Hong Kong tobacco ban moves a step closer

Leading academics have laid out a road map for Hong Kong to move to a total ban on tobacco products by the end of the decade.

The dean of the LKS Faculty of Medicine, the University of Hong Kong (HKUMed), together with the tobacco control research team from the Schools of Nursing and Public Health, has called for the government to consider a total ban on tobacco in Hong Kong.

It comes as the population has until the end of the month to participate in Hong Kong Government’s Public Consultation Tobacco Control Strategies with the theme “A Vibrant, Healthy and Smoke-free Hong Kong” which opened in July. The government has set the goal of reducing the smoking prevalence to 7.8% by 2025 and ultimately achieving a tobacco-free Hong Kong.

Professor Chak-sing Lau explained: “Tobacco use has long been identified as the biggest global health risk and held responsible for many types of diseases or preventable deaths. In Hong Kong, tobacco use causes 7,000 deaths annually, and health hazards to hundreds of thousands of children exposed to toxic second hand smoke at home.

“Legislating for a total ban on tobacco will help implement effective short-term control measures such as raising tobacco tax and expanding statutory no smoking areas, in order to strive for tobacco endgame in Hong Kong for a healthier future.”

The team described the call as “decisive” and based on years of research by the university into a range of impacts including smoking-related deaths and economic loss, tobacco control policy, smoking cessation and second-hand smoke exposure in children.

Its study found an average of 77% support for banning tobacco by 2030. Of those surveyed 85% of those who had never smoked 65% of former smokers and 17% of current smokers supported the ban.

The team said 79% of all people supported raising tobacco tax and 59% supported increases that match inflation. Among a total of 3,014 smokers, 55% would quit or reduce smoking by half if cigarette price was increased, more likely so among those younger.

“To achieve the target smoking rate of 7.8% by 2025, it is paramount to raise tobacco tax to at least 75% share of retail price, as recommended by the World Health Organization (WHO), by 2024 as it takes time to implement other proposed measures,’ said professor Kelvin Wang Man-ping of the School of Nursing, HKUMed.

The Team’s extensive smoking cessation research in both clinical and community settings has identified effective strategies such as grasping the opportunity of medical encounters, quit lines, smartphone support, brief advice, active referral, monetary incentives and convenient services.

“Our evidence-based smoking cessation strategies can be further enhanced to support the expected large-scale quitting before the total ban on tobacco,’ said Professor Sophia Chan Siu-chee of the School of Nursing, HKUMed.

The team found an increasing trend of adolescent exposure to second-hand smoke at home. In 2020-2021, 29.8% of secondary school students were exposed from inside home and 40.7% from neighbours in the past seven days. Exposure to either was 59%, reaching 63% if third-hand smoke (32%) was also included. Such exposures were more common in those with less educated parents and lower perceived family affluence.

“Such high exposure of children to toxic tobacco smoke at home is unacceptable. Only a total ban on tobacco can effectively protect them under such high-density housing environment in Hong Kong,’ said Dr Daniel Ho Sai-yin, associate professor, School of Public Health, HKUMed.

‘For our children’s health and the long-term benefit of Hong Kong, it is time to step up our action and considering legislation for tobacco endgame,’ added professor Lam Tai-hing, emeritus professor and honorary clinical professor, School of Public Health, HKUMed.

The team have proposed a pathway to the end of tobacco in Hong Kong by 2030.

Next year would see tobacco tax increased to 75% with mechanism for further increases through 2029. A mechanism to monitor public support of tobacco control policies and tobacco use would be created alongside the initiation of a discussion for a total tobacco ban.

It would see the government target smoking rate of 7.8% researched in 2025, as public support of tobacco control policies and tobacco use is monitored as enhanced tobacco control measures would be introduced.

The aim would be to reach a smoking rate of 5% in 2027, with the figure hitting under 3% by 2029 at which time cessation support would be offered to those remaining smokers.

2030 would then see a tobacco-free Hong Kong.

“The Public Consultation on Tobacco Control Strategies has provided a golden opportunity to end the tobacco epidemic in Hong Kong,” The team said. “To safeguard public health and to protect children from tobacco harm, the time is ripe to consider legislation for a total ban of tobacco.

“The public is encouraged to actively express their views on the Government’s public consultation on tobacco control strategies by end of this month. By adopting a multi-pronged approach and scaling up our tobacco control measures, we are set to reduce smoking prevalence and attain tobacco-free in the foreseeable future.”