News
HKUMed advocates for consideration of a total ban on tobacco in Hong Kong

13 September 2023

The Dean of the LKS Faculty of Medicine, the University of Hong Kong (HKUMed), together with the tobacco control research team (hereafter ‘the Team’) from the Schools of Nursing and Public Health, advocates for consideration of a total ban on tobacco in Hong Kong. Professor Chak-sing Lau, Dean of Medicine of HKU, stresses, ‘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 secondhand 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.’

This decisive call is based on years of research findings by the Team including smoking-related deaths and economic loss, tobacco control policy, smoking cessation and second-hand smoke exposure in children.

Key recent findings
In 2019-2021, two large surveys (N=7,101 and 5,238, respectively) found an average of 77% support for banning tobacco by 2030 (never smokers 85%, former 65%, current 17%).

In eight waves of policy surveys during 2015-2022 (total N=17,960), 79% of all people (29% of smokers) 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. The HKU Youth Quitline has counselled over 3,100 young smokers with a six-month quit rate of 24%. ‘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.

Eight waves of territory-wide school-based surveys during 2010-2021 have found an increasing trend of adolescent exposure to secondhand smoke at home. In 2020-2021, 29.8% of secondary school students were exposed from inside home (family members) 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,’ echoed Professor Lam Tai-hing, Emeritus Professor and Honorary Clinical Professor, School of Public Health, HKUMed.

Background
2023

• Conclude public consultation and issue an overall tobacco control strategic plan

2024

• Raise tobacco tax to 75% with mechanism for further increases through 2029
• Set up mechanism to monitor public support of tobacco control policies and tobacco use
  
• Initiate discussion for a total tobacco ban 
  
• Enhance tobacco control measures

2025

• Reach government target smoking rate of 7.8%
• Monitor public support of tobacco control policies and tobacco use
• Enhance tobacco control measures

2027

• Reach smoking rate of 5%
• Monitor public support of tobacco control policies and tobacco use
• Enhance tobacco control measures

2029

• Reach smoking rate of <3%
  
• Ensure cessation support for remaining smokers

2030

• Tobacco-free Hong Kong
  
• Monitoring of tobacco control policy support and tobacco use to continue

Conclusions
The Public Consultation on Tobacco Control Strategies has provided a golden opportunity to end the tobacco epidemic in Hong Kong. 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.