The overarching rationale behind temporarily banning the sale of tobacco products during level 4 of the lockdown was to protect human life and health and to reduce the potential strain on the health-care system.

Also, the ban would mean that a “sizeable number of South Africans” would quit smoking once the lockdown comes to an end - with the “poor and youth ... particularly likely to quit”.

Co-operative governance & traditional affairs minister Nkosazana Dlamini-Zuma made these comments in an affidavit filed with the high court in Pretoria on Wednesday.

She was giving reasons for the decision taken by the government to temporarily ban the sale of cigarettes and tobacco products during level 4 of the lockdown, in an application brought by the Fair-Trade Independent Tobacco Association (Fita). The association wants the court to set aside the government's decision to temporarily ban the sale of tobacco products.

President Cyril Ramaphosa has since announced that cigarettes will remain banned under level 3 of the lockdown, which starts on June 1.

“The constitution imposes positive duties on the state to protect, promote and fulfil the rights in the Bill of Rights, including the right to life and the right to have access to health-care services,” Dlamini-Zuma said.

Dlamini-Zuma said the state thus had a duty to take steps to reduce the burden on the health system, so as to ensure that those who need these services can have access to them.

“This duty is particularly acute in the pandemic situation in which we find ourselves.”

She said studies concerning the potential links between the use of tobacco products and Covid-19 are still being undertaken.

“However, from the studies that have been done so far, the evidence is that the use of tobacco products increases not only the risk of transmission of Covid-19, but also the risk of contracting a more severe form of the disease.”

This, in turn, increased the strain on the public health system, by increasing the number of people who need access to resources such as intensive care unit beds and ventilators.

She said banning the sale of tobacco products during level 4 lockdown served to reduce these risks.

“Empirical evidence shows that the health benefits of stopping smoking begin soon after quitting.”

In addition, she said a report by the Human Sciences Research Council indicated that 88% of smokers were not able to buy cigarettes during level 5 lockdown, suggesting that the temporary ban was effective in reducing access to cigarettes and usage thereof.

She said decisions regarding level 4 restrictions had to be taken in a manner aimed at protecting the rights to life and health care.

She said the health-care system, including health workers, had to be protected and prevented from being overburdened and overwhelmed.

“In pursuit of these objectives, and after careful consideration and discussion, it was deemed necessary to continue the temporary ban on the sale of tobacco products under the level 4 lockdown.”

Dlamini-Zuma said as tobacco use was known to lead to respiratory diseases, and Covid-19 primarily affects the respiratory system, it was logical to proceed on the basis that tobacco use might lead to increased risks in relation to Covid-19.

Dlamini-Zuma said the available research showed that the severity of Covid-19 outcomes was greater in smokers than non-smokers.

“Smokers have higher ICU admissions, higher need for ventilation and a higher mortality rate than non-smokers.”

She said tobacco use also increased behavioural risks associated with Covid-19 transmissions.

“In poorer communities, people are more likely to share cigarettes, hookah pipes, zols, skyf, and/or lighters and matchboxes. This can increase the risk of Covid-19 transmission in communal and social settings due to lack of social distancing and sharing infected saliva.”

She said the practice of puffing and sharing “roll your own” tobacco products was common in lower socio-economic communities.

She said given the short and long-term benefits of stopping smoking, it was decided that a temporary ban on the sale of tobacco products would be likely to reduce the risk associated with Covid-19 transmissions and severity of disease.

“Further, based on the experience during level 5 lockdown, it was considered likely that continuing to temporarily ban the sale of tobacco products during level 4 would be effective in reducing the number of people who had access to these products.”