Speeches
Second Reading Speech by Mr Amrin Amin, Parliamentary Secretary for Health, on the Tobacco (Control of Advertisements and Sale) (Amendment) Bill, 7 November 2017
7 November 2017
This article has been migrated from an earlier version of the site and may display formatting inconsistencies.
SECOND READING SPEECH BY MR AMRIN AMIN, PARLIAMENTARY SECRETARY FOR HEALTH, ON THE TOBACCO (CONTROL OF ADVERTISEMENTS AND SALE) (AMENDMENT) BILL, 7 NOVEMBER 2017
Mr Speaker, on behalf of the Minister for Health, I beg to move, “That the Bill be now read a Second Time.”
2. Smoking continues to be a significant public health problem in Singapore. While smoking rates have decreased from over 18% in the 1990s, they have stagnated at around 12 to 14% in the last decade. 23% (or about 1 in 4) Singaporean men still smoke, much higher than in countries such as Australia (14.5%) and the US (15.6%). Every day, six Singaporeans die prematurely from smoking-related diseases.
3. Singapore adopts a multi-pronged approach to tackle tobacco addiction. This includes public education, taxes, tobacco control laws, regulations on smoke-free areas and help for smokers to quit. In recent years, we have enhanced our control measures. Our goal is to denormalise the use of tobacco products over time.
Minimum Legal Age
4. Mr Speaker, please now allow me to highlight the major provisions being introduced in the Bill. First, let me elaborate on the proposed increase in the Minimum Legal Age (MLA) for tobacco from age 18 to 21 for the purchase, use, possession, sale and supply of tobacco products.
5. Clause 2 of the Bill inserts a new definition of “under-aged person” in Section 2 of the Act, to provide for a phased increase in the MLA. Consequently, provisions in the Act that refer to “persons aged below 18 years” will be amended to an “under-aged person”. The details of the changes are in Clauses 3, 4, 5 and 9 of the Bill.
Vulnerability of youths to tobacco products
6. We are increasing the MLA for tobacco for several reasons.
7. First, adolescent brains are especially vulnerable to nicotine addiction, according to a 2015 report by the US Institute of Medicine[1]. The 2012 US Surgeon General’s report also showed that the younger someone tries smoking, the higher the probability of him becoming a regular smoker[2]. Smokers who start earlier also find it harder to quit smoking later in life.
8. Secondly, our data shows that we need to do more to discourage smoking among our young. Close to 95% of smokers had their first puff before they turned 21. 45% of smokers became regular smokers between their 18th and 21st birthdays. Based on HPB’s student health surveys[3], among youths below 18, two-thirds of smokers get their tobacco from friends and schoolmates. Raising the MLA to 21 will mean that retailers cannot sell tobacco to youths between their 18th and 21st birthdays, thereby denying such youths and those in their social circles easy access to tobacco.
9. We know that social and peer pressure strongly influence youths to start smoking. By raising the MLA, we are further denormalising smoking, particularly for those below 21. This will further reduce opportunities for youths to be tempted to take up smoking before attaining the age of 21.
Implementation of MLA increase
10. We have consulted extensively on the MLA increase. There is strong support from all segments of society, from youths, parents and businesses. The MLA will be progressively raised over a period of three years to minimise impact on smokers currently between the ages of 18 and 21. We plan to raise the MLA to 19 on 1 Jan 2019, 20 on 1 Jan 2020 and finally to 21 on 1 Jan 2021. Nonetheless, during the transitional years from now till 2021, we will encourage all youths to refrain from smoking as smoking is harmful. Quitting is a journey and it will take time for smokers to successfully quit. The phased implementation recognises this.
11. The Health Sciences Authority (HSA) will be distributing the new “No Sale of Tobacco to Under-aged Persons” signages and educational materials to all tobacco retailers. We will continue to work together with tobacco retailers, schools, institutes of higher learning, and agencies like MINDEF and MHA to ensure smooth implementation of the MLA increase.
Ilicit trade and enforcement
12. During the public consultation, some have raised concerns that youths will turn to the illicit market for cigarettes if they are unable to buy cigarettes legally. We will work with Customs and relevant agencies to monitor the situation regarding illicit trade and step up enforcement and educational efforts.
Emerging and harmful tobacco products
13. Next, MOH will further tighten control over emerging and imitation tobacco products to protect our young and general community.
14. At present, the importation, sale and distribution of shisha and other emerging tobacco products (such as smokeless tobacco), as well as imitation tobacco products such as e-cigarettes and other types of vaporisers (collectively known as Electronic Nicotine Delivery Systems or ENDS) are prohibited. The purchase, use and possession of these products are however not prohibited currently.
15. The World Health Organisation has urged countries to regulate ENDS, including banning them where feasible. 28 countries, including Australia, Brunei and Switzerland currently ban the sale of ENDS.
16. To tighten regulation of emerging and imitation tobacco products in Singapore, Clauses 6 and 7 of the Bill provide for new subsections under Sections 15 and 16 of the Act respectively to prohibit the purchase, use and possession of these products.
17. Effectively, the importation, sale, distribution, purchase, use and possession of emerging and imitation tobacco products shall be prohibited. Why we are taking this step?
Public health protection against ENDS
18. First, ENDS and all tobacco products are harmful to health. ENDS produces toxic substances in the vapour, including carcinogens which increase the risk of cancer of the throat, stomach and bladder. ENDS also contain nicotine, which is highly addictive. It is well known that nicotine has harmful effects on fetuses and brain development in adolescents. There are claims that ENDS are less harmful than cigarettes. Some of these actually come from research sponsored by the tobacco industry. So-called lesser-harm tobacco products still expose the user to toxic substances that are harmful to health, and keep the user addicted to nicotine.
19. Second, we do not want ENDS or other emerging tobacco products to become entrenched in Singapore. We have seen an exponential increase in the number of people using ENDS in other countries. For example, an estimated 2.8 million adults in Great Britain used e-cigarettes in 2016, representing a 4-fold increase from 700,000 users in 2012[4]. The use of e-cigarettes among school students has also increased significantly in countries such as New Zealand[5] and the US[6].
20. Overseas, tobacco companies are increasingly marketing ENDS the same way as tobacco products were marketed. There is growing evidence that ENDS manufacturers are targeting the youth market. For example, using flavours such as chocolate, strawberry and mint, and with sleek videos and marketing them as trendy choices.
21. Third, ENDS can be a gateway or “starter product” which gets the user hooked on nicotine, and leads to cigarette use later. A systematic review of nine studies involving more than 17,000 youths in the US found that e-cigarette users were three times more likely to become cigarette smokers compared to non-users. Another study showed that among more than 19,000 Canadian 14 to 18 year old youths, those who used ENDS were twice as likely to go on to regular smoking. Other studies in England, Scotland and Poland similarly support this “gateway effect”.
Tobacco Harm Reduction
22. MOH has received feedback arguing that we should consider allowing the use of ENDS by smokers to quit smoking. There are also views that offering a less harmful product like ENDS is a way to reduce the harm of smoking-related diseases in smokers. We have considered these arguments, but are not persuaded.
23. We have already approved nicotine replacement therapies, such as nicotine inhalers, gum and patches, to help smokers quit. These are registered as therapeutic products under the Health Products Act. Such products have undergone stringent evaluation of their safety, quality and efficacy as a smoking cessation therapy prior to registration. They are exempted from the Tobacco Act.
24. While there are some studies which suggest that e-cigarettes may help smokers to quit, the current limited evidence is neither robust nor conclusive. If any ENDS manufacturer has supporting data from credible and robust scientific studies, it can submit its product for evaluation as a smoking cessation therapy. Till now, none has done so. Once registered, its product will be exempted from the ban in the Tobacco Act. For smokers who wish to quit, there are proven methods and products, and ENDS has not been proven to be one of them.
Other amendments
25. Next, I will turn to other amendments in the Bill.
26. Clause 8 of the Bill provides for a technical amendment to Section 18 of the Act, to specifically restrict every licensed retail outlet to having only one point of sale. This amendment eliminates the need for HSA to specify the location of the single point of sale in each license issued.
27. Clause 2 of the Bill inserts new definitions of “tobacco product” and “tobacco substitute” to improve clarity.
28. Clause 6 repeals Section 15(6) of the Act, to align the definition of smoking for Section 15 with the general definition of “smoking” in section 2(1).
29. Clause 10 of the Bill amends Section 35 to state that composition sums collected shall be paid into the Consolidation Fund, instead of being retained by HSA.
30. Clause 11 of the Bill inserts a new section 35A, which provides that persons involved in the administration, collection, and enforcement of payment of any composition sum collected under section 34 shall be treated as public officers for the purposes of the Financial Procedure Act.
Conclusion
31. Mr Speaker, Sir, smoking is a major cause of premature death in Singapore. The changes proposed in this Bill will go towards protecting our population and especially the young from the harms of tobacco products.
32. There is mounting pressure, especially from self-interested parties to relax our position on ENDS. Our interest is in protecting our people.
33. I seek Members’ support for this Bill.
Mr Speaker, I beg to move.
[1] US Institute of Medicine’s Public Health Implications of raising the MLA of Legal Access to tobacco products, 2015
[2] The 2012 US Surgeon General’s report showed that a younger age of initiation is strongly associated with greater nicotine dependence in both young adulthood (18 to 25 Years old) and older adults. This also supported findings from other longitudinal studies in the US that the earlier age of initiation, the greater the intensity and persistence of smoking beyond adolescence and through adulthood.
[3] Student Health Surveys conducted from 2014 to 2016
[4] From Action on Smoking and Health (ASH), Factsheet on Use of electronic cigarettes (vapourisers) among adults in Great Britain (May 2016)
[5] A 2014 survey found an increase in the percentage of Year 10 students who had tried e-cigarettes, from 7 percent in 2012 to 20 percent in 2014. In another 2014 survey, 21 percent of students reported having tried an e-cigarette (most of them were non-smokers).
[6] CDC reported from 2011 to 2015, past 30-day use of e-cigarettes increased more than ten-fold for high school students (1.5% to 16.0%) and nearly nine-fold for middle school students (0.6% to 5.3%). There were nearly 2.5 million U.S. middle and high school students e-cigarette users in 2014.