- When first introduced, strict rules about tobacco advertising in South Africa helped to cut smoking from 32% to 24% in a decade.
- But 20 years later the country isn't the public health darling it once was, and adult smoking prevalence has stagnated at around 20%.
- Although a new draft Tobacco Bill was published in 2018 to get tobacco control back on track, it's stalled for years, and it's unclear when — or if — it will become law.
- What's behind the slow progress? The tobacco industry, suggests the research from the authors of this op-ed.
Although a new draft Tobacco Bill for South Africa was published in 2018 to get the country's nicotine habit under control, it's stalled for years, and it's unclear when — or if — it will become law. What's behind the slow progress? The tobacco industry, suggests the research from the authors of this op-ed
In the late 1990s, South Africa banned all tobacco advertising. No more did cigarettes appear on billboards or in newspapers and magazines, they weren't allowed airtime on radio or TV, and tobacco sponsorships were taboo.
It helped to cut smoking from 32% to 24% by 2003 , a decade after the country first introduced tobacco control laws.
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But 20 years later South Africa isn't the public health darling it once was, and the proportion of adults smoking has stagnated at around 20% — in stark contrast to the big wins from before.
Research among young people suggests the country isn't likely to kick its nicotine habit soon. A 2024 study found that close to four in ten (37%) learners from high schools in urban areas across eight of the country's nine provinces have vaped at least once, and one in six said they had used e-cigarettes in the last 30 days. Researchers described it as a "vaping crisis" .
South Africa's planned new smoking law is meant to get tobacco control back on track by introducing rules that would make public spaces completely smoke free, leave cigarette packages without any branding and ban displays at tills — and it would cover all tobacco products and e-cigarettes.
Yet despite the draft Bill first being published in 2018, it has languished for years, and it's unclear when — or if — it will become law.
In February, Parliament said provincial hearings held by the National Assembly's portfolio committee on health were done and oral submissions were scheduled to go ahead. After these, the committee was to ask the health department "to respond to all the issues that were raised" following which "they will adopt a motion of desirability, which will establish whether the committee is proceeding with the Bill or stopping [with the process]" .
What's behind the slow progress?
The tobacco industry, our research suggests . And the 2025 Global Tobacco Industry Interference Index , which surveyed 100 countries and was released in November, confirms this: it found many countries' parliamentarians, heads of state and ministers don't fight hard enough against industry interference in policymaking resulting in them sabotaging or delaying legislation.
South Africa ranks 56th on the list of countries (country nr 1 has the lowest interference and country nr 100 the highest interference).
Tobacco tactics: derail, dilute, delay
For our own research, we conducted 20 semi-structured interviews with experts in the tobacco policy space and used parliamentary documents and media coverage to see if the information matches.
Although South Africa has ratified the World Health Organisation (WHO) Framework Convention on Tobacco Control — of which Article 5.3 says public health policymaking should be protected from industry interference — we found a pattern of the opposite.
Tactics included funding campaigns that exaggerated potential job losses and illicit trade , surveys that compared public support for measures in the Bill to public support for addressing other health topics, and building alliances with tobacco farmer groups and small retailers, who were positioned as the public face of opposition .
Industry arguments were largely focused on the supposed negative economic consequences, similar to what previous research has shown , while omitting the potential costs borne by companies themselves, should the Bill pass. Some pro-tobacco lobbyists have reportedly called South Africa's efforts to get stricter on tobacco and nicotine use an example of "nanny state" overreach.
Industry actors were said to have flooded officials and researchers with lengthy documents to review during the health department's assessment on the Bill's social and economic consequences, and researchers supportive of the Bill were publicly criticised, sent hostile letters, and even faced complaints lodged with their employers.
Another tactic was to set up informal meetings with government agencies such as the South African Revenue Service and to promote alternative policy solutions, such as tax stamps. These controls fall outside the health portfolio, and so officials may be less aware of Article 5.3 of the WHO tobacco control convention and more susceptible to industry influence. Trying to get the focus to shift to alternative, less comprehensive policy solutions could be seen as a way to undermine stricter control measures.
The global playbook, tailored to the local context
These games aren't new. In fact, the tactics fit in well with what researchers call policy dystopia , seen worldwide in how the tobacco industry uses tricks to make up and spread misleading and harmful narratives to derail, delay and dilute public health regulation. Similar strategies have been used by the alcohol and food industries to oppose health policy in South Africa such as the 2014 alcohol advertising restrictions and 2018 sugary drinks tax .
But these strategies are also tailored to the local context.
For example, plain packaging and track-and-trace systems were framed as "foreign templates" that would disadvantage black-owned small businesses competing with multinational companies. This shows the industry was willing to tap into historical injustices in the South African context to fuel resistance.
Building relationships with media professionals and working with influencers to push pro-tobacco messages appears to be a strategy in South Africa too , as also seen elsewhere in the world, with examples seen of articles paid for by tobacco companies and local influencers sharing misinformation about the Bill.
In such news stories, arguments are often touted without a counter perspective or evidence being cited. For instance, in July, a TimesLIVE piece quoted the founder of the Centre of Excellence for the Acceleration of Harm Reduction (CoEHAR) at the University of Catania, without disclosing that the group was set up with and continues to receive money from the Foundation for a Smoke-Free World (now Global Action to End Smoking) , which is funded solely by Philip Morris International. This shows a worrying lack of transparency — a finding echoed also in previous research on media coverage, both in South Africa and also in other countries .
How can South Africa get on top of tobacco control again?
Our research points to three things that could help:
Stay alert: Knowing and tracking what tricks the tobacco industry gets up to, and how to counter these, can help South African policymakers spot strategies aimed at influencing the process of getting the Bill passed — and ensure these do not derail efforts to advance public health. For example, in Uganda, the tobacco industry worked hard to derail and delay the 2015 Tobacco Control Act , but effective responses from the public health community helped to ensure its passage . Exposure to tobacco advertising, promotion and sponsorship decreased from 25.4% in 2013 to 10.5% in 2023 .
Keep a list of meetings: Public officials and politicians should be required to make all meetings with people who have ties to the tobacco and nicotine industries known, in line with the implementation guidelines for Article 5.3. For example, Australia and the EU have transparency registers for logging "interest representatives" . Creating such databases, even if not completely comprehensive, can help improve transparency, allowing public health experts and civil society to call out inappropriate interactions with the industry.
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Get strict on illicit trade: As a party to the WHO's Protocol to Eliminate Illicit Trade in Tobacco Products , the country needs to improve how it enforces rules to limit illicit sales. For example, after 2010 Kenya introduced digital "track-and-trace" excise stamps and an electronic cargo tracking system, which allow authorities to follow tobacco products from manufacture to sale. These measures increased excise revenues by approximately 20% in two years (2013–2015), and increased overall tax compliance by 45% in 2014 .
With young people being lured by newer tobacco and nicotine products and a health system still recovering from COVID-19 (which, for example, overburdened hospitals and shifted the focus away from noncommunicable diseases), policymakers need to act decisively to reduce avoidable health risks and step up to help South Africans breathe easier — and keep the future generation safe.
Adam Bertscher is a teaching fellow in global and public health at King's College London. His research explores health-related public policy, with a particular focus on the commercial determinants of health
Britta Matthes is a research fellow in the Tobacco Control Research Group at the University of Bath. She focuses on tobacco industry interference in policymaking, and the role of tobacco control advocacy.
Allen Gallagher is a research fellow at and a co-director of the Tobacco Control Research Group at the University of Bath. His primary research focus is on exploring contemporary tobacco industry involvement in the illicit tobacco trade and related policy.
This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.
