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First national Global Adult Tobacco Survey highlights the huge burden of tobacco use in SA

SmokingCape Town | The Global Adult Tobacco Survey (GATS) undertaken by the South African Medical Research Council (SAMRC) on behalf of and supported by the National Department of Health (NDoH), has highlighted the extent of the burden of tobacco use and exposure to secondhand smoke among South Africans.

As part of today’s various planned activities to mark World No Tobacco Day (WNTD), a factsheet with key findings of the Survey was launched by the National Department of Health in the Eastern Cape. Annually, this day aims to raise awareness of the negative health, social, economic and environmental impacts of tobacco production and use.

Implemented for the first time in South Africa in 2021, the GATS, a component of the Global Tobacco Surveillance System (GTSS), provides a global standard for systematically monitoring adult tobacco use and tracking key tobacco control indicators. It is a nationally representative household survey that monitors tobacco use among adults aged 15 years and older, using a standard protocol. The survey’s primary focus was to investigate the extent of the burden of tobacco use in the country, and on exposure to secondhand smoke among South Africans.

The recent conclusion of the GATS South Africa (GATS-SA) survey data collection and analysis has been hailed by many as a great achievement, considering the challenges posed by COVID-19 at the time of its implementation.  It has also been described by national and international tobacco control and public health communities as timeous, in light of the Control of Tobacco Products and Electronic Delivery Systems Bill for which local data are much needed.

Key findings from GATS show that South Africa has a huge burden of tobacco use, exposure to second-hand smoke, and a significant amount of money is being spent on manufactured cigarettes in a country with high levels of poverty. Specifically, the survey shows that:

  • 29.4% overall (12.7 million adults), 41.7% of men, and 17.9% of women currently used tobacco (smoked and smokeless products).
  • 25.8% overall (11.1 million adults), 41.2% of men, and 11.5% of women currently smoked tobacco.
  • 18.0% of adults (7.7 million adults) were exposed to tobacco smoke inside their homes.
  • The median monthly expenditure on manufactured cigarettes was 263.1 (South African Rand).

However, according to Dr Catherine Egbe, survey lead investigator and specialist scientist within the SAMRC’s Alcohol Tobacco and Other Drug Research Unit, some positives were garnered from the findings as the survey showed that at least two-thirds of current smokers planned to or were thinking of quitting smoking. “This finding suggests that most South Africans who use tobacco are open to cessation interventions and underscores the need for government to provide support for the use of evidence-based cessation aids,” she said. Moreover, she added that the survey results emphasize that 9 out of 10 people believe that smoking or breathing in other people’s smoke causes serious illness, suggesting that South Africans are aware of the dangers of tobacco use and exposure.

Dr Lynn Moeng-Mahlangu, Chief Director: Health Promotion, Nutrition and Oral Health at NDoH has welcomed the results, saying that the implementation and completion of the first GATS-SA is momentous. “As a monitoring tool, GATS is conducted repeatedly over time to continuously provide up-to-date information on the trends of the tobacco epidemic in implementing countries. Similarly, South Africa hopes to engage in repeated surveillance to ensure continuous availability of data to aid in the design, implementation, and evaluation of tobacco control programs in the country,” she concluded.


The Global Adult Tobacco Survey (GATS) was undertaken by the South African Medical Research Council (SAMRC) commissioned by the National Department of Health (NDoH).


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