Number of Singaporeans Who Have Given Up Smoking in Past Two Years and Proposal to Consider Total Ban on Sale of Tobacco Products

10 Dr Lim Wee Kiak asked the Minister for Health (a) how many people gave up smoking in the past two years compared to the pre-COVID-19 pandemic figures; (b) whether this trend is in line with our target to reduce the smoking rate to 5% by 2035; and (c) whether the Ministry will consider a ban on cigarette sales to young Singaporeans born after 2012 that can result in the gradual phasing out of tobacco smoking altogether in Singapore.

11 Mr Louis Ng Kok Kwang asked the Minister for Health (a) whether the Government will study the implementation of a ban on the sale of tobacco products to those born after a particular year, in addition to the current minimum legal age; (b) if so, what are the factors the Government will look into when determining whether to implement such a ban and when will the results of the study be announced; and (c) if not, why not.

12 Mr Liang Eng Hwa asked the Minister for Health whether the Government will consider introducing a lifetime ban on cigarette sale to young persons below a certain age, similar to New Zealand’s plan to introduce legislation to eliminate smoking for the next generation, reported on 9 December 2021.

13 Ms He Ting Ru asked the Minister for Health (a) whether the Ministry intends to introduce a generational tobacco purchasing ban similar to that implemented by New Zealand; and (b) whether other measures are being studied to reduce rates of smoking in the general population.

14 Mr Melvin Yong Yik Chye asked the Minister for Health (a) for each year over the past five years, how much does smoking-related diseases cost the healthcare sector; (b) whether the Ministry will study New Zealand's ban on the sale of tobacco products to those born after a particular year; and (c) if so, when will the study be expected to be completed and results presented to the public.

The Senior Minister of State for Health (Dr Koh Poh Koon) (for the Minister for Health): Mr Speaker, with your permission, can I take Question Nos 10 to 14 together, please?

Mr Speaker: Yes. If you can try and keep your response succinct if possible.

Dr Koh Poh Koon: Sir, smoking and second-hand 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 approach has been to reduce our smoking rates and encourage smokers to quit.

We do not have comparable figures of the smoking quit rate in the past two years as requested by Dr Lim Wee Kiak. But our tobacco control measures have been successful. It has progressively reduced smoking prevalence rates from 11.8% in 2017 to 10.1% in 2020.

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 3% to 5% reduction of new young people taking up smoking as well. [Please refer to " Clarification by Senior Minister of State for Health ", Official Report, 11 January 2022, Vol 95, Issue No 45, Corrections by Written Statement section.]

But it was last increased in 2018. So, with inflation and income increases, the tax burden gets eroded over time and we will have to continue to work with the Ministry of Finance (MOF) to review the tobacco tax rate.

In 2020, standardised packaging and enhanced graphic health warnings were required for all tobacco products sold here in Singapore to reduce the attractiveness of cigarettes. It is, however, still too early to evaluate the effectiveness of this measure.

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.

The Ministry of Health (MOH) and the Health Promotion Board (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.

Smokers who are looking for support to quit can also join HPB's 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.

There have been several questions raised by Members of Parliament 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 restrictions on older smokers. Then, of course, as the years go by, more and more cohorts are smoking free.

MOH is open 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 other countries. Our youths today no longer see smoking as glamorous and are aware of its harms.

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, outrightly banned here in Singapore. But with e-commerce, they still find their way here. 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 amongst the younger population, it undoes all the progress we made on curbing smoking and will take an enormous effort over many years to curb its use.

Although New Zealand has announced a cohort smoking ban, it promotes vaping as an alternative to smoking. So, over time, the habit may well shift from smoking to vaping, which in itself is still harmful.

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 offences 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.

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 applied here to Singapore.

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.

1.35 pm

Mr Speaker: Order. End of Question time. Mr Leong Mun Wai, you have a Personal Explanation?

[Pursuant to Standing Order No 22(3), Written Answers to Question Nos 15-16, 22, 27-28, 30-31, 33-40, 43-56, 58, 60-71, 74-75, 77, 79-85, 87-89 and 91-97 on the Order Paper are reproduced in the Appendix. The remaining Question have been postponed to a later sitting of Parliament or withdrawn.]