Harm reduction not the way to go

MOH's reply

The Straits Times, 28 Jun 2018

Harm reduction not the way to go

We refer to the commentary by Dr Jeremy Lim (E-cigarettes: Neither ban nor permit, but reduce harm; June 19).

Tobacco products contain nicotine and are highly addictive. Nevertheless, we have made steady progress to bring down smoking rates. Smoking prevalence fell to 12 per cent last year. We intend to bring the number down to below 10 per cent by 2020.

Dr Lim suggests a harm reduction approach. This entails enabling, even facilitating, a person to do harm to himself, albeit to a lower degree. We should be focused on preventing harm in the first place.

Dr Lim cited the sterile needle and syringe availability programmes, which have helped control the spread of HIV infection among intravenous drug users in Australia.

Unlike Australia, Singapore does not face such a problem. Intravenous drug use accounted for less than 2 per cent of HIV cases in Singapore over the last 25 years.

This is because of our zero-tolerance approach towards drugs. We are one of the few nations in the world where the drug abuse situation is well under control.

The harm reduction approach, when it comes to drugs, in fact encourages their consumption.

In Portugal, the number of students trying drugs and drug-related deaths went up after the introduction of harm reduction strategies.

Countries go for such strategies because their anti-drug policies have failed and they need to mitigate the disastrous public health and other consequences from their failure to control drug addiction. Singapore is not in this position.

There is evidence that e-cigarette use is harmful to health, given that they contain highly toxic carcinogens like formaldehyde.

E-cigarettes can also be a "gateway" to smoking for youth, as studies in Britain, Canada and the United States have shown. A teenager who starts vaping has a higher risk of eventually progressing to smoking.

Research also suggests that e-cigarettes can re-normalise smoking in populations where smoking prevalence has been on the decline.

Given the high stakes, it would be irresponsible of the Government to make a hasty decision on e-cigarettes.

We are closely monitoring the global evidence, which will shape our policy.

We are prepared to allow e-cigarettes as a smoking cessation therapy prescribed by doctors, if there is rigorous evidence of their safety and effectiveness.

Lim Siok Peng (Ms)
Director, Corporate Communications
Ministry of Health

Sunny Lee
Director, Media Relations
Ministry of Home Affairs