BACKGROUND AND IMPLEMENTATION CHALLENGES: Singapore’s smoking prevalence had increased from 12.6% in 2004 to 14.3% in 2010, reversing a previous long-term decline.
INTERVENTION OR RESPONSE: Since then, Singapore redoubled its multi-pronged, multi-sectoral tobacco control efforts, including MPOWER and FCTC-recommended measures.
Bans on smoking in public places were expanded to include outdoor areas in parks, beaches, universities and a central business precinct. In 2016, display of tobacco products, including at the Point-Of-Sale, was banned. The Minimum Legal Age was raised from 18 to 21 in 2021, with implementation supported in schools and uniformed services by the Ministry of Education (MOE) and Ministry of Defence. In 2020, standardised packaging was implemented and graphic health warnings size increased to 75%. Tobacco taxes were increased in 2014, 2018, and 2023.
Concurrently, a harm elimination approach was adopted to reduce the range of legal tobacco products. Import, distribution and sale of shisha and emerging tobacco products, including smokeless cigarettes and e-vaporisers, were banned. In 2018, the ban was expanded to include purchase, use and possession. The Health Sciences Authority works closely with the Immigration and Checkpoints Authority and Customs on enforcement.
The Health Promotion Board (HPB) has been running campaigns to educate on the harms of smoking. In 2013, the I Quit smoking cessation programme was launched and subsequently refined, to better support smokers to quit. HPB works with MOE on efforts targeted at youths, such as incorporating anti-smoking messages into the school curriculum and having on-site counsellors in schools to support smoking cessation.
RESULTS AND IMPACT: Singapore’s efforts have resulted in an all-time-low smoking prevalence of 8.8% in 2023.
CONCLUSIONS: Singapore’s experience highlights these lessons:
1. A multi-pronged tobacco control strategy that maintains a strong harm elimination stance against new and emerging products can effectively reduce smoking prevalence.
2. Effective tobacco control requires coordinated efforts across agencies, beyond health ministries.