In December 2021, New Zealand announced one of the world’s toughest crackdowns on smoking. People aged 14 and under in 2027 would never be allowed to purchase cigarettes in their lifetimes. On paper, the policy is an attractive one: young people are prevented from taking up smoking while older, more habitual smokers aren’t slapped with many restrictions. This reduces the potential backlash that might arise whilst ensuring that more cohorts over time are smoke-free.
Following New Zealand’s announcement, MPs in Singapore filed a total of 7 Parliamentary Questions asking the government whether it was exploring or implementing a ban on cigarette sales.
What does the Singapore government have to say about a tobacco ban? And will the policy even work in the first place? We explore tobacco control in other countries to answer these questions.
The only country with harsher tobacco laws than New Zealand is the Himalayan kingdom of Bhutan. In 2004, the country banned the sale of tobacco as well as smoking in public places, offices and even bars and pubs. As implementation was weak, they introduced the Tobacco Control Act in 2010, which made the sale of tobacco a non-bailable offence. The Act, however, allowed the limited import of tobacco for personal consumption.
While Bhutan was lauded for going smoke-free, there was public outcry after people were imprisoned for smoking or chewing tobacco. Under public pressure, the law was amended in 2012 to increase the permissible limit for tobacco imports for personal use.
The law was modified yet again in 2020, amidst the Covid-19 pandemic. The ban led to a thriving black market for tobacco, supplied by smugglers from India. The smuggling problem was so bad that, after Bhutan shut her borders in March 2020 and stepped up border security, they still caught an average of 30 smugglers a day.
And when the case count in India surged in August 2020, the Prime Minister temporarily lifted the ban, to prevent imported Covid-19 cases from smugglers coming from India. Some argued that the ban should have been lifted long ago, since it criminalized people and restricted access to potential tobacco tax revenue.
Other than the issues of public dissatisfaction and black market sales, there is evidence to show that the ban did not reduce smoking rates. According to a WHO survey, nearly 25% of Bhutanese use tobacco. A 2019 Health Ministry survey further found that smoking prevalence actually increased from 6% in 2014 to 9% in 2019. The ban in Bhutan hence hasfailed to achieve its objective.
New Zealand Faces Pushback
Unlike Bhutan’s ban, which affects all citizens, New Zealand’s ban will only affect younger cohorts of smokers. The ban will also be accompanied by a shift to low-nicotine cigarettes and a significant reduction in the number of places authorised to sell cigarettes. But some predict that similar problems will arise.
For one, a black market for cigarettes already exists in New Zealand, which could be exacerbated should a ban on sales come into effect. The government acknowledged this in their proposal, saying that “evidence indicates that the amount of tobacco products being smuggled into New Zealand has increased substantially in recent years and organised criminal groups are involved in large-scale smuggling.” The government has also acknowledged that more border control would be needed.
There are issues with the accompanying measures as well. The shift to low-nicotine cigarettes may just compel smokers to buy a greater quantity to get their hit. If so, it would counterproductively increase wasteful spending on cigarettes without reducing smoking.
In addition, thousands of gas stations and corner stores in New Zealand – small businesses – depend on cigarettes sales for income. The reduction of approved retailers would hit many of these businesses hard. It is also important to note that in 2017, New Zealand adopted vaping as a pathway to help people quit their tobacco adoption.
What About Singapore?
While only about 10.6% of people smoked daily in Singapore, the social and economic costs of remain relatively high. A 2017 paper estimated the cost of smoking in Singapore to be around US$479.8 million, with a staggering US$464.9 million being derived from productivity losses alone. Healthcare costs directed at the treatment of heart disease and lung cancer amounted to US$14.9 million.
This explains why some Singaporean MPs have been calling for a lifetime ban on cigarette sales as early as 2016. While the Ministry of Health (MOH) responded to these earlier suggestions by stating that it would not pursue a cohort ban, in 2022 the ministry said that it was open to studying the policy.
Both then and now, however, the MOH thinks that enforcement might be a challenge. Younger cohorts of smokers could circumvent the ban by buying cigarettes from older smokers. This, in turn, means that new offences must be created to penalise older persons who are not subjected to the ban but who supply younger smokers with cigarettes.
This is extremely difficult to catch, considering the wide variety of settings in which a younger smoker could obtain cigarettes. They could obtain it privately from older friends or relatives, smuggle it in from overseas, or buy it off a black market as mentioned above. Without enforcement, the ban would be ineffective, but with enforcement, it would be resource-intensive.
Notwithstanding smoking, Singapore also has to deal with e-cigarettes. As with New Zealand’s approach, many tobacco smokers see vaping as a substitute for smoking. A tobacco ban may merely nudge smokers to shift from smoking to vaping. This is undesirable as vaping creates the some of the same issues as smoking, be it heart and lung disease, or addiction.
Without proper controls on vaping as well, a ban on tobacco sales would just replace the cigarette problem with a vaping problem. This is particularly so for younger cohorts, who do not see smoking as glamorous, but are attracted to vaping. Though it is illegal to buy or use e-cigarettes in Singapore, e-commerce has enabled many to still buy and use them.
This means there is a black market for e-cigarettes, on top of the black market for standard tobacco cigarettes, which could potentially be exacerbated by a ban.
No Clear Answers
The presence of these problems does not automatically make a cohort ban ineffective. Take the argument that a tobacco ban will exacerbate a black market. If the black market responds to a ban by suppling the same amount of, or more, tobacco, than the policy would be considered ineffective. On the other hand, if it reduces overall consumption, like some studies have suggested it would be considered effective. The problem of a black market has always existed, but to tell if a tobacco ban would be effective, one would first need to study and quantify how it responds to legal restrictions, which is very hard to do.
Beyond studying black markets, the government would also need to investigate how readily smokers switch over to vape when cigarettes become unavailable. If smokers switch over, there is a need to regulate the online sale of e-cigarettes, as MOH has highlighted. But it is also possible that smokers just stop smoking once cigarettes are banned. Without studying this, there is no way to know.
A third aspect that needs to be studied is rules regarding tobacco imports. Bhutan, for example, permits imports of up to 300 cigarettes for personal use. If something similar was implemented in Singapore, some would shuttle to and from Malaysia repeatedly to import large quantities without breaking the legal limit. Finland’s tobacco laws only allow people to import cigarettes after spending 24 hours overseas to prevent such abuse, but that does not solve the problem either. Furthermore, given that Singapore receives a vast quantity of imports (and pre-pandemic, large numbers of visitors) everyday, enforcing against the illegal import of cigarettes would be very resource-intensive.
All these questions and more, are important to consider before implementing a tobacco ban. Broadly, they are all different ways of asking the same, million-dollar question: Does a tobacco ban actually work?
From Bhutan’s example, smoking rates actually increased whilst the ban was in effect. This suggests that a ban on tobacco sales does not work in Bhutan; but it also does not mean that it cannot work elsewhere. For this reason, many policymakers are going to closely watch New Zealand’s rollout of the policy, to see what lessons can be learnt and if they will be successful where Bhutan has not.
It is intuitive to think that a tobacco ban works. But without asking and investigating these hard questions, it is simply impossible to tell.