Singapore’s Response to World Health Organisation’s (WHO) Report

Singapore welcomes the World Health Organisation’s report on Electronic Nicotine Delivery Systems (ENDS), of which the most common prototype are electronic cigarettes (e-cigarettes). The Report was released by the WHO today (http://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6_10-en.pdf).

The ENDS Report

2 The report provides the latest evidence on health risks of the vapour from ENDS, including e-cigarettes, to users and nearby non-users (bystanders). These include potentially:

a) having adverse effect on brain development in unborn babies, children and teenagers;

b) development of nicotine addiction;

c) developing exposure to toxic and cancer causing chemicals; and

d) developing exposure to PM 2.5 particles.

3 The report also looked at the available evidence and concluded that there is very limited and inconclusive evidence that ENDS work as a method for quitting tobacco smoking.

4 It notes that 13 countries, including Singapore, have banned the sale of ENDS, including e-cigarettes. For countries that have not done so, in order to not ‘renormalise’ or ‘re-glamourise’ smoking, or undermine current tobacco prevention policies, the report recommends that regulatory options should be adopted, such as the ban on sales to minors and the prohibition of marketing especially to children, young people or other non-smokers. Such marketing would include unsubstantiated health claims, sponsorship of sporting events, product placement and the use of flavours designed to appeal to youth. The report acknowledges the right of countries to select an appropriate level of protection from the harms of ENDS through regulatory measures.

ENDS in Singapore

5 The Ministry of Health (MOH) takes a serious view of the importation of these products into the country, including online purchases and hand-carrying into Singapore. The import, distribution and sale of ENDS, including e-cigarettes are currently prohibited under the Tobacco (Control of Advertisements and Sale) Act.

6 ENDS, including e-cigarettes, that claim to be smoking cessation products to help smokers quit tobacco use should demonstrate their safety and effectiveness with the same level of scientific rigour required for approved Nicotine-Replacement Therapies under the Medicines Act. As yet, there have been no applications to register ENDS as smoking cessation therapies. As the WHO report indicates, there is as yet no conclusive evidence that supports the registration of ENDS for this purpose.

7 MOH will continue to monitor, the safety and efficacy evidence base of ENDS as smoking cessation aids.

8 Smokers seeking to quit smoking should use methods that have been proven to be safe and effective. These methods include going cold turkey, undergoing smoking cessation counselling, and undergoing nicotine replacement therapy, which have proven to be effective in helping smokers quit smoking in the long run.

9 Smokers who wish to quit can speak with a Quit Consultant on the toll-free Quitline at 1800 438 2000 or join the iQuit club at www.iquitclub.sg. In addition, health ambassadors under the Health Promotion Board’s I Quit programme provide peer support to help smokers quit the habit.