High Smoking Rates in South Africa Highlighted in Latest GATS Report

Dr. Catherine Egbe of the South African Medical Research Council (SAMRC) reported that 21.2% of adults smoke daily, and 4.6% smoke occasionally.

The prevalence of smoking in South Africa remains notably high, with daily smokers averaging 8.5 cigarettes per day, according to the 2021 Global Adult Tobacco Survey (GATS) South Africa report released by the Department of Health. This report, based on data from 7,245 households, reveals that 29.4% of South Africans use tobacco, with a significant gender disparity: 41.7% of men compared to 17.9% of women.

Dr. Catherine Egbe of the South African Medical Research Council (SAMRC) reported that 21.2% of adults smoke daily, and 4.6% smoke occasionally. The Northern Cape has the highest tobacco prevalence, while Limpopo has the lowest. The average age of smoking initiation is 17.6 years for adults aged 20-34. Moreover, 20.9% of urban residents and 13.5% of rural residents started smoking before age 15. A striking 33.9% of daily smokers use tobacco within five minutes of waking up.

Regarding alternative smoking methods, 2.2% of adults use e-cigarettes, with higher usage among men (3.8%) than women (0.7%). Most e-cigarette users cite enjoyment, flavor, perceived reduced harm, and social influences as reasons for their use. Additionally, 3.1% of adults reported smoking hookah pipes, with an average initiation age of 21.1 years.

In terms of quitting, 80.9% of smokers attempted to quit without assistance, 4.1% used pharmacotherapy, and 42.9% received cessation advice from healthcare providers. Exposure to second-hand smoke (SHS) is significant, with 74.4% of adults encountering SHS in public places like bars and nightclubs, and a notable presence at schools (19.9%) and tertiary institutions (16.0%).

Financially, men spend slightly more on cigarettes (R273.20) than women (R207.20) monthly. Deputy Director General of Primary Healthcare, Jeanette Hunter, has noted a concerning increase in the use of hookah, e-cigarettes, and vapes among youth, despite their marketed perception as healthier alternatives. The Department of Health has responded by amending the Tobacco Product Control Act to include electronic delivery systems, with the amendment bill currently in Parliamentary processes.

Hunter also emphasized the need for tobacco cessation programs in primary healthcare facilities and the importance of the proposed ban on smoking in enclosed spaces, given that 44.5% of adults are exposed to SHS. Recommendations from Dr. Egbe include implementing tobacco taxes, smoke-free laws, graphic health warnings, and total bans on tobacco advertising to reduce smoking initiation and protect public health. She highlighted the potential positive impact of passing the Tobacco Products and Electronic Delivery Systems Control Bill of 2022 in reducing long-term tobacco use and related health issues.