Ending Tobacco Addiction by the Tobacco Free Generation, Endgame Paradigm: Introductory Paper & Opportunities for Youth Leadership

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Written by Dr. Koong Heng Nung –  Founding Director of the Tobacco Free Generation International & Medical Director of Koong & Ho Surgery Pte Ltd. Mount Elizabeth Novena Hospital

A common social challenge the youth face is addictions especially to nicotine. The legal acceptability of nicotine, superimposed onto the experimental phase of a life that is often lead by peer influence, is a well-known effect that disappointingly, not many, including governments and global bodies have not been able to address. Once addicted, even the best smoking cessation programmes by cessation experts continue to struggle as many fail abstinence and multiple relapses are common.

Tobacco Free Generation

Over the last 8 years, I have been advocating that we need to stop blaming and targeting persons who use cigarette as it hurts them too. Additionally, I have initiated an international social programme called the Tobacco Free Generation that arose from a scientific paper I published. (Koong et al, 2010, Tobacco Control journal. Proposal to deny access to tobacco to those born after the year 2000; .https://tobaccocontrol.bmj.com/content/19/5/355)

A key feature includes training youth to lead this social movement as demonstrated in the two URL links listed below. Evidence has shown that the best social outcome is one that can impact a social norm change and even better, a policy change.http://tislep.pgme.utoronto.ca/wp-content/uploads/2016/11/TISLEP2016-Benrimoh-Innovative-advocacy-leadership-curriculum-for-medical-education.pdf

I have developed the material and pedagogy for implementing a more positive programme/ecosystem in school and municipalities. This website provides some visuals of the school sessions in Singapore. My international progress is in www.tobaccofreegen.com as it is tactical not to put much international material on my website.

The Distinct Advantage of the TFG Ecosystem

  • It does not target addicted, adult smokers but instead, focused on providing evidence-based tobacco prevention education for kids.
  • Smokers, no longer being targeted, support TFG as they do want their children and future generations not to start smoking.
  • This unity of both smokers and non-smokers for a common healthier, future population is more harmonious than the current divisive tobacco control regulations that penalize, alienate and dividing our people, allowing the tobacco addiction to prevail.
  • It is inexpensive and captivating as it mobilizes the creativity and social media networks of the young people.


If you find this non-antagonistic, endgame approach more logical than current punitive measures in tobacco control, I am happy to provide more details. After all, we share the common vision of a better society by working with youths.


The opinions expressed in the article are the writer’s own and do not reflect the view of MPS YPC.

Dr Koong Heng Nung is a practicing lung surgeon who has won multiple best educator awards and consistently directed the best programme within the Orientation to Clinical Year course at the DukeNUS Graduate Medical School. He has successfully mentored many junior college students aspiring to be doctors and is known for creative teaching methodologies. He founded the Tobacco Free Generation Social Movement in 2011 where to date, has continued to get interest and endorsement from global health care bodies. Despite being a surgeon in private practice, he continues with a strong public health agenda by creating opportunities for young people to lead on international public health platform, grooming leadership in doctors and advising local government units from ASEAN to AFRICA

Awards received

  • Outstanding Educator Award 2009, Duke NUS Class of 2011
  • Outstanding Leadership Award 2009 DukeNUS Class of 2011
  • Outstanding Developer Award 2010 DukeNUS Class of 2012
  • Outstanding Faculty for Engagement Award 2013 DukeNUS
  • Outstanding Faculty for Learning Award 2013 DukeNUS
  • Golden Apple Award for Programme Innovation (Medical) 2013 Academic Medicine Education Institute, Singapore Health Service
  • Multiple appreciations from overseas municipalities for his international tobacco prevention programme.