Posted on June 25, 2013
The prevalence of smoking and consumption of cigarettes has decreased in South Africa over the last 20 years and this decrease is as a result of comprehensive tobacco control legislation, particularly large cigarette tax increases. However, little attention has been given to the potential use of ‘roll-you-own’ cigarettes as cheaper alternatives, especially among the socio-economically disadvantaged population.
In South Africa, smoking prevalence has been reported to have decreased from 34% in 1993 to 21.4% in 2003. This decrease has been attributed to an increase in the price of factory-made cigarettes, anti-smoking legislation and greater public awareness.
Between 1994 and 1999, the real excise cigarette taxes increased by up to 149%. However, the public health impact of cigarette taxes may be lessened if, instead of quitting, smokers switch to roll-your-own cigarettes, which usually cost less than factory-made cigarettes. Such switching between products is particularly likely in South Africa because the tax structure for tobacco products provides an incentive for smokers to substitute roll-your-own cigarettes for factory-made cigarettes. For example, in South Africa, the 2011/2012 excise tax on cigarette tobacco was R 210.51 per kilogram, while the excise tax on the pipe tobacco used for roll-your-own cigarettes was R119.16 per kilogram in packages weighing less than 5 kg.
Although some smokers regard roll-your-own cigarettes as a safer alternative, roll-your-own cigarette smokers have actually been reported to be more likely to be exposed to higher levels of smoke elements than smokers of factory-made cigarettes. The manufacturers of factory-made cigarettes control the weight, diameter, packing density of the tobacco and the porosity of the wrapping paper used in their products. This is not the case for roll-your-own cigarettes, for which these elements are controlled by the user, thereby giving rise to wide variation in the finished products.
Roll-your-own cigarette smokers may take more puffs, inhale more smoke per cigarette and for longer periods and have been reported to be less likely to make quit attempts than those who smoke factory-made cigarette.
In South Africa, roll-your-own cigarettes are commonly made from pipe tobacco available in different pack sizes; a 5 g pack is the smallest. It is predominantly smoked rolled in strips of newspaper without filters, thus making the cigarettes potentially more dangerous. However, thus far, little attention has been given to the use of roll-your-own cigarettes in South Africa.
This study therefore sought to determine socio-demographic correlates of roll-your-own cigarette use among South African adults between 2007 and 2010.
Although, some other studies have found that roll-your-own cigarette smokers are less likely to make quit attempts than those who smoke the more expensive factory-made cigarettes, there was no difference in quit attempts between the two groups in this study. This suggest that contrary to a prior observation that roll-your-own cigarette smokers are more addicted to smoking than other smokers, it may very well be that roll-you-own cigarette smokers are as addicted to smoking as the smokers of factory-made cigarettes. However, roll-your-own smokers are less confident to quit smoking successfully.
This highlights a need for healthcare providers to offer cessation assistance to all smokers, especially those of low socio-economic status. With the motivational support from health care providers, a roll-your-own cigarette smoker is equally likely to succeed in quitting smoking, which in the long-term could reduce the growing burden of non-communicable diseases among low-income roll-your-own cigarette smokers.
“The study has a policy message to the government in that it needs to focus on affordability and not just increasing cigarette prices. Cigarette price increase should also take into account the income increases as well. Roll-your-own cigarette smokers are less confident in quitting smoking and the smokers of factory-manufactured cigarettes also find cheaper means of smoking instead of quitting. Therefore health care providers who come in contact with these people should give them support which would help them quit smoking”, said Prof Ayo-Yusuf.
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