Tuesday, April 12, 2011

Health minister says: I'd ban cigarettes if I could

April 7, 2011 - 4:18pm
By Ng Wan Ching

But Health Minister Khaw Boon Wan says it’s hard as they’ve been around for too long and it will ‘upset’ 700,000 smokers

BAN cigarettes.

Some say that’s one definitive way to stamp out the “dirty habit”.

As a Health Minister who has already prohibited alternative tobacco and nicotine products, banning cigarettes should be easy to do for Mr Khaw Boon Wan.

But it is something he won’t do.

Not that he does not agree with it in principle.

“I have no problem with banning cigarettes,” he said. But he explained that it would be very hard to do because cigarettes have “been around for so long”.

“About 14 per cent of the population (smoke), so that’s more than half a million people, 700,000 people (will get upset),” he said.

Speaking to The New Paper on Sunday earlier this week during a two-hour interview on a wide range of topics, Mr Khaw said that he and his ministry will use other tactics to deal with products such as cigarettes and shisha – in which fruit flavoured tobacco is smoked through large water pipes – which are already in Singapore.

But what is not yet here, he’ll do his best to keep out.

It was a lesson he learnt from Subutex, which was listed as a controlled drug in the Misuse of Drugs Act in August 2006.

Before that however, it was permitted as a prescription drug in 2002 to help heroin addicts kick the habit.

But instead of using the drug to help wean themselves off heroin, addicts took it for a fix.

Listen 'intellectually'

In the beginning, Mr Khaw did not know the issues that Subutex was causing in the heartlands.

There had been debates on whether to make Subutex a scheduled drug, and he was listening to the arguments “intellectually”.

But when he was rostered to Sembawang, he learnt first-hand how it was affecting lives.

“Immediately the feedback was so strong from families who were wrecked by Subutex. A father who came to my Meet the People session (said) please lock up my son,” said Mr Khaw.

At that time, Subutex was not a scheduled drug. If it had been heroin, the Central Narcotics Bureau would have gone down.

“Nobody could do anything about it. It was a proper drug. With a prescription, they could take it,” he said.

So he sat down with Deputy Prime Minister Wong Kan Seng. “(I said) let’s acknowledge that I think Ministry of Health made a mistake of not registering this, and allowing this drug to come in,” he said.

But as it was already in Singapore, then “let’s do the second best thing”, which is to make it a controlled drug. It took a few months.

“When we did it, the problem just disappeared overnight, but unforeseen damage had already been done, a few hundred people have already become Subutex addicts,” he said.

“It just shows...a decision, taken probably wrongly, or without proper advice, and the damage it makes.”

He said that Subutex manufacturers promoted it as a substitute for heroin and as being good for patients.

“Of course they (the manufacturers) make tons of money, and the doctors all join in the chorus, and our people at that time did not know. All countries are doing it, why not Singapore?

“Our method is different. Our method is zero tolerance for drug addiction, just don’t let it in,” he said.

He carries the same lesson in his mind when he had to deal with artificial cigarettes.

“Remember when I banned smokeless cigarettes, you get those wisecracks saying, no, it’s a good substitute for cigarettes, it allows them to stop smoking.

“Utter rubbish,” said Mr Khaw.

It will be just like Subutex.

“Because one thing leads to the other. You get addicted to this substitute, and then you want stronger, which means go back to the original which is heroin.

“Likewise, if you get addicted to smokeless cigarette, thinking it’s less harmful, it does not stop there,” he said.

“(The user) will then graduate to become a ‘proper smoker’.

“So I think our approach in Singapore, zero tolerance, it’s harsh, but to me I think it’s the correct way. I’ll defend it.”

He takes the stand that “those which are not yet here, don’t let them come here”.

Those that are here, like cigarettes, “let us slowly get (people) to wean (themselves) off it”.

“Things like shisha. I would like to ban shisha too. But it’s already here, very hard to ban. But it’s harmful,” said Mr Khaw.

The Health Promotion Board has said that a single session of shisha – which lasts from 15 minutes to 90 minutes – delivers more than 20 cigarettes’ worth of nicotine.

High levels of carbon monoxide can also lead to brain damage and unconsciousness.

“So you may think that it’s not so harmful, but actually it’s very harmful,” said Mr Khaw.

Like how Subutex was in the beginning.

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