Political change in South Africa: new tobacco control and public health policies.

Abstract

Over the past decade, there has been a dramatic turnaround in the South African government’s attitude toward tobacco control. Before 1993, tobacco control policy was virtually nonexistent, but the 1999 Tobacco Control Amendment Act gave the country some of the most progressive tobacco control policies in the world. Today, all tobacco advertisements and sponsorships have been banned; smoking at work and in restaurants is illegal, except in clearly demarcated areas; and explicit health warnings are required on all cigarette packs. Although cigarettes are still relatively cheap in South Africa, excise taxes represent almost 50 percent of their total retail price, after significant increases in 1994 and again after 1997 (van Walbeek 2002b). As a result of these policies, cigarette consumption is on a downward spiral. According to Corné van Walbeek of the School of Economics, University of Cape Town, it decreased from 1.9 billion packs in 1991 to about 1.3 billion packs in 2002. The rate of decline has accelerated especially since 1997, when large tax increases sharply increased the price of cigarettes. In light of these accomplishments, many today regard South Africa as a model for other countries. But these gains have not come easily. They are the result of decades of steadfast lobbying by the health community and antismoking groups and of the new South African government’s commitment to public health. And they have come in the face of vehement opposition from the tobacco industry, advertising agencies, hospitality associations, and, until the early 1990s, an apartheid government with extraordinarily close links to the trade itself.