First Lung Cancer Awareness Month Opening Ceremony

06 Nov 2004

By Dr Mohamad Maliki Osman, Parliamentary Secretary (Health)

Venue: National Cancer Centre

Opening Address by Dr Mohamad Maliki Osman, Parliamentary Secretary for Health and Community Development, Youth and Sports at the First Lung Cancer Awareness Month Opening Ceremony at the National Cancer Centre on November 6, 2004, at 9.40am

Prof Tan Ser Kiat - Group CEO, SingHealth

Prof Soo Khee Chee - Director, NCC

Dr Lam Sian Lian - CEO, Health Promotion Board

Dr Koong Heng Nung - Chairman, Lung Cancer Awareness Month

Distinguished Guests

Ladies and Gentlemen

Introduction

Over the past 20 years, Singapore has made great progress in reducing lung cancer incidence. There has been a 28% reduction in lung cancer incidence in males and a 25% reduction in females between 1980 and 2000. This highly commendable outcome is largely credited to the National Smoking Control Programme introduced in the 1970s. Although the incidence of lung cancer has declined over the years, today, 7 tobacco related deaths and 3 lung cancer deaths occur in Singapore daily. The mortality rate from smoking-related diseases in Singapore is 466 per 100,000 population. Hong Kong, which has a smoking prevalence rate similar to that of Singapore has a mortality rate of 657 per 100,000 population.

Smoking in Young Females & Youths

The smoking trend among young females poses a great concern. The smoking prevalence rate among young females aged 18-24 years increased by more than 3 fold within a decade, from 2.8% in 1992 to 8.4% in 2001.

The burden of deaths from smoking lags behind trends in cigarette consumption by 30 to 60 years. The health hazard of smoking in a population becomes pronounced decades after the habit is adopted by a sizeable percentage of young adults. This is seen in the development of the tobacco epidemic in the United States. Smoking among women in the United States started in the 1930s and 1940s, and peaked in the 1960s. In 1955, there were only 1,500 deaths attributable to smoking among women in the United States; by 1995, there were 226,000 smoking-attributable deaths among women. The severe magnitude of the delayed health consequences of smoking was seen in 1987, when lung cancer surpassed breast cancer as the leading cause of cancer death among women in the United States. The latest statistics show that lung cancer has remained the leading cause of cancer death among women in the United States.

The scenario in the United States will be seen in Singapore in the not too distant future unless measures are implemented now to curb the escalating smoking prevalence among young women in Singapore.

A survey conducted in 2000 among secondary one to four students in Singapore found that about one in ten students smoked on at least one day in the past month and one in four have tried smoking. Of greater concern is the age of initiation. While most young people started experimenting with smoking when they were 12-13 years old, 20.5% tried smoking before the age of 10. We must focus on helping our youths stay smoke-free as most adult smokers establish the habit during adolescence. Youths start smoking due to curiosity, peer influence and stress. Many underestimate the power of nicotine addiction, thinking that they can stop smoking anytime they want to. To many, it is often hard to counter the temptation of being part of a "cool gang" that smokers often attract. These young smokers often draw the most attention as school authorities are always on their back. These are developmental challenges that youth will have to face - the sense of belonging and the need to feel accepted by peers. What is important is to highlight that it is equally if not more "cool" to be part of a non smoking group. These young non smokers should be empowered to claim their smoke free space as they relate to their peers. Such actions should be supported and reinforced by adults in school, at home and in the community.

To help our youths stay smoke-free, the Health Promotion Board implements both school and community based programmes targeted at teens. These programmes include peer-led smoking prevention programmes to encourage students develop their own reasons to stay smoke-free and interactive skill-based programmes like travelling skits and Street Soccer Programmes.

Healthcare Professionals

Reviews on the effectiveness of smoking cessation interventions indicate that there are few medical interventions as cost effective as smoking cessation advice by health professionals in reducing mortality and morbidity. Studies show that even very brief advice of 1-3 minutes will significantly increase the quit-rate among smoking patients, with long-term smoking-abstinence rates ranging from 2% to 6%. By themselves, the percentage success rates may look modest, but if all healthcare professionals consistently provide cessation advice to all smoker patients, the effects cumulated over time is substantial.

A decline in smoking prevalence will significantly reduce the morbidity and mortality from smoking related diseases. In particular, the risk of lung cancer is reduced by 50-70% after 10 years of abstinence from smoking.

I would like to take this opportunity to encourage medical professionals, especially family physicians, to use your patient consultations to encourage your smoker patients to quit smoking. Smokers of any age will find it beneficial to stop smoking. It is the duty of healthcare professionals to advise their patients to stop smoking and to prevent the onset of smoking related diseases that will destroy their lives and that of their loved ones.

Today's event is an important step towards a smoke-free Singapore. It deals with empowerment of non-smoking youths. This event should be a model for more empowerment activities. I urge more organisations to support the Lung Cancer Awareness Month activities.

The media plays an important role too. The media can support by giving more coverage to tobacco related issues, to express anti tobacco messages and by featuring youth & community champions and their endeavours to promote a smoke free lifestyle.

Conclusion

I congratulate the National Cancer Centre for taking this step to work with partners in its advocacy programmes and in your commitment to work towards a healthier nation.

It is my pleasure now to launch the first Lung Cancer Awareness Month and the CLEAR collar pin in Singapore. This internationally recognised pin symbolizes the "invisible" population of lung cancer victims suffering from the lack of public awareness in lung cancer. Wear the pin and use it to initiate discussions and projects towards a smoke free Singapore. With closer partnerships between the people, public and private sectors, I am confident that this will accelerate our community towards a smoke-free nation, with the air as clean and clear as the pin.

Thank you.