More radical approach to tackle smoking may be needed

Singapore has been at the forefront of vigilantly implementing the MPOWER smoking prevention and cessation measures advocated by the World Health Organisation's Framework Convention on Tobacco Control; but smoking prevalence has still hovered between 12 per cent and 14 per cent for over 10 years (Plain packaging planned for cigarettes; Nov 1).

There are compelling reasons why people start and continue smoking, including the high non-debilitating re-enforcement effects; genetic vulnerability; mental illness and other addictions; peer acceptance and pressure; adolescent rebellion; family and social modelling; ease of availability and affordability; and the cycle of bio-chemical tolerance and withdrawal effects.

With all these powerful influences at play, is it reasonable to expect that packaging plays a material part in attracting and keeping people smoking?

Smoking, like all addictions, reaches a stage of compulsion and dependence that goes well beyond the influence of conventional marketing ploys, such as packaging.

Is it time to admit that conventional prevention and cessation strategies have reached the point of saturation? Should we be open to considering alternative measures? An example is replacing smoking with the new nicotine delivery technologies. While they deliver highly addictive nicotine, they do not involve the hundreds of toxins in burning tobacco smoke.

Long-term, credible, peer reviewed population studies in Sweden have established that daily nicotine use does not materially increase the onset of diseases. Can we afford to ignore them, when evidence in developed countries shows that smoking prevalence has fallen dramatically (by 27 per cent in Japan, between 2016 and 2017) after these technologies became popular?

Singapore is at the forefront of bio-scientific research. We are in a prime position to explore the technologies, and ensure that they are as safe as they can be. Perhaps a more open and radical approach is now called for?

Andrew John da Roza

A version of this article appeared in the print edition of The Straits Times on November 03, 2018, with the headline 'More radical approach to tackle smoking may be needed'. Print Edition | Subscribe