After the governing and opposition camps have for the past decade been negotiating amendments to the Tobacco Hazards Prevention Act (菸害防制法), the Cabinet on Jan. 13 finalized draft amendments.
Preventing tobacco hazards is one of the WHO’s priorities, and Taiwan cannot afford to lag behind on this issue if it wants to join the organization. The WHO said that 8 million people worldwide die from smoking each year. Smoking is said to be preventable, and quitting smoking is health-enhancing.
By contrast, fewer than 4 million people died from COVID-19 in the first two years of the pandemic. Yet fear of the pandemic has led people to go to enormous lengths to prevent the disease.
Faced with tobacco’s hazards, with a fatality rate twice as high as from the COVID-19 pandemic, how can people turn a blind eye to these dangers and not implement strict controls?
Regarding the draft amendments, the major changes being proposed are to be applauded.
The draft bill proposes raising the minimum legal age required to purchase tobacco products from 18 to 20. On the surface, this change appears to be a trivial matter and it should be easier to achieve than the others. In what is a rare consensus, raising the age limit is highly supported by smokers and non-smokers. At the same time, it is likely to reduce the number of new young smokers once it is enacted.
Most students are 18 when they graduate from high school, when smoking is no longer prohibited. Half of adult smokers first started smoking and even became addicted to it during the first two or three years after graduation. Once people pass this age — and have more self-awareness and a more mature mindset — they might no longer want to start smoking.
The US Institute of Medicine believes that raising the smoking age could reduce the number of deaths in the US by 250,000 per year and the smoking rate by 20 percent, while the scope of the effect is likely to extend to adolescents under the age of 18.
Teenagers under 18 can ask older brothers or sisters above that age to buy cigarettes for them, but if the legal age limit is raised, the smoking rate among young people would surely decline.
The government has also proposed a ban on flavored cigarettes, which are favored by teenagers.
The government has proposed enlarging the warning labels on cigarette packs, which serve as anti-smoking advertisements and cost nothing. A person who smokes one pack (20 cigarettes) per day would see the candid images 20 times each day, or more than 7,300 times per year. Therefore, the larger and scarier the warning label, the more effective it might be.
The amendments would increase the area of warning labels on cigarette packs from 35 to 85 percent. Thus, Taiwan would follow in the footsteps of Thailand, which set an unprecedented example for the world about eight years ago when it maximized the area of the ugliest and most disgusting images on cigarette packs.
A Thai academic published an analysis of the effectiveness of maximizing the images. Those who smoked became petrified when they found out how bad smoking was for their health, non-smokers were dissuaded from ever trying smoking and the unsightly warning labels began to circulate in the marketplace.
The policy has bolstered tobacco hazards prevention in Thailand as public support for stricter controls continues to grow.
Tobacco hazards prevention in Taiwan has stagnated over the past few years and needs a boost.
Taiwanese seem to believe that the nation’s prevention policy is good enough, unaware that there are still 2 to 3 million smokers in Taiwan. As each household typically has three to four members, the smoking population is affecting nearly 10 million people.
Additionally, about 20,000 Taiwanese die from smoking every year, showing that Taiwan is lagging behind many countries in the Asia-Pacific region.
The most important change — after years of debate between the governing and opposition camps over new tobacco products — is that the amendments would ban e-cigarettes and restrict heated tobacco products.
However, some criticize the government for banning one while allowing the other, accusing it of being bought off by tobacco companies. As a member of the Taiwan Medical Alliance for the Control of Tobacco (台灣醫界菸害防制聯盟), I and others disagree with this analysis.
The draft bill clearly stipulates that heated tobacco products are to be strictly regulated, as business operators would be required to conduct “health risk assessments,” and they would not be able to import or manufacture such products unless the assessments were reviewed and approved by the authorities.
As we know, heated cigarettes are just like traditional cigarettes — the former simply replaces the traditional burning process of the latter with a new heating process, and heated cigarettes contain the same substances as traditional ones, including more than a dozen of Group 1 human carcinogens.
In terms of traditional cigarettes, it has long been proven that one out of every two smokers dies from a smoking-related illness. Although long-term data on heated cigarettes are not available due to their relatively short history, it is an inarguable fact that they also contain a variety of Group 1 human carcinogens.
The alliance has always advocated high standards for the safety of food and environments, with environmental risks kept to less than 0.0001, but the health risk associated with traditional and heated cigarettes is as high as 0.1.
Just as Taiwan uses high standards based on scientific evidence to assess food imports from areas with mad cow disease, nations that allow the animal feed additive ractopamine, and Japan’s Fukushima and nearby prefectures, health risk assessments of heated cigarettes can also be based on international standards.
By doing so, no matter what tobacco companies say, an assessment of heated cigarettes is unlikely to pass in Taiwan if the public and academics can monitor the review process.
The government has taken the first step. If legislators can perform their duties without being swayed by the tobacco industry, a significant improvement in the nation’s public health can be expected by the passage of these amendments.
This goal is attainable, as the ruling Democratic Progressive Party holds a majority in the Legislative Yuan.
Wen Chi-pang is chairman of the Taiwan Medical Alliance for the Control of Tobacco; Yen Chi-hua is founder of the alliance.
Translated by Eddy Chang
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