the briefing and assured the delegation that the information presented would be considered by the Members in accordance with a caveat not to encourage over-regulation. Tobacco legislation contained a significant element of self-regulation that should not be forgotten. Any legislation introduced should maintain respectability in the international context while remaining realistic and enforceable. Public scrutiny of the Bill would be required and Parliament would need to provide for this. The 1999 amendments had produced positive results and it was hoped that the present proposals would continue in this vein. The overriding objective of tobacco legislation was to encourage healthy lifestyles and encourage smokers to stop and dissuade the youth from becoming addicted. The Committee would support the Department in this regard.

The meeting was adjourned.

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