Case study: South Africa’s COVID-19 tobacco ban - intent, impact, and lessons

In March 2020, during the national COVID-19 lockdown, South Africa became the only country in the world to implement a total ban on the sale of tobacco and vaping products [^1]. The government’s stated intent was to reduce the risk of severe COVID-19 among people who smoke and limit transmission through shared cigarettes. Policymakers also hoped that the restriction would encourage people who smoke to quit, reducing health system pressure during the pandemic.

However, the ban’s impact was largely counterproductive [^2]. Surveys showed that while a small proportion of people who smoke, around 8%, reported quitting during the ban, most later relapsed once sales resumed [^2], [^3]. The vast majority continued to access cigarettes through illicit markets, often at inflated prices more than double pre-ban levels. As a result, the policy led to substantial growth in illegal trade, loss of tax revenue, and a strengthening of unregulated supply networks. Evidence also suggests that the ban eroded public trust and diverted enforcement capacity away from other health priorities.

The main lesson from South Africa’s experience is that prohibition without cessation support or market regulation is unsustainable. While well-intentioned, the policy highlighted the risks of relying on restrictive measures in contexts with limited enforcement and strong informal economies.