Should Hong Kong ban e-cigarettes?

March 26, 2018 11:53
Hong Kong's Legislative Council is set to discuss a regulatory framework for e-cigarettes and other new tobacco products. Photo: Reuters

Last week there was good and bad news for activists who campaign against consumption of tobacco products in Hong Kong.

The number of daily smokers, aged 15 and over, fell to 10 percent, or 615,000 people, a historic low and down from 641,300 in 2015, government data suggested.

But the number using electronic cigarettes rose more than five-fold to 5,700 last year from less than 1,000 in 2015. A survey of primary and secondary schools between November 2016 and June 2017 found that 29,380 teenagers had tried e-cigarettes, with 2,770 still using them.

E-cigarettes create a vapor by mixing propylene glycol, glycerine and flavorings that replicate the smoking experience. Some, but not all, contain nicotine.

The modern e-cigarette was invented in 2003 by a Chinese pharmacist, and commercial sales began in 2004. China accounts for more than 70 percent of global production. There are 500 brands, with global sales of more than US$7 billion. A majority of users still smoke tobacco.

In the UK, in 2015, there were about 2.6 million users, about five percent of the population; 59 percent of current smokers said they had tried them. Among those who had never smoked, 1.1 percent said they had tried them and 0.2 percent still use them.

In France, in 2014, between 7.7 and 9.2 million people have tried e-cigarettes; 1.1 to 1.9 million use them on a daily basis. Sixty-seven percent of French smokers use e-cigarettes to reduce or quit smoking.

Tobacco companies argue that e-cigarettes are less harmful than traditional cigarettes and say that they are a step to help smokers give up the habit.

Next month Hong Kong's Legislative Council will discuss a regulatory framework for e-cigarettes and other new tobacco products. What should it do?

It could follow the example of Macau and Singapore. In January, Macau amended its Tobacco Prevention and Control Regime by banning the sale of e-cigarettes. Then Singapore banned the purchase, use and possession of emerging and imitation tobacco products, such as smokeless tobacco products, chewing tobacco and shisha.

On March 22, in a statement, the Hong Kong Council on Smoking and Health stated its position: “The marketing strategies of e-cigarettes are mainly targeting young people. Some smokers may also use emerging products like heat-not-burn tobacco products as a substitute to conventional cigarettes. The government should enact a total ban on e-cigarettes and tighten the regulations on emerging tobacco products promptly.

"The government proposed to regulate e-cigarettes in May 2015. However, the concrete measures are yet to be released. The implementation plan should be confirmed as quickly as possible," it said.

The Council criticized the government for freezing the tobacco tax in the 2018-2019 budget for the fourth consecutive year. “We strongly recommend the government to raise the tobacco tax substantially in the coming financial year. It is hoped that the smoking prevalence will be lowered to a single-digit percentage in the near future and to five per cent or below in 2027.”

Many governments are struggling to find the right legislation. It will be about five years until conclusive studies show how harmful the new products are. So governments are having to make policy decisions ahead of the science.

Professor Judith Mackay, Director, Asian Consultancy on Tobacco Control Hong Kong, said there were two crucial questions: "Do the new products initiate youth smoking and, secondly, do they help smokers quit or do they encourage smokers to keep on smoking, possibly using both cigarettes and e-cigarettes?

"Over decades, smoking has been reduced in Hong Kong to a world low, and is heading into single figures. It is less socially acceptable to smoke in most public areas, including the workplace and public transport. There is a real danger that these chic new ways of using nicotine or tobacco might renormalize social attitudes and acceptance of smoking," she said.

"All would agree that we need more evidence: should not sell these products to youth: should not advertise false health claims. World Health Organization and the Hong Kong government advocate a ‘precautionary principle’ until there is better evidence. Meanwhile, the best advice for smokers is to quit completely, and for youth is to avoid all tobacco and nicotine products," Mackay added.

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A Hong Kong-based writer, teacher and speaker.