Singapore ‘open to the idea’ of cohort smoking ban, will study how New Zealand implements ban
SINGAPORE: Singapore is open to the idea of a cohort smoking ban, Senior Minister of State for Health Koh Poh Koon said in Parliament on Tuesday (Jan 11).
He was responding to Members of Parliament who asked smoking-related questions, including whether Singapore will study and introduce such a ban, following the New Zealand government’s plans to do so.
Under the New Zealand government's plans, people aged 14 and under in 2027 will never be allowed to purchase cigarettes in the country.
The New Zealand government will consult a health task force before introducing legislation in June, with the aim of making it law by the end of this year. Restrictions will then be rolled out in stages from 2024.
Dr Koh said: "It is an attractive proposal, in that it prevents young people from taking up smoking while not putting too many restrictions on older smokers. Then, of course, as the years go by, more and more cohorts are smoking free."
While the Ministry of Health (MOH) is open to studying such a policy, he noted that the Government needs to take into account a few considerations.
CHALLENGES IN IMPLEMENTING COHORT BAN
In Singapore, young people are generally not taking up smoking, unlike the youths in many other countries, he said.
“Our youths today no longer see smoking as glamorous, and are aware of its harms,” he said.
He added that Singapore’s bigger challenge among young people is e-cigarettes, which are still tobacco products and harmful to users. Although banned, these illegal devices still find their way here, Dr Koh added.
“We will need to do more to enforce the current ban to push back against the tide of popularity and increasing use.
"If vaping becomes entrenched among the younger generation, it undoes all the progress we have made on curbing smoking, and will take an enormous effort over many years to curb its use,” he said.
Dr Koh added that although New Zealand has announced a cohort smoking ban, it promotes vaping as an alternative to smoking. Over time, the habit may shift from smoking to vaping, which is still harmful, he said.
Another challenge with a cohort ban is in enforcement, he said.
“For such a ban to be effective, we would need to introduce laws to penalise older persons who are not subject to the ban, but for abetting offences such as supplying tobacco products to the affected cohorts,” he said.
A similar proposal was discussed in Parliament in 2016 when amendments to the Tobacco (Control of Advertisements and Sale) Act were introduced, and MOH at the time explained the challenge of implementation and enforcement then, Dr Koh said.
"Nevertheless, we remain open to the idea. New Zealand’s (announced) ban will be the first time a country will be implementing such a ban at the national level," he said.
"We will study how New Zealand implements the ban, its effectiveness and how their experience could be applied here to Singapore."
TOBACCO TAX MOST EFFECTIVE
Responding to MPs who asked about measures to reduce the smoking rate in Singapore, he said that the most effective measure has been the tobacco tax.
"Several economic studies have reached a consensus that for every 10 per cent increase in real price, there will be about a 3 to 5 per cent decrease in overall tobacco consumption, a 3.5 per cent reduction in young people taking up smoking," Dr Koh said.
This works out to a total of about 7 per cent reduction of "kids" taking up smoking, MOH said in a subsequent release on its website.
The tobacco tax was last increased in 2018.
“With inflation and more income increases, the tax burden gets eroded over time, and we will have to continue to work with the Ministry of Finance to review the tobacco tax rate,” Dr Koh said.
In 2020, standardised packaging and enhanced graphic health warnings were required for all tobacco products sold in Singapore to reduce the attractiveness of cigarettes. It is still too early to evaluate the effectiveness of this measure, he said.
The authorities also progressively raised the minimum legal age for smoking from 19 years in 2019 to 21 years in January last year.
It has contributed to a decline in smoking among younger adults aged 18 to 29, from 9.8 per cent in 2017 to 8.8 per cent in 2020, he said.
Overall, tobacco control measures have been successful, Dr Koh said, citing a reduction in smoking prevalence rates from 11.8 per cent in 2017 to 10.1 per cent in 2020.
Smoking and secondhand smoke exposure are associated with at least 11 major medical conditions that accounted for about S$180 million of healthcare cost in 2019, he added.
“Our consistent policy approach has been to reduce our smoking rates, and encourage smokers to quit,” said.
He added that the Ministry of Health (MOH) and the Health Promotion Board will be piloting a new smoking cessation programme where eligible individuals will be offered subsidised nicotine replacement therapy that is complemented with counselling in public healthcare institutions.
MOH will continue to enhance its approach to tobacco control through public education, provision of smoking cessation services, legislation and taxation, he said.
“We will also study new measures to further reduce access to tobacco products and tackle vaping, particularly among our youths,” he said.
Editor's note: This article has been updated following a correction from the Ministry of Health to a quote from Dr Koh, in which he referred to studies showing the effect of a price increase on the smoking take-up rate.