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Tobacco control could have greatest impact on reducing cardiovascular disease

Tobacco control could have greatest impact on reducing cardiovascular disease


Shaistah Bux comes from a family of smokers, and lost several family members to cardiovascular disease (CVD). The death of her father from a heart attack when she was 16 was devastating, but when two of her uncles also had a heart attacks within months of each other, the tables turned. Shaistah, a smoker since the age of 9, had become a 2-pack a day chain-smoker by 31. She immediately destroyed all her cigarettes and smoking paraphernalia and quit cold turkey. Now, almost two years later, her own risk of heart disease has dramatically reduced.


“I feel so much better, although it is still very challenging to be in smoky social environments, to see people smoking and to be around friends who smoke,” says Bux.  “Having struggled with my own nicotine addiction and having seen how smoking can destroy families, I wish people wouldn’t smoke in public spaces and that young people could be more aware of the harms and not be exposed to cigarettes as much.” 

Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa (HSFSA) and President of the African Heart Network, says quitting is one of the best things you can do for your heart and health. “Shaistah would have experienced almost immediate benefits; and if she continues to avoid smoking, over time her risk of heart disease and stroke can fall to one that is almost equal to that of a non-smoker. It’s fortunate she stopped when she did, as smoking almost triples the risk of heart disease and more than doubles the risk of having a stroke. The risk for heart disease is also 25% higher in female smokers than in male smokers.”

Naidoo makes it clear that smoking and passive smoking pose very real dangers to cardiovascular health. “Smoking is the second leading cause of cardiovascular disease and cerebrovascular disease. It narrows blood vessels, leading to raised blood pressure and expands blood clots, causing the cardiovascular equivalent of a traffic jam on the highway to your heart and brain. Reduce blood flow to the heart and you risk having a heart attack. Reduce it to the brain and you risk having a stroke.

Naidoo says that on average, smokers die 13 to 14 years earlier than non-smokers. “Tobacco really has a devastating effect on cardiovascular health.  Worrying links between heart disease and e-cigarettes are also emerging. E-cigarettes are just as addictive as tobacco smoking and can cause significant harm to the cardiovascular system, and also increase risks for lung cancer. To reduce South Africa’s high incidence of cardiovascular disease and other non-communicable diseases that deplete our health budget, we must move to address the risk factors with effective tobacco control legislation.”


Fortunately, progress is being made that may help Shaistah and others as the long awaited Control of Tobacco and Electronic Delivery Systems Bill makes its way to parliament to be passed into law. September is Heart Awareness Month, culminating on World Heart Day (WHD) on 29 September.  United in the Protect our Next campaign, South Africa’s leading health organisations are calling for swift passage to law for the Bill, to help reduce mounting CVD deaths in South Africa. 

The five key changes in the new Bill are introducing 100% smoke-free indoor areas; the regulation of e-cigarettes; the requirement for plain or standardised packaging and pictorial health warnings; banning advertising at tills; and eliminating cigarette vending machines. 


“The bill will make it easier to quit and more difficult to smoke cigarettes, e-cigarettes or vape products, hookah pipes and other related tobacco products, says Dr Sharon Nyatsanza of the National Council Against Smoking. “It’s critical to protect people from second-hand smoke, and to curtail the tobacco industry’s ability to reach a new generation of smokers through misleading advertising. The root of this change is education, taxation and effective legislation, and we cannot afford to delay. An all-of-government approach, as well as a groundswell of citizen-led support and multisectoral partnerships, is essential to progress tobacco-control in South Africa.”  


#heartawarenessmonth #protectournext #worldheartday2021


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Smoking is the single most preventable cause of death in the world. The World Health Organisation (WHO) says that in South Africa (SA) alone, smoking results in more than half of lung cancer deaths, 37% of chronic obstructive pulmonary disease deaths, and over 20% of cardiovascular deaths and tuberculosis (TB) deaths. Smoking-related TB deaths are especially prevalent in South Africa, due to a higher vulnerability of HIV-positive individuals to TB.  Because it attacks the lungs, the novel coronavirus (COVID-19) could be an especially serious threat to those who smoke or vape.

The new Control of Tobacco and Electronic Delivery Systems Bill will make it easier for South Africans to choose smoke-free lives, regulate the danger of e-cigarettes and decrease the impact of second-hand smoke on the majority of the population, who are non-smokers. Why is taking time to implement? Tobacco industry profits are at the expense of addicted smokers, their families, and public health.  Together, the National Council Against Smoking (NCAS), the Cancer Association of South Africa (CANSA) and the Heart and Stroke Foundation of South Africa are steadfast in campaigning for the new Bill to be passed. It’s time for our people and our government to show leadership in implementing global best practice to curb the onslaught of big tobacco. 

Zanele Mthembu, Public Health Development and Policy Consultant

Savera Kalideen, Executive Director of the National Council Against Smoking 

Sharon Nyatsanza, Project and Communications Manager, National Council Against Smoking 

Lorraine Govender, National Advocacy Co-Ordinator, Cancer Association of South Africa (CANSA)

Professor Pamela Naidoo, CEO, The Heart and Stroke Foundation of South Africa

Dr Catherine Egbe, Specialist Scientist: Alcohol, Tobacco and other Drug Research Unit, South African Medical Research Council

Tamaryn Brown
Connect Media for Cart Agency
+27 (0) 84 3510560

Nirvana Kishoon 
Cart Agency
+27 (0) 82 823 3167


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