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  News Article  
 

Allow tobacco alternatives? Remember Subutex abuse...

 
  Tuesday, 20 l 07 l 2010 Source:  The Straits Times   
     
 

THREE Members of Parliament yesterday urged the Health Minister to consider allowing the regulated use of tobacco substitutes to help smokers quit.

But Mr Khaw Boon Wan declined. He cited Singapore’s experience with Subutex, a drug used to treat heroin addition,as a reason to be sceptical of such a strategy.

The House yesterday passed a law to ban alternative tobacco and nicotine products.

During the debate on the Bill, two medical-doctor MPs spoke of the potential benefits of alternative tobacco products.

The first was Dr Lam Pin Min (Ang Mo Kio GRC), who chairs the Government Parliamentary Committee for Health. He said studies in Europe showed that such products helped smokers quit.

His views were shared by Dr Fatimah Lateef (Marine Parade GRC), who said the new law appeared to lack tobacco harm reduction strategies.

Harm reduction strategies acknowledge that risky behaviour cannot be entirely prevented, and aim to mitigate its effects.

Dr Fatimah proposed one such strategy: tobacco users who cannot quit can be encouraged to shift to less harmful nicotine products.

Smokeless tobacco products carry only 2 per cent of the health risk of smoking, she pointed out.

While nicotine is the primary substance responsible for tobacco addiction, most harm caused by tobacco use is due to the by-products of smoked tobacco, such as carcinogens, she said.

Hong Kah GRC MP Alvin Yeo suggested that products could be assessed, perhaps by an advisory panel of medical experts, before decisions to ban are made.

The Government could also provide an avenue for appeal, he said.

In response, Mr Khaw raised Singapore’s“disastrous” experience with Subutex as a reason to doubt the effectiveness of harm reduction strategies.

Subutex was used from 2002 as a prescription drug to help heroin addicts quit.

But it gained addicts of its own, and was banned in August 2006.

Drawing a parallel with alternative tobacco products, Mr Khaw noted that Subutex was similarly intended as a less harmful substitute for heroin.

Yet the plan backfired: “Instead of reducing the number of drug addicts, we ended up with more,” said Mr Khaw.

He advised against such harm reductionstrategies.

There are other means to help smokers quit gradually, such as nicotine replacement therapy, said Mr Khaw. The Government does not prohibit nicotine used in such a manner.

To Mr Yeo’s point, Mr Khaw said that the Government will “keep an open mind” in assessing products, and undertakethe necessary studies before imposing any ban.