Prohibition has never and will never lead to smokers quitting

It is now beyond clear that SA's continued ban on tobacco-related products has been a total disaster in the midst of the Covid-19 pandemic. The government loses R35m in tax revenue every day, and South Africans continue to smoke as before.

What comes after the lockdown ends? Research from the Australian government suggests that there should be a relaxation of tobacco policy given that country’s own failures. SA should take note.

Recent evidence from Australia illustrates the folly of trying to reduce demand through regulation, not that we necessarily need to look beyond the lived experiences of our friends and relatives here at home. On July 16, the Australian Institute of Health and Welfare published its 2019 National Drug Strategy Household Survey (NDSHS).

The survey asked more than 22,000 Australians about the performance of their government’s health policies, which includes tobacco control. Australia introduced plain packaging for tobacco products in December 2012, and is the only market for which longer-term data exists on policy effectiveness.

NDSHSs were conducted before and after this policy became operative, giving an indication as to whether it has succeeded.

Plain packaging was introduced to make tobacco products less appealing and thus lead to lower demand. But the NDSHS findings are not surprising and confirm what economists have known for decades: regulation and, at worst prohibition, does not lead to lower demand.

The percentage of daily smokers in Australia up to the introduction of plain packaging had been declining at a steady rate of 0.46% a year for more than two decades. After 2012, the decline slowed - not accelerated - to just 0.26% a year.

Before plain packaging, three in 10 Australians had no interest in giving up smoking - and that number did not decline afterwards. This is not to say that plain packaging was the cause of an increased demand, but rather that it certainly did not reduce demand.

Where plain packaging and other regulations can be blamed for an increased demand is with illegal loose-leaf tobacco, consumed either in roll-your-own form or inserted into empty cigarette tubes. The proportion of Australian smokers consuming these products increased by 37% after plain packaging was introduced, meaning that the 10.5% of illicit tobacco users in 2010 became 14.4% in 2019.

A May 2020 KPMG study agrees, but puts the latest numbers far higher for overall consumption of illicit tobacco (which includes unbranded loose tobacco, along with contraband and counterfeit product) - there has been an 80% increase in demand, from 11.5% in 2012 to 20.7% in 2019.

The Covid-19 lockdown regulations in SA have similarly caused the demand for illicit tobacco to skyrocket. Indeed, the only reason smokers aren't rioting in the streets of SA is because they have managed to source cigarettes from the "black market", which is short for "the economy doesn't care about your politics".

Prohibition cannot work: demand will always be supplied. Governments should find innovative ways of decreasing demand, such as education and information about alternatives to smoking, such as vaping.

The data shows that plain packaging is not helping Australian smokers quit. It might even be contributing to growth in the illicit tobacco trade. The law of unintended consequences, as with all policy, makes its presence known. It would therefore be unwise, reckless even, for SA to introduce plain packaging as contemplated in the Control of Tobacco Products and Electronic Delivery Systems Bill of 2018.

As I pointed out at the time of the bill's public participation process, the impact assessment undertaken by the government was woefully inadequate. That it did not factor in the poor performance of the plain packaging experience in Australia, goes to show that the bill was ill-considered.

President Cyril Ramaphosa should send the bill back to parliament, where any plain packaging provisions should be removed.

Moreover, the bill's anticipated over-regulation of vaping products should also be revised, as vaping might prove to be one of the more effective means of getting people to quit smoking. If there is to be regulation, it must be proportionate and reflect the simple fact that vaping isn't smoking, and they should not be treated in the same way. Public Health England argues that it is at least 95% less harmful than cigarette smoking, and e-cigarettes have also been found much better for quitting smoking, compared with nicotine replacement treatment.

The Covid-19 ban on tobacco product sales is, however, the more pressing problem. It has cost government more than R1bn a month in revenue since March, and has likely led to the smoking of far more hazardous cigarettes than would be available on the legal market. It is not government’s place, nor is it evidently within its expertise, to dictate lifestyle choices, even and perhaps especially during this particular pandemic.

Even the National Institute for Communicable Diseases has admitted that there is little to no evidence linking smoking to severe Covid-19 cases.

If SA does not wish to learn from history, which teaches the lesson that prohibition has never and can never work, then perhaps we can learn a lesson from experiences in other countries right now. The Australian experiment with plain packaging shows that at best it has no influence on the prevalence of smoking, and at worst might lead to an increased demand for illicit tobacco products, already a major problem in SA.

If our government insists on being involved in the lifestyle choices of citizens, it must stick to education and information, and leave the disastrous ideas of over-regulation and prohibition in the dustbin of history.

This article was first published on BDLive on 23 July 2020
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