IN CASE YOU MISSED IT

Clearing the air nationwide

This story was first published in The Sunday Times on July 25, 2013

IT IS the first spark: A pilot project to make Nee Soon South the first non-smoking constituency, with all its public areas smoke-free, will take its first steps by year's end.

Smokers will be asked to refrain from lighting up in all public areas except at designated points, in a voluntary initiative being rolled out in stages and probably starting with one of its seven resident committee zones.

In Singapore, smoking is allowed in any place that does not come under the public smoking ban as stipulated by the National Environment Agency (NEA). This ban covers most indoor public areas like malls and schools, as well as void decks and covered walkways.

So, people are free to puff at outdoor public places like parks and park connectors, beaches, surface carparks, and also at home and in private vehicles.

But the initiative in Nee Soon South - a Yishun estate of 50,000 - may become a tipping point, as it flips the default of outdoor smoking to non-smoking except at designated points.

Dr Ong Kian Chung, who heads the Chronic Obstructive Pulmonary Association, believes the Nee Soon South move will go a long way to protect the constituency's non-smoking residents.

Non-smokers in other neighbourhoods in Singapore - having learnt of the initiative - say they want to see their precincts smoke-free too.

While Nee Soon South MP Lee Bee Wah - a non-smoker - is encouraged, she concedes that smoking "has always been an addiction that is hard to kick", so the pilot will be carried out progressively.

It will be done with the Health Promotion Board (HPB) and the NEA. "We don't want to be too aggressive and caught up with achieving results," Ms Lee said. "We hope Nee Soon South can be truly clean and green."

Further details are unavailable. But if this pilot proves persuasive, smokers may only light up outside their homes at designated smoking points around the estate.

While the initiative may seem radical, anti-smoking advocates say that declaring an area smoke- free may not be enough to get people to quit. Dr K. Thomas Abraham, who heads the non-profit Sata CommHealth, said eradicating the habit takes an "all-rounded effort".

For example, high taxes alone have not deterred many smokers. Also, Singapore was the first in the world to ban tobacco advertising in 1971, and the first in Asia to introduce gory images on cigarette packets in 2004.

Even so, more and more people continue to light up. Some 14.3 per cent of adults aged 18 to 69 in Singapore smoke, up from 12.6 per cent in 2004. "We have to ringfence the problem with a slew of measures," said Dr Abraham.

National plans

THERE is a national initiative to eventually make all public areas smoke-free, said Dr Annie Ling, who heads adult health at HPB.

Work has started with the launch of the Blue Ribbon Movement, which gets organisations to voluntarily declare their premises 100 per cent smoke-free. Some 13 hawker centres and seven hotels, among others, have joined in.

Nee Soon South is trying to do likewise - except that instead of targeting buildings, its objective is the neighbourhood. So its initiative is not too big a leap.

Besides, other countries are already miles ahead in restricting outdoor smoking. Dozens of municipalities across Canada and the United States have extended smoking bans to places like parks, beaches and even streets.

The same goes for states in Australia; Queensland does not allow smoking at patrolled beaches. Smoking in cars carrying children is also a no-no.

Meanwhile, Bhutan was the first in the world to go entirely smoke-free in 2004, when it banned the sale of tobacco.

A World Health Organisation (WHO) report in 2011 notes that Singapore does not have as many smoke-free public places as other countries, such as Australia, New Zealand and Canada.

Singapore, taking a more gradual approach, aims to lower its smoking rate from the current 14.3 per cent of the adult population to below 10 per cent by 2020.

To do this, the HPB needs to get 15,000 people to quit each year. But it is not easy: for every successful attempt, studies show there are up to seven failed ones.

Adults between the ages of 18 and 39 are the biggest worry, with more than 16 per cent of them smokers, higher than the national average. It is worse in certain "pockets" - 31.5 per cent of hotel employees and 27 per cent of Malay-Muslims light up regularly.

As such, making Nee Soon South totally smoke-free may not be that far-fetched.

Making it work

BUT how will the project be carried out, that is, seeing to it that smokers keep to the rules?

Answers, perhaps, can be found in the estate's smoke-free park. The Yishun Neighbourhood 8 Park, at blocks 809 and 810 along Yishun Ring Road, disallowed smoking last year under the Blue Ribbon Movement.

Ms Lee said the success of the smoke-free park made her optimistic.

The key is the direct involvement of residents who take it upon themselves to patrol the park. Mr Toh Boon Teck, 64, has lived in the area for close to 30 years. The stall keeper goes on patrol once every few weeks and is sometimes joined by other residents' committee members. When they see someone smoking, they will politely remind him that the park is a no-smoking zone. Sometimes, they tell them that smoking is bad for their health.

Happily, most take the message well. "The most important thing is our attitude - we should not be confrontational," Mr Toh said. "We chat, not lecture."

Ms Lee hopes that expanding smoke-free zones will drive some to stub out the habit as they would have to "hide" to smoke. But she expects "some strong reactions" from die-hard smokers.

Several who were interviewed lamented this latest barrier, with one saying that "the Government might as well ban cigarettes altogether". One 33-year-old labelled the Nee Soon South project "drastic", adding that "smokers have rights too".

Some netizens have also pointed out that hardcore smokers can always find somewhere to smoke, or retreat into their homes.

Driving people to smoke at home means their families will be exposed to more second-hand smoke, said Dr Ong, who is a respiratory specialist in private practice. For the Nee Soon South project to produce results, it has to go islandwide, he added.

Other measures required

UNTIL then, current initiatives have to be sustained - especially those that can help smokers to quit the habit for good.

Many are probably immune now to the usual scare tactics like graphic warnings on cigarette packs. "People get tired of hearing 'smoking kills'," Dr Abraham said. "What we should do is to equip people with the resilience to say no to cigarettes."

The HPB's QuitLine, a national hotline for smokers, is an example which saw more than 1,000 smokers call for help between June and November last year. Over 30 per cent of callers stayed off cigarettes for more than six months, said the HPB's Dr Ling.

Another effort is the training of service personnel by the Singapore Armed Forces (SAF) to support colleagues trying to quit.

Colonel (Dr) Gan Wee Hoe, Commander of the SAF Military Medicine Institute, said that most young Singaporean males start smoking before enlisting. The SAF and HPB are looking into whether counselling could be given to pre-enlistees who smoke when they come for medical screening.

Hospitals and some pharmacies also offer such counselling.

The Nee Soon South pilot sends a strong signal that non- smoking public areas could be the norm of the future.

That is good news for those who do not smoke. But for those who do, or are tempted to, other measures are needed. Anti-smoking efforts do not, and will not, work in isolation.

chpoon@sph.com.sg

This story was first published in The Sunday Times on July 25, 2013To subscribe to The Straits Times, please go to http://www.sphsubscription.com.sg/eshop/