Call for education to back anti-smoking laws

Proportion of smokers is at plateau over past decade, with new smokers added: Experts

Manager Balamurali Murugan, 38; his wife, Ms Priya Govindaraju, 36, who is a manager at the Land Transport Authority; and their children, Sarisha Diya, four, and Sachin Dev, 10. Mr Murugan found it easier to quit smoking as his children were growing
Manager Balamurali Murugan, 38; his wife, Ms Priya Govindaraju, 36, who is a manager at the Land Transport Authority; and their children, Sarisha Diya, four, and Sachin Dev, 10. Mr Murugan found it easier to quit smoking as his children were growing up and he started worrying about his health. ST PHOTO: ONG WEE JIN

A multi-pronged approach combining laws and education to tackle tobacco use here is necessary, given that the proportion of smokers has hit a plateau over the past decade, said health experts.

The latest step last week by the Ministry of Health, in proposing a Bill in Parliament to raise the minimum age of smoking from 18 to 21, once again ups the ante against smoking.

The Bill to amend the Tobacco (Control of Advertisements and Sale) Act, if passed, will also make it illegal for people to own imitation tobacco products such as e-cigarettes.

Currently, only importing, distributing, selling or offering to sell such products is illegal.

"While we have made huge strides in smoking control, the proportion of smokers among the population has unfortunately hit a plateau over the past 10 to 15 years, which indicates a significant number of new smokers each year," said Professor Chia Kee Seng, dean of the National University of Singapore's Saw Swee Hock School of Public Health.

"The majority of them are young, and the tobacco industry is targeting them precisely because research has shown that if an individual does not start smoking by the age of 21, he or she is unlikely to pick up the habit thereafter," he added, lauding the move to raise the minimum legal age.

In particular, the proposal targets impressionable youth, including those in national service who start smoking because of peer pressure, said Dr Andrew da Roza, a therapist at Promises Healthcare, a mental health and addictions consulting and training company.

Said Dr Ong Kian Chung, a respiratory physician at Mount Elizabeth Hospital: "Underage smokers are most prone to misconceptions about harmful effects of smoking and most likely to be influenced by their peers.

"Youth who smoke are at risk of developing nicotine dependence that can lead to smoking in adulthood even though most of them think that they can quit any time."

Prof Chia added that smoking is one of many Singaporeans' poor lifestyle choices and habits that include overeating and a lack of physical activity. These, in addition to an ageing population, will increase the country's chronic disease burden, he added.

The proposal to raise the minimum age joins a series of other measures by the authorities to clamp down on smoking.

More public areas have been added this year to the list of places where smoking is banned, including Orchard Road, outdoor areas of universities and private-hire cars.

The National Environment Agency also announced in June that it will not be accepting applications for new smoking corners in all food retail establishments islandwide with immediate effect.

In addition, a ban on the display of tobacco products sold at stores took effect in August .

"Banning smoking in more public places not only helps to prevent second-hand smoking, but it also helps to change the social norms about smoking," said Assistant Professor Kim Hye Kyung from Nanyang Technological University's Wee Kim Wee School of Communication and Information.

"Although past changes in smoking regulations, such as eliminating smoking on airplanes, appeared radical at first, those regulations became accepted by the public and contributed to forming anti-smoking norms in public places."

She added that banning point-of-sale tobacco displays can help to reduce young Singaporeans' smoking experimentation as tobacco companies have become more reliant on such displays as an advertising tool to attract young consumers.

However, Prof Chia noted that macro-level measures such as raising the minimum legal age of smoking and banning alternative tobacco products are "often deemed punitive or infringing on personal liberties" and hence it is important to explain to the public the rationale and context of such measures.

He added that with increasing evidence on the harm from second-hand smoke, non-smokers need to be "protected".

"While smokers have the right and personal choice to smoke, there is a need for them to engage in their habit responsibly towards those around them," he said.

For Mr Balamurali Murugan, 38, who started smoking when he was 15 because of peer pressure, kicking the habit became an easier decision to make as his two children grew up and he started worrying about his health.

"Quitting smoking has always been my New Year resolution, but it kept getting postponed until I realised that I also have to be responsible to those around me," said the manager in a destination management company.

He was able to quit smoking in August last year with the help of the Health Promotion Board's "I Quit" programme.

"If I had known about the (health) repercussions of smoking when I was 15, that would have been a deterrent," he added, recalling that cigarettes were more readily available then, even to underaged smokers like himself.

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A version of this article appeared in the print edition of The Straits Times on October 09, 2017, with the headline Call for education to back anti-smoking laws. Subscribe