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Singapore: Accidental tobacco sales to minors keep health officials on constant vigil

The Health Sciences Authority (HSA) has been actively dealing with the problem of tobacco being sold to underage buyers as it is seen as an increasing problem.

http://www.ibtimes.sg/singapore-accidental-tobacco-sales-minors-keep-health-officials-constant-vigil-public-health-18251

Cashiers at the respective shops were either new or judge the buyer based on their appearance, which has sometimes led to the shop’s tobacco license to be suspended.

HSA has been on their constant rounds to make sure this does not occur, by sending officials dressed in plain clothes.

They closely observe the situation which is going on inside the said shop, and if they find that the shop has sold it to someone who is underage, the shop’s license gets suspended or revoked.

A spokesperson for HSA told Channel NewsAsia that the penalty for selling tobacco products to under-aged buyers is a maximum fine of S$5,000, and S$10,000 for subsequent offenses. In addition, the tobacco retail licensee will also be suspended for the first offense and revoked for subsequent offenses, she said.

“If tobacco were sold to under-aged persons in school uniform or those below 12 years of age, the tobacco retail license will be revoked, even at the first offense,” the spokesperson added

A few months ago, Sally Ng, a minimart owner received a frantic call from her employee saying that a member of her staff had sold cigarettes to a student in uniform and that officers from the HSA saw it and revoked the shop’s tobacco licence.

In his defence, the employee who committed the offence said he did not see that the boy was in uniform, as he was holding his bag in front of him.

Sally Ng said the owner, though constantly reminded her employees to check the identity cards of customers who choose to buy tobacco products, failed to prevent the sale to minors.

In a major opeation Channel NewsAsia went to six of the shops to see what the underlying problem could possibly be regarding their offences, which revealed that the cashiers were new, foreign or judged the buyer based on their appearance instead of asking them for their identity cards.

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Ban on display of tobacco products to take effect on Aug 1 as grace period ends

After a one-year grace period, the ban on displaying cigarettes and other tobacco products in stores will take effect on Aug 1, the Ministry of Health (MOH) reminded in a news release on Tuesday (Jul 18).

http://www.channelnewsasia.com/news/singapore/ban-on-display-of-tobacco-products-to-take-effect-on-aug-1-as-9041262

Retailers must keep the tobacco products in plain, undecorated storage devices, and out of customers’ direct line of sight.

“Existing display cabinets can be modified to one that is permanently fixed, self-closing and opaque,” said the ministry. “Alternatively, new storage units that meet the same requirements can also be constructed.”

Laws to ban the display of tobacco products were passed in Parliament last March, under amendments to the Tobacco (Control of Advertisements and Sale) Bill. It is part of MOH’s efforts to discourage smoking, particularly among younger people in Singapore.

Under the regulations, the point of sale will remain fixed at the cashier, to reduce the accessibility of cigarettes to youths and non-smokers.

In addition, a text-only price list based on a template prescribed by MOH may be shown to customers only at their request.

Retailers convicted of flouting the ban face a maximum jail term of six months, a fine of up to S$10,000, or both. The penalties are double for repeat offenders.

Curbing teen smoking ‘must go beyond raising minimum age’

http://www.straitstimes.com/singapore/health/curbing-teen-smoking-must-go-beyond-raising-minimum-age

Teens below the age of 18 have been barred from smoking legally since 1993 – but the data two decades later tells a different story.

In 2013, the average age when smokers took their first puff was just 16, according to the National Health Surveillance Survey.

Said Mr Vincent Tng, 21, a non-smoker serving full-time national service: “I have friends who started smoking as young as 14 or 15 – they just got their friends to buy cigarettes for them. There are contraband cigarettes around, so you don’t even have to go to a proper shop.”

Experts said the discrepancy shows that efforts to curb teen smoking must go beyond raising the minimum legal age. Issues such as raising awareness and enforcement cannot be sidelined.

Said Sata CommHealth chief executive and anti-smoking advocate K. Thomas Abraham: “We should have a slew of measures that go concurrently with raising the minimum age. How are these young people able to get cigarettes? How do we plug the existing loopholes?”

Last week, the Ministry of Health (MOH) said it plans to raise the minimum legal smoking age from 18 to 21. In Singapore, these are the years when nearly half of smokers become regular smokers. The idea is to put cigarettes out of the reach of underage smokers, who tend to obtain them through their social circles.

A town in the United States known as Needham is often held up as a success story of how this measure can reduce smoking rates.

In 2005, it increased the legal smoking age from 18 to 21. Smoking rates among under-18s dropped by nearly half within five years – from 13 per cent in 2006 to 7 per cent in 2010. At least 215 other locales in the US have followed suit in recent years, including New York City, Boston and California.

Dr Chia Shi-Lu, who chairs the Government Parliamentary Committee for Health, said: “I don’t think that in itself will be enough… but raising the age would help interdict further access to cigarettes amongst the young.”

To complement the move, experts suggested increasing the size of graphic health warnings on cigarette packets, introducing plain packaging to make cigarettes look as nondescript as possible and even raising the tobacco tax.

According to the World Health Organisation, increasing tobacco prices in high-income countries by 10 per cent is estimated to reduce consumption by 4 per cent, said Professor Chia Kee Seng, dean of the Saw Swee Hock School of Public Health at the National University of Singapore.

Tobacco taxes were last raised in 2014, from $352 per kg to S$388 per kg of tobacco, or 1,000 cigarettes.(+import tax + GST) It was reported that out of the $12 (HKD66) for an average pack of cigarettes, $8.50 (HKD 47) goes to the Government as tax.

Prof Chia said tobacco taxes should be raised further if smoking remains a serious issue, even after the age limit is raised.

At the same time, said Dr Abraham, even more work needs to be done to drive home the anti-smoking message among young people, as “the long-term effects of smoking are not always immediately apparent to a young smoker”.

Nee Soon MP Louis Ng, who used to smoke, said enforcement needs to be stepped up to ensure cigarettes are not sold to underage teens, and more has to be done to change the image of smoking.

“They think it’s cool to smoke and we need to tackle that mindset with a series of public awareness campaigns,” he said.

Management executive Catherine Ruth Jeyaseelan, 34, suggested involving parents too. “Sometimes parents smoke at home and kids will get curious, they might try it when their parents are out.”

Curbing teen smoking ‘must go beyond raising minimum age’

Teens below the age of 18 have been barred from smoking legally since 1993 – but the data two decades later tells a different story.

http://www.straitstimes.com/singapore/health/curbing-teen-smoking-must-go-beyond-raising-minimum-age

In 2013, the average age when smokers took their first puff was just 16, according to the National Health Surveillance Survey.

Said Mr Vincent Tng, 21, a non-smoker serving full-time national service: “I have friends who started smoking as young as 14 or 15 – they just got their friends to buy cigarettes for them. There are contraband cigarettes around, so you don’t even have to go to a proper shop.”

Experts said the discrepancy shows that efforts to curb teen smoking must go beyond raising the minimum legal age. Issues such as raising awareness and enforcement cannot be sidelined.

Said Sata CommHealth chief executive and anti-smoking advocate K. Thomas Abraham: “We should have a slew of measures that go concurrently with raising the minimum age. How are these young people able to get cigarettes? How do we plug the existing loopholes?”

Last week, the Ministry of Health (MOH) said it plans to raise the minimum legal smoking age from 18 to 21. In Singapore, these are the years when nearly half of smokers become regular smokers. The idea is to put cigarettes out of the reach of underage smokers, who tend to obtain them through their social circles.

A town in the United States known as Needham is often held up as a success story of how this measure can reduce smoking rates.

In 2005, it increased the legal smoking age from 18 to 21. Smoking rates among under-18s dropped by nearly half within five years – from 13 per cent in 2006 to 7 per cent in 2010. At least 215 other locales in the US have followed suit in recent years, including New York City, Boston and California.

Dr Chia Shi-Lu, who chairs the Government Parliamentary Committee for Health, said: “I don’t think that in itself will be enough… but raising the age would help interdict further access to cigarettes amongst the young.”

To complement the move, experts suggested increasing the size of graphic health warnings on cigarette packets, introducing plain packaging to make cigarettes look as nondescript as possible and even raising the tobacco tax.

According to the World Health Organisation, increasing tobacco prices in high-income countries by 10 per cent is estimated to reduce consumption by 4 per cent, said Professor Chia Kee Seng, dean of the Saw Swee Hock School of Public Health at the National University of Singapore.

Tobacco taxes were last raised in 2014, from $352 per kg to $388 per kg of tobacco, or 1,000 cigarettes. It was reported that out of the $12 for an average pack of cigarettes, $8.50 goes to the Government as tax.

Prof Chia said tobacco taxes should be raised further if smoking remains a serious issue, even after the age limit is raised.

At the same time, said Dr Abraham, even more work needs to be done to drive home the anti-smoking message among young people, as “the long-term effects of smoking are not always immediately apparent to a young smoker”.

Nee Soon MP Louis Ng, who used to smoke, said enforcement needs to be stepped up to ensure cigarettes are not sold to underage teens, and more has to be done to change the image of smoking.

“They think it’s cool to smoke and we need to tackle that mindset with a series of public awareness campaigns,” he said.

Management executive Catherine Ruth Jeyaseelan, 34, suggested involving parents too. “Sometimes parents smoke at home and kids will get curious, they might try it when their parents are out.”

Commentary: Smoking is an archaic habit with no place in modern society

The move to raise the legal age for smoking gives a much needed boost to Singapore’s efforts at reducing the prevalence of smoking among youths.

http://www.channelnewsasia.com/news/singapore/commentary-smoking-is-an-archaic-habit-with-no-place-in-modern/3584938.html

Shocking as it sounds, many doctors used to smoke.

The groundbreaking study which first confirmed the link between smoking and lung cancer was carried out on British doctors in the early 1950s. UK Medical Research Council member Sir Richard Doll, who conducted the study chose doctors as his research participants because many of them smoked, and it would be easier to observe what happened to them as a result of smoking.

Within three years of observation, 37 died from lung cancer. All were smokers. The number of deaths rose to 70 after five years. His work provided strong evidence of the dangers of smoking and laid the groundwork for future public debates about smoking

Since then, governments around the world have put in place policies and programmes to stop people from picking up the habit and help smokers kick theirs. For instance, the United States introduced the tobacco advertising ban and tax in the 1960s.

Singapore became the first Asian country to ban tobacco advertising in 1971, followed by the banning of smoking in various public places. The Singapore Government has also dramatically increased the excise tax on tobacco since 1983.

The impact of such combination of measures was visibly evident. The proportion of smokers among male Singaporeans aged 18 and above declined from 42 per cent in the late 1970s to 24.3 per cent in 2010, and the per capita consumption of tobacco decreased from 2.36 kilograms to 0.77 kilograms in a short span of 30 years. The incidence of lung cancer also halved from around 60 per 100,000 in the 1980s to 30 per 100,000 today.

Nonetheless, the decline in the proportion of smokers has since hit a plateau over the last ten years, hovering around 23 to 24 per cent in males, and 3.5 to 4 per cent in females, and has not budged since. What this effectively means is that the number of new smokers now equal those who have died from or quit the habit. To lower the proportion of smokers, more aggressive efforts will be required to prevent Singaporeans from picking up the habit.

WILL RAISING THE MINIMUM LEGAL AGE REALLY HELP STEM THE HABIT OF SMOKING?

Senior Minister of State for Health, Dr Amy Khor, announced recently on Thursday that the legal age for smoking and buying tobacco products will be raised from 18 to 21.

This will be a much needed boost to Singapore’s efforts at reducing the prevalence of smoking among youths.

Raising the minimum legal age (MLA) makes it harder for them to get tobacco products either directly or through their social networks. More importantly, it contributes toward de-normalising smoking.

95 per cent of smokers in Singapore had their first puff before age 21. Increasing the legal smoking age to 21 reduces youth exposure to tobacco products during their adolescence – a critical stage of life where they are more susceptible to peer pressure, where their psycho-social maturity, including sensation seeking, impulsivity, and future perspective taking, are still not fully developed.

Detractors may question the rationale for raising the MLA.

Some critics argue that raising the legal smoking age is simply delaying initiation into the habit. But the fact is that those who do not pick up smoking by age 21 are unlikely to ever begin. There is evidence that the younger the adolescent is when he starts smoking, the higher the level of nicotine dependence, and the greater the probability of him becoming a long-term, heavy smoker.

Others may make invidious comparisons. After all, if an 18 to 20 year old can legally marry, drive, consume alcohol or serve national service, why is he not allowed to smoke?

Tobacco smoking is clearly very different from and far outweighs the aforementioned activities when it comes to fatalities. It is deliberately designed to be addictive and is known to cause disease and disabilities in both the smokers, as well as those breathing in secondhand smoke. There is no moderate level of consumption at which tobacco smoking is safe – for the smoker and those around him. It is a unique product that kills its user when used as instructed.

Another objection is that raising the MLA may lead to the emergence of a black market peddling tobacco products to underage smokers. To deal with that, law enforcement efforts can be intensified, and harsher penalties imposed on the sellers. For instance, New York City stepped up its enforcement and increased penalties for supply of illegal tobacco products when it raised the MLA.

Of course, even with these efforts, it is impossible to entirely curtail a black market. However, future generations of youths will be discouraged from smoking, disease will be averted and lives saved albeit with this negative “side effect”.

ADOPT AN APPROACH THAT IS SYMPATHETIC, EDUCATIONAL AND SUPPORTIVE

In meting out consequences for underage smokers, we ought to bear in mind that they too are victims of Big Tobacco advertising strategies directed at the aspirations of impressionable youth.

Our best defence would be to adopt an approach that is sympathetic, educational and supportive of their efforts to quit the habit. To successfully curb smoking initiation in our youths, we would do well to ensure adequate enforcement of the MLA on retailers who sell tobacco to minors.

The debate over the Government’s move to raise the minimum legal age is a reminder that no single silver bullet to reduce smoking prevalence exists. The MLA is only but one of the existing and additional future measures for effective tobacco control. Singapore has banned electronic cigarettes which tobacco companies intentionally market as “safer” to youths. They also claim that heated cigarettes are safer but studies have shown that they have the same nicotine content as traditional cigarettes.

There are other measures that we can consider in the fight against smoking. First, there is evidence that increasing the size of graphic health warnings (GHW) on the cigarette packaging prevents youth smoking initiation, boosts motivation to quit, reduces smoking among adults and sustains smoking cessation. Expanding the size of the GHW is a highly cost-effective control measure that we should consider implementing.

Second, several countries like Australia, France and UK have augmented their GHW with standardised packaging. Also known as “plain packaging”, this requirement removes all branding elements such as colour, image, trademarks, logos and text, and only allows the brand name to be printed in a standardised font, size and location on the pack. This reduces the appeal of the pack, weakens any branding power each product might have, and strengthens the impact of the GHW.

Australia was the first nation in the world to adopt plain packaging in 2012. Even though the health impact of the policy will take years to be fully seen, a post–implementation review published in February 2016 reported that the policy has reduced smoking and exposure to tobacco smoke, and is expected to continue doing so.

Third, price and taxes are effective tools for tobacco control. According to the World Health Organisation, a 10 per cent increase in tobacco prices will reduce consumption by about 4 per cent in high-income countries. We should raise tobacco taxes further as part of our suite of enhanced control measures, if we think that smoking remains a serious issue even after the MLA has been raised.

Last, internationally, there is a movement to go beyond conventional tobacco control strategies and adopt fundamentally different strategies that aim to eliminate smoking altogether. These are broadly classified as “Endgame Strategies”. Singapore should begin thinking about eliminating smoking completely. We would not be the first country to endorse and adopt this approach. New Zealand, Finland, Canada, Sweden and France have all endorsed the goal of achieving a smoke-free society in the next eight to 23 years.

Smoking was introduced commercially in the 1880s. It is an ancient and archaic habit, and has no place in our modern and progressive society.

Professor Chia Kee Seng is Dean of the Saw Swee Hock School of Public Health at the National University of Singapore.