1. Smoking and secondhand smoke exposure are associated with at least 11 major medical conditions that accounted for about $180 million of healthcare cost in 2019. Our consistent policy has been to reduce our smoking rates, and encourage smokers to quit.
2. We do not have comparable figures of the smoking quit rate in the past two years as requested by Dr Lim Wee Kiak. Our tobacco control measures have been successful. It has progressively reduced smoking prevalence rates, from 11.8% in 2017 to 10.1% in 2020.
3. The most effective has been tobacco tax. Several economic studies have reached a consensus that for every 10% increase in real price, there will be about a 3 to 5% decrease in overall tobacco consumption, a 3.5% reduction in young people taking up smoking, and a total of about 7% reduction of kids taking up smoking as well. It was last increased in 2018. So 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.
4. 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 however still too early to evaluate the effectiveness of this measure.
5. We also progressively raised the minimum legal age for smoking from 19 years in 2019 to 21 years in January 2021. This aims to denormalise tobacco use among youth below the age of 21, restrict their access to tobacco products in their social circles, and hence reduce the likelihood of smoking initiation. It has contributed to a decline in smoking among younger adults aged 18 to 29 years, from 9.8% in 2017 to 8.8% in 2020.
6. MOH and HPB 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.
7. Smokers who are looking for support to quit can also join the Health Promotion Board’s (HPB) I Quit Programme. It offers smokers a range of smoking cessation interventions, such as phone or face-to-face counselling, or frequent nudges via text messages to encourage participants to sustain their behaviours.
8. There have been several questions raised by MPs on New Zealand’s recently announced cohort smoking ban. It is an attractive proposal, in that it prevents young people from taking up smoking while not putting too many restriction on older smokers. Then, as the years go by, more and more cohorts are smoking free.
9. MOH is opened to studying such a policy. But we need to take into account a few considerations. First, in Singapore’s case, young people are generally not taking up smoking, unlike the youths in many countries. Our youths today no longer see smoking as glamorous, and are aware of its harms.
10. Second, our bigger challenge amongst the young people here, are e-cigarettes, which are still tobacco products and harmful to the users, despite its fruity flavours. It is therefore outright banned in Singapore. But with eCommerce, they still find their way here. We will need to do more to enforce the current ban, push against the tide of popularity and increasing use. If vaping becomes entrenched amongst the younger population, it undoes all the progress we have made on curbing smoking, and will take an enormous effort over many years to curb its use.
11. Although New Zealand have announced a cohort smoking ban, it promotes vaping as an alternative to smoking. So over time, the habit may shift from smoking to vaping, which in itself is still harmful.
12. Third, the challenge with a cohort ban is in enforcement. 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 offenses such as supplying tobacco products to the affected cohorts. A similar proposal was discussed in Parliament in 2016 when amendments to the Tobacco (Control of Advertisements and Sale) Act were introduced, and MOH explained the challenge of implementation and enforcement then.
13. 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. We will study how New Zealand implements the ban, its effectiveness and how their experience could be applicable to Singapore.
14. My Ministry will continue to enhance our approach to tobacco control, through public education, provision of smoking cessation services, legislation and taxation. We will also study new measures to further reduce access to tobacco products and tackle vaping, particularly among our youths.