| Summary: | Introduction
In response to COVID-19, the South African government banned the
sale of tobacco products for 20 weeks. Before the ban, the illicit cigarette market
was well-entrenched and smoking cessation services were not widely available.
Several surveys conducted to ascertain cigarette smokers’ responses to the ban
reported substantial differences in the proportion of smokers who quit. This study
provides a broadly nationally representative ex-post investigation into cigarette
smokers’ quitting behavior related to the sales ban.
Methods
We used data from wave three of NIDS-CRAM (the National Income
Dynamics Study-Coronavirus Rapid Mobile Survey) conducted in November–
December 2020. We first investigated the proportion of people who quit and
who continued smoking during and after the sales ban. We subsequently linked
the NIDS-CRAM survey to the fifth wave of NIDS (2017) to identify a subset
of established smokers, and considered whether their quitting behavior differed
from that of all smokers who smoked at the start of the sales ban.
Results
The cross-sectional analysis showed that 7.8% of cigarette smokers quit
during the sales ban, but that 55% of these quitters relapsed after it was lifted.
Of the pre-ban smokers, 3.5% indicated that they did not smoke both during
and after the sales ban, and 3.7% quit after the ban was lifted. The longitudinal
analysis showed that 7% of people who were smoking in 2017, quit smoking
cigarettes during the tobacco sales ban, but that >70% of quitters relapsed after
it was lifted. Only 2% of pre-ban established smokers indicated that they did not
smoke during or after the ban.
Conclusions
The sales ban did not have the intended objective of encouraging
large-scale smoking cessation. This reflects policy failures to provide smokers
with appropriate cessation support and to effectively control the illicit market
both prior to and during the sales ban.
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