Time to change tack in fight against smoking

On Feb 1, Singapore's Ministry of Health (MOH) brought into force new measures targeted at further reducing smoking rates in Singapore. (Buying, using and possessing imitation tobacco products like e-cigarettes will be illegal from Feb 1: MOH; Jan 26).

Singapore has always had tough laws to curb smoking, including a ban on cigarette advertisements, heavy taxes on tobacco products, a minimum age limit to purchase such products and graphic warnings on tobacco packaging. In fact, MOH is currently seeking public feedback on such packaging.

Yet, smoking rates in Singapore went from 12.4 per cent in 2004 to 13.3 per cent in 2013. And this number has not dropped significantly since.

So, as unpopular as it may sound, we may need to face the fact that an abstinence-only message towards smoking has its limits. Perhaps we can learn from other countries that have taken an alternative approach to reduce their smoking rates, and which has led to some success.

In 2015, an expert independent evidence review published by Public Health England concluded that e-cigarettes have the potential to help smokers quit smoking.

E-cigarettes were made legal, and from 2015 to last year, smoking rates among adults in England dropped from 16.9 per cent to 15.5 per cent.

What was more significant was the steep decline in smoking rates among young adults (age 18 to 24), which is also a priority for Singapore.

Dr Penny Wood, chief executive of the British Lung Foundation was quoted saying: "These statistics confirm that e-cigarettes are mainly being used to help people quit."

A paper published in the BMJ medical journal last year also concluded that the substantial increase in e-cigarette use among adult smokers in the United States was associated with a statistically significant increase in the smoking cessation rate at the population level.

A little closer to home, the New Zealand Ministry of Health has stated that e-cigarettes release negligible levels of nicotine and other toxicants into ambient air, with no identified health risk to bystanders.

We all share the same goal of reducing smoking rates in Singapore. The current measures we have in place seem to have reached the limit of their efficacy. Perhaps it is time for us to consider alternative approaches to the problem.

Tan Kok Kuan (Dr)

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A version of this article appeared in the print edition of The Straits Times on February 08, 2018, with the headline Time to change tack in fight against smoking. Subscribe