The new Prime Minister has repeatedly said the Government is committed to addressing the tobacco epidemic and that it will follow the evidence; both coalition agreements declare decisions will be “based on data and evidence”. Yet, one of the coalition government’s proposed actions – to repeal the world-leading smokefree legislation – runs directly contrary to evidence and will ensure smoking continues to cost thousands of lives and millions of health care dollars. Prime Minister Luxon could yet display strong leadership by retaining legislation that will end the smoking epidemic.
The evidence clearly supports the current smokefree legislation and predicts it drastically reduce smoking rates and bring major health gains, particularly for Māori.
Arguments the government has adduced for removing the legislation are weak, inconsistent with robust research evidence, and will bring neither health nor overall economic benefits.
Implications for public health policy
The Prime Minister has a crucial opportunity to show leadership by drawing on the strong evidence, revising the coalition agreement, and protecting the smokefree legislation.
Ground-up social movement and working with youths are vital to rapidly change social norms. Activating youths bring extensive social media reach which in turn garner buy-in unlike conventional tobacco/vaping prohibitive approaches that receive push-backs. Besides being spontaneous, self-driven, scalable and sustainable, youth involvement is energetic! Additionally, the mobilisation of such massive support from the future generation results in no more new demand in which the industry will naturally withers. Thus, engaging the future generation is both our best defence and offence.
We had the privilege to listen to several Filipino youths present what they understand of the Tobacco Free Generation International Social Movement on 9 January 2021. This was under the leadership of Mr Russel Sarmiento of Dinalupihan, the Republic of Philippines. These youths presented well and confidently. They also added in their independent opinion on how TFG is better and more harmonious in PREVENTION than what the rest of the world is doing now in pushing for legislation that will curb smokers. We learnt this analogy from this Filipino team “The Minimum Age Law creates that Forbidden Fruit effect like how Adam & Eve, in the Garden of Eden, were told not to eat the fruit”. Congratulations to these youths for adding value to the global TFG Endgame narrative. We are proud of you all!
We congratulate these Philippines youths for a great return presentation to show that they have internalised the TFG approach, language and practice. This follows after an earlier demonstration to them several weeks ago.
This null finding, combined with regional differences, should caution against complacency in the global tobacco control community, motivate greater implementation of proven tobacco control policies, encourage assertive responses to tobacco industry activities, and inform the design of more effective health treaties.
Think about it a bit more : these possible scenarios exist with the current minimum age law where it is just as easy for anyone above 21 to buy and pass to those under 21. TFG is not any weaker.
Instead, on enforcement (at the Point of Sales) : Please watch the video comparing Minimum Age Law versus TFG Law
Tobacco-free generation laws ban the sale of tobacco to those born after a specific year and prevent future generations from ever starting to smoke, while not affecting existing smokers.
The tobacco-free generation proposal was made in Singapore as early as 2010, but is now set to be adopted by a foreign country instead. The cities of Balanga in the Philippines and Brookline in the United States also have laws supporting a tobacco-free generation.
Former MP Lee Bee Wah has said that she believes such a generational approach could work.
Laws like Singapore’s that set a minimum age for using tobacco products make smoking seem like something that is acceptable for people of a certain age, when in reality, it is harmful for everyone. Some young people may even see smoking as an act that marks a person’s coming of age, and that is even worse.
While we applaud this gentleman on his 21st try, it must have been an arduous journey. His family would have been very pleased. Many more have challenges in quitting and many others fail.
Let’s revisit our preventive strategies, as societies have not been aligned sufficiently. TFG delivers better methods. Let us help you improve your prevention strategies. It saves a lot more time, effort and anguish.
TFG prevents smoking through an evidence-based, mass education ecosystem. This form of education should best precede any legislation.
Petitioners John Ross and his wife Megan Sandel are area doctors and see a number of patients with tobacco-related problems. Their warrant article for May’s Town Meeting calls for a ban on the sale of tobacco products to anyone born after 1995.
This publication in Tobacco Control has been cited 51 times. 9% of its citations have been received in the past two years.
Compared to other publications in the same field, this publication is extremely highly cited and has received approximately 8.83 times more citations than average.
Million-dollar ad campaign characters such as the Marlboro Man and Joe Camel lured many people to take up the tobacco habit through magazine ads and TV commercials. Gimmicks such as “Camel Cash” that could be mailed in, in exchange for prizes such as cigarette lighters and t-shirts, made tobacco users walking advertisements, perpetuating an ethos of cool. Eventually, advertising standards were altered so as not to be so kid-friendly and enticing to young people.
Although ads to promote tobacco products have been curtailed during the past few decades, cancer from using tobacco products still kills more than 8 million people each year, according to the World Health Organization (WHO).1 It is also known that second-hand smoke is also dangerous and contributes to 1.2 million deaths around the world.
The challenge now is preventing future generations from ever becoming users.
Presenter Heng Nung Koong, MD, founder and director of the Tobacco Free Generation International, discussed this topic during the Education Session “The ‘How To’ of Modern Tobacco Control” (ES21). In 2010, Dr. Koong wrote a journal article, “Phasing-Out Tobacco: Proposal to Deny Access to Tobacco for Those Born from 2000” as a way to think about new generations of never smokers and how best stop them from ever becoming tobacco users.2 One way is to limit the supply and retail operations of tobacco and to create new policies around obtaining and publicly using tobacco in order to eradicate the initial desire or demand for tobacco products.
The ‘Tobacco Endgame’
Tobacco control researcher and policy analyst Ruth Malone, RN, PhD, FAAN, coined the term “tobacco endgame” in 2011 to propel tobacco-free priorities across the globe.
This Tobacco Endgame concept, “replaces the globally accepted, flawed minimum age [to legally purchase products]” Dr. Koong said. Children receive mixed messages; they are told about the dangers of smoking, and yet they see adults smoking. They are exploited by advertising, which promotes the idea that using these products makes one cool or glamorous. Teenagers, many of whom are eager to appear like adults, may engage in risky behaviors to be like the adults in their life and also their peers. The industry capitalizes on the rebellious psyche of teenagers by continuing to say that it only markets to adult smokers, leading many to accept the legitimacy of the industry and its claims.
Additionally, many young people do not suffer immediate health issues. The dangers of smoking increase over time, so many do not experience the health consequences until decades from their first cigarette, vape, or chew.
Improving Education
Saito et al,3 published in the British Medical Journal in 2013, an analysis of 40 textbooks that covered the dangers of tobacco usage and found that very few books presented ways to resist the allure of tobacco (Table).
The movement “needs to go beyond saying ‘smoking is bad and causes various diseases.’ Instead it is the peers who need to stand up in front of a group and advocate to thousands of children,” Dr. Koong said.
“It needs to be an ecosystem that gets permanent internalization in mass education in schools,” he added.
He suggested ways to accomplish this through positive peer pressure. Ideally, schools will develop youth leadership programs within education systems, especially targeting the teenage years, when youth are vulnerable and eager to fit in with peers.
Tobacco-Free Ordinances
As of 2015 in the Philippines, 23.8% overall (16.6 million adults; 41.9% of men and 5.8% of women), were current tobacco users.4)
Dr. Koong developed the world’s first tobacco-free ordinance in 2016 with the support of legislative leaders in the Philippines. In Balanga City, Bataan, the mayor approved this ordinance “as a novel preventive measure against tobacco abuse and tobacco’s harmful effects in the Philippines. It aims to regulate the sale of tobacco to any citizen born on or after January 1, 2000,” per the ordinance. The ordinance is being explored by the other municipalities within the province.
More recently, in November 2020, in Brookline Massachusetts, the Tobacco-Free Generation initiative was passed during a town meeting in a 139 (yes) to 73 (no) vote. This is the first initiative passed in the United States. This measure to prevent the sale of tobacco to anyone born on or after January 1, 2000, is awaiting approval from Massachusetts Attorney General Maura Healey.
These ordinances do not shame or condemn current tobacco users in any way. The idea is to prevent the next generation from starting in the first place.
“This is a phased-in, non-antagonist social movement that will result in no new smokers in future generations,” Dr. Koong said.
The hope is that this compelling initiative will catch on other states as well as globally. Currently more than 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries.1 To become sustainable as a country, inform your local municipalities and mayors on the Tobacco Free Generation merits. Get them to contact the Tobacco Free Generation team to start this better nicotine prevention ecosystem within your education system. The training workshops can be completed within 3-4 days.
For further information: A related abstract (Abstract 1039), “Achieving the Tobacco Free Generation Endgame: #1 Reimagining the Implementation of Better Mass Tobacco Prevention Education,” was presented by Lynn Ong.
Khoo D, Chiam Y, Ng P, Berrick AJ, Koong HN. Phasing-out tobacco: proposal to deny access to tobacco for those born from 2000. Tob Control. 2010;19(5):355-360.
Saito J, Nonaka D, Mizoue T, et al. Limited potential of school textbooks to prevent tobacco use among students grade 1–9 across multiple developing countries: a content analysis study. BMJ Open. 2013;3: e002340.
We had the privilege to listen to several Filipino youths present what they understand of the Tobacco Free Generation International Social Movement on 9 January 2021. This was under the leadership of Mr Russel Sarmiento of Dinalupihan, the Republic of Philippines. These youths presented well and confidently. They also added in their independent opinion on how TFG is better and more harmonious in PREVENTION than what the rest of the world is doing now in pushing for legislation that will curb smokers. We learnt this analogy from this Filipino team “The Minimum Age Law creates that Forbidden Fruit effect like how Adam & Eve, in the Garden of Eden, were told not to eat the fruit”. Congratulations to these youths for adding value to the global TFG Endgame narrative. We are proud of you all!
Statue of Confucius at Foon Yew High School, Johor Baru, Malaysia
子曰“因材施教”与“有教无类”。这也是无烟新一代(TFG)的所秉持的教育精神。为了预防年轻人染上烟瘾，TFG团队（Dr Koong, Dr Lynn 和 Emma）于2020年1月16日和2月29日到访位于马来西亚柔佛州的宽柔中学。我们有幸和约20名宽中的学生交流，探讨烟草对吸烟者乃至整个社会的害处，以及TFG将如何克服这些烟草有关的问题。
这是新山宽柔中学同济会副会长，叶姿贤，对分享会的感想：“（TFG团队） 很用心地把TFG倡导的内容传授给学生们，不只是一昧地传授无烟草的概念，更是训练同学们的表达能力以及自信，让他们可以继续感染同侪，从而实现TFG的愿景。当今社会抽烟者日益增加，身为地球的一份子，我们都有责任阻止情况继续恶化。然而，同侪之间的鼓励与渲染是最有效的方式，因此我认为TFG的概念有必要在青少年的圈子里广泛宣导，使抽烟者不再增加，甚至不再有抽烟者出现。如今我们正协力倡导TFG，愿所有人能够一同努力，创造无烟草新一代。” 新山宽柔中学教师,杨珮云老师,对TFG也给予极高的评价：“TFG programme 借由数据、机密文件、传媒包装等，充分展示烟草公司如何欺骗年轻人的手段。课程的信息多元丰富，深入浅出。（TFG团队）耐心地指导学生，学生们具有更大的信心，以一颗刚强谨守的心，拒绝烟草，更在反烟草运动上，寻见自己的能力，奉献个人力量。透过年轻人兴起，表决不吸烟，当无烟草一代的信念已经传递并且凑效，许多生命必然获得拯救。就如课程最后，无烟草世代的宣告：烟草将有末后的时刻，因为“龙”世代的火焰更甚于一支打火机(The blazing fire of the dragon generation is more powerful than a lighter. ) ”
As we recognise that education is the most important for our future generations, we, in Singapore, made this birth year based law for future cohorts born after 1 January 1991. Shouldn’t we have a birth year based law to protect the health (probably even more important, if not the same as education) of our future generation?
Well done TFG Advocates Von Harley (from 2018) and Bea Santos (from 2017); Well done Sam. Thank you Barangay Baseco, Mariveles for enabling better knowledge for your children. Thank you for preventing others from being addicted though better tobacco prevention education May all of you, The Future Generation, now lead your people too!
PROVINCIAL Hataw Run Bataan Grand TFG Run 6 Dec 2019
From Congressman Joet Garcia : ‘Heartfelt thanks to all who joined the run cob: Hataw run bataan grand ttfg run!
More than 15,000 bataeño woke up early, hataw and running to show their appreciation to healthy lifestyle in the daily workout of the ttfg movement.
The last phase of 2019 hataw run bataan has recorded the most runner in the history of our province! We expect that this program will be more fun and big. Time will come that we can like this in world renowned New York and Tokyo marathon that extends to more than 50,000 runner.
Thank you so much to the provincial government of bataan for the leadership of gov abet, Vice Gov Cris, bokal, Dr. Osang and pho, city government of balanga in leading Mayor Francis, Vice Mayor Vianca, councillors, Dr. Mart and cho, sir cholo and health promotion board, Youth Health Ambassadors, all towns in leading their mayors, barangay officials, Deped in leadership of bataan sds dr. Romeo Alip and balanga sds dr. Ronnie Mallari, all ngas and members in the inter-Agency technical working group.
More thanks to my colleagues at the congressional district office in leadership of cos Jett! The Victory of 2019 hataw run bataan is the fruit of your dedication and diligence to serve.
Response from students from a sample location in 2019. Students born in year 2006 and 2007, ages 14 and 15 respectively after understanding the implications of TFG.
We think it is possible to be 100%. This 90% might have been due to language/translation misunderstanding.
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