Smoking out public service priorities

It’s one of the neatest proposals I’ve come across in a long time. In April this year, Professor A J Berrick suggested a progressive ban on tobacco using the turn of the century as the cut-off year-of-birth for the sale of cigarettes.

See a short write up here on Towards Tobacco-free Singapore.

In Singapore, as in many countries, shopkeepers have to check identity cards to ensure that the customer is at least 18 years old before cigarettes can be sold. Some amount of mental calculation has to be performed between the current year and the year of birth as stated in the ID card. Mistakes can happen; more problematically, time is wasted making the mental calculation.

Berrick’s idea was that after 2017, the cut-off year would forever remain 1999. In other words, anyone born in 2000 or later will never be allowed to buy tobacco products. It is a simple cut-off for all shopkeepers to remember.

Smoking is a habit that, if not acquired by the time a person is in his early twenties, is unlikely ever to be acquired for the rest of the person’s life. Consequently, much hope has been placed on youths not getting started. However, experience has shown that success is elusive. Despite years of campaigns, as recently as 2007, some 24 percent of males and 4 percent of females were still smoking (Personal Health Practices, by Lily Chua Ai Vee, Epidemiology and Disease Control Division, Ministry of Health).

More details can be seen in this reply by the Health Ministry to a parliamentary question, 12 January 2010:

However, this still means that about 360,000 Singaporeans smoke. Our age-specific smoking prevalence exceeds 10% for all age groups, from 18 to 69, peaking at 17% for those aged 18 to 29 years.  Men are 6 times more likely to smoke than women. The age-specific male smoking prevalence exceeds 20% for all age groups from 18 to 69.  There is a significant racial difference.  Malays’ smoking prevalence is more than double that of Chinese or Indians.  Malay men aged 30 – 39 years, have the highest smoking prevalence of 49%, as compared to 19% for Chinese and 12% for Indians.  Fortunately, our female smoking prevalence is low, at single digit percentage, except for young Malay ladies (14%).  But more than half of women smokers are below 29 years old and their smoking rate has risen sharply from 5% in 1998 to 9% in 2007.

Source link.

The peak age group is 18 – 29, the statement said. This would be the young adults who picked up smoking in the last ten years. The measures we’ve been taking this while — raising taxes, adding shockingly graphic photos of disease to the pack covers — aren’t producing results. The key problem is that these measures are aimed at getting people who are already smoking to quit the habit, which is very hard to do, and this explains the poor success rate.

It’s quite obvious to me that a progressive ban is the best idea we have. It stops another generation from picking up the habit without further penalising those who are already addicted; they can carry on smoking till the end of their days. But over time, the number of smokers will decline as the smoking cohort ages.

Yet, we hear no discussion about this idea, and there are no indications that the government is considering adopting it.

* * * * *

Instead, changes that make no sense to the public are quietly implemented. The Straits Times reported that police posts in the six public hospitals have been done away with.

The posts were shut down in April, after being in service for close to 30 years.

When contacted, a police spokesman said they were opened in the 1980s, with officers deployed to provide a working link between the hospitals and the police.

Whenever the officers were not tied up, they also provided a point of contact for the public to lodge police reports.

The Straits Times understands that most often, these reports were lodged following accidents and criminal cases, when those involved were taken to hospital. The officers also had cases referred to them when hospital staff suspected foul play.

The posts, usually located near the hospitals’ emergency departments, also made it convenient for victims of crimes to lodge reports after they had been treated for their injuries.

— Straits Times, 15 July 2011, All 6 hospital police posts closed down, by Mavis Toh

Years ago, when I had a small accident on the road and checked myself in to a hospital, a constable attended to me to take my story as soon as I was warded. More recently, when my mother was rushed to an emergency department, I saw a constable at work obtaining details from two young men who had been brought by ambulance to the same department. From their cuts and bruises, it looked to me that they had been robbed or attacked.

I think it is important to get an incident report as quickly as possible while memory is still fresh, otherwise crucial leads may be lost. This is especially as some victims may have to be hospitalised for several days. Are they expected to make a police report only after being discharged? Are they expected to make their own way to a police station even if they’re in a plaster cast after discharge?

Or is the hospital expected to contact the police headquarters who may or may not send someone over to the ward? If so, wouldn’t the cost involved — getting an officer to travel to the hospital to take a report each time there’s a call — be no less (if not more) than that of having a manned police post?

Even more curious, whatever the reason or alternative procedure is, the police aren’t saying.

When asked why the hospital posts were shut down, the police spokesman would only say that it is because of the streamlining of work processes with the hospitals.

— ibid.

Or is this yet another example of making it so difficult and opaque that people will give up and not make police reports?

I’m not alone in feeling that this is a bad decision. The newspaper quoted two former police officers:

‘I am surprised that the posts are being closed down, because the officers played quite an important role,’ said Mr Ang, who was in the force for 28 years.

Mr Chan Soo Wah, another former police officer, called the hospital police posts an asset, as officers there made the initial assessment to determine whether a case needed further investigation.

‘When notified of a case by the hospital, the officer visits the patient and finds out how he got injured,’ said Mr Chan, who spent 34 years in the force. ‘This fast action is important because many a time, the patient dies the next day.’

— ibid.

Perhaps, our police force is desperately short of manpower that could have been deployed better elsewhere. Indeed, my recollection was that they were young and fit constables, who, one might argue, could have been more useful on the beat. But the hospital police post function can be easily performed by a semi-retired police officer, who may not be fit enough to run after robbers, but whose experience would be very useful in taking incident reports and asking the right questions of victims. Here we are trying to think of ways to keep our gradually aging population at least partially employed — why not this?

* * * * *

And while we’re on the subject of police manpower, I was speaking to former head of NTUC Income Tan Kin Lian yesterday and he mentioned something that I myself had noticed.

“Have you noticed that at the airport, they have police officers check your passport three times?” he said.

It’s something that I had long thought was bordering on the ridiculous.

  1. As you enter the controlled area on the Departure level, your passport and boarding pass are checked.
  2. As a Singapore citizen, I use the automated gate that scans my passport and thumbprint.
  3. A metre away from the automatic scanner, I am stopped by another police officer who checks the same passport that the computer had just checked.
  4. Entering the holding room, putting my jacket, computer and carry-on luggage into the X-ray machine, my passport is manually checked a third time.

They are going overboard, Tan said, “just because there was one time when someone boarded a place with the wrong passport, and a minister jumped.”

These examples raise the questions: How are decisions made? What are the priorities that guide our public service?

32 Responses to “Smoking out public service priorities”

  1. 1 Anonymous 19 July 2011 at 23:46

    The police is most proficient when it comes to:

    1) intimidating peaceful protest by the public;
    2) pushing away responsibility of bomb disposal;
    3) hand-cuffing teenagers for distributing flyers.

    • 2 Desmond 20 July 2011 at 22:14

      No no it is more like

      1) intimidating peaceful protest by the public;
      2) ensuring that the opposition is fixed;
      3) ensuring that Singaporeans are ball-less;

  2. 3 jax 20 July 2011 at 02:48

    i dont believe anyone actually puts any Thought into such things. why else would you have signs on grass verges asking you in Malay to pick up your dog’s poo? As a rule, Malays don’t keep dogs, for religious reasons.

    meanwhile, the senselessness of 3 checks of a person’s passport at the airport and the closing of police posts at hospitals seem to be the new normal behaviour for the police these days, like handcuffing 12-yr-olds. perhaps the force should hire foreign talent?

    • 4 Agents Provocateur 20 July 2011 at 18:19

      Being more fluent in Bahasa Melayu than the other official languages doesn’t make you Muslim. Heck, being Malay doesn’t necessarily mean you’re Muslim.

  3. 5 namioiman 20 July 2011 at 09:44

    A little short-sighted but maybe they do want the healthy profit generated from tobacco sales to keep rolling in.

  4. 6 Anonymous 20 July 2011 at 11:36

    Anon 23:46: “Malays don’t keep dogs, for religious reasons.”

    I think you mean “Muslims don’t keep dogs, for religious reasons.” Ergo, the signs are not extraneous.

    I agree with the observations regarding the police force though. They seem to be spending way too much manpower on cosmetics, especially if there is a genuine manpower shortage within the force.

  5. 7 Anonymous 20 July 2011 at 13:37

    Fast forward to 2021. How could anyone argue that, say, of two 21 year olds born just a day apart, one can smoke legally for the rest of her life and the other cannot? That seems quite arbitrary. Surely this could be easily challenged and defeated…?

  6. 8 This is Anfied 20 July 2011 at 14:13

    The Police is desparately short of manpower, but are too ashamed or thick headed to admit it!

    The salary is miserable and career options limited for the rank-and-file and even for officers in the junior ranks, ie, the “farmers” who walk the beat daily, compared to the stratospheric salaries of those “scholars” who sit in the comfort of Cantonment Road dreaming of the next big paper to submit for their minister. This situation is ironic, as these are the “farmers” are the ones most needed by ordinary citizens for security. The rate of “farmers” dropping out is faster than MHA can replace because its just not worth it.

    If you know any of these “farmers” personally, you will realise the younger ones treat this only as a job or stepping stone to a better career, and the older ones will play things safe for the sake of a monthly paycheck to feed his family. Both groups will give less than their best in their daily work to make sure the end of their eight hour shift as peaceful as possible.

  7. 9 Teck Soon 20 July 2011 at 14:32

    If someone else is smoking, they aren’t harming me or bothering me, so why should I try to ban their behavior? Just withhold all health subsidies for smoking-related illnesses so that people are held responsible for their own behavior (or fund them through cigarette taxes). Surprised that Yawning Bread would want to ban something that only marginally affects him. What of individual liberties?

    • 10 ET 20 July 2011 at 16:44

      Breathing in someone else’s smoke, assuming they are indoors, is very harmful and causes cancer. Age discrimination against younger adults is not the solution though, and could be unconstitutional. High taxes on cigarettes works well in many countries.

    • 11 Ian 20 July 2011 at 18:10

      Search second-hand smoke, search pollution caused by smoking and tell me its not harming you.

    • 12 Anonymous 20 July 2011 at 21:50

      @Teck Soon. What are you talking about? Smoking affects everybody. Try walking outside any office building or shopping mall and you have to run a gauntlet of poisonous fumes.
      Clean air is hard enough to come by without the selfish smokers inflicting their habit on the rest of us. It is my liberty to breath clean air without a thoughtless person fouling it up.

    • 13 Desmond 20 July 2011 at 22:22

      Seriously? Have you heard of 2nd hand smoke? The ones all scientist agree can also cause cancer and heart attacks.

      I don’t know about you, but I don’t like to be surrounded by smoke when I have food at a coffee shop. I don’t like to go into a lift and have some inconsiderate and ass-hole smoker hold his smoke when the life is going up or down. Telling them to put it out would cause them to go “I’m not smoking what!”. So what else can we do? Or go into a life when an ass-hole smoker either smoked or held his cigarette in the lift, leaving their 2nd hand smoke behind.

      How about the ones that like to smoke down wind of the bus stop causing everyone to get a whiff of their smoke.

      Where are MY LIBERTIES! Where are my liberties to not get cancer caused by 2nd hand smoke? Where are my liberties NOT to smell the evil smelling smoke when I’m waiting for a bus at a bus stop.

      You people talk about the rights of a smoker to smoke, but what about MY RIGHTS not to smell it?

      • 14 Teck Soon 1 August 2011 at 05:17

        Everyone seems to refer to secondhand smoke but it is not relevant. I have no problem with regulating smoking in public places. But banning it completely and then trying to say it is because of secondhand smoke doesnt seem logical. Someone smoking in his own home alone is not bothering anyone. So why all the comments above about liberties of nonsmokers? It is like saying we need to ban pornography to protect people from it.

  8. 15 ape 20 July 2011 at 15:42

    About the smoking, the first response was ‘why didn’t I think of that?. Great recommendation!
    Being a smoker myself, I agree that:
    1) Smoking is a habit
    2) Smoking becomes a habit around age 20
    3) It’s very hard to get habitual smokers to quit… not to mention chronic smokers.
    Many non-smokers talks as if they are the experts without knowing chronic smokers can suffer worse health if they quit.
    This problem of getting ‘old chimneys’ to stop smoking has been bothering me. The professor has certainly offered a great suggestion.

    • 16 ET 20 July 2011 at 16:53

      It’s an interesting idea. However, we just had a whole article where equality before the law was a central theme. If people who were born before a certain date can uniquely be prosecuted for an action that others cannot, then they are not equal before the law. It would set a dangerous precedent and could lead to an acceptance of inequality in other areas.

      • 17 Paul 21 July 2011 at 15:47

        I’m sympathetic to the equality argument, but I think there is a general principle which says that an individual is accorded the rights to do whatever he wants **as long as it does not harm another**. (This is the sense in which psychopaths are not accorded the right to liberty.) This is why other commenters are pointing out that smoking does pose a harm to non-smokers if they are unduly exposed to second-hand smoke; it is a public health issue and not just an issue of private rights. The right of people to smoke is thus different from, say, the right of people to engage in consensual homosexual intercourse, because in the former there is a chance that exercising one’s right will impinge on someone else’s well-being, whereas in the latter that is not the case (hence the saying that homosexuality is a crime with no victims).

        The way I see Prof Berrick’s proposal, allowing people over the cut-off to continue to smoke is already a concession to their rights.

        Perhaps smoking should be framed not as an issue of personal rights, but as a public health issue, and efforts to stamp out smoking not as efforts to curtail individual rights but to prevent young people from taking up a habit that affects their health and possibly those of the people around them.

        (Nb. And yes, I’m aware of course that there are other legislative means to limit the public health impact of smoking, such as by designating ‘smoking areas’, but what non-smokers have noticed is that most of these efforts have limited effectiveness. As long as smoking is allowed outdoors and air can freely circulate, cigarette smoke will be present in public places. Perhaps the use of enclosed ‘smoking booths’ would help, but who would bear the infrastructure costs?)

    • 18 Acher 22 July 2011 at 22:25

      Out of curiosity, why would chronic smokers suffer if they quit? What happens to them?

      (I’ve just started internship at a hospital and may be helping out with a project investigating the health of chronic smokers who manage to quit, and would like to hear it from the horse’s mouth.)

  9. 19 Qzact 20 July 2011 at 16:23

    Hi Teck Soon, it is not true that someone else smoking does not harm you. You can be harmed by second hand smoking. In fact, people who do not smoke but inhale second hand smoke from regular smokers have a higher risk of getting lung cancer than the regular smokers.

  10. 20 Rabbit 20 July 2011 at 16:48

    First we need to be clear about our police force and who do they served – in favour of PAP or in favour of Singaporeans. If the former is the answer, everything can get quite screwed up sometimes and could eventually become a country with two systems or two set of laws for the same offense.

    • 21 Desmond 22 July 2011 at 10:26

      In Singapore, we don’t have a clear separation of executive, legislative or judicial branches.

      All of them are tied to the legislative branch, which as we all know means that what the gahmen wants the gahmen gets.

      So do we really think the police ever worked for Singaporeans?

  11. 22 Loh 20 July 2011 at 18:33

    Professor Berrick probably has good intentions to propose the progressive smoking ban but I would say it would be quite foolish to try and change human behavior to such a large degree. Don’t forget the “law of unintended consequences”. Just imagine if the law was passed, what would it be like for future generations of Singaporeans? Would they meekly submit to a law that applies only to them because of their year of birth or would such a law create an underground culture of smoking? After all, the law wouldn’t apply to foreigners. How would a Singaporean feel when he sees a foreigner do something he cannot? Forbidden fruits taste sweetest. We should be mindful of the proposed law as it is highly possible it would attract young people to smoke.

    The proponents behind the proposed law openly admit that the current laws which ban anyone under 18 from smoking backfired badly. It created a “rites of passage” perception among the young who now sees smoking as a symbol of adulthood. The statistics bear out this fact – more young Singaporeans are smoking than before. So let’s hope they don’t make the same mistake again with the proposed law.

    Using graphic images on cigarette packs has also been shown scientifically to have a reverse effect. Read “buyology”. Instead of turning away the guy from smoking, the graphic image works like a reminder. In other words, when shown the graphic image, the smoker is more likely to yearn for a cigarette.

    In conclusion, I like to point out that Mr Khaw Boon Wan once mentioned when he was still Minister of Health that his ministry is studying the proposal.

    • 23 Iann 21 July 2011 at 22:03

      then they proceed to ban cigarettes altogether at like… 2099? Now smokers will stand out like black sheeps.
      Though i would agree that to some extend there will be underground smokers, but that doesn’t affect the public, does it?

    • 24 guest 31 July 2011 at 01:04

      Interesting point about the unintended consequences of banning smoking. I can imagine that by banning smoking completely, it may lead to younger generations classifying smoking cigarettes in the same category as other complete bans such as the consumption of drugs.

      It may still be easy for them to get sucked into the underground culture of smoking because they will be able to obtain cigarettes rather easily from other sources. What is more worrying is if they are able to smoke, they may harbor the mindset that ” since Im able to smoke and do it without getting caught or experiencing immediate negative health effects, why not do drugs?”

      All these situations are very arbitrary, but I feel that by placing a complete ban on smoking, there is a possibility of undermining other more serious vices.

  12. 25 Misha 20 July 2011 at 23:57

    Another example, minister on flight so all passengers are routed to an area by the check-in counters to have every item in the check-in luggage flipped over by police.
    Lots of manpower & time involved.
    We tell ourselves to bear with it.
    Greeted by police again after clearing the auto gates, which really defeats the purpose of such a set-up.
    Final staw is when we are at the gate & everyone is asked to open their hand luggage to have every item flipped as well.
    Obviously, some lives are more precious than others..

  13. 26 Chow 21 July 2011 at 03:33

    My understanding may be faulty but I always thought that assault was a non-seizable offence. This means that you go to a magistrate and lodge a complaint and then they decide if they want to order the other party to court or something along these lines. I can’t help but wonder that this may be one of the things they checked off when deciding whether to pull the plug on these police posts in the hospitals.

    On another note, I think it’s the airport police and not the real cops-on-the-streets who check your passports? I may be wrong here because I really don’t bother to even look at them. They want to see my passport and boarding pass, I just show them and head for the gate.

    • 27 ape 21 July 2011 at 16:21

      The state police holds the main entrance to transit area, if I recall correctly. The auxiliary police (or was it ICA officers) holds the point after ICA counters. The auxiliary police, again, does the final round at the holding gates before boarding.
      I’m not certain of the reasons (why so many parties to check security?) but I guess it has to do with areas of responsibilities.
      My guess is that first check point is focused on restricting ppl with no business in transit area to access transit… AOR lies with airport operator. 2nd checkpoint is to do with immigration laws… ensuring departing passenger is the actual person recorded. AOR is ICA. 3rd is ensuring contraband and unauthorized passengers are not brought into aircraft. AOR is airlines (or is it airport operator?) Thus, our passports gets checked again and again and again. This is just my guess.

  14. 28 James 21 July 2011 at 15:13

    Regarding the airport checks, you could argue that having more eyeball checks acts as a stronger deterrent and lowers the risk of oversight, especially when there’s high volume of passengers. Anyway, the first check is just a simple quick check to make sure that people without tickets aren’t allowed into the departure area. The second check is redundant though.

  15. 29 X_n 21 July 2011 at 23:12

    To put things in perspective…

    If people want smoking to be banned because the second-hand smoke affects the health of non-smokers, what about alcohol?

    Arguably, alcohol does a lot more damage, since being intoxicated can result in:

    1. drink-driving, which can lead to accidents, causing death to driver, passenger(s), other road users, pedestrains;

    2. people losing judgement and sense of their thoughts.

    So, why the unfair focus on cigarettes and not alcohol?

    • 30 Paul 22 July 2011 at 13:14

      The deleterious effects of alcohol only arise when consumed in excess, and even then the act of consumption itself does not affect anyone other than the drinker – it’s the drinker’s actions subsequent to the (over-)consumption of alcohol that can potentially harm others. And such actions as drunk-driving are already proscribed by laws.

      In that sense, your example doesn’t “put things in perspective” because smoking isn’t exactly parallel to alcohol consumption.

      • 31 X_n 25 July 2011 at 20:43

        And I suppose there are also laws limiting smokers to where they can smoke in public.

        The point I am trying to make it is, there seems to be another “social ill” that can potentially create more tragic consequences as opposed to smoking or second-hand smoke, so shouldn’t we we look into that as well?

        And in supporting a ban (even progressively) on smoking, or alcohol for that matter, there are many other factors that requires consideration, for e.g. how do you recover the lost in revenue from the taxation of cigarettes? How do you find alternative employment for those employed in the industry?

  16. 32 reservist_cpl 27 July 2011 at 00:41

    I use the human passport gantry. Some officers have said welcome home to me.

    I fear the day where it is all us lowly Singaporeans using the machines, with the foreigners getting first class service by humans.

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