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- Research by Annals of Global Health found that the government's policy on tobacco reduction was not being adequately enforced at public hospitals.
- Researcher Phindile Shangase said drug-resistant tuberculosis patients had little no restrictions when it came to accessing cigarettes in public hospitals.
- She said while private hospitals provided nicotine alternatives to patients, some public hospital staff did not know such replacement therapy solutions existed.
South Africa's healthcare system's regulation of access to cigarettes for patients is so far behind the government's ambitions to curb tobacco consumption that drug-resistant tuberculosis (DR-TB) patients can typically access cigarettes at a state hospital more easily than non-tobacco alternatives.
This is according to research conducted by academics for the online journal, Annals of Global Health. The study was conducted between September and October 2015 with respondents at three hospitals in KwaZulu-Natal.
According to the World Health Organisation's Framework Convention on Tobacco Control, which South Africa is signatory to, smoking cessation support should be available at most hospitals.
However, these research findings indicate the fraught state of the government's tobacco and nicotine products regulation. Nicotine alternatives exist in the healthcare system to assist patients with DR-TB and other respiratory conditions to get nicotine through less harmful means.
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The international event served as a platform to discuss policies affecting nicotine product and promote harm reduction.
One of the researchers behind the paper, Phindile Shangase, told Fin24 during the Global Forum on Nicotine in Warsaw, Poland on Thursday that the research uncovered a range of problems in hospitals' ability to keep patients away from tobacco.
"First, from the evidence of the research, we observe that when it comes to controlling smoking in public places, the government's policies are not being enforced. In hospitals, there is access to cigarettes. It is not a secret," said Shangase.
Shangase said while barriers to accessing cigarettes were few among public hospitals, what made matters worse was that awareness about safer alternatives, including vapes and heating systems, was also low among state hospital patients and staff.
"They don't know about vapes or other nicotine-replacement therapy. The most they know is nicotine gum. Nobody mentioned e-cigarettes, and even staff did not know about this," Shangase said.
The research paper said the survey findings reiterated the need for smoking cessation intervention to be incorporated as an integral component of DR-TB management in South Africa.
"Many patients expressed an interest in pharmacological aids and psychological support to help them quit smoking. Additionally, offering extramural activities and enforcing smoke-free policies in hospital facilities will help to reduce patients' access to cigarettes while at the hospital," the paper said.
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The study said the research found several barriers to smoking cessation for DR-TB inpatients due to a range of personal and institutional factors.
"As a strategic recommendation for policymakers and managers, addressing these barriers will require a holistic and targeted smoking cessation intervention as an integral component of DR-TB management in South Africa," the research paper said.
It further stated that patients had expressed an interest in nicotine-replacement therapies and psychological support to aid them in quitting smoking.
"Additionally, offering extramural activities and reducing the availability of cigarettes in and around hospital facilities may reduce cravings and the number of cigarettes consumed. Furthermore, TB hospital-based research addressing specific cessation strategies for DR-TB inpatients is required."
Shangase said the higher price of nicotine alternatives made them even harder for most South Africans to access, driving them to return to dangerous combustible cigarettes.
The reporter was invited by the Global Forum on Nicotine to a conference in Poland.
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