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National Smoking Control Programme

The National Smoking Control Programme was launched by the Ministry of Health on 1 December 1986 with the aim of making Singapore a nation of non-smokers. The programme includes the National Smoking Control Campaign, an on-going project, which was launched on the same day as the campaign The campaign has continued to use various approaches to educate smokers and non-smokers on the dangers of smoking, and on how to seek help to quit the habit.

History
The Ministry of Health conceived the National Smoking Control Programme after seeing a rise in the number of smokers and smoking-related deaths in the country. Most of the deaths were caused as smoking had hastened the onset of cancer and heart disease. From 30 deaths due to cancer in 1950, the numbers peaked at around 100 deaths in 1984, and from a little over 50 deaths due to heart disease in 1950 the numbers had risen to more than 110 deaths in 1984. These figures tallied consistently with the rate of cigarette sales. From 3.6 million kg. of cigarette sold in 1973, the figures rose dramatically over the years to peak at 4.4 million kg. in 1983. The rise in cigarette sales and the increase in the number of smokers are due to various factors. These include youths viewing smoking as hip and the lack of information on the perils of smoking amongst the general public. The National Smoking Control Campaign was conceived three months before its launch in December 1986. It is as an on-going project and is part of the programme, aiming to preventing the young from picking up the habit and helping smokers to kick the habit by getting them to seek help. Prior to the launch of the programme, the government had introduced laws to restrict smoking in public places and in 1970, had banned tobacco advertisements in print and television. These laws have stood by in good stead to ensure the success of the National Smoking Control Programme, by helping to reduce smoking rates in the country.

Description
The programme and the campaign was inaugurated by the Minister of Health Dr. Richard Hu at a ceremony held at the Public Utilities Board Auditorium on 1 December 1986. The ceremony featured an audio-visual show and an exhibition. On the same day, 42 public and private organisations put up "No Smoking" signs on their premises to discourage staff from going for a puff. The Communications and Information Ministry printed posters that depicted smoking as a mark of disrespect for others. The posters carried a range of humorous to gruesome scenes from day-to-day living portraying smoking as an unhealthy act and an act of discourtesy. It also helped smokers know where they should not smoke, such as near fresh food in a supermarket or an air-conditioned office, and helped to reduce the perception that smoking is glamorous. In January 1987, the campaign began quit-smoking sessions on a pilot basis to help smokers quit smoking with medical help. The programme also addressed the dangers that came from passive smoking, or the exposure to cigarette fumes by non-smokers. The government therefore designated non-smoking and smoking areas in public places, and while protecting the rights of the smokers, this approach also helped to protect non-smokers from harmful cigarette fumes. The government also banned tobacco advertisement and sponsorship in all forms in apart from its 1970 television and print ban.

In 1990, cartoon drawing, poster design and song composition competitions were held as a part of the campaign. Aimed primarily at the youth to, rap music and simple science experiments were used to pass on the message that smoking causes various illnesses. A smoke-free week was also held from 24 May to 31 May 1990. The slogan for the campaign was "Growing up without tobacco". In the same year, Permanent Secretary (Health) Dr. Kwa Soon Bee, during his address to the World Health Assembly at Geneva, spoke on the success of the programme by highlighting the fall in smoking rates and showing that the country was on the right track in its desire to realise its dream of becoming a nation of non-smokers. From 1984 to 1987 the percentage of youth in the age range of 15 to 19 who smoked dropped from 5.1% to 2.9%. However it rose again in 1988 to 3.6%. Thus the programme began to consider legislating a ban on the sale of cigarettes to under-18s. In 1991, the government formally introduced the ban. The 1991 programme adopted the theme "Tobacco-free environment for all". The campaign was made more community based by roping in popular stage personalities together with families and parents in the campaign's effort to pass on the message to young people that is harmful to smoke.

In 1994 the programme placed a greater emphasis on dealing with smokers by opening a toll-free 24-hour information service, called Quitline, manned by trained nurse counsellors who give callers tips on how to quit smoking. In the same year the government banned smoking in all air-conditioned private offices and factory floors. Surveys in that year showed that the programme had succeeded in raising awareness amongst the public on the dangers of smoking. In 1996 the programme featured a youth rally to pass on the message to teenagers that smoking in uncool and harmful. However, the challenge for the programme continues to come from these young Singaporeans who have to decide for themselves whether they want to remain smoke-free or not. Two other kits were introduced, QuitKit and Helper's Kit, which are self-help kits to help smokers with tips on smoking cessation. The National Health Survey of 1998 showed that smoking was on the decline with the rates dropping from 18.3% in 1992 to 15% in 1998. But the number of smokers in the age group of 18 to 24 did not drop. It was also found that smoking was more prevalent among the Malay than the Chinese and Indians. Therefore the programme came up with a fear-based approach to shock smokers out of their complacent attitude towards smoking. In 1999, the programme featured post-mortem images of smoker's arteries, lungs and brains. Various methods that were introduced to the programme to enhance its effectiveness further included the use of Nicotine patches that were designated as a non-prescription item (easily obtained from any pharmacy) and the implementation of individual and group smoking cessation counselling programmes to deal with behavioural and stress management techniques. Street performances were added to the campaign in 2002. The 2003 campaign was focused on adult smokers. It carried the slogan "When you smoke, they suffer" and encouraged smokers to give up the habit for the sake of their loved ones.

Medical help, psychological help, use of posters, community-based events and various activities have continuously been improvised upon each year. Apart from dissuading the young and the old alike to refrain from taking the first puff, these events and activities have continued to provide a conducive environment for smokers to seek help and quit smoking.


Author
Naidu Ratnala Thulaja



References 
Anti-smoking contests. (1990, April 5). The Business Times, p. 2.

Campaign to control smoking begins today. (1986, December 1). The Business Times. 

Courtesy joins 'no smoking' campaign. (1986, November 24). The Straits Times.

From the humorous to the gruesome. (1986, December 2). The Straits Times, p. 20.

Koh, B. A. (1991, May 5). Under-18s to be banned from buying cigarettes. The Straits Times, p. 1.

Pereira, M. (19990, May 1). Glamour image of smoking to get a kick in the butt. The Straits Times, p. 17.

Singapore aims to be a nation of non-smokers. (1990, May 13). The Straits Times, p. 19.

Smoke-free air for one and all. (1991, May 2). The Straits Times, p. 21.

Tan, S. (1986, December 2). Nothing personal against smokers. The Straits Times.

Youths use science, rap music, to relay anti-smoking message. (1990, May 20). The Straits Times, p. 15.


Further Readings
Anti-smoking campaign to target two different groups. (1994, May 17). The Straits Times, p. 25.

Community-based drive against smoking. (1991, July 21). The Straits Times, p. 15.

Health campaigns succeed in raising public awareness: Survey. (1994, October 24). The Straits Times, p. 19.

Nadarajah, I. (1996, April 27). Curbing teenage smoking. The Straits Times, p. 26.

No-tobacco day. (1990, May 31). The Business Times, p. 2.

Tan, H. Y. (1994, May 18). Soon: Smoking ban in air-conditioned offices and factories. The Straits Times, p. 1.

Health Promotion Board. (2001-2002). National Smoking Control Programme (NSCP). Retrieved December 10, 2003, from www.hpb.gov.sg/hpb/pro/pro02.asp

National Health Department, MOH. (1999, July). Smoking control strategies for patients for the busy practitioner. SMA News, 31 (7). Retrieved December 10, 2003, from www.sma.org.sg/sma_news/3107/news/3107n1.html

The information in this article is valid as at 2004 and correct as far as we are able to ascertain from our sources. It is not intended to be an exhaustive or complete history of the subject. Please contact the Library for further reading materials on the topic.

Subject
Events>>National Campaigns
Smoking--Law and legislation--Singapore
Smoking cessation--Singapore
Health and medicine>>Healthy living>>Public health



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