Introduction
Analysis of Smoking Prevalence Globally
Despite general usage drops in some countries, significant increases in cigarette use are appearing among teenagers and in low-income nations. To avoid an increase in cigarette damage, legislatures must enact a stricter tobacco control policy. Smoking is presently practiced by 945 million men and 177 million women aged 156and up globally (Patwardhan & Rose, 2020). Close to three-quarters of male regular smokers reside in countries with a substantially greater Human development index, whereas 50% of female heavy smokers dwell in countries with a far more high HDI.
The incidence of male smoking has increased dramatically in the majority of low to very high Human Development Index countries during the last century, although in very high Human Development Index countries it has occurred earlier. Almost all nations with a Development Index observed a considerable decline in male smoking after the 1960s (Riahi et al., 2018). Many nations with a medium or high Human development report have experienced a decrease in frequency, although a modest one since the turn of the twentieth century. Regardless of the fact that the smoking rate has consistently been modest in most low HDI nations, this still equates to millions of smokers (Riahi et al., 2018). In high HDI nations, female tobacco consumption peaked several generations later than male smoking rates, however, it has stayed relatively low or risen mildly in other countries.
Sir Walter Raleigh is reported to have introduced cigarettes to the United Kingdom on August 01, 1587, when he arrived from Virginia (Musk & De Klerk, 2003). Tobacco, on the other hand, would have been most likely widely available in the UK far before this time. For several years, Spanish and Portuguese mariners smoked tobacco, and British seamen are assumed to have started smoking pipes around 1587. It is possible that Sir John Hawkins and his men introduced it to these coasts as early as 1567. In 2020, the percentage of cigarette smokers in the UK was 15.1 percent or around 8 million people. The most recent numbers show a considerable decrease in the number of regular smokers from 2017 when 13.9 percent of individuals smoked, and this trend is expected to continue.
It is vital to realize that the emergence of South African tobacco coincided with the nation’s democratic reformation following the end of segregation. Once this connection is recognized, the significance of political ties to the tobacco business may be better understood. Till the mid-twentieth century, the white Afrikaner community was mostly involved in the South African agriculture industry. Approximately 7.9 million individuals aged 15 and above currently smoke. Smokers in South Africa consume approximately 20 billion cigarettes per year or 2,640 cigarettes per individual. Unauthorized tobacco products constitute almost a third of the target segment of in South Africa.
Critical Analysis of the Policy Drivers
There is now general agreement that governments must enact comprehensive tobacco control programs in order to substantially reduce cigarette consumption. Here are a few instances:
- The Act, which went into effect on July 1, 2007, prohibits smoking in all public enclosed or substantially enclosed locations, as well as workplaces.
- Smoking is prohibited in vehicles that serve the public or are used for employment.
- Appropriate no smoking posters indicators should be conspicuously plotted in all public regions.
- Smoking enclosures in the workplace are not permitted under current legislation.
- The owners/managers of any facility must make reasonable measures to ensure that all workers and/or visitors are aware of the restriction and that it is implemented.
- Smokers searching for a suitable smoking space should observe the no smoking signs posted throughout the site or ask a staff member.
Policy drivers in the UK and South Africa
The restriction of smoking in public places (2007) policy in the UK
Passive smoking, often known as secondhand smoke, has a comparable impact on nonsmokers. According to Manouchehrinia (2013), secondhand smoking is associated with greater Intellectual deficits in adults over the age of sixty who have stayed with a smoker for a minimum of 25 years. In these circumstances, secondhand smoking increased the chances of dementia by 32% in adults beyond the age group of 51. Passive smoking by a parent or close relative can cause cognitive impairment in children and teens (Little et al, 2004). Riahi (2018) used a meta-analysis of 130 cohort studies, 170 case-controlled studies, and 170 cross-sectional studies to confirm that persive smoking elevates the chances of lung and cervical cancer.
Secondhand smoking is connected to beyond than 30,000 cases of lower respiratory tract infection, 130,000 episodes of asthma, more than 23,000 new reports of reports congestion and asthma, 300 reprts of bacterial meningitis, and 40 unexpected newborns fatalities in the United Kingdom per year. As a result, the NHS spends at least 23.3 million pounds per year on over 300,000 primary care visits and over 9,500 hospitalizations. Every year, secondhand smoking is associated with 2700 fatalities in persons aged 20 to 63, and over 8,000 deaths in those aged 65 and over (Riahi et al, 2018). In 2012, smokers’ cigarette postpones, illness, and persona responsibility expenses amounted to more than 3,500 pounds per year. Reduced productivity costs were 300 pounds, time off work was 346 pounds, tobacco breaks were 2,145 pounds, additional health costs were 1,387 pounds, and a pension of 200 pounds per year (Little et al., 2013)
Smoking policy in South Africa
South Africa has a prohibition on tobacco advertisements and smoking in public places, as enacted by the Tobacco Products Control Act 83 of 1993. The statute, as amended in 2008, raised the selling age from 16 to 18 years old and prohibited tobacco sales in health and educational organizations. Although smokeless tobacco and heat-not-burn products are controlled as tobacco products, e-cigarettes are not explicitly forbidden by statute and are subject to medical restrictions. In practice, however, this is not strictly controlled, and vaping goods are commonly available. The policy enacted are as follows
- Approximately 8 million people ages 15 and older currently smoke.
- Smokers in South Africa smoke approximately 28 billion cigarettes per year or an average of 4,771 cigarettes per smoker annually.
- Illegal tobacco products account for an estimated 26 percent of the South African market.
Leadership challenges of policy implementation to curb smoking.
Ban of smoking in public policy
After 18 months of enforcement, 99.2 % of the institutions inspected were deemed to be in compliance with the limitation. Shortly after the smoking ban went into effect, there was a decrease in respiratory sickness among bartenders. According to one study, hospitalizations for hypertension reduced by 3.2% after the policy was modified, resulting in 1,300 fewer cardiac attacks annually. Less than 16% of UK residents smoke now, down from 22% in 2006, marking a significant decrease in the country’s overall smoking rate (Little et al., 2013). It’s arguable if the smoking ban contributed to the drop in smokers, although it seems probable that it did.
According to a 2017 YouGov poll, support for a smoking ban has grown since 2008, with 84 % in favor, up from 72% in 2006. Tobacco smokers are often thought to be the primary source of this propensity. The long-term impacts of England’s smoking prohibition are more difficult to anticipate. We won’t know how the smoking ban has affected public health for a while because lung cancer rates tend to diminish over time. Between 2007 and 2015, more than 7,000 pubs (out of a total of 56,000) in the United Kingdom closed owing to a restriction on the sale of alcoholic drinks. It’s unclear if the smoking prohibition, the 2007 financial crisis, or changing attitudes about drinking led to the decline in the number of pubs. Pubs have grown more family-friendly and restaurant-like since the smoking ban went into place, but many traditional pubs have had to modify their business techniques to stay viable. The United Kingdom has risen to the top of the European tobacco control league table. “England was simply jumping on a bandwagon when the Legislation was enacted. In the previous time, there has been congestion of legal provisions, with the Great Britain often leading the way.” Since 2007, England has increased the limit purchase age for tobacco commodities, added graphic cautions pictures to packaging, prohibited the sale of tobacco products through vending machines, and implemented regulated tobacco product packaging. The smoking ban was intended not just to enhance public wellbeing but also to usher in a new age of tobacco policy.
Resource allocation strategies
A lack of authority is a problem caused by those in places of authority failing to enforce the policies. Tobacco control organizations, such as the Tobacco regulatory Board, which has been without funding since 2009, may be contributing to the situation. Because of their minimal involvement in policy creation, it is probable that law enforcement officers are uninformed of their function. There are no specific criteria in place to continue the policy of keeping cigarette tax rates high in order to improve public health. Incorrect use of sanctions to address cigarette fraud, particularly among repeat offenders.
Strengths of the Policies to Reduce Tobacco Smoking
The program’s primary strength was its ability to reduce the economic, health, and social costs of smoking. Every year, billions of pounds are spent on treating diseases and problems caused by smoking and secondhand smoke. Furthermore, many people are less productive because they must take time away from work to receive care for their illness. Furthermore, smoking causes a substantial number of premature deaths among young individuals, reducing productivity and increasing social costs.
Weaknesses of the policies to reduce tobacco smoking
Policies on pricing
Tobacco use can be minimized by boosting the price of cigarettes through excise taxes. The price elasticity, Which evaluates the rate adjustment in the brand necessary as a result of a 1% inflation rate, is a standard method for determining customer responsiveness.
Non-smoking air regulations
Tobacco use is prohibited in all public places, including workplaces, designated smoking areas such as pubs, restaurants, and retail establishments, as well as public transportation. The United Kingdom is a high-income country that can benefit from initiatives in health communication with a large audience. Broadcasting, print, digital media, and out-of-home advertising are all examples of mass-reach health communication programs (eg, billboards, point-of-sale). It is standard practice to use formative testing to produce messaging aimed at reducing the initiation of cigarette use in youthful individuals or increasing smoking cessation, hence boosting the country’s taxation standing.
South Africa, on the other hand, is a middle-income nation that should raise the price of cigarettes, ban tobacco sponsorship, promotions, and advertising, support comprehensive tobacco control programs that include implementing full SFALs and media campaigns if they wish to reduce smoking (Groenewald et al. 2007). Cessation therapy policies and obvious visual health warnings are likely to have the most impact when incorporated with other legislation that increases the number of persons attempting to quit smoking.
Conflicts of interests in the national government
The implementation of the introduced policy is decided in part by its impact on the present cigarette adjustment surrounding and whether or not additional interventions are implemented concurrently. Interventions have a lesser likelihood of success in locations with strong anti-tobacco legislation and cultural norms than in regions with fewer or no tobacco prohibitions at all. As a result, policies implemented concurrently may have overlapping effects. To evaluate the compounding impact of incorporating numerous legislative measures, it is advisable to use effect sizes as consistent comparative cutbacks for policy measures with effect sizes and applied to prevailing smoking consistency (Ayo-Yusuf & Szymanski, 2010). When combined with other policies, this proposal resulted in a slightly smaller utter decline in cigarette consumption than if each policy was implemented independently. Given the uncertainty around the types and amount of tobacco policy interconnections, the impact estimates of combination policies should be assigned a more reasonable range.
Comparison
Tobacco tax costs should be increased, and more regulations should be put in place, with the most essential measures being a ban on smoking in public and at work, as well as a ban on all cigarette advertising and promotion. Between 1994 and 2004, the actual (devaluation) price of cigarettes grew by 120 % as a result of excise tax hikes (Gilmore et al., 2013). Since 1994, total cigarette consumption has declined by around one-third, while per capita use has decreased by roughly 43%. Despite a drop in cigarette usage, tobacco excise taxes increased government income by more than 145 percent between 1994 and 2004. Smoking is the greatest avoidable cause of mortality in the United Kingdom, accounting for approximately 150,000 fatalities every year (Gilmore et al., 2013). As a result, reducing the number of smokers is a key goal for promoting public health, and Stop Smoking Services are a vital NHS strategy to achieve this. Despite the fact that smoking prevalence in the UK has decreased, the health implications of smoking continue to be a major public health concern. Stop Smoking Services provided by the NHS provide intense group therapy or one-on-one assistance to those who want to quit smoking. At the five-week follow-up, the percentage of participants who claim they have not yet smoked in two weeks may be used to assess their success.
Between 2007–2008 and 2019-2020, the percentage of smokers who used NHS Stop Smoking Services and self-reported being successful in quitting after four weeks remained very steady, hovering around 50%. According to early figures, during the coronavirus (Covid-19) pandemic, the number of people who self-reported being successful in quitting increased to 60 %. This might be because of concerns that smokers are more prone to develop severe Covid19 effects.
Conclusion
South Africa has been more effective than the United Kingdom in lowering tobacco smoking in general. Intensive and constant agitation was necessary to persuade the government to create an effective cigarette monitoring system. Country-specific research from a number of industries was utilized to back up and bolster the lobbyists’ arguments. Second, quick increases in tobacco excise duty have been shown to be very effective in lowering tobacco consumption. Cigarette prices go up when the excise duty is raised, reducing cigarette use. In South Africa, an 11% rise in the real price of cigarettes reduces cigarette smoking by around 7% to 9%. Many other emerging countries have seen similar results. Third, while an increase in the excise tax is sometimes viewed as the most successful tobacco control instrument, tobacco control legislation is an important part of a comprehensive tobacco control strategy. Tobacco advertising restrictions and smoking prohibitions in public places and workplaces denormalize and deglamorize smoking, which is likely to increase the success of other tobacco control efforts. Fourth, the tobacco industry frequently states that it wants to work with legislators to achieve “fair and rational” cigarette control legislation.
When South Africa participated in the legislative process in 1994, the industry’s role was to delay and dumb down the legislation. When an amendment to the original legislation was created in 1999, the industry’s proposals were largely rejected, resulting in a clearer and more sustainable piece of legislation. Fifth, tobacco control legislation, particularly those prohibiting smoking inside in public places, is frequently self-enforcing. The firm, as it frequently claims, does not require heavy-handed police action. The Act underlines and shows that nonsmokers’ rights to clean air take precedence over smokers’ rights to smoke. Smokers usually avoid no-smoking areas.
References
Ayo-Yusuf, O. A., & Szymanski, B. (2010). Factors associated with smoking cessation in South Africa. South African Medical Journal, 100(3).
Boachie, M. K., Rossouw, L., & Ross, H. (2021). The economic cost of smoking in South Africa, 2016. Nicotine and Tobacco Research, 23(2), 286-293.
Evans, J. R., Fletcher, A. E., & Wormald, R. P. L. (2005). 28 000 Cases of age related macular degeneration causing visual loss in people aged 75 years and above in the United Kingdom may be attributable to smoking. British Journal of Ophthalmology, 89(5), 550-553.
Gilmore, A. B., Tavakoly, B., Taylor, G., & Reed, H. (2013). Understanding tobacco industry pricing strategy and whether it undermines tobacco tax policy: the example of the UK cigarette market. Addiction, 108(7), 1317-1326.
GRAHAM, H. (1988). Women and smoking in the United Kingdom: the implications for health promotion. Health Promotion International, 3(4), 371-382.
Groenewald, P., Vos, T., Norman, R., Laubscher, R., Van Walbeek, C., Saloojee, U., … & Collaboration, S. A. C. R. A. (2007). Estimating the burden of disease attributable to smoking in South Africa in 2000. South African Medical Journal, 97(8), 674-681.
Little, J., Cardy, A., Arslan, M. T., Gilmour, M., Mossey, P. A., & ITS MAGIC collaboration includes. (2004). Smoking and orofacial clefts: a United Kingdom–based case-control study. The Cleft palate-craniofacial journal, 41(4), 381-386.
Manouchehrinia, A., Tench, C. R., Maxted, J., Bibani, R. H., Britton, J., & Constantinescu, C. S. (2013). Tobacco smoking and disability progression in multiple sclerosis: United Kingdom cohort study. Brain, 136(7), 2298-2304.
Méndez, D., Alshanqeety, O., & Warner, K. E. (2013). The potential impact of smoking control policies on future global smoking trends. Tobacco control, 22(1), 46-51.
Musk, A. W., & De Klerk, N. H. (2003). History of tobacco and health. Respirology, 8(3), 286-290.
Patwardhan, S., & Rose, J. E. (2020). Overcoming barriers to Disseminate effective smoking cessation treatments globally. Drugs and Alcohol Today.
Riahi, M., Mohammadi, A. A., Rohani, H., & Bidkhori, M. (2018). Dataset on the prevalence of tobacco smoking in men and women of selected countries whit difference human development. Data in brief, 18.
van Walbeek, C. (2002). Recent trends in smoking prevalence in South Africa-some evidence from AMPS data. South African Medical Journal, 92(6), 468-472.
Verghese, C., Redko, C., & Fink, B. (2018). Screening for lung cancer has limited effectiveness globally and distracts from much needed efforts to reduce the critical worldwide prevalence of smoking and related morbidity and mortality. Journal of Global Oncology, 4.
write