Angry Doctor

Thursday, October 06, 2005

Doctors of the World Unite!

Neurologists join Oncologists to call for tobacco ban in Singapore.

Oct 6, 2005
No reason to wait 10 years to ban smoking

IT WAS with great interest that we read about cancer specialists from a group of Asian countries calling for a ban on tobacco within the next 10 years ('Singapore cancer specialists to push for tobacco ban'; ST, Sept 22).

Among the many diseases causally linked with cigarette smoking is stroke. Stroke is Singapore's fourth leading cause of death, and the leading cause of adult neurologic disability. Up to 25 per cent of all strokes are directly attributable to cigarette smoking. Data from Singapore hospitals shows that 25 per cent of patients admitted to hospital admitted to being smokers.

Current research shows that the risk of stroke among smokers compared to non-smokers is increased by 1.5 times for stroke due to blockage of brain blood vessels (atherothrombotic stroke), two times for stroke due to bleeding into the brain (intraparenchymal haemorrhage), and three times for stroke due to bursting of a bubble on a brain vessel (aneurysmal subarachnoid haemorrhage), to even four times among female heavy smokers.

Environmental tobacco smoke - that is, passive smoking - puts additional, innocent lives at risk of major diseases.

Stroke is an expensive disease to treat. Hospital bills for stroke in Singapore average $7,500 a patient, rising to $29,000 for subarachnoid haemorrhage.

Additional costs for the lifetime of the patients, especially for the more disabled survivors, include outpatient medication and rehabilitation, loss of income, home help (e.g., maid), disability aids (e.g., wheelchairs, bedside commodes) and medical supplies (e.g., diapers, milk feeds).

Societal costs include absence from work and workforce attrition from premature death and disability of previously able-bodied Singaporeans.

With approximately 10,000 admissions to Singapore hospitals for stroke and related disorders every year, the total cost of this disease to Singapore would run into the millions.

While a part of the cost may be offset by duties on cigarette imports, it is largely borne by the stroke patient, the family, and the taxpayer.

Stopping smoking reduces the risk of stroke significantly within five years. The risk of a light smoker returns to that of a non-smoker, while that of a heavy smoker (more than 20 cigarettes a day) is certainly reduced, but does remain above that of a non-smoker.

Without any clear evidence of benefit from cigarette smoking that would outweigh its many risks, there is little to support its continuance. We, too, support the call for its total ban in Singapore, to run concurrent with further support for programmes to help smokers quit.

If chewing gum, which neither kills nor disables, can be banned practically overnight, we see little reason to wait 10 years to ban cigarette smoking in Singapore.

Dr N. V. Ramani
Senior Consultant Neurologist
Clinical Coordinator (Stroke Programme)
National Neuroscience Institute

A/Prof Lee Wei Ling
Director and Senior Consultant Neurologist
National Neuroscience Institute


How long before the cardiologists and respiratory physicians join in?

Imagine all the reductions in cancer, stroke, heart attack, and COPD cases...

Doctors of the World, Unite! We have nothing to lose but our jobs!

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  • I love the last line :

    "If chewing gum, which neither kills nor disables, can be banned practically overnight, we see little reason to wait 10 years to ban cigarette smoking in Singapore."

    I always say that to everyone! I was arrested before for bringing in 1 box of bubble gum across the causeway!

    By Anonymous Anonymous, At October 06, 2005 7:07 pm  

  • that's nonsense.
    you can bring in bubble gum if you're not gonna sell it.
    for personal consumption is ok.

    and you can chew gum here, just don't sell it / throw it anywhere anyhow

    By Anonymous Anonymous, At October 06, 2005 10:26 pm  

  • hear! hear! no ciggies, no CA!

    By Blogger andrew, At October 07, 2005 10:51 am  

  • Smoking is different, it is addictive. whereas chewing gum is not. frankly, i don't think that the government's current measures to stop smoking work. Raising the price of cigerattes doesn't stop people from smoking. Shock tactics like using those scary pictures don't work either.

    That said, i can't think of a really effective way to decrease the incidence of smoking.

    By Anonymous Anonymous, At October 07, 2005 4:16 pm  

  • I don't think thinking up ways to discourage people from smoking is a problem - the real problem is whether you are willing to implement those measures.

    Try raising the price of a pack of cigarettes to S$50 and see how many people can keep up their one-pack-a-day habit.

    Ot try withdrawing the medical subsidy for smokers AND their families and see who will continue to smoke. Tag to that a limit of one pack per IC per day.

    By Blogger angry doc, At October 07, 2005 5:20 pm  

  • many news magazines like the fronline in india supported or used support of Indian tobacco companies and printed for years their advertisements on backpages,have you people noted?i wrote once to frontline but they never replied,typically india!!!

    By Anonymous Anonymous, At October 03, 2006 10:24 pm  

  • in india we live a very fragile life.many smokers give a horrible time to our women in buses....come to pondicherry bustand and you see men of all types smoking and even in public buses women have to bear men smoking in buses and fumes killing them.
    when will indian government do something about smoking in public?in bangalore too government turns its back on smoking....many drivers of the public sector
    KSRTC and tamilnadu drivers or andhra APSRTC drivers smoke while driving public buses!!!in india everything is okay!!!!!

    By Anonymous Anonymous, At October 03, 2006 10:29 pm  

  • A great deal of effective information for me!
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    By Anonymous Anonymous, At February 16, 2013 9:29 pm  

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