South Africa does not exist in a risk-free bubble. Every day we accept – and expect – a range of harm-reduction measures to protect us from the dangers inherent in ordinary, and sometimes unhealthy, human behaviour.
We buckle our seatbelts the moment we get into a car. Motorcyclists won’t dare ride without helmets. Sunscreen is a non-negotiable defence against skin cancer.
Condoms and PrEP are embedded pillars of our public health system.
Around the world, harm-reduction strategies for drug use, from needle-exchange programmes to supervised consumption sites, are recognised as essential public-health interventions.
And today, low-alcohol and alcohol-free drinks sit comfortably alongside beer taps in almost every bar.
In so many areas of life, society acknowledges that people will continue certain behaviours, and therefore the responsible thing to do is reduce the harm associated with those behaviours, not moralise them. We do not demonise the individual; we design safer choices.
Yet when it comes to tobacco harm-reduction, the logic suddenly collapses.
Despite extensive scientific evidence that smoke-free alternatives are significantly less harmful than cigarettes, governments – including our own – remain reluctant to embrace or properly regulate them. It is a contradictory stance that defies the very harm-reduction principles we already apply elsewhere.
This contradiction is even more glaring when viewed against the backdrop of South Africa’s rapidly escalating gambling crisis.
Different voices have triggered a national debate by highlighting an uncomfortable truth: while cigarettes are subjected to intense regulatory scrutiny, gambling – which destroys families, drains household incomes, and preys particularly on youth and low-income communities – continues to operate with minimal restriction and astonishingly aggressive marketing.
Walk through any township, taxi rank, or local tavern and you will find sports-betting ads plastered across walls, windows and phone screens. Gambling is now available 24/7 on every mobile device in the country, and yet regulatory intervention remains weak and fragmented.
Gambling has escalated into a serious social and economic threat in our communities. In 2024/25 alone, South Africans spent R1.5 trillion on gambling, R1.1 trillion of it on betting, driving a surge in harm reflected in distress calls to the National Responsible Gambling Programme, which jumped from 140,000 to over one million. With 31% of South Africans showing signs of problem gambling, families are increasingly bearing the brunt: essential income, including social grants and student allowances, is being diverted to betting, while anxiety, depression, debt, and broken trust are becoming common features of households caught in the spiral.
Alcohol marketing, too, continues to permeate community spaces, despite its well-documented role in violence, road deaths, addiction and immeasurable social harm.
This raises a critical question: Why are some harmful behaviours met with sweeping bans, while others are allowed to flourish almost unchecked?
It is a dichotomy of South Africa’s demons, one that communities on the ground feel every single day.
From a community-constituency perspective, the inconsistency is indefensible. Whether it is cigarettes, gambling, alcohol, or hard drugs, the impact on families and communities must be addressed holistically – not selectively, and certainly not politically.
If a risky behaviour cannot realistically be eradicated, then the rational response is to reduce the harm associated with it fairly, consistently and based on evidence, not ideology.
The goal is not to promote any vice. The goal is to protect South Africans through realism, not moral panic.
We cannot claim to care about public health while turning a blind eye to the addictions ravaging our communities simply because they fall outside government’s current political spotlight.
A truly fair and rational harm-reduction approach demands that we confront all harmful behaviours with equal scrutiny, evidence, and urgency. Gambling addiction is no exception. As its impact grows across South Africa, it is time for policy to catch up, protecting individuals, families and communities with the same intent and vigour applied to any other public-health risk.
Written by Nhlanhla Ndlovu, NEDLAC Community Constituency (Chief executive officer of the NEDLAC Community Trust, Lead Negotiator on the Tobacco Bill)