Dhlomo Shares Experience on South Africa’s Tobacco Bill

A former chairperson of South African parliament’s portfolio committee on health, Dr. Sibongiseni Dhlomo, has shared his experience on the country’s Tobacco Bill in an article titled: “What I Learnt on the Tobacco Bill as Chair of the Health Committee,” which was originally published by Sowetan, one of South Africa’s leading daily newspapers.

According to him, “When I took on the chair of parliament’s portfolio committee on health, I held a view on nicotine regulation that I no longer hold.”
He explained that the story of how that view changed became more useful to share than any policy argument he might make today, particularly now that the committee has voted to advance the bill and the detailed work of resolving it properly belongs to others.

He said smoking-related diseases accounted for an estimated 50,000 South African deaths every year, roughly seven percent of all deaths, adding that the case for legislative attention is not the question. The question is what form that attention should take.

“I came into the work with what could broadly be called a “harm is harm” view of nicotine products. A cigarette, a vape, a pouch — all delivered nicotine, all carried risk, and all warranted similar treatment under the law. At the time that view seemed logical and consistent. It was also, as I came to understand, incomplete.

“The committee’s consultation was deliberately broad. By the time its deliberations on the bill concluded, it had held hearings in 27 municipalities across all nine provinces, drawing close to 7,900 attendees, more than 1,100 oral submissions and some 40,000 written ones — by any measure, one of the most thoroughly consulted pieces of health legislation parliament has handled,” Dhlomo said.

He further said the submissions that stayed with me most came from medical and scientific specialists.

“As a medical doctor by training, I am accustomed to revising my views when experts in a given area present credible evidence, and the evidence presented during the process was difficult to set aside.

“The argument, in essence, was that the harms most strongly associated with traditional cigarettes flow from combustion. Burning tobacco produces the carcinogens that drive smoking-related cancers; nicotine on its own does not. From a regulatory standpoint, that distinction matters.

“It means that products which deliver nicotine without combustion, and products which combust tobacco directly, do not sit at the same point on the risk spectrum and that treating them as if they did is a regulatory shortcut rather than a regulatory strategy,” Dhlomo explained.

He however said the detailed architecture of the bill would properly be a matter for the current committee and the legislature, and that clause-by-clause work now lies ahead.

What I hope South Africa is left with is a framework grounded in evidence rather than habit, one that addresses the disease burden honestly, protects the next generation and remains open to revision as the evidence continues to develop, he said.

Speaking about the endorsement of the bill by the committee, Dhlomo said the endorsement of differentiation was the product of the committee’s own deliberations and the weight of the submissions before it. “If anything held steady for me even as the specifics of my thinking shifted, it was a few principles rather than any single conclusion,” he said.

The first is the order of priorities. Supporting smokers to quit is and should remain the most direct public health objective. Any pathway to lower-risk alternatives is most defensible as a complement to cessation, not a substitute for it.

That ordering shapes what kind of regulation is being built — one that primarily helps people stop, with provisions for those who genuinely cannot, he further said.