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Regulating e-cigarettes a better option than an outright ban

The total ban on owning, possessing and using e-cigarettes took effect in Singapore on Feb 1.

Reuters file photo

Reuters file photo

Andrew John Da Roza

The total ban on owning, possessing and using e-cigarettes took effect in Singapore on Feb 1.

The action stands in contrast to credible, published scientific evidence, which continues to accumulate, that e-cigarettes - those which vapourise man-made e-liquids, but not tobacco, and heat not burn products, which heat tobacco without burning it - are 95 per cent safer than cigarettes. There are no long-term scientific clinical control trials or population studies, as these devices are new. Hence, the authorities have chosen to be cautious.

But just week, the National Academies of Sciences, Engineering and Medicine, an American body, released what The New York Times described as “the most comprehensive analysis of existing research on e-cigarettes”.

The research found conclusive evidence that most e-cigarette products contain and emit numerous potentially toxic substances, but also “cited conclusive proof that the devices are safer than traditional smoking products and may help smokers quit, citing conclusive proof that switching can reduce smokers’ exposure to deadly tar, dangerous chemicals and other carcinogens”, The Times noted. To be sure, the research also did not declare e-cigarettes to be safe.

Nevertheless, recent population studies show that these products have been widely adopted by smokers as a substitute for cigarettes.

As a result, the numbers of smokers who have given up their cigarettes in favour of these nicotine delivery products is impressive: Over six million in Europe; two million in Britain, and millions more in the United States, Japan and South Korea. Notably, Japan Tobacco experienced an unprecedented 17 per cent year-on-year drop in cigarette sales in 2017.

Indeed, the reduction in smoking prevalence is at unprecedented levels in these nations.

This has resulted in many developed nations, including all EU countries, Canada and New Zealand, choosing to regulate rather than ban such products. Regulations have been imposed to prevent children and youth from accessing e-cigarettes, thereby preventing any “gateway” effect and a transition to smoking. A ban prevents such targeted regulatory prevention.

Bans have proven of limited effect with youth. A smoking ban imposed in Bhutan in 2011 led to the country having the highest prevalence of adolescent smoking in the world, at 30 per cent.

Singapore is at the forefront of tobacco control regulations. No nation, with the possible exception of Australia, has done more. Yet, both nations have been unable to achieve meaningful decreases in smoking prevalence over the last 10 years, and the percentage of the smoking population remains between 14 per cent and 16 per cent.

The science assessing and improving these products is moving quickly, and targeted regulations are needed to bar their use among youths.

But is a ban justified when over 700,000 smokers and their families in Singapore are suffering? Or is it time to recognise the urgency of what the World Health Organization calls a smoking epidemic and regulate these safer devices?


Andrew John Da Roza is a psychotherapist  and a member of several expert committees dealing with addiction, including the Singapore Anti-Narcotics Association.

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