Tobacco Products Control Amendment Bill: public hearings

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Health

23 January 2007
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Meeting Summary

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Meeting report

HEALTH PORTFOLIO COMMITTEE
24 January 2007
TOBACCO PRODUCTS CONTROL AMENDMENT BILL: PUBLIC HEARINGS

Chairperson
: Mr L Ngculu (ANC)

Documents handed out
Tobacco Products Control Amendment Bill [B24-2006]
South African Tobacco Industry PowerPoint Presentation
Written Presentation by Dehran Swart
South African Medical Research Council presentation
Presentation by National Heart and Stroke Foundation of South Africa
Presentation by Youth for Health
British American Tobacco company Presentation
National Institute for Occupational Health: Tobacco Smoking in Public Places


SUMMARY
The public hearings on the Tobacco Products Control Amendment Bill continued.

Members put questions to the Tobacco Institute of South Africa, which had given a presentation highlighting that although there was no doubt that smoking was harmful to health, South Africans would continue to smoke for some time. A properly regulated industry provided many economic benefits and although controls were necessary, an over regulated industry would increase the illicit trade in cigarettes which did not always comply with current health standards. The Institute was concerned about the powers given to the Minister. Definitions of brand elements and organised activity were also discussed.

A private submission from Mr Dehran Swart supported the Bill, on the basis that youth were targeted. He proposed increasing the fines for smoking in public places, removing ambiguities that made enforcement difficult, and tightening the use of labels like “light” and “mild” as they implied safety; and further controls on emission, which could also lessen the fire hazard. Members asked questions on the research groups used.

The Medical Research Council was in full support of the Bill, because South Africa was one of the earliest signatories to the WHO’s Framework Convention on Tobacco Control (FCTC), and should take the lead in promoting legislation. Other reasons motivating its support included the risk of coronary heart disease, the effects of Environment Tobacco Smoke (ETS), even amongst non-smokers, and the fact that tobacco related diseases were the fastest growing cause of disease and disability in developing countries. Questions by members included whether the measures were sufficient, sources of funding for research, enforcement, and clarity on snus.

The National Institute for Occupational Health and National Health Laboratory Services focused on tobacco smoking in public places, stating that tobacco smoke did drift into non smoking areas through poor controls, affecting the patrons and waitrons, who were often young and vulnerable. The Institute suggested that smoking be banned in all public places. Questions related to whether Clause 2 of the Bill placed sufficient responsibility on the owners of the establishment.

The University of Pretoria was concerned about the lack of transparency as to what was in the product. South Africa was bound to comply with World Health standards and the Conventions on tobacco. There was an increase in people using own rolled cigarettes and smokeless tobacco, including pregnant women. He said that nothing should be used in the mouth that was not to be swallowed. The University supported the definition of tobacco products, supported the health warnings, particularly those geared to those unable to read, and emphasized that the burden of proof of reduced harm must be placed with the manufacturer, not on the state. Smoking should not be permitted at all in public transport or where any passenger in a private car was under 18. There should be treatment of tobacco dependence, supported by medical schemes. Questions addressed the composition of snus, and the relative harmfulness of nicotine and tar.

The Heart and Stroke Foundation of South Africa and its Youth For Health division both were full support of the bill. Both were particularly concerned to prevent the youth from starting to smoke, and protecting non smokers from the toxins produced by tobacco smoke. They wholeheartedly supported the Bills increased requirements regarding smoking in public places as well as the further protection of defenceless children from the dangers of smoking, which they believed government had a duty to protect.

The British American Tobacco company urged Parliament to seek pragmatic rather than abolitionist solutions, and emphasised that the company would support balanced regulation of tobacco products and suggested that South Africa have the opportunity to lead the world in regulating tobacco harm reduction. Mr Crow commended the current Act and mentioned that it had substantially met the requirements of the WHO FCTC. Mr Crow further highlighted the fact that BAT was committed to working with all stakeholders to reduce the negative health impact of tobacco use. Mr Crow summarised the issues of concern to BAT, which included the definitions of “brand element”, “organised activity”,
and “tobacco product” as well as issues regarding the Standard for the Manufacturing and Export of tobacco products, not to mention the Minister wide regulatory powers and the ignition propensity of cigarettes. Many of the questions sought to clarify snus and the correlation between dosage of tar and uptake. Time constraints limited the responses and the Chairperson ruled that BAT be given further time to respond on resumption of the hearings.

The hearings would continue the following week, Tuesday 30 January, at 9 am.

MINUTES
Tobacco Institute of South Africa (TISA) submission
Mr Francois van der Merwe, Chairperson, TISA summarised his presentation from the previous day by saying that TISA was advocating a process of constructive dialogue between the industry and the Department of Health (DOH). He maintained that over regulation of the tobacco industry could result in an increase in illicit trade in cigarettes.

Discussion
Ms M Matsemela (ANC) stated that Section 6 of the principal Act, conferred executive powers on the Minister, and stated that there should be special consideration given to the Clauses 3(a) and 3(b). She cited a hypothetical example, that if another country did not have any standard set around tobacco issues, and the local industry in South Africa wanted to export cigarettes to that country, the Bill required the standards of South Africa to apply to that country. She further mentioned that if the Minister was not given as much power to regulate, the industry would be in a position to manipulate standards in certain countries. She felt the Minister's powers were needed to create a balance.

Mr van der Merwe maintained that TISA did not think it was a good principle for South Africa to impose its jurisdiction on other countries. He did not support power being vested with the Minister, as the Health Portfolio Committee should be the custodians.

The Chairperson agreed this was an important issue. She noted that Clauses 3(A)(1) and 3(A)(2) provided for regulation of manufacturing standards and information about the product and emissions. She asked whether he was opposed to this clause.

Mr van der Merwe responded that TISA did not have a particular concern with the clause, but was only concerned about the practicalities, and the cost and time associated with the gathering of additional information. He reiterated that the major concern related to giving more power to the Minister, especially since only one month was given for consultation.

Ms R Mashigo (ANC) commended TISA for its presentation, and the industry for taking responsibility in creating awareness. TISA’s presentation clearly showed a good side to the tobacco industry, especially in terms of creating employment for South Africans. However, Ms Mashigo emphasized the negatives of tobacco, highlighting the fact that tobacco was a very serious health risk, which affects vital organs such as the lungs. She commented that the research of the Medical Research Council (MRC) indicated that there were 2.5 million working days lost due to illnesses and disease resulting from f tobacco use. Ms Mashigo requested whether Mr van der Merwe had any contrary statistics.

Mr van der Merwe made clear that TISA did not have such statistics, since they were not arguing with them. He clarified that the industry agreed that tobacco was a health risk. It made clear the dangers of smoking in the promotion and marketing of the product, specifically referring to the fact that approximately 25% of the area of a cigarette box contained a warning message. A radio debate that morning expressed concern that there were bigger health problems to contend with in South Africa, such as HIV/Aids, alcoholism and obesity. He agreed, and added that the youth were of key concern to the tobacco industry. He suggested that the Bill include a provision to raise the legal age of smoking from 16 to 18 years of age, and again reiterated that this problem needed to be solved in partnership with the Department of Health. SARS and the industry had shown, in relation to illicit trade, that they were willing to enter partnerships to address problems. ,

Mr N Godi (PAC) stated that smoking was a health risk, and asked Mr van der Merwe whether South African society was better off with or without smoking. He further asked that Mr van der Merwe comment on the last paragraph of the Preamble in the Bill, which resolved to align the health system with the democratic values of the Constitution and the World Health Organisation’s (WHO) Framework Convention on Tobacco Control (FCTC).

Mr van der Merwe replied that South African society was better off without smoking, but this assumed we lived in an ideal world. He highlighted the declining legal local market and stressed that the use of cigarettes in the illegal market was very high, estimating the use of the illegal product to be over 70%.

Members raised the inclusion of “brand element” in Clause 1(a) of the Bill, which expanded on the definition of “advertisement.” Mr Bernard Asia (Department of Health) suggested that the extended definition of “brand elements” be deleted. Members and TISA agreed.

The Chairperson asked Mr Van der Merwe whether the definition of “organized activity” in Clause 1(f)(b) was considered satisfactory.

Mr van der Merwe expressed concern over this definition of “organized activity”. He said a tobacco manufacturer such as BAT would not be able to display its company name at a corporate event for stakeholders. Mr Van der Merwe reiterated his concern with the powers of the Minister to legislate.

Mr Asia drew attention to Clause 1(f)(a)(ii), pointing out the line “which is organized for the purposes of entertainment”. Mr Asia emphasized that the principal Bill was about tobacco legislation and advertising, and that it would be a contradiction if one were to include other stakeholders as Mr Van der Merwe was suggesting.

The Chairperson clarified that this provision did not mean that if the tobacco company owned a building it would not be able to have its sign displayed. The Chair further pointed out that the Minister's executive powers were in line with the Constitution.

The Chair suggested that the State Law Advisors investigate the matter and report back.

Dehran Swart: Submission
Mr Dehran Swart clarified that whilst he was employed by the Paraffin Association of South Africa (PASA), he was making this presentation in his personal capacity. He wholeheartedly supported the Tobacco Amendment Bill, primarily because tobacco produced a net loss to the economy, according to the World Health Organisation (WHO) and the World Bank. Mr Swart’s greatest concern, having three children of his own, was that the young children of South Africa were being coerced into a lifetime of nicotine addiction.

Mr Swart proposed strengthening the existing Act to increase the fines for smoking in public places, and removing ambiguities that made enforcement difficult. He further proposed that misleading labels like “light” and “mild” be removed as they gave the impression of safety; and that there be control of the ingredients and emissions from cigarettes by establishing manufacturing standards and setting standards so that cigarettes were less likely to start fires.

Mr Swart submitted that in terms of the Constitution, everyone had the right to an environment that was not harmful to their health and well being and concluded that the Bill was in line with international legislative changes, particularly the
WHO Framework Convention on Tobacco Control.

He tabled a number of graphs illustrating smoking trends, and welcomed the tobacco awareness campaigns and interventions, which he believed would have a positive effect, particularly on the youth.


Discussion

Mr Morgan (DA) asked Mr Swart about self extinguishing cigarettes, saying that TISA had commented on this point that it was not necessarily opposed to these. He asked if the industry was generally aware of such cigarettes.

Mr Swart responded that he was not aware of the workings of the tobacco industry, and added that the industry should have done research on this subject a long time ago.

Ms Matsemela asked, in relation to Clause 2 of the Bill, if Mr Swart was satisfied with the increases in Bill in regard to smoking tobacco products in public places.

Mr Swart confirmed that he was satisfied with the increased measures in the Bill.

Ms N Nkabinde (UDM) asked in which group the research was done.

Mr Swart responded that the surveys were conducted amongst grade 10 learners in 1999 and 2002 respectively, and expressed a wish for the Medical Research Council (MRC) and DOH to continue with these surveys. He added that much scientific literature existed that labeling cigarettes as ‘light’ and ‘mild’ was incorrect.

Medical Research Council(MRC) Submission
Prof Anthony Mbewu , President, MRC said that the vision of MRC was to build a healthy nation through research. The MRC supported the Tobacco Products Control Amendment Bill. Furthermore, since South Africa was one of the earliest signatories of the WHO Framework Convention on Tobacco Control (FCTC), it was compelled to ensure that its tobacco legislation was in line with the FCTC.

Prof Mbewu highlighted the fact that Environmental Tobacco Smoke (ETS) had an impact on coronary heart disease, and estimated that making work places smoke free would significantly reduce the number of strokes and heart attacks in non-smoking individuals. Prof Mbewu emphasised that the latest research evidence showed that there were implications that those harmed by ETS could litigate against their employers or the owners of the establishment in which they were exposed to ETS.

Prof Mbewu concluded that tobacco legislation in South Africa was important internationally as many developing countries follow the lead of South Africa in promulgating their own legislation, and that tobacco related diseases are the fastest growing cause of disease and disability in developing countries.

Discussion
Ms M Malumise (ANC) made the point that restaurant workers were continuously at risk from smokers, and asked whether Prof Mbewu thought that the existing legislation in the Bill was adequate.

Prof Mbewu was of the opinion that enforcing the increased fines for contravention of the law would be an effective measure.

Mr B Mashile (ANC) requested clarity regarding whether the MRC received funding from the tobacco industry.

Prof Mbewu made it clear that MRC did not receive any funding from the tobacco industry for any type of research, especially given the fact that tobacco represents 4% of the burden of disease.

Mr G Morgan (DA) questioned whether Prof Mbewu would have liked to have seen any further topics included in the Bill. He further asked whether Prof Mbewu was in agreement with increasing the legal smoking age from 16 years to 18 years. Finally, he asked whether Mr Mbewu believed that the State, particularly the Department of Health, had the capacity to control and enforce the ETS aspects of the Bill.

Prof Mbewu responded that he was not an expert to comment on the ETS portions, and that the National Council Against Smoking (NCAS) would be better positioned to answer that question. He was uncertain whether the Department of Health had the capacity for enforcement. MRC had assisted the Department of Health only in terms of the biochemistry of the composition of the cigarette.

Ms Matsemela mentioned that the issue of research needed to be further discussed, and emphasized that the members were told that 1400 chemicals are being used in this product.

Prof Mbewu stressed that nicotine was a highly addictive substance, hence the tobacco companies tried to get their customers at an early age.

Mr A Madella (ANC) queried that the members had heard arguments that snus was less harmful, whilst MRC had indicated that, because of its nicotine ingredient, it was very addictive. Mr Madella said that there was very little information around snus in South Africa, hence it should be excluded from the definition.

Prof Mbewu confirmed that he did not believe that snus was less harmful.

The Chairperson mentioned that TISA were of the view that the product (snus) contains tobacco, but since the tobacco is not burnt, no tar is created.

Prof Mbewu repeated that he did not believe that snus was less harmful.

National Institute for Occupational Health and National Health Laboratory Services (NIOH and NHLS) submission
Dr Abednago Baker, NIOH, focused on tobacco smoking in public places such as restaurants, bars, pubs, taverns and casinos. The current Regulations permitted a person in control of a public area to designate part of the public area as a smoking area and ensure that the rest of the public place was not affected. He submitted that, owing to poor controls, there was exposure to those in non smoking areas, which included waitrons, many of whom were part time, young and vulnerable. He mentioned that even ventilation and filter systems could not remove all harmful elements and therefore recommended that all work and public places should be smoke free.

Discussion
A Member asked whether Dr Baker was satisfied with Clause 2(4) of the Bill relating to the responsibilities of the owner or person in control of the establishment. Dr Baker responded that he was satisfied with the provision, but repeated his position that there was very little control of the smoke, and that it could filter into the non smoking areas.

University of Pretoria (UP) submission
Dr O Yusuf, Department of Community Dentistry, University of Pretoria stated that tobacco use posed a health risk to society, yet millions of people continue to smoke. Of more concern was the fact that the tobacco industry still failed to reveal Ingredients contained in the product, so that people did not know the product that they ingested or inhaled.

Dr Yusuf also stressed that the South African government , acknowledged as a global champion of tobacco control since 1993, had not only a moral obligation to protect the health of South Africans, but also a duty to comply as a signatory to the WHO FCTC.

Dr Yusuf outlined the increased usage of non-cigarette products such as own rolled cigarettes, tobacco used for pipe, snuff or snus. He estimated that approximately 1 million black South Africans were using smokeless tobacco, which is the term used by the industry, which led to the impression that it was safer. He was particularly concerned at use by pregnant women during pregnancy, which carried the risk of premature birth of the child. He was also concerned that those of a low socioeconomic status often smoked hand-rolled cigarettes through newspaper, which was unable to filter out carcinogens.

Dr Yusuf said that snus or snuff was an important component of cultural systems in Africa, but expressed his opinion, as a dentist, that nothing should be placed in the mouth that one was not able to swallow.

The University supported the amendment of the Bill in terms of defining tobacco products, and concluded that regulations would reduce morbidity and mortality. Dr Yusuf expressed his support for health warnings, especially for those unable to read, and stressed that knowledge of the chemicals contained in the cigarette was vital for users. He believed the burden of proof of reduced harm must be placed with the manufacturer, not on the State.

Dr Yusuf further added that it would be irresponsible for the state to allow persons to smoke in public transport vehicles. He recommended that the ban include private cars with passengers under 18, who would be at risk of developing cancer without making an informed decision.

Finally, he emphasized the importance of treatment of tobacco dependence, since it was a
disease. Dr Yusuf further suggested that treatment should be supported by medical schemes.

Discussion
Ms Malumise asked Dr Yusuf whether it would be feasible and acceptable for South Africa to have a smoke-free 2010 World Cup.

Dr Yusuf responded that it would indeed be a great responsibility for South Africa to have a smoke free 2010, adding that South Africa could not afford to imagine that the 2010 World Cup was not smoke free. Dr Yusuf urged the committee to support any effort to ensure that 2010 was smoke free.

Ms Malumise further enquired whether snus was the same as snuff, and whether chemicals were added to snuff

Dr Yusuf confirmed that chemicals were added to snuff, and maintained that this was why regulatory oversight was necessary.

Ms Matsemela said that Dr Yusuf’s presentation had added totally new information. She emphasised that all of the information heard needed to be balanced. Ms Matsemela asked whether tobacco product was defined as a product containing tobacco, which included snus. Ms Matsemela further enquired about the difference between ingredients and emissions, and finally whether nicotine or tar was more harmful.

Dr Yusuf responded that the current definition served the purpose. He added that nicotine could be delivered in various ways, including through water, lotion and gel. Dr Yusuf mentioned that If the definition covered such delivery modes, snus would definitely be a tobacco product for human consumption. In response to the query on ingredients versus emissions, Dr Yusuf clarified that the ingredients constituted the product, and emissions were produced from it.

Dr R Rabinowitz (IFP) asked whether there would be spectators to the 2010 World Cup if it were tobacco free. She further asked what would be recommended as a behaviour change or a replacement activity for smokers, and whether they would be likely to smoke dagga or move to alcohol as a replacement. Finally, she asked if there was any research to indicate that snuff was not addictive or that it was carcinogenic.

Dr Yusuf suggested that the generic description of snuff be used for this discussion, although all snuff products were different, just as every cigarette product is in terms of the way it is manufactured. He said that products could be made in a relatively harmless manner if they did not have a high pH, something which did not have a high pH would not be used as it would not be able to give the user “a rush”. On the subject of activity replacement, Dr Yusuf mentioned that there was no actual need in the body to replace nicotine, but the product had unfortunately been engineered to make it addictive. Using the example of a prevention programme in Limpopo Province, Dr Yusuf indicated that some people used snuff to keep themselves awake to study, and there were suggestions that even such “casual” use was enough to create addiction. Dr Yusuf also mentioned that studies did exist which indicated that snus increased cardiovascular risk.

The Chairperson thanked Dr Yusuf for his elucidation which had helped eliminate confusion. Swedish Match was yet to make its presentation on snuff and snus.

The Chairperson asked Dr Yusuf whether he was comfortable with the definition.

Dr Yusuf confirmed that he was and stressed again that ,the burden of proof should be borne by the manufacturer.

Heart and Stroke Foundation of South Africa (HSFSA) and Youth for Health (Y4H) submission
Ms Zulfa Abrahams, National Health Promotion Manager, HSFSA outlined that the HSFSA, a community based programme, were in full support of the legislation which aimed to prevent the youth from starting to smoke, and to protect non smokers from the toxins produced by tobacco smoke. She further outlined that the HSFSA wholeheartedly support the Bills increased requirements regarding smoking in public places as well as the further protection of defenceless children from the dangers of smoking, and indicated that the statistics of smokers had declined since introduction of the stricter legislation. Smoking currently killed 80 South Africans per day and increased the risk of strokes and heart disease. Tobacco, the second world wide cause of death, produced ill effects when used exactly as the manufacturer intended. It also worsened a number of other diseases. Ms Abrahams tabled numerous statistics, including the specific effects of smoking on children. She concluded that smoking was best dealt with through health promotion interventions, such as legislation banning smoking in public places, as well as individual stop-smoking programmes, maintaining that such initiatives could save South Africa R300 million per annum. Finally, she stated that governments had a duty to inform the public of the hazards of breathing in other peoples tobacco smoke, and that adults should act on that advice to protect the health of children.

Ms Wanelisa Albert, Youth For Health, a global youth activist group, said that four youths were nominated by HSFSA to attend a Global Youth Summit on Health in India in 2006, when tobacco was on the agenda. A youth branch of HSFSA had now been formed. Most youths started smoking before 18 years old, and the starting age was lessening, to as young as 10. Half of those who take up smoking would die from it. There were still many misconceptions that smoking was glamorous, and therefore there needed to be action programmes. Ms Albert expressed her full support for government to enforce legislation which would help protect the health of the youth and increase longevity. Ms Wanelisa also expressed support for the amendments to increase the legal purchasing age and control smoking in public places..

There were no specific questions.

British American Tobacco (BAT) company submission
Mr David Crow, Managing Director, BAT made it clear that BAT was not opposed to regulation. BAT was the largest tobacco manufacturer in South Africa, investing more than R127 million in corporate social investment in the past four years. It employed 2 300 people and sold 70% of legal tobacco products in South Africa.

Mr Crow accepted that harm reduction was an established public health priority, and included condom distribution, regulation of fat content in foods, healthier food options, safety glass and air bags in vehicles. There were numerous aspects to reduction of harm of tobacco products. He urged Parliament to seek pragmatic rather than abolitionist solutions. BAT supported balanced regulation of tobacco products and suggested that South Africa had the opportunity to lead the world in regulating tobacco harm reduction. Mr Crow commended the Act and said that it had substantially met the requirements of the WHO FCTC. Mr Crow further highlighted the fact that BAT was committed to working with all stakeholders to reduce the negative health impact of tobacco use.

Mr Crow highlighted a number of possible ways to reduce tobacco harm, including lower tar and nicotine intake, reducing the number of smokers, eliminating under age consumption, limiting public exposure to environmental tobacco smoke (ETS) and alternative methods of nicotine ingestion such as Swedish style snus. He quoted a report that stated that switching to snus could save lives.

BAT did have a number of concerns about the proposed legislation. These included the definitions of ‘brand element’; ’organised activity’ and ‘tobacco product’. Mr Crow said that the current wording of the Bill was problematic insofar as hosting of corporate events was concerned. BAT was also concerned about the powers given to the Minister, and felt that a number of issues could be amended without referring back to Parliament.

Dr Crow tabled some details on ignition propensity of cigarettes, stating that the tests were not conclusive and more research was needed.

BAT proposed that the Department of Health should engage constructively with all stakeholders to understand the dynamics of tobacco harm reduction and establish a foundation for regulation. It should be cautious of over regulation. Parliament should ensure that its authority was not usurped. Further research was needed on some issues.

Discussion
Mr Morgan (DA) questioned why BAT in South Africa did not set its own targets and better its current minimum in terms of tar content.

Mr Crow responded that BAT believed openly that there was a close relationship between the amount of tar in cigarettes, and the amount of damage the tar can do. The lower the tar content, the less damage. He added that cigarettes in Europe had a tar content of 10mg, and that there was a progressive step-down of tar by governments. BAT offered cigarettes at 1mg, 2mg, 4mg, 6mg, 8mg and 12mg based on ISO testing, and clarified that BAT offered consumers the choice. Mr Crow stated that 92% of consumers in South Africa smoked a 11mg or 12mg product, whilst only 5-6% smoked lower tar cigarettes, or “extra mild”. He reiterated that consumers would make the final decision.

Mr Morgan was concerned that there should be more discussion with the Department of Health. He further mentioned that he was interested to know comments on a court case last year regarding the marketing of cigarettes to children. Obviously it would make sense for cigarette companies to market to children in order to secure future clientele.

A representative of BAT clarified that the litigation was not brought against any of the BAT companies, and therefore did not impact on it, although he was at pains to point out that BAT had no intention of marketing cigarettes to children. Mr Crow agreed, and stated that he and the company would not want people under age to smoke. He added that marketing to this group would be bound to fall foul of government and societal feelings.

Mr Morgan expressed his hope that BAT was doing research regarding self extinguishing cigarettes.

Mr Crow highlighted that many people were doing research. He expressed his view that this should be legislated properly and openly debated. Mr Crow mentioned that Canada and two states in the United States had done this. He added that the scientific community was querying whether this was the right technology. Mr Crow added that it was not just a Phillip Morris technology, and that there were many paper suppliers that existed. He emphasized that BAT believed it was a good thing, but that any solution must be robust and scientifically based.

Mr Crow reiterated his concern about derogating power to the Minister without enough public consultation. Time was not a factor, and even if this research took a year or 18 months, it would be useful to have the research and the legislation done properly. He further urged the Portfolio Committee to allow the NGOs and the industry to share the science with the Department of Health and themselves.

In response to Mr Morgan's comment regarding dialogue with the Department of Health, Mr Crow mentioned that BAT were also hoping for this necessary discussion with the Department of Health. Mr Crow mentioned that his colleagues in the pharmaceutical industry, the medical industry and the nursing area are also finding it difficult to communicate with the Department of Health, although cooperation was working well in regard to other Departments. It might be that DOH suffered from lack of resources and a busy agenda that. Dialogue was necessary in order to move forward.

The Chairperson referred to the possible reduction of tar and nicotine intake. She had understood from previous presentations that as long as there was nicotine, the addiction and craving to smoke would remain. She asked what would the impact be of returning to ‘mild’ and ‘light’ cigarettes.

Mr Crow responded that BAT believed that there was a dose response to nicotine. BAT did not deny that this was harmful. He added that the drive to lower tar content, whether it be ‘mild’ or ‘light’, was a debate that the Portfolio Committee should have. He reiterated BAT’s position that less tar is less harmful.

The Chairperson asked Mr Crow whether he meant that there would be less harm because there was less tar and therefore less nicotine.

Mr Crow responded that there was no such thing as a safe cigarette, which BAT very openly acknowledged. Nicotine would always be addictive, and tar would always be harmful. Mr Crow added that government had chosen the regulations, and industry had complied with them. It would take some incredible science for industry to create a safe cigarette.

A BAT representative) mentioned that when discussing dose harm relationships, it was necessary to discuss the physiological concept of yield as well, which would include the amount of smoke that the smoker actually ingested. She further questioned how we correlate that with a dose harm relationship. She said that the individual yield was the starting point of understanding a dose harm relationship.

Ms Mashigo (ANC) mentioned that, from a physiological viewpoint, a cigarette did contain tar. She suggested that Ms Mary Ann’s qualification was an assumption, and not a fact. Ms Mashigo clarified that there would be no uptake of tar from a cigarette until it was lit, when the tar would be activated by combustion. Cigarettes caused harm to the physiological, cardiac and respiratory systems.

The same BAT representative mentioned that tar was an acronym meaning Total Aerosol Residue, and clarified that referred to the gas once the leaf was burnt. She added that the quantification of zero tar in a cigarette was correct from a scientific point of view, but that this did not mean that there was no chemistry taking place during combustion.

Ms Fay Kajee, Communication Manager, BAT added that at no time did BAT suggest that smokeless is harmless, and clarified that snus was regarded as being 90% less harmful than cigarettes.

In response to a further question about snus, the Chairperson stated that this issue could be more appropriately addressed at a later stage during the discussions and presentations with Swedish Match, the manufacturers of Swedish style snus. She reminded Members that Mr Crow had stated that snus contained nicotine, and that some doubts had been expressed by Dr Yusuf about the information and education from the Swedish government on harm reduction.

Mr Crow mentioned that the government of Sweden had fought the EU as they believed that there was a reduction in harm from the consumption of snus. He urged the Chair to see the real data, and not the emotion regarding this matter.

The Chairperson stated that the final decisions must be balanced and if something was working, and if the Swedish government was supporting the issue, then the positive aspects must be seen. Mr Crow mentioned that the Swedish government would not politely accept what the tobacco industry has to say.

Ms Malumise stated that there was no way that this democratic government was intending to ban smoking or cigarettes in South Africa altogether. She stated that the Committee had heard that South Africa’s tobacco control laws had harmed the tobacco industry. She wondered just how the profits had been affected.

Mr Godi asked why this Portfolio Committee should aim for half way in harm reduction rather than promote abstinence, since all appeared to agree that tobacco was harmful.

Ms Matsemela said that the Committee should acknowledge the fact that the industry had all of the negatives. She commented that this presentation supported legislation. She pointed out that Section 22 of the Constitution,referred to choice of profession and occupation, but highlighted that the law could regulate that profession. She felt that the issues needed to be honed. There was agreement that snus was a product that contains tobacco. She did not see that there was a problem in the Bill, as it was understood that snus was ultimately consumed through diffusion. In regard to Mr Crow’s concern regarding the executive powers given to the Minister, Ms Matsemela referred Mr Crow to section 27(2) of the Constitution which stated: “The state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realization of these rights.” She added that the powers of the Minister were entrenched in the Constitution.

The Chairperson felt that he would like Mr Crow to have more time to be able to address some of the questions raised effectively, and suggested that the public hearing resume on Tuesday morning, 30 January 2007 at 9am, when BAT should be given a further opportunity to speak.

The Chair acknowledged the assistance of PMG with technical issues and use of its laptop.

The meeting was adjourned.


 

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