Singapore adopts a harm restriction approach in its tobacco control, including limiting the places where one can smoke, taxation, advertising bans, and more recently, raising the minimum legal age for smoking and introducing standardised packaging of tobacco products.
While these measures reduced smoking rates 50–60 years ago, the proportion of smokers has remained stagnant in recent years.
“Perhaps the answer lies in harm reduction strategies, a well-accepted and established approach in public health,” said Professor Chia Kee Seng, Founding Dean.
Harm reduction tools include nicotine patches, low-tar cigarettes, and more recently, the introduction of e-cigarettes as a smoking cessation aid.
However, the option of e-cigarettes as a harm reduction strategy has divided the tobacco control community. Opponents express deep reservations about the efficacy and effectiveness of e-cigarettes as reduced-risk products, while proponents believe that they make a viable tobacco end-game option.
How can we better understand the popularity of e-cigarettes and the continuing debate over whether they are harmful or less harmful than traditional tobacco cigarettes?
Prof Chia shares some viewpoints on ‘efficacy’ vs ‘effectiveness’ studies, the possibility of e-cigarettes as a prescription device, and the tobacco industry’s involvement in the e-cigarette market.
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