Restricting drinking and smoking after lockdown will save many lives: experts

As the country awaits President Cyril Ramaphosa’s pronouncement on whether the ban on the sale of alcohol will be relaxed, a leading expert on alcohol and drugs has warned that drastic measures to reduce the dependency on alcohol by many South Africans should be applied after the lockdown.

Prof Charles Parry, director of the alcohol, tobacco and drug research unit at the SA Medical Research Council (SAMRC), said greater restrictions such as reducing the sizes of alcohol containers, a ban on alcohol advertising and making cheap alcohol more expensive are some of the long-term measures the country could adopt to reduce heavy drinking and the burden of alcohol use on health and trauma centres.

Parry said that during the lockdown it became clear many South Africans were addicted to alcohol.

“I think we have also discovered that large sections of our population are dependent on alcohol and we should implement these broad public health measures to create a context in which heavy drinking is discouraged.”

Parry said less drinking has been evident in the reduction of trauma cases in some of the major trauma units in the country. Groote Schuur Hospital is one of the health centres that has experienced a huge drop in alcohol-related trauma cases during the lockdown.

Prof Andrew Nicol, head of trauma at that Cape Town hospital, recently said that since the lockdown, trauma cases had dropped by two-thirds.

He attributed this to less drinking and fewer road accidents.

Nicol said before the lockdown the hospital used to see about 1,100 patients a month, with 60% of cases due to interpersonal violence and 30% from road traffic injuries. Weekend cases had dropped from 150 to about 37.

Parry said immediately after lockdown, measures to reduce the trauma burden and prevention of community transmission of Covid-19 needed to be maintained.

“In the immediate period post lockdown, we will probably need to return to the lockdown lite provisions and only allow off-consumption outlet sales of alcohol with restricted hours, such as 9am-5pm on weekdays and 9am-1pm on weekends and public holidays.”

Ramaphosa is expected to announce on Friday whether alcohol sales will be restricted during the next two weeks of lockdown.

This follows demands made by the Gauteng Liquor Forum, which proposed that the ban should be lifted on the sale of alcohol.

Catherine Egbe, a specialist scientist at the SAMRC whose interest is tobacco use, suggested  the government should continue to impose strict restrictions on tobacco use even after the lockdown.

“We should ditch tobacco and nicotine products. If we must not ban them outright, there must be stricter regulations to prevent people from getting addicted before they become aware of the risks of addiction these products pose.”

She said 80% of smokers in SA started smoking as children, when they could not be legally held responsible for their decisions.

She said lessons to be learnt from the ban on the sale of cigarettes during the lockdown included the power of the tobacco industry “to convince people cigarettes are essential and make some people protest the ban”.

Egbe said: “Most of the reasons put forward to protest the ban on cigarette sales could be summarised in two words: nicotine addiction.”

She said the lockdown has also shown that quitting smoking is possible.

“Quitting smoking and vaping is possible. People who used the lockdown ban on cigarettes sales as an opportunity to ditch using tobacco products must ditch them for good. This decision is life-saving and will save money for both individuals and the government in hospital bills and maintenance of the nicotine addiction,” she said.

University of Cape Town professor of pulmonology Keertan Dheda said when the  lockdown ends and the virus pandemic subsides, South Africans should have more respect for nature.

“At an individual and societal level, make every effort to reduce air and environmental pollution. There have been many reports globally about nature bouncing back and wildlife returning to areas where it has not been seen for many years, and levels of pollution have markedly reduced. Like Covid‑19, air pollution causes ill health by the inhalation of small particles that results in lung and cardiovascular disease.”

Dheda said when the Covid-19 crisis is over, South Africans should not forget about other respiratory diseases that still kill South Africans in numbers — such as tuberculosis.

“When the Covid-19 pandemic subsides, TB will still be there and we need to make concerted efforts to address this problem, which will continue to have significant negative effects on our economy,” he said.