NATIONAL
COUNCIL AGAINST SMOKING .
SUSTAINING SUCCESS
THE ”TOBACCO PRODUCTS CONTROL
AMENDMENT BILL 2007”
A submission to the NCOP
31 July 2007
INCORPORATED ASSOCIATION NOT FOR GAIN. Reg.
No. 76/00025/08 NONPROFIT Reg.
No. 023-970-NPO
SUMMARY:
Tobacco is a uniquely
dangerous consumer product. It is the only legal product that kills the user
when used exactly as the manufacturer intends.
In
Tobacco use is bad
for business too – it makes workers sick, so reducing productivity in all
sectors of the economy. Tobacco also keeps poor people poor.
The purpose of the Bill is to
ensure that young people don't start smoking, to protect non-smokers from
pollution due to tobacco smoke, to help smokers quit and to reduce the risks
for those who continue to smoke.
The
NCAS is especially supportive of the Bill’s increased requirements regarding
smoking in public places. The Bill seeks to better protect children from
passive smoking and seeks to guarantee workers their constitutional right to an
environment that is not harmful to their health.
SECTION 2
The
changes proposed to Section 2 of the Act include:
1.
Restricting
smoking near air inlets and entrances to public places. Many people now smoke
near entrances and exits to buildings as an unintended consequence of the
current law. As a result, high concentrations of tobacco smoke can be found
near doorways and smoke enters buildings via general airflow. This can be
particularly problematic for those with asthma or heart conditions, for whom
even short exposures to smoke can trigger an attack.
2.
The Bill seeks
to protect children in two ways. It proposes not allowing smoking in private homes
used commercially for childcare or educational purposes and in cars when young
children are passengers. It also proposes not allowing minors into the areas
set aside for smoking. Young children
are especially vulnerable to second-hand smoke and may suffer from many
respiratory problems. They are also less able to complain or remove themselves
from smoke-filled rooms
3.
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. The Bill proposes making it possible for people to safely
voice their concerns without fear of repercussions. The Bill also requires
employers to respect an employee’s right not to be forced to work in a smoking
section. People should not be required to endanger their health for the
opportunity to work.
4.
Section 2(3)
allows the Minister to prohibit smoking in certain outdoor areas, where smoking
may constitute a fire or other risk. In
crowded sports stadia exposure to tobacco smoke is likely to be sustained (from
a few hours to the whole day for cricket lovers) and significant. Vulnerable
people, who are very sensitive to smoke, can have their health put at risk.
SECTION 3
The amendments to Section
3A of the Act addresses regulation of the tobacco product itself. Manufactured
tobacco products are more toxic and dangerous than they need to be to deliver
nicotine.
The WHO has recommended
that countries establish manufacturing standards for tobacco products so as to
reduce their appeal to children, decrease their addictive qualities, and
decrease potential harm to users.
Cigarettes are the
deadliest form of nicotine delivery available on the market. Yet, cigarette manufacturing
is barely regulated. By contrast, pharmaceutical products that help people stop
smoking (such as nicotine gum and
inhalers) are subject to a lengthy and expensive government approval process
before they can be marketed.
A cigarette manufacturer
can add anything it wishes to cigarettes without any regulatory oversight. On
the other hand, if a pharmaceutical company wants to add mint flavouring to
nicotine gum to improve the taste, it must obtain approval from health
authorities. There is an overwhelming case for regulating tobacco products more
stringently.
The Bill allows for the
regulation of the substances that the manufacturer can put into tobacco
products (its constituents) and the chemicals that may be produced when tobacco
products are used (its emissions).
The
purpose of Section 3A is to reduce the harmfulness of tobacco products. It
requires tobacco manufacturers to produce the least dangerous product
technically possible.
The Bill also proposes
that cigarettes be manufactured in a way that reduces the likelihood of it
causing fires. In 2004, cigarettes
caused 1400 (or 4% of the total) fires in SA. Over R45 million worth of
property was destroyed. The devastating fire in 2005 at
Finally the Bill
increases the penalties so that they are a real deterrent to contraventions of
the Act. A fine of R200 for allowing
smoking in a restaurant is miniscule and has no impact on restaurant owners.
The National
Council Against Smoking (NCAS) welcomes the draft Tobacco Products Control Amendment Bill (B24-2006).
INTRODUCTION
1. The National
Council Against Smoking (NCAS) welcomes the draft Tobacco Products Control Amendment Bill (B24-2006).
2. The NCAS is a non-profit
organization established in 1976 with the mandate of promoting public health
through encouraging nonsmoking as a societal norm.
3. Tobacco harms both public
health and the economy. The World Health Organization and the World Bank have
both urged governments to control tobacco because it is a threat to health and
sustainable economic development.
4. The NCAS has consistently supported the country’s tobacco laws
and is in favour of the proposed amendments. The Bill will build on the important gains
that have already been achieved in lowering tobacco consumption since 1994.
5. This submission will
briefly review the policy objectives that will be served and evaluate the
likely effectiveness of tobacco control measures proposed in the Bill.
Unique treatment for a unique
product
6. Tobacco is the only legal
consumer product that kills the user when used exactly as the manufacturer
intended. There is also no safe level of
use.
7. All forms of tobacco
are harmful but cigarettes are more dangerous than cigars, snuff and snus.
8. Tobacco use causes, or
worsens, over 40 diseases including cancer, heart attacks, lung disease,
complications of pregnancy and TB.
9. Tobacco use kills about 30
000 South Africans each year or about 80 people a day. This is more than double
the number of deaths on our roads every year
10. A smoker is more likely to die from
tuberculosis (TB) than a non-smoker. Every day about 16 avoidable deaths from
TB occur amongst smokers.
11. Globally, only two major
causes of death are increasing rapidly - HIV and tobacco. The WHO predicts
that, unless urgent action is taken worldwide deaths from tobacco will double
from the current 5 million to 10 million annually by the year 2025.
12. Approximately 70% of these future deaths will
occur in the poor nations of the world, where already overburdened health
services are unprepared for this coming epidemic.
Tobacco use in
13. Fewer adults and children are smoking in
14. Since 1994, the number of adults who smoke has
gone down by over a third. About 5 million or 23% of adults smoke. Snuff is
used by about 10% of African women.
SECTION 2:
CONTROLLING TOBACCO USE.
Policy
goals
15. The reasons
for enacting legislation to control smoking in public places are to:
(a) ensure a clean and healthy environment;
(b) ensure that
the smoking of others does not impair the health of non-smokers;
(c) prevent the
nuisance which smoking may cause to non-smokers;
Background
16. In 2004,
smokers burned 25 million kilograms of tobacco in our air making tobacco smoke
one of our largest sources of indoor air pollution.
17.Cigarette smoke
contains over 4500 chemicals, including over 200 known poisons (arsenic,
cadmium, cyanide, nicotine, etc) and 60 chemicals that cause cancer.
18. Over 600
scientific studies have now linked passive smoking and ill health. It is a
cause of lung cancer and heart disease in adult non-smokers. In children it increases the risk of sudden infant
death syndrome (SIDS), acute respiratory infections (croup and pneumonia), ear
problems and asthma attacks.
19. 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.
20. A number of countries have now banned smoking
completely in indoor public areas, including
21.
A total ban on smoking in indoor public places has several advantages. It
would:
• be more effective than a partial ban in
decreasing 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;
• generate considerable cost savings to
society; and
• be simpler, more consistent and easier to
enforce.
22. Surveys show
that 80% of smokers and non-smokers support a ban on smoking in public places
in
23.
The Tobacco Products Control Amendment Act of 1999 took significant steps
toward protecting the public by prohibiting smoking in all enclosed public places
and workplaces, except for designated areas set aside for smokers.
24.
Almost overnight, the social norms regarding secondhand smoking changed.
Whereas previously people smoked anywhere and everywhere including in
hospitals, now the ashtray and smoky haze has almost disappeared.
25. Clear rules
defining where smoking is, or is not, permitted has averted needless conflict
between smokers and non-smokers. Both smokers and non-smokers can then
be sure of their
rights. The
public has embraced the law and shopping malls, public transport and workplaces
rapidly became smoke-free. With the exception of some in the hospitality
industry, the law is working well.
27.
The law is self-enforcing. The police did not have to sit in every cinema,
café, and office waiting to arrest offenders. Instead, ordinary citizens stood
up for their right to clean-air.
The Proposed Amendments.
28.
The NCAS is especially supportive of the Bill’s increased requirements
regarding smoking in public places. The Bill seeks to better protect children
from passive smoking and seeks to guarantee workers their constitutional right
to an environment that is not harmful to their health.
Restrictions on smoking near entrances
to enclosed public places:
29.
The NCAS supports moving 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.
30.
Significant numbers of people now smoke near entrances and exits to buildings as
an unintended consequence of the current law. As a result, high concentrations
of tobacco smoke can be found near entrances and exits through which the public
must go, and smoke enters buildings via general airflow.
31.
The NCAS has received numerous complaints from the public on this issue. For
example, many indoor diners complain that in coffee shops and restaurants they
are exposed to smoke from those smoking outside in the alfresco area.
32.
The problem can be fairly easily resolved by prohibiting smoking within 3
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.
33.
Since 1997,
Smoking in day care centres and the
entry of minors into smoking sections.
34.
The Bill seeks to protect children in several ways. It proposes not allowing
smoking in private homes used commercially for childcare or educational
purposes. It also proposes not allowing minors into the areas set aside for
smoking or in cars when children under 12 years are passengers.
35.
Young children are especially vulnerable to second-hand smoke because they
breathe more air relative to body weight than adults and so absorb more tobacco
smoke toxins. They are also less able to complain or remove themselves from
smoke-filled rooms.
36.
It is vital that facilities for children be smoke-free. Children of non-smoking
parents should not be exposed to harm while in day care. For children of parents who smoke exposure in
the home plus in the day care will be additive and increase the harm.
37.
In day care facilities, even if smoking is restricted to a single room in the
house, smoke will still drift throughout the home. It is not possible to
confine smoke to one area. The NCAS have
received reports of caregivers walking from other parts of the house into the
room where the children were with a lighted cigarette because he or she was not
consciously mindful of his/her smoking.
38.
Prohibiting smoking in day care and tutoring facilities only during times when children
are actually on the premises will not work. This disregards the fact that many
of the more volatile chemicals in smoke remain in the air for a long time
following the smoking of a cigarette (from four hours to days). Some of the
solid particles in smoke will settle on furniture, carpets and other surfaces
in the room. These then slowly re-enter
the atmosphere creating a hazard long after smoking has ceased. A simple test of how long smoking persists is
that one can still smell cigarette smoke in a home, or on clothes, long after
someone has smoked.
39.
In relatively confined spaces, such as smoking areas, where many people smoke,
high levels of tobacco smoke toxins can build up, To take children into these
places is recklessly exposing them to harm.
40.There is strong public support for a ban on smoking in
cars while children are passengers. The Bill is silent on this issue. Smoking
in cars can produce high concentrations of smoke. Even with all the windows open the
particulate matter levels can be higher than what is considered ‘safe’ for
sensitive groups like children and the elderly.
When the windows are closed the smoke concentrations can reach levels
considered hazardous for the general population.
41.
Prohibitions on taking children into public smoking areas can have an
educational effect for parents, who may be less inclined to smoke at home.
Smoking in sports stadia and other
crowded facilities.
42.
Section 2(3) allows the Minister to prohibit smoking in certain outdoor areas,
where smoking may constitute a fire or other risk. In crowded sports stadia exposure to tobacco
smoke is likely to be sustained (from a few hours to the whole day for cricket
lovers) and significant. Vulnerable people, who are very sensitive to smoke,
can have their health put at risk.
43.
In addition, many communities ban nuisances like loud noise at night, public
drunkenness, dogs defaecating on pavements, etc. So even when tobacco smoke may
not harm health it is still a major nuisance which should be controlled in
areas in which exposure cannot be easily avoided such as at railway platforms
and entrances to buildings.
Protecting the constitutional rights of
workers.
44.
The Constitution guarantees everyone the right ‘to an environment that is not
harmful to their health or well-being”. Sections 2(3) and (4) require employers
to respect employees’ rights and protect them from the harms caused by tobacco
smoke pollution.
45.
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. The Bill proposes making it
possible for people to safely articulate their concerns without fear of
repercussions.
46.
The Bill also places an obligation on employers to respect an employees right
not
to
be forced to work in a smoking section against their wishes. People should not
be required to pay with their health for the opportunity to work. The Bill
proposes prohibiting employers from coercing people desperate for employment to
work in the smoking section (section 2(5)(c)) and from seeking legal guarantees
that employees will not to hold them responsible for harm caused by working in
a smoking section.
47.
Business owners cannot contract with their workers to relax workplace safety
standards and the same rule should apply to tobacco smoke.
The special case of domestic workers.
48. The Act in
general prohibits smoking in workplaces, but continues to allow it in private
homes. Private homes can be a workplace for domestic workers. These workers are
therefore not protected from tobacco smoke in smoker’s homes. The Act has
created the discriminatory situation where domestic workers are given less
protection than other workers. The NCAS urges that this anomaly be ended and
that all workers, including domestic workers, be protected from pollution by
tobacco smoke.
SECTON 3A:
STANDARDS FOR MANUFACTURING AND EXPORT OF TOBACCO PRODUCTS
Policy goals
49.
The purpose of Section 3A is to reduce the harmfulness of tobacco products. It requires
tobacco manufacturers to produce the least dangerous product technically
possible.
50. The way tobacco
products are designed and manufactured affects their safety, appeal, and
addictiveness. Manufactured tobacco products are more toxic, carcinogenic, and
hazardous to health and the environment than they need to be to deliver
nicotine.
51. The Bill allows for
the regulation of the substances that the manufacturer’s can put into tobacco
products (its constituents) and the chemicals that may be produced when tobacco
products are used (its emissions).
52. The WHO has
recommended that countries establish manufacturing standards for tobacco
products so as to reduce their appeal to children, decrease their addictive
qualities, and decrease potential harm to users.
Background
53.
Despite their toxicity, tobacco products are currently subject to little
regulation regarding their content, design and manufacture. New tobacco
products can be introduced and the design of currently available products can
be changed on the whim of the manufacturers, and with almost no regulatory
oversight.
54.
Paradoxically, medications to help people quit smoking are strictly regulated
by the Medicine’s Control Council. These have to meet the same safety and
product standards as any other scheduled medicine and can only be sold through
pharmacies.
55.
A policy that barely regulates nicotine in its deadliest form (cigarettes),
while strictly regulating it in its safest form (medications) is not rational.
The WHO has recognized this is anomaly. The FCTC mandates that
governments require tobacco companies to reveal what ingredients they use in
producing cigarettes and that these are disclosed to the public.
56.
The cigarette is more than just dried tobacco wrapped in paper, and snuff is
not simply powdered tobacco leaf. Modern
tobacco products are highly engineered.
The manufacturers have spent enormous resources researching the design
and manufacture of cigarettes. The key goal is to deliver nicotine rapidly and
in sufficient quantities to feed a smokers craving.
57.
Highly sophisticated technologies are used to fine-tune the addictiveness of
the modern cigarette:
·
Ventilated
filters provide cooler and more dilute smoke. This enables the smoker to readily
inhale larger quantities more deeply into the lungs.
·
The physical
size of smoke particles is carefully controlled – using the science of particle
physics - to allow smoke particles to penetrate deep into the lungs.
·
Chemical
ingredients are added to the tobacco, filter, and paper during the manufacture
of cigarettes or snuff. These ingredients are called ‘additives’ and serve many
purposes.
58.
Up to 1400 chemicals can be added to tobacco. These additives:
·
Mask the
irritating and harsh taste of smoke (sugars are added).
·
Enhance nicotine
delivery, so increasing the addictive “kick” of nicotine (ammonia).
·
Keep the product
fresh (anti-fungals);
·
Control the rate
at which cigarettes burn (nitrates).
·
Produce a white
ash (chalk).
·
Give brands
their special flavour (cocoa, chocolate).
59.
Recognising that children often find the taste of cigarettes unpleasant,
60.
Chocolate, licorice, honey, sugars, menthol, and other flavourings help hide
the unpleasant taste of tobacco and make it easier for children to start
smoking. Menthol, for instance, numbs the throat and reduces coughing.
61.
On October 11 2006, a U.S tobacco company agreed to stop marketing candy and
alcohol flavored cigarettes in the U.S, because of its appeal to children, In a
legal settlement with government lawyers the company agreed to stop selling
cigarette brands with names like “Twista Lime” and “Mocha Mint”.
62.
Additives, such as ammonia change the pH of smoke so increasing ‘freebase’
nicotine levels. Free nicotine, like crack cocaine, passes more rapidly and
completely through the lungs into the bloodstream and has a faster effect on
the brain.
63.
The safety of many of the flavourings and other additives when burned and
inhaled has not been established.
64.
By engineering products to enhance addictiveness the industry makes it more
difficult for smokers to quit, and is thus deliberately increasing the overall
harm to the public.
65. The tobacco companies have over the years filed many patents
for technology that would have removed some of the harmful components of
tobacco smoke, but never made these ‘less toxic’ cigarettes available to the
public. The problem, according to industry documents is that in order to market
these changed cigarettes as ‘safer’, the industry would have had to admit that
its existing products were dangerous.
66. When a cigarette is
lit, the process of burning will produce over 4500 chemicals in the smoke – 200
of these are poisons (arsenic, cyanide, carbon monoxide, nicotine) while over
60 can cause cancer. The chemistry of
smoke is influenced by many factors including the type of tobacco used, the
length of the cigarette, the burn rate of the paper and how the cigarette is
smoked.
67.
Currently, the law in
68. The tar and nicotine
numbers that appear on South African cigarette packs are meaningless. They
convey no accurate information to smokers about what they are inhaling.
69. This is because the
International Standards Organization (ISO) testing methods currently in use for
measuring tar and nicotine are flawed. There is little relationship between the
ISO machine-measured yields of cigarettes and what smokers actually absorb.
Further, there are no methods for testing smokeless tobacco products.
70. Smokers can obtain as much
nicotine and tar from smoking ‘low-tar’ cigarettes as they can from smoking
regular cigarettes. This complicates the ability to regulate tobacco products.
To date, no country has fully met the challenge of developing comprehensive
product regulation standards.
Regulatory
Approach
71.
A new regulatory framework is needed in which the manufacturer is obliged to
demonstrate that no additional harm arises for tobacco product design decisions
such as the use of additives. While it is impossible to make a cigarette safe,
it is reasonable to prevent manufacturer’s doing anything that increases the
harm caused by tobacco smoke.
72.
A new framework should:
·
Require
manufacturers to disclose all additives used in tobacco products, by brand, to
the government.
·
Also require
them to disclose the purpose of an additive and its biological effects, if any,
when inhaled
·
Enable
government to order the removal of additives which increase harm.
·
Only allow new
additives if its safety can be demonstrated
·
Permit additives
necessary for the manufacturing and storage of tobacco products provided these
are safe, but bar all additives that may influence smoking behavior.
·
Not allow any
health claim based on the levels of ingredients, or emissions, or whether the
product meets regulatory standards.
73. The Bill proposes
providing broad legal authority to the Minister to develop standards for
constituents, emissions, product design, and testing methods, once there are
clear international guidelines for doing so.
74. While there is no such thing as a safe cigarette,
it remains the goal of public health to make cigarettes less harmful. The benefits of
reducing the levels of toxic chemicals are very small compared to the benefits
of stopping smoking. However, because of the large numbers of people involved
even a small reduction in risk is worth pursuing.
Reducing the fire-risks from cigarettes
Policy goal
75. The aim is to reduce
deaths, injuries and property damages resulting from fires started by
manufactured cigarettes.
Background
76. Smokers’ materials are a leading cause of residential
fires and fire-related losses in
77. Cigarette fires
typically result from lit cigarettes left unattended, falling asleep while
smoking in bed, smoking while under the influence of alcohol, or the tossing
away of a lit cigarette. When a lit cigarette comes into contact with flammable
products such as mattresses, bedding or upholstered furniture, it can start a
smouldering process that can continue undetected for some time before bursting
into flame.
78. It is possible to
reduce cigarette ignition propensity (that is the likelihood that a lit
cigarette will start a fire) by altering certain design characteristics of
manufactured cigarettes.
79. In July 2000, a major
American cigarette manufacturer released a reduced-ignition propensity version
of one of its cigarette brands in the
80. On December 31, 2003,
81. Reduced ignition propensity does not mean fire-safe. It
is impossible to make a burning object completely fire-safe. However, the
proposed regulations can save lives by significantly reducing the number of
fires started by cigarettes.
Regulatory approach
82. The Bill allows the
Minister to set a ‘performance standard’ that all cigarettes sold in
PENALTIES.
83. The Bill increases the penalties for contraventions of the law so
that they are a meaningful deterrent.
The fine for the owner of a public place is increased from R200 to a
maximum of R50 000, and for individual from R200 to a maximum of R500.
84. The proposed fines are reasonable and modest compared to those for
other offences. For instance the maximum
fine for selling liquor to a minor is R 1 million, and for poaching perlemoen
it is R 800 000.
CONCLUSION
85. This
submission has provided a rationale for the amendments contained in the
Bill. The NCAS believes that the Bill is
fair, reasonable and workable. It will make a significant contribution to
reducing the health, economic and environmental harms caused by tobacco use in
86. Freedom from
addiction is a child’s right and society’s responsibility. We trust that the
NCOP Committee will put the freedom of children to grow up healthily above the
freedom of an industry to sell a deadly drug.
31 July 2007
NCAS