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Singapore Looks To Be Tobacco Free

Last updated: July 20, 2010

Source: Government of Singapore

Tobacco  (Control of advertisements and Sale) Act closing speech by Mr Khaw
Boon Wan.

Mr Speaker, Sir, 11 Members have spoken on this Bill. Dr Lam Pin Min gave us
a good account of the harm of tobacco.

Mr Hri Kumar’s passionate speech struck a chord. Your common message is loud
and clear: “tobacco is harmful, let’s do our best to protect our people from
its harm”.

Thank you for supporting this Bill. We will do what is practical to
implement it effectively.

Emerging Products

First, many members support the ban on emerging tobacco products. Mr Seah
Kian Peng’s account on snus, a smokeless product, is instructive. Let’s not
allow them to land here.

However, Dr Lam Pin Min and A/Prof Fatimah Lateef suggested that we do not
ban such products entirely, but to consider some of them as part of a harm
reduction strategy to help smokers quit smoking.

It reminded me of our experience with Subutex as a harm reduction strategy
to get drug addicts off heroin. The West touted this strategy and we tried
it out with disastrous results. It took MHA and I quite some time to reverse
the policy.

A less harmful tobacco product is an oxymoron. I share Mr Hri Kumar’s view
on this subject and agree with his robust approach. In the 1970s, the
tobacco companies introduced cigarettes purported to be “low tar”, “light”
or “mild” as safer alternatives.

They promoted such cigarettes to smokers who had heath concerns and were
thinking of quitting. These products rapidly gained market share. As a
result, there was a net increase in cigarette consumption. Independent
research later on showed that smokers compensated by smoking more cigarettes
or inhaling more deeply.

Prof Lateef quoted the positive experience of snus in Sweden. The Swedish
experience has never been replicated outside of Sweden. I note that snus is
a Swedish product.

The evidence is actually the opposite, with the use of snus resulting in
smokers becoming addicted to both cigarettes and snus. More smokeless
tobacco use does not mean less cigarette smoking.

Smokers use smokeless tobacco products to tide over nicotine craving in
places where smoking is prohibited while continuing to smoke in other places
where smoking is allowed – this perversely reduces the impetus for them to
quit smoking.

Meanwhile, tobacco companies get to entice non-smokers to develop nicotine
addiction, adding to their customer base.

Our experience with Subutex as a less harmful heroin substitute is similar.
Instead of reducing the number of drug addicts, we ended up with more. I
strongly advise against adopting such so-called harm reduction strategy.

But I agree with Dr Lam and Prof Lateef that we should try to help smokers
“to gradually quit in a controlled manner”. There are proper ways to do so,
one is through controlled Nicotine Replacement Therapy (NRT), by following
strict guidelines. We do not prohibit nicotine used in such a manner.

I would like to assure Mr Alvin Yeo that we will, in the assessment process,
undertake the necessary studies before imposing any ban under Section 15. We
will keep an open mind about this.

Education and Smoking Cessation

Second, all the members expressed concerns over the rising smoking
prevalence among certain population groups, including the young, the ladies
and the Malays. Mdm Halimah’s speech in Malay made a heart-felt appeal to
the Malay smokers to think about the welfare of their children and to get
them to stop smoking.

To be credible, they have to walk the talk by quitting smoking themselves. I
join her in this appeal. I also thank Mdm Halimah for highlighting the harm
pregnant mothers bring to their infants if they smoke.

All the Members called for stronger smoking control measures. I agree
entirely.

We have implemented various programmes, and we will continue to try new
ones. We work with schools, religious institutions, the employers, the
charity sector and the community at large. I note Mdm Halimah’s illustration
of the Sheraton Towers as an exemplary employer who went the extra mile to
get their employees to quit smoking. I applaud such employers and urge more
to join the movement.

I heard Mdm Cynthia Phua’s call for schools to reach out to students who
smoke and get them to quit. I appreciate her sharing several research
findings done in schools overseas on effective counselling, including
telephone counselling. I note her point that with teens, enforcement and
penalty do not work as well.

The psychology often works the other way. What is prohibited becomes highly
valued. We try to tap on the young to guide us on how to reach out to their
peers.

I had focus group discussions with young lady smokers. They knew the harm of
tobacco and had tried to quit but when their own family members and close
friends are smokers, they found it difficult. This is obviously a complex
issue. As Prof Straughan noted, one underlying cause could be the larger
problem of some youths needing to embrace “sub-cultures” in order to seek
“affirmation from like-minded peers”.

We will definitely try to do more and learn from others. We have discussed
the various initiatives in this House before. In the interest of time, I
will not repeat them here.

Our efforts have not been futile. Let me quote one indicator. The proportion
of Secondary School students who have ever tried cigarette smoking has
dropped from 26% in 2000 to 16% in 2009. This is a victory for us. But we
need to do better.

Third, Ms Ellen Lee, Mdm Halimah, and Prof Straughan called for stronger
enforcement against sales to the under-age. I agree. We will step up
policing on tobacco retail outlets. We will consider raising the penalty on
repeat offenders. We are also considering disallowing tobacco sales in
outlets frequented by young customers.

FCTC Obligations

Fourth, Dr Lam Pin Min asked about Singapore’s compliance with the Framework
Convention on Tobacco Control (FCTC) and whether we had been tardy. To date,
we will be the third country in the world to fulfil all the obligations on
tobacco labelling should this Bill be passed.

Dr Lam wondered if the delay in implementing the FCTC was a cause for the
increase in smoking prevalence here. I doubt it. We have been ahead of the
curve in tobacco control and in any case were largely FCTC compliant right
from the start.

Dr Lam asked if we should give the tobacco companies more than 12 months to
implement the changes to tobacco product packaging. We decided on “12
months” based on actual past experience when we introduced mandatory health
warning labels. They were able to comply.

I appreciate Mr Sin Boon Ann’s thoughtful piece on “lateral advertising”,
“subliminal marketing” and “advertising through the internet”. Mr Calvin
Cheng made a similar observation. Indeed, these are the innovations that
tobacco companies are mounting to get around the FCTC. It is a hot topic
currently being discussed among international regulators including
ourselves.

We do not yet have all the answers to these challenges. For example, how do
we deal with internet advertising?

How do we censor out scenes of James Bond smoking a particular brand of
cigarette? I have not noticed Mr Sin’s observation that Mark Lee seemed to
be particularly fond of Marlboro cigarettes. I will have a quiet word with
him the next time I see him.

But where we can, we should act. For example, we have removed the exemption
for congratulatory messages and sponsorship publicity.

Mr Hri Kumar has described past misleading behaviours by tobacco companies.
This is unethical behaviour. I agree with his observations.

From a public health perspective, misleading terms are just as misleading,
even if they are part of a trade mark. Mr Alvin Yeo raised several legal
queries on this. The new s17A will affect trademarks if they contain
misleading descriptors.

We are aware of our TRIPS and other international obligations and have
consulted the relevant authorities extensively on this point. The proposed
section 17A is aligned closely to the FCTC and will not violate Singapore’s
international obligations. We are in good company: the EU prohibits
misleading terms and descriptors even if they are part of the trademarks or
brand names.

Other Issues

Lastly, there were some comments which do not pertain to the proposed
amendments in the current Bill. But let me briefly address them.

Ms Ellen Lee and Mr Hri Kumar made a plea on behalf of the non-smokers and
especially innocent children, from the effects of second hand smoke from
inconsiderate neighbours, and irresponsible parents. Ms Lee asked the NEA to
widen the outdoor smoking ban to include more common places in HDB towns,
such as void decks and common corridors.

I will raise her suggestion with the NEA. Mr Hri Kumar asked rhetorically
how we could extend the law to the privacy of the home, in order to protect
the children from second-hand smoke. He knew it is outside my purview. But I
note his point.

Dr Lam suggested that we control retail pricing of tobacco products, to make
them expensive, thus curbing consumption. In practice, price fixing seldom
works, as we live in a region where cigarettes are cheap. For the same
reason, while we have been aggressive in tobacco taxation, there are limits,
but we will continue to use this strategy where practical and feasible.

Conclusion

Mr Speaker, Sir, tobacco related deaths and illnesses are preventable. Let’s
try to make Singapore as tobacco free as possible. When drafting this Bill,
we had extensive consultation with Singaporeans. The amendments received
strong support from them.

Mr Speaker Sir, I beg to move.

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