Hong Kong smoking level falls to near world’s lowest

June 02, 2022 06:00
Photo: Reuters

The proportion of adult smokers in Hong Kong has fallen to a historic low of 9.5 per cent, one of the lowest in the world, and puts the city on track to achieve its target of 7.8 per cent by 2025.

“This is a new low and it is the first time we are seeing a single digit since records began,” said Secretary of Food and Health Sophia Chan Siu-chee in announcing the news. “It shows that the comprehensive tobacco control policies such as legislation, taxation, law enforcement, health education and smoke cessation policies have been effective with the joint efforts of society.

“Later this year we will announce a road map and schedule to reduce the proportion of smokers to five per cent or lower,” she said. This is the final objective of the government.

This achievement is the result of 40 years of hard work by civil society and government. The figure is less than half the rate of 23.3 per cent in 1982, with men at 40 per cent and women at five per cent.

The leader of the anti-smoking movement in Hong Kong is Dr Judith Mackay, who in 1984 resigned a full-time post as a physician at United Christian Hospital in Kwun Tong to become a full-time campaigner against tobacco. In 1987, she became the first Executive Director of the newly established Hong Kong Council on Smoking and Health (COSH).

It was the first semi-autonomous organisation in Asia dedicated to the fight against tobacco, funded by a government. COSH continues to fulfil this role today.

Dr Judith Mackay, now Director of the Asian Consultancy on Tobacco Control, said : “Breaking the double-digit barrier of the prevalence of smokers in Hong Kong is a wonderful cause for celebration. The prevalence is now the lowest in Asia.”

In the 1980s, Hong Kong was fortunate to have male smoking rates closer to those of Western countries than of most Asian countries like South Korea, Japan or Indonesia. The female rates were lower than in Western countries and similar to those in other Asian countries. Also it had a government ready to take action, helped by the fact that smoking control was accelerating in Britain and British people and organisations influenced Hong Kong.

The government launched health education programmes in the late 1970s, and enacted the first Smoking (Public Health) Ordinance in 1982, which has been progressively strengthened since. In 1983, it increased tobacco tax by 300 per cent. The same year the tobacco industry set up the Tobacco Institute of Hong Kong – a sign of its alarm at the success of the anti-smoking measures.

Between 1983 and 1987, the government passed four further amendments to the Smoking (Public Health) Ordinance of 1982. These covered a wide range of tobacco control issues, exceptional in the world at that time and, with the exception of Singapore, far ahead of other jurisdictions in Asia.

Hong Kong is part of an intense and bitter battle against the global tobacco epidemic, which kills more than eight million people a year, 1.2 million of them non-smokers exposed to second-hand smoke. It is the largest single preventable cause of death. By 2025, the number will rise to 10 million, seven million of them in low and middle-income countries.

Hong Kong has an importance larger than its size as the gateway to China, the world’s largest cigarette market, with about 340 million smokers, where prevention has been less successful.

One key difference is the packaging used in the two jurisdictions. Since October 2017, 85 per cent of the front and back of the packs in Hong Kong have had a torial health warning – lurid pictures showing a skeleton or a damaged lung. Those in China still have only a small text warning at the bottom of the packet.

The latest battleground between Big Tobacco and the public health campaigners was e-cigarettes and heated tobacco products. Sophia Chan said that the number of Hong Kong people using e-cigarettes last year reached 17,500, more than double the 7,200 in 2019. Those using heated tobacco products fell to 8,400 from 13,100 in 2019.

From April 30, the law banned import, promotion, manufacture and possession for commercial use of electronic cigarettes, heated tobacco products and herbal cigarettes. So the number will be expected to fall from 2022 onwards. In total, about 40 countries worldwide have banned such products, and over 100 have legislation regulating their sale and use.

Looking to the future, Mackay said: “The first priority action for Hong Kong now is to raise tobacco tax substantially in the 2023 budget. Tax increases should at minimum be annual to keep pace with the cost of living. Tax increases are the best way to reduce youth smoking, as they price cigarettes beyond the reach of youngsters. It is inexplicable why tobacco taxes have been frozen in Hong Kong since 2015.

“The second measure is to ban cigarette flavours. The survey shows that nearly two thirds of today’s young smokers in Hong Kong smoke flavoured cigarettes, usually menthol. Flavour bans elsewhere have been shown to have an increased quitting rate among menthol cigarette users compared with non-menthol smokers. These two measures could highly influence the endgame goal of the Hong Kong government, in fact, that goal is unlikely to be achieved without them,” she said.

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A Hong Kong-based writer, teacher and speaker.