The Heart and Stroke Foundation South Africa Presented by: Zulfa Abrahams (Dietician)

MISSION STATEMENT “The Heart and Stroke Foundation South Africa (HSFSA) is a community based health organisation established to reduce the incidence of heart disease and stroke in the population of South Africa by providing education and supporting research.”

The HSFSA supports the Tobacco Products Control Amendment Act, whose purpose is: Prohibit the sale of tobacco products by means of vending machines. Make the standards that apply to manufacturers of tobacco products applicable. Increase the fine for contravening the Act. Furthermore, we whole heartedly support: The Bill’s prohibition of selling tobacco products to and by persons under the age of 18 years. Since the first ‘Tobacco Products Control Act of 1993’ was initiated, many steps towards effective tobacco control policies have taken place. The impact of the tobacco control policies was dramatic. In South Africans, 15 years and older, the smoking prevalence decreased from 32% in 1993 to 24% in (Heart Disease in SA Report, MR2007)

Smoking & Heart Disease A deadly combination Tobacco use kills half of its users before the age of 60 years if they start smoking at a young age and continue throughout their adult life. Smoking kills 80 South Africans per day – resulting in more than double the number of deaths occurring on our roads each year. (MRC) Tobacco users die of various diseases prematurely, but most die because of CVD (stroke and heart attack) followed by chronic lung diseases. In South Africa tobacco use accounts for 8% of all deaths annually. (MRC) Smokers have a 4 times greater risk of stroke compared with people who have never smoked cigarettes. (World Heart Federation)

The Fact: ANY form of Tobacco marketing sells DEATH 5 million deaths occur annually due to smoking related diseases (WHO). This is a lot of customers, which the tobacco industry needs to replace. Tobacco industry uses various marketing strategies to target particular groups. A key target is children since few smokers start after about 18 years of age. Since the ban of advertising of tobacco, other avenues of hidden advertising have been used such as colour coding venues and one on one interaction which still aim to increase consumption and brand share! Tobacco is the only legal consumer product that kills the user when used exactly as the manufacturer intended. A complete ban on any form of tobacco promotion is a cornerstone of the tobacco control policy!!

Smoking and Children Children inhale more air relative to their body weight than adults – therefore absorb more tobacco smoke toxins. Smoking by parents is the biggest contributor of children’s exposure to second hand smoke Children are less able to complain and remove themselves from smoke filled rooms! Children who breathe second-hand smoke are more likely to get colds, allergies, middle ear infections, and "glue ear", which is the most common cause of deafness in children. South African adolescents have the highest reported smoking prevalence amongst African health surveys (Healthy Active Kids Report 2007) Amongst these youths, 21% are smokers, nearly 7% frequent smokers and 6% had smoked before their 10 th Birthday.

Adolescence is characterized by a feeling of invincibility and a sense of curiosity. Young people experiment with different behaviors without giving thought to the long- term consequences of their actions. Parents & teachers warning them of the long term effects of smoking doesn't mean much to a young person, as living until 50 sounds like they would have had a VERY long life! The marketing of tobacco effectively lures teenagers to start smoking – as it is portrayed as classy and glamorous and smokers appear to be mature and popular – something teenagers aspire to be! Protect our future generation

Conclusion Smoking is best dealt with through health promoting interventions such as legislation banning smoking in public places, as well as through individual smoking cessation programmes. Conservatively it is estimated that such interventions alone could save South Africa R 300 million per annum We support the Tobacco Bill’s objective of preventing any form of promotion or distribution of tobacco products, as well the sale of tobacco products to under 18s. We are passionate about the health of our nation and our children and therefore champion the fight in protecting our children from the dangers of smoking. We believe the Bill will make a significant contribution to reducing the health, economic and environmental harms caused by Tobacco use in South Africa. Government has a duty to protect the future of this country from harmful substances such as tobacco.