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SINGAPORE: Singapore has been a difficult place to live for a smoker.
It seems that smokers cannot take a break, particularly with the suggestion to ban smoking near the balconies and windows of houses by Nee Soon GRC, Member of Parliament and Committee of Parliament of the Group for Sustainability and the Environment, Louis Ng, in October, reliving a national debate about how far the country should go. to combat smoking completely.
Get smokers to close their windows when they smoke, some suggested.
Ban smoking altogether, some frustrated netizens said.
LISTEN: Is it time to go after the smokers who light themselves near the windows of their houses?
HARD MEASURES AGAINST SMOKING IN RECENT YEARS
Singapore has implemented a series of increasingly aggressive legislative measures to stop the habit, especially in the last three years.
Stores cannot display cigarettes openly since 2017.
Tax increases in 2018 have increased tariffs on cigarettes by 10 percent.
Following the amendments to the Tobacco Act, ugly health warning labels and standardized packaging have been imposed, contributing to the stigmatization of the habit.
Laws have also been toughened to raise the legal age for smoking, as the 2010 National Health Survey study showed that eight out of 10 smokers were hooked before their 21st birthday.
Photo: (REUTERS / Beawiharta / File Photo)
And to curb the demand for alternative tobacco products that act as easy gateways to cigarettes for young people, such as e-cigarettes and shisha, a ban on their possession, purchase or use was imposed in 2018.
In fact, this multi-faceted effort to stop smoking in 2018 was so publicly visible that the dean of the NUS Saw Swee Hock School of Public Health, Dr. Teo Yik Ying, coined it the year Singapore tried to quit smoking.
READ: Comment: The year Singapore tries to put out tobacco
Today’s smokers are also not free to light anywhere they want on smoke-free Orchard Road and have to stand on bright yellow boxes if they do.
These efforts have paid off. The smoking rate has fallen from 14.3% in 2010 to 10.6% in 2019.
This is a significant achievement that should be commended, when the Ministry of Health had previously revealed in 2018 that the incidence of smoking had fluctuated between 12% and 14% during the last decade with no clear pattern of decline.
Smoking rates must be lowered where public health costs are high. At least S $ 600 million a year in direct healthcare costs and lost productivity for Singapore, according to a 2014 estimate from the renowned medical journal BMJ Open.
Some public health experts, such as Professor Chia Kee Seng, have gone even further in calling for the total extermination of smoking, seeing that it is “an archaic habit with no place in modern society.”
READ: Comment: Smoking is an archaic habit that has no place in modern society
ADDRESSING SMOKING ON WINDOWS A PRIORITY
Ultimately, people should be able to do whatever they want at home, many say. But when it comes to smoking, all of us smokers and non-smokers know that it is an entirely different game.
Stock photo of a person smoking. (Photo: AFP)
For one thing, while smokers have it bad in terms of health effects, those around them also bear the costs of their habit.
This used to apply to family members trapped at home with the smoker, but has taken on broader significance as the pandemic unleashed Singapore’s biggest shift towards working from home (WFH) and learning at home.
Smoking-related complaints in HDB areas increased almost sixfold in the first nine months of 2020 compared to all of 2017, State Minister for National Development Sim Anne revealed in Parliament last week.
READ: Comment: When Singapore Homes Become Workspaces: Big Changes at Home and Beyond
Even that increase may be an understatement considering how many of us tend to be educated residents who are embarrassed to make a fuss every time our neighbor smokes or creates a minor inconvenience.
“Working from home is the new normal. People used to work in the office. They go home and, for an hour or two, the neighbors can smoke once or twice a night. But people are now home most of the time, and they can face a whole day of secondhand smoke, ”Mr. Ng told me on CNA’s Heart of the Matter podcast.
The consequences can be serious. “Many of the residents complained to me about secondhand smoke because their children have asthma… yet they have a neighbor who constantly smokes at their windows,” Mr. Ng emphasizes.
“Imagine if your neighbor is spraying toxic chemicals outside your home and you breathe it in … that’s exactly what secondhand smoke is.”
READ: Comment: COVID-19 Offers New Impetus To Quit Smoking
“There is no safe minimum level of secondhand smoke,” shared Dr. Yvette van der Eijk of the NUS Saw Swee Hock School of Public Health about the same episode.
“Secondhand smoke contains something like 60 carcinogens and hundreds of chemicals that are known to be toxic … It can be more dangerous to our health than what smokers breathe in … because (they) don’t burn completely ”, He highlighted.
SINGAPORE’S APPROACH TO HEALTH CARE HAS ALWAYS BEEN INTERVENTIONAL
When this latest smoking ban suggestion was resurfaced in October by Mr. Ng, concerns about hacking and enforcement multiplied online, which surprised me.
Stock photo of elementary school students.
Singapore has arguably taken an aggressive and interventionist approach to public health for decades.
Countless mandatory immunization programs, such as those against measles and diphtheria, which included mass vaccination of infants and school-age children as part of the National Childhood Immunization Program, have been accepted without much fuss.
Even when these programs are optional, like the BCG injection that protects against tuberculosis, the adoption rate has been close to 100 percent for decades. Equally high rates are also expected for the optional human papillomavirus vaccination program for Secondary 1 girls, which began last year.
READ: Comment: Making Sense of Changing Targets in COVID-19 Science and Public Policy
Public acceptance of the enforcement of the law against other endemic diseases, such as the National Environmental Agency’s controls against dengue, which can carry fines but require permission from residents for inspections, has also been welcomed.
I suspect that people understand and accept the rules that regulate individual behavior that could have ramifications for the health of the community.
READ: Comment: Uncovering the Factors Fueling Singapore’s Record Dengue Cases
You need to consider the practicalities of imposing a ban on smoking near windows, but the technology exists.
Cameras are already used to detect thermal scanners and thermal scanners smoking in common hallways. It may be worth considering extending its use to monitor smoking as a stronger public health imperative.
During the podcast, Mr. Ng showed us an image taken by these cameras of a smoker throwing cigarette butts out of the window.
Cigarette butts are seen on a patch of land. (File photo: Hidayah Salamat)
“That’s how powerful our cameras are, powerful in the sense that … they are not intrusive … if you are sitting on your couch or lying in your bed, they cannot capture you, but if you are on your balcony, leaning outside and smoking , then they can capture you. “
But he was also quick to warn that such media should be a last resort, letting the laws provide a strong deterrent against smoking near windows and modifying social norms in the same way that Singapore has treated garbage.
For a MP whose GRC has struggled to build smoking boxes to accommodate smokers, he understands how much a middle ground is needed.
READ: Comment: Youth smoking is a problem, so is youth vaping
IN ADDITION TO REDUCING SMOKING TOO
As Singapore moves towards a national health insurance scheme to pool risks and costs related to hospitalization (through MediShield Life) and disability (Careshield Life) and to strengthen these programs in the spirit of collective responsibility, it is possible that it is only a matter of time before an even more intrusive step in smoking pricing can be said to be taken.
Smokers tend to pay a higher premium for life insurance policies compared to non-smokers, according to AIA Insurance, given the health risks associated with smoking.
In the United States, smokers also pay up to 50 percent more for health insurance.
We may be a bit far from that, but where Careshield Life already adopts actuarial principles such as charging women higher premiums in accordance with insurance industry practice, and Medishield Life premium increases have been proposed, that Chicken might come home to sleep sooner than we think. .
READ: Comment: When it comes to insurance, less is more for young adults just starting out
And seen in these terms, banning smoking near windows is a small topic in the smoking debate.
Even if you neglect such trends, it is worth looking at Mr. Ng’s suggestion, which gets to the heart of concerns about smoke reaching the homes where people spend the most time, including the elderly and young children.
As Mr. Ng said on our podcast, the challenge should be viewed through a public health lens rather than a dispute between neighbors or non-smoking complaints.
Lin Suling is an executive editor at CNA Digital News, where she oversees the comment section and hosts the Heart of the Matter podcast.
