World Congress on Tobacco or Health 2012 - Singapore

S'pore aims to make smoke-free the norm

Health Minister shares country's experience at summit

By Salma Khalik, The Straits Times, 21 Mar 2012

SINGAPORE wants to become a place where being smoke-free is the norm. It was heading that way when smoking rates went down from 18.3 per cent in 1992 to an all-time low of 12.6 per cent in 2004.

But numbers have crept up and now stand at 14.3 per cent, due to a 'significant increase' in younger smokers aged 18-29, said Health Minister Gan Kim Yong yesterday.

To counter this, Singapore announced earlier this month that it will align tax for all tobacco products to stop users from shifting to cheaper alternatives, and getting non-smokers to help smokers quit.

Speaking at the opening of the World Congress on Tobacco or Health, Mr Gan said this bad habit puts a toll on health-care expenditure, and results in loss of productivity and absenteeism.

For individuals, spending on tobacco means 'income is diverted away from meaningful and more important household purchases and investment such as healthy food and education'.

Painting a broader picture, he blamed tobacco use for killing five million people worldwide each year - or about 12 per cent of adult deaths.

On top of that, another 600,000 people die from inhaling second-hand smoke yearly. He said: 'Tobacco kills more than tuberculosis, HIV/Aids and malaria combined.'

He also told the 2,600 delegates from 124 countries - including six other health ministers - of Singapore's fight against smoking which dates back four decades.

'We were the first country in Asia to ban tobacco advertisements in 1971. We have also progressively banned smoking in public places since 1970.

'In 2004, we were the first country in Asia to implement requirements for all cigarette packets to bear graphic pictures warning smokers about the dangers of smoking.'

The five-day meeting, held every three years since 1967, is recognised as an important forum for international collaboration on the subject, and is attended by policymakers, health-care workers, scientists and academics.

This year's event at Suntec Convention Centre was organised by the Health Promotion Board (HPB). Participants are expected to discuss issues such as whether plain or gory packaging for cigarettes is more effective in reducing its use, whether rich tobacco companies are sabotaging stop-smoking drives and the effectiveness of smoke-free zones and taxation.

HPB chief executive officer Ang Hak Seng in his speech said Mr Gan has given him the task of bringing smoking in the country down to 10 per cent by 2020.

He revealed that less than 8 per cent of smokers who quit were able to stay off for a year because of peer pressure from friends who smoke.

The HPB will try to counter this with support for those trying to make it, he said, noting that the best encouragement is from a former smoker.

Dr Margaret Chan, the World Health Organisation's director-general, in her keynote address at the opening ceremony yesterday, hit out at tobacco firms for trying to derail anti- smoking campaigns in countries like Uruguay, Norway, Australia and Turkey.

'Big money can speak louder than any moral, ethical or public health argument, and can trample even the most damning scientific evidence.'

Calling smoking a 'killing addiction', she said: 'Tobacco use is the world's No. 1 preventable killer.'

Stopping smoking, she added, 'would deliver the single biggest preventive blow to heart disease, cancer, diabetes and respiratory disease'.

Dr Surin Pitsuwan, Asean secretary-general, said 125 million of Asean's population of 600 million are smokers. Some member countries, he added, still rely heavily on the revenue from tobacco, and ignore the expense caused by smoking.

He announced, to great applause, that the Asean secretariat in Jakarta will be smoke-free from April 1.

Yesterday, the 10 member nations also pledged to create a smoke-free region.

Have more hard-hitting anti-smoking drives: Expert
By Poon Chian Hui, The Straits Times, 22 Mar 2012

SINGAPORE has done well to reduce smoking rates but could do more to highlight the dangers of tobacco, an international expert told The Straits Times yesterday.

Public awareness campaigns appear to have become more experimental in nature, said Ms Sandra Mullin, senior vice-president of policy and communications at the World Lung Foundation, adding that several experts have found this 'surprising'.

'Singapore used to run very hard-hitting mass media campaigns. We are not seeing them to the degree we saw earlier on,' she said.

She was speaking at the launch of The Tobacco Atlas, an in-depth publication on smoking around the world. It was unveiled yesterday by the World Lung Foundation and the American Cancer Society at the 15th World Conference on Tobacco or Health, which Singapore is hosting at the Suntec convention centre.

For example, the latest National Smoking Control Campaign appears to have adopted a softer tone, choosing to inspire smokers to quit the habit through the use of motivational messages, support groups and counselling services.

But considerable evidence shows that graphic campaigns and those that spark negative emotions are the most effective.

'Campaigns that almost make you cry, showing somebody dying and leaving children behind - things that cause negative emotions work much more than aspirational campaigns that are feel-good and positive,' said Ms Mullin.

Trying to 'galvanise' or create camaraderie among smokers does not usually work, she added. 'Things don't come across as serious as they should be.'

Mass media campaigns cited as exemplars in the publication include a TV advertisement entitled 'Sponge' from Australia, which shows tar being squeezed from a dirty sponge to show the amount of tar a smoker's lungs absorb.

However, Ms Mullin and other international experts lauded Singapore for being a leader in other areas, such as in imposing high taxes on tobacco and creating smoke-free zones in public places such as coffee shops.

Singapore has one of the lowest smoking rates globally, at 14 per cent of the adult population. In contrast, 27 per cent of adults in the United States smoke, as do 21 per cent of adults in Britain and 23 per cent in Japan.

The panel of experts also recommends that countries continue increasing taxation to as high as 70 per cent, citing this as one of the most effective deterrents.

Singapore imposes an excise tax of 60.7 per cent on cigarettes.

Published in five languages, the Atlas will be distributed to health ministries and policymakers around the world.

Ban on display of cigarettes in shops?
By Poon Chian Hui, The Straits Times, 23 Mar 2012

SHOPS here could soon be barred from openly displaying cigarettes for sale.

Speaking on the sidelines of the 15th World Conference on Tobacco or Health at Suntec Convention Centre, Health Promotion Board chief executive Ang Hak Seng said Singapore is considering a display ban in a bid to further stub out the habit.

Currently, most shops and supermarkets here display cigarette packets on shelves behind cashier counters, such that the brands are visible for customers to pick and choose.

A display ban would require shops to keep such tobacco products out of sight of customers.

In other countries where the ban is enforced, such as Britain, Canada, New Zealand and Thailand, cigarette packs are kept under counters and produced only on request.

Proponents of the move say that placing cigarettes alongside daily essentials like bread and children's snacks makes smoking seem like a normal and acceptable part of life.

Associate Professor Munidasa Winslow, a psychiatrist in private practice who specialises in addiction, said that such a ban would help discourage smoking.

'It makes life more difficult for smokers so they will think twice about what they are doing,' he said.

Mr Ang also did not rule out plain packaging measures similar to the ones Australia announced in 2010.

From December, cigarettes and all other tobacco products in Australia have to be sold in olive-green packs that carry large graphic health warnings.

'We will consider adopting any policy in tobacco control, if it is something which works well in Singapore's context,' he said.