Smokers’ behaviour in lockdown reveals power of their addiction

World No Tobacco Day is a fitting time to assess the industry’s potential for harm, write Sam Filby and Corné van Walbeek of the University of Cape Town (UCT).

Each year, on May 31, the World Health Organisation and its partners celebrate World No Tobacco Day. The event serves to highlight the health risks of tobacco and nicotine use, and to encourage governments to implement effective tobacco control policies.

The theme for this year’s World No Tobacco Day is “Protecting youth from industry manipulation and preventing them from tobacco and nicotine use”.

Given that tobacco use kills about 8-million people each year, the tobacco industry needs to get young people addicted to its products to ensure its long-term existence and profitability. To do this, the industry aggressively markets and promotes its products to young people.

Despite traditional tobacco advertising and promotion having been banned in SA since 2001, the tobacco industry has developed novel ways of keeping its products in the public eye. Some common strategies used by the industry to target young people include hiring “influencers” to promote tobacco and nicotine products on social media, and launching new flavours and designs of tobacco and nicotine products that encourage young people to underestimate the health risks of using them.

These marketing activities are part of the industry’s survival strategy. Once people are addicted to tobacco and nicotine products, it is difficult to quit. Recent evidence from SA shows how powerful the addiction to smoking is, and highlights the importance of ensuring that young people do not start using tobacco and nicotine products.

Cigarette sales have been banned in SA since March 27 as part of the response to the Covid-19 pandemic. Under the auspices of the Research Unit on the Economics of Excisable Products, based at the University of Cape Town, we conducted an online survey of about 12,200 people who were regular smokers in the week before the ban became effective. We wanted to understand how the ban had affected their smoking behaviour.

We found that 41% of smokers indicated that they had attempted to quit smoking cigarettes after the ban was introduced. Of the smokers who had tried to quit, only 39% had successfully quit by the time they completed the survey. This means that only 16% of all smokers in the sample successfully quit smoking during the lockdown period.

About 90% of survey respondents who did not quit smoking during the lockdown indicated that they had purchased cigarettes during the lockdown. This is in spite of cigarette prices having practically doubled by the time we did the survey, and that it is a crime to buy tobacco products during the lockdown. With highly inflated cigarette prices, many smokers are spending less on other household items in order to get cigarettes. This points to the strength of the addiction.

One respondent commented: “Paying ridiculous pricing for previously cheap cigarettes. Breaking budget. Not knowing where my next pack is coming from makes me very anxious and I tend to smoke more. I could have spent that extra cash on my children and family. Prices on black market are crazy. They are making a killing in profit on cigarettes.”

Though most smokers are buying cigarettes through spaza shops (44%) and street vendors (26%), 4% of smokers openly acknowledge that they have bought their cigarettes through “drug dealers”, “cigarette smugglers” or “black market traders”.

Though the cigarette sales ban during the lockdown does not represent normal market conditions, it does illustrate how price-insensitive the demand for cigarettes is for many people. That cigarettes are so addictive shows the importance of protecting young people from tobacco and nicotine to prevent the onset of a lifelong addiction.

The best way to prevent any disease caused by tobacco and nicotine is through prevention. Because

most lifelong smokers begin smoking in their teens, governments must act swiftly to protect young people from industry manipulation and prevent them from ever using tobacco products. The adage “prevention is better than cure” has never been truer than now.

Sam Filby and Corné van Walbeek are with the Research Unit on the Economics of Excisable Products, University of Cape Town.