In a rare outbreak of evidence-based policy, the Portfolio Committee on Health has repudiated the dogma that “harm is harm”. Credit where credit is due.
I have not been kind to the Tobacco Products and Electronic Delivery Systems Control Bill.
I have called it an anti-smoker bill that ignores science and will backfire. I have described South Africa’s tobacco policy as a contradictory mess. I have argued that the Bill ought to be scrapped in its entirety and replaced with a tobacco policy copied from Sweden, since it has been unusually successful.
So, it is only fair, having spent years flogging Parliament for its prohibitionist instincts, to give credit when Parliament gets something right.
On 24 June, the Portfolio Committee on Health adopted a motion of desirability on the Bill, by ten votes to one, with support spanning the ANC, DA, MK Party, EFF and ActionSA. That, in itself, is unremarkable. Motions of desirability are usually rubber stamps.
Learning from submissions
What was remarkable was the statement issued by the committee’s chairperson, Faith Muthambi.
The committee, she said, had learnt from the scientific submissions before it, and from its own deliberations, that not all tobacco and nicotine products carry the same risk. Combustible products – the ones that burn – pose the greatest threat to public health. Non-combustible products do not belong in the same category, and a law that pretends otherwise is, in her words, “not a stricter law, it is a less accurate one”.
The committee has consequently endorsed differentiation between product categories as a guiding principle, and Muthambi noted that the Department of Health, in its March 2026 responses to public comments, has officially accepted the same principle, making concessions and proposing amendments to give effect to it.
She went further. Harm reduction, she said, must be applied carefully, and not dismissed as a loophole in tobacco control. It is not a commercial argument or a special interest’s plea: it is the position of the World Health Organisation itself.
Article 1(d) of the Framework Convention on Tobacco Control – the very treaty that prohibitionists invoke to justify their crusade – defines tobacco control as a range of supply, demand and harm reduction strategies.
That last clause is the one the anti-smoking lobby routinely pretends does not exist.
A doctor changes his mind
Muthambi credited her predecessor for the admission that “harm is harm” is not a scientifically defensible principle on which to build legislation. That predecessor, Dr Sibongiseni Dhlomo, a medical doctor and former deputy minister of health, wrote candidly in the Sowetan earlier this month about how his own view changed.
He came into the job holding the orthodox position: a cigarette, a vape, a nicotine pouch – all deliver nicotine, all carry risk, all deserve similar treatment under the law. It seemed logical and consistent. It was also, as he came to understand, wrong.
What changed his mind were the submissions from medical and scientific specialists. The harms most strongly associated with cigarettes flow from combustion. Burning tobacco produces the carcinogens that drive smoking-related cancers; nicotine on its own does not.
Products that deliver nicotine without combustion simply do not sit at the same point on the risk spectrum as products that burn tobacco, and treating them as if they did is, in Dhlomo’s phrase, “a regulatory shortcut rather than a regulatory strategy”.
The willingness to revise an approach in the light of better evidence, he concluded, is not a weakness in public service, but the discipline the work requires.
“South Africa is showing what evidence-based lawmaking looks like in practice,” said Dr Delon Human, leader of tobaccoharmreduction.net, in a statement. “When a policymaker is willing to revisit a starting assumption in light of the science, the result is regulation that actually reduces harm, rather than regulation that simply looks strict. We hope this principle of risk-proportionality is carried through every remaining stage of the Bill.”
In a political culture where changing one’s mind is treated as ideological betrayal, and doubling down on error as strength, Muthambi and Dhlomo’s about-turns are worth celebrating.
It is doubly worth celebrating because the committee’s conversion was not the product of backroom lobbying, but of public participation on an extraordinary scale: hearings in 27 municipalities across all nine provinces, attended by nearly 7,900 people, with more than 1,100 oral submissions and some 40,000 written ones.
And then the committee actually listened. This is what deliberative democracy looks like on the rare occasions that it works.
Evidence heeded
The evidence for differentiation is not subtle. Sweden, by embracing snus, nicotine pouches and vapes as safer alternatives to smoking, and taxing them in proportion to their risk, became the first country in Europe to reach the official ‘smoke-free’ threshold of less than 5% smoking prevalence – 16 years ahead of the European Union’s 2040 target. It boasts dramatically lower rates of lung cancer and tobacco-related mortality than the EU average.
The United Kingdom integrated vaping into its national smoking cessation strategy, on the strength of successive evidence reviews finding that vaping, while not entirely risk-free, poses a small fraction of the risk of smoking.
Its ‘swap to stop’ programme hands smokers vape starter kits; in a randomised trial run through hospital emergency departments, smokers given vaping kits were 76% more likely to have quit a year later than those merely given quitting advice.
Roughly 50,000 South Africans die of smoking-related diseases every year – some 7% of all deaths. The moral stakes of getting this law right couldn’t be clearer. “Quit or die” is not a public health strategy. It is a death sentence for the many smokers who, despite every tax, ban and lurid warning label, cannot quit.
The hard part lies ahead
A note of caution is in order. A motion of desirability endorses the subject matter of a Bill, not its text.
Muthambi herself was explicit that the current draft still regulates combustible and non-combustible products identically, and that the vote is a mandate to improve it, with differentiation and harm reduction as the lens through which every provision is tested in the clause-by-clause deliberations to come.
That is where this battle will be won or lost. The prohibitionist lobby did not surrender on 24 June, and it will fight to claw back every concession.
Legitimate concerns remain, too: keeping nicotine in all its forms away from children, containing an illicit cigarette trade that already commands most of the market thanks to the government’s idiotic 2020 tobacco ban, and ensuring penalties proportionate to actual harm.
But the principle has been conceded, and principles matter. If the committee holds its nerve, South Africa could become the first country in Africa with a genuinely risk-proportionate, evidence-led framework for tobacco and nicotine – a law that resembles the proven successes of Sweden and Britain, rather than the unscientific “harm is harm” principle that itself causes harm to smokers who want to quit.
Muthambi and Dhlomo deserve to be commended for following the evidence where it led, at the cost of admitting they once got it wrong.
That is rarer, and braver, than it should be. Now let us hold them to it.
[Image: harm-reduction.webp]
[Caption: Parliament has recognised that vaping or using smoke-less tobacco products is much less harmful than smoking tobacco. (AI-generated image.)]
The views of the writer are not necessarily the views of the Daily Friend or the IRR
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