Re-emergence of Traditional Tobacco Products Usage in South Africa: an Unintended Consequence of Existing Tobacco Control Policy

ABSTRACT

South Africa has made observable and globally acknowledged successes in tobacco control. This paper examines a decade of the response to tobacco control policy in South Africa. It draws on previously published data and preliminary results from a recently conducted national survey of patterns and forms of tobacco products used in South Africa. Results suggest that smoking prevalence has decreased from 34in 1993 to 21.4in 2003; albeit a slower decline in the last five years among males. Similarly; smokeless tobacco (snuff) use has decreased from 12.6in 1998 to 8.4in2003 among black South African women; and from 18.2in 1999 to 14.5in 2002 among adolescents. This is despite the lack of excise tax on snuff. However; the use of snuff; previously used only by the elders; remains high among adolescents. The use of hand-rolled smoked-tobaccos accounted for 19of total tobacco consumption and it is especially common among the socially disadvantaged group in South Africa. The continued prominence of the use of traditional nicotine-delivery vehicles - snuff and hand-rolled smoked tobaccos - may represent consumers' method for compensating for the increases in cigarette prices. Indeed; an unintended consequence of the existing policy environment. The study highlights the need to establish culturally relevant tobacco cessation services and suggests the need for a combination of tax reform and product regulation