Government imposed the smoking ban to free up 16 ICU beds: Tobacco company

British American Tobacco South Africa (Batsa) says it is hopeful of a swift end to what it says is a ‘failed tobacco ban’.

The group’s application to set aside the ban on the sale of tobacco products has been heard in the Western Cape High Court this week, with judgement reserved.

One of the key arguments presented by Cooperative Governance and Traditional Affairs (Cogta) minister Nkosazana Dlamini-Zuma is that the ban on tobacco product sales will help free up needed hospital beds during the coronavirus pandemic.

However, Batsa head of external affairs Johnny Moloto said that tobacco company has demonstrated that the government’s ban is not justified in either law or science, and would result in freeing up only 16 ICU beds – less than 0.5% of a national total of more than 3,300 – based on the government’s own “best case” scenario.

“Meanwhile, the ban, which has been in force for 132 days, has cost more than R4.5 billion in lost excise tax revenue, put 300,000 jobs at risk and forced smokers to buy unregulated products from the underground market at exorbitant prices,” he said.

Only 16 beds freed up 

In its court arguments, Batsa said that Cogta’s own estimation is that the smoking ban would lead to around only one million smokers quitting. This is the maximum number of people the ban would ‘protect’, considering the balance of smokers would continue smoking, it said.

This has been supported by research by the University of Cape Town, which recently found that 93% of smokers have continued to smoke throughout the ban.

This would mean that the government’s own estimates would lead to the conclusion that only 16 ICU beds would be freed up as a result of a ban, Batsa said.

Below is a brief breakdown of how Batsa reached this conclusion, as per its court papers:

• The minister said that if 1% of the estimated 8 million smokers in South Africa were to contract Covid-19 – and if 5% of that number were to need ICU – this would translate to about 4,000 smokers needing ICU beds and ventilators.

• However, the presented evidence shows that the number of people who will quit smoking as a result of the prohibition is between 800,000 and 1.2 million. For the sake of simplicity, Batsa took a mid-range value of ‘1 million quitters’.

• Since the evidence estimates that 1 million smokers will quit smoking, the minister’s calculations must be performed on the number of 1 million smokers – rather than 8 million smokers referred to by the minister. Batsa said the reason is obvious: those smokers who continue to smoke during the pandemic will continue to be exposed to the risk of disease severity on which the minister relies.

• The minister says that, if 1% of 8 million smokers were to contract Covid-19, this would translate to 4,000 smokers needing ICU beds and ventilators. It follows that, if 1 million smokers were to quit, this would mean that 500 fewer ICU beds and ventilators (i.e. one eighth of 4,000) would be required as compared to what the position would have been had there been no prohibition on smoking.

• This means the prohibition on selling tobacco and vaping products will at most “free up” 500 ICU beds and ventilators that would otherwise have been required for smokers over the entire period of the pandemic.

• However, Batsa argued further that those 500 smokers would not all have required ICU beds and ventilators at the same time. If one assumes an average period of 12 days in ICU, a total period of one year for the pandemic, and an even spread across the year, at any one time there will be 16.4 fewer patients in ICU than would have been the case had there been no prohibition on smoking.

• If the pandemic lasts for six months, the number doubles to 33 ICU beds that are no longer required at any point in time due to the ban on smoking.

• There are approximately 3,300 ICU beds in South Africa. A freeing up of 16 ICU beds equates to 0.5% of the total ICU beds in the country.

Batsa said that the minister has not put up any evidence to establish that a reduction of 16 ICU patients would mean that the health system could not cope with the pandemic.

“In short, the minister’s version is that the prohibition on smoking is likely to free up approximately 16 ICU beds at any one time across the entire country. This extraordinarily small number does not begin to justify the massive harm that is caused,” Batsa said.

No signs of lifting ban 

The sale of tobacco products, including cigarettes, has been prohibited since the country first introduced a lockdown on 27 March.

The ban has been in place to protect the health of South Africans, according to submissions from the government, and cigarette producers have failed to convince the country’s courts that the sale of tobacco products is a necessity.

On Thursday (7 August), Health minister Dr Zweli MKhize confirmed that government’s prohibition on the sale of alcohol and tobacco products in South Africa will continue for as long as Covid-19 infection numbers remain high.

Mkhize said that there were clear health benefits to introducing and continuing with the bans – including the freeing up of hospital beds.

“Everything else will open up when the numbers settle down. We shouldn’t really be dealing with it as though there is a contest. We are not contesting anything.

“We just want to make it clear that if something is going to disturb the ease with which we are managing beds, patient numbers, and improving care, we will actually stand up and say that these things should be avoided until we are over the hump.”

He noted that the country is currently going through a surge in coronavirus cases, and that it is difficult to guess what is going to happen. He also disagreed with claims that the ban has served its purpose.

Read: Former Shoprite CEO joins court battle against South Africa’s alcohol sales ban