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Tobacco Staff Quitting Posts

Celine Sun, SCMP – May 19, 2009

Plagued by a high resignation rate among tobacco control inspectors, the government is considering bringing them into the civil service as a way of retaining them.

Nearly a quarter of the inspectors hired by the Tobacco Control Office quit their jobs in 2007-08, compared to 16 per cent the previous year.

Most quit to take new jobs, the government said in a document submitted to the Legislative Council for discussion.

The office employs 124 people, including 85 tobacco control inspectors who are authorised to initiate prosecution for such offences as smoking and the displaying or publishing of tobacco advertisements in areas where smoking is banned.

Legislators called last year for more inspectors to be employed and police to be more actively involved in smoking enforcement after several assaults on inspectors and people who complained about smoking.

But the government said later it had no plans to hire more inspectors, even though their workload will increase when the ban on smoking in public venues is fully enforced in July.

In the document, the government said it was studying the possibility of “absorbing tobacco control inspector positions into existing civil service grades as far as practicable”.

It is also considering creating a new civil service grade especially for the inspectors if no appropriate grade can be found in the system.

The subcommittee of the Legislative Council on the fixed penalty system for smoking offences will today discuss implementation of the Fixed Penalty (Smoking Offences) Bill, which is due to come into effect in the first half of this year. Under the bill, anyone who smokes in a no-smoking area or on public transport is liable to a fixed penalty of HK$1,500.

As well as tobacco control inspectors and police, the ordinance empowers officers of the leisure and cultural services, housing, and food and environmental hygiene departments to issue fixed penalty notices.

Under such arrangements, about 900 hygiene staff – including health inspectors, hawker control officers, and market assistants in public markets and hawker bazaars – will be entitled to issue fixed penalty notices.

Meanwhile, 2,000 housing officers, managers and assistant managers of the Housing Department and about 2,000 leisure officers will be authorised to enforce the smoking ban.

The Tobacco Control Office has started organised training for the officers involved.

Should The Full Smoking Ban Be Delayed?

Jan 17, 2009 – SCMP

The answer is absolutely “No”. The grace period that was allowed before implementation of the full smoking ban should not be prolonged.

Why are people so selfish? Everybody knows that smoking adversely affects our health and damages our respiratory system.

Non-smokers working in places where smoking is allowed are forced to inhale poisonous second-hand smoke. They are forced to sacrifice their health in order to feed their families.

Smoking is a selfish form of behaviour that exploits the basic human rights of others.

Winnie Fong, Lam Tin

Should The Full Smoking Ban Be Delayed?

Updated on Dec 18, 2008

Lam Kwok-tung’s claim (Talkback, December 13) that the University of Hong Kong’s study of second-hand smoke lacks validity is classic tobacco-industry-style misinformation.

Our full report, to be published in a peer-reviewed international scientific journal, does demonstrate clear evidence for a causal relationship between workplace air quality and respiratory health (“Stick by full smoke ban, urge academics”, December 10).

Higher levels of particulates, wherever they occurred, were associated with greater reductions in lung function.

Your correspondent’s implausible explanation for this is that the most vulnerable workers, with previous respiratory problems, somehow selectively occupied jobs in the most polluted workplaces during the two years since the smoking ban legislation.

His shroud waving is baseless. For example, why does he claim that “thousands are no longer employed” given that government statistics since 2006 show the catering business has increased by 30 per cent and bars were exempted from the ban?

The only “competing interest” in this issue is the tobacco industry and a small section of the hospitality trade which says it cannot make a profit in Hong Kong without serving food and drink in filthy air.

Independent economic analyses in other jurisdictions show no negative impact of smoke-free policies, except on tobacco sales.

Despite Mr Lam’s denial, your readers can be sure that smoke-free legislation has led to dramatic improvements in the health of bar workers and the general population, measured as inflammation, respiratory symptoms, lung function or hospital admissions for heart disease. That includes the Scottish workers study published in the Journal of the American Medical Association, and reports from New York, Montana, Ohio, Colorado, and two from Italy.

Mr Lam accuses us of prejudice, but our only bias is the identification of serious occupational health risks. He admits that Hong Kong’s outdoor pollution is a major problem, but wants to create workplace contamination four times this level.

This cynical trade-off does not “pale into insignificance”, and the increased risks of heart attack, stroke and cancer will be unacceptable to anyone who is properly informed.

The suggestion that our catering industry is either willing or able to advise on these hazards is ludicrous.

Anthony J. Hedley, school of public health, University of Hong Kong

HKU Study Shows High Health Risks for Catering Workers (and Bar Patrons) in Venues Exempted from the Smoking Ban

Department of Community Medicine, School of Public Health, The University of Hong Kong – December 9, 2008

Secondhand smoke
Secondhand smoke (SHS) is a dangerous poison. Major studies in Hong Kong have shown how breathing SHS causes a serious injury to the heart, other blood vessels and lungs. SHS kills over 1,300 people a year in Hong Kong. However, in 2006, the Government and legislators supported exemptions from the Smoking (Public Health) (Amendment) Ordinance for “qualified premises” selling alcohol and food, until June 2009.

The Study
A new survey conducted by a team from the Department of Community Medicine, School of Public Health, The University of Hong Kong; a biophysicist from Repace Associates, a secondhand smoke consultancy in Maryland USA, and Professor Neil Benowitz’s laboratory in the University of California, has examined the exposure to tobacco smoke and the health of catering workers in both smoke-free and exempted premises.

157 non-smoking workers in smoke-free Chinese restaurants and Char Charn Ting (Hong Kong style café) and 47 non-smokers who worked in exempted bar/restaurants were examined by interviews, lung function tests and analysis of urine samples for tobacco chemicals.

Results of the study

1. Air pollution level

  • The level of fine particulate pollution (PM2.5) in exempted venues was four times as high as (300% higher than) the level in the smoke-free premises.
  • The indoor pollution was
    o slightly lower than outdoor pollution for smoke-free venues
    o over 100% higher than outdoor pollution for exempted venues

2. Toxic substances in urine of workers

  • Cotinine is a breakdown product of nicotine which can be measured in urine. It is a marker in the human body for other toxic substances from tobacco smoke which cause heart disease, stroke, cancers and other health problems.
  • The research team found that cotinine in the urine of workers was
    o highest in those working in exempted hospitality venues
    o also raised in workers serving smokers on patios and terraces
    o raised in many non-smoking workers who we found were exposed to tobacco smoke at work from their co-workers during break periods
  • Catering workers who served smokers had higher levels of tobacco chemicals in their urine than those in other jobs.

3. Lung function in catering workers

The level of indoor air pollution, as measured by fine particulates, was strongly associated with reduced lung function in catering workers:

  • In the group of workers in exempted venues who successfully completed a lung function test, the average level of PM2.5 was 261 microgrammes per cubic metre (μg/m3), and in smoke-free venues was 61 μg/m3. All workers show declining lung function with increasing PM2.5 levels. The research team estimates that the average difference in lung function between workers in exempted and smoke-free venues on the day of the survey is 6.3% for ages 18-65 years; for older workers (aged 30-65) the estimated average difference is much higher at 10.9%. At the average level of PM2.5 in exempted venues the estimated overall reduction in lung function is 14% for ages 18-65 and up to 22% for ages 30-65.
  • We regard these reductions in lung function as very important indicators of harm to current and future health. Other scientific studies have shown that damage to the lungs carries a serious risk of both acute and chronic disease including bronchitis, pneumonia and chronic obstructive pulmonary disease (COPD). Reduced lung function is a strong predictor of reduced life expectancy.

4. Health risks:

  • More workers in exempted venues than in smoke-free venues perceived that the poor indoor air quality increased their health risks:

Workers who said they were always bothered by smokers near them had lower urine cotinine levels than those who were seldom bothered. This apparent reduction in exposure, from action to protect themselves from smoke, was much greater in workers in non-smoking venues compared with those in exempted venues.

  • In 2001, we estimated the average increased risk of fatal heart disease and lung cancer in Hong Kong catering workers was 1 in 33 (3%) and up to 1 in 10 (10%) for the highest (top 10%) exposures. For those workers in catering venues which were exempted under the 2006 Amended Ordinance, this increased risk will remain unchanged for 2.5 years (from 1.1.2007 to 30.6.2009). The result of this unchanged risk will cause serious life-long harm to the health of many of them.
  • This study clearly shows that indoor air quality in Hong Kong is generally extremely poor and very much worse when smoking is permitted.

o In non-smoking venues the average levels of fine particulates (PM2.5) in our spot tests (61 μg/m3) were 240% above the World Health Organization (WHO) 24 hour guideline of 25 μg/m3 and 610% above the annual WHO guideline of 10 μg/m3.
o In exempted catering premises, the extremely high levels of particulates and other tobacco chemicals we measured will cause serious harm to the health of workers, both smokers and non-smokers.


  • All exemptions of premises from the smoke-free workplace policy creates a serious health risk for workers and should be rescinded as a matter of urgency. While the HKSAR government used the research evidence on the serious harm caused by SHS to promote public acceptance of smoke-free policies it should not have introduced legislation which perpetuates and increases catering workers exposure to SHS.
  • The introduction of “smoking-rooms” currently being argued for by the catering and tobacco industries should not be permitted for the following reasons:

o Smokers suffer additional health problems when subjected to intensive exposures to SHS.
o We have previously shown in Hong Kong that smokers who inhale SHS from other smokers experience higher risks of lung disease.
o Smoking rooms in catering and licensed facilities will create an intense source of pollution which will contaminate surrounding air. Existing smoking rooms in Hong Kong, such as those in the Airport Authority, are poorly managed and create health risks for those who use them or have to clean them.

  • These facts on the harm caused by SHS should not be ignored by the Hong Kong health authorities (the Food and Health Bureau and the Department of Health) in formulating future policy.
  • The government should focus on improving its compliance with the WHO Framework Convention on Tobacco Control rather than spending public money on smoking rooms.

Professor Sarah McGhee, a leading member of the research team said, “The study shows that the occupational health impacts of smoking in catering facilities must outweigh any other argument for the continuation of exemptions or the introduction of smoking rooms. There was no evidence anywhere in the world that the food and licenced trade had suffered any economic downturn on top of existing background trends from smoke-free policies.”

Dr Chit Ming Wong, a researcher leading several environmental health projects of the Department of Community Medicine, The University of Hong Kong emphasized, “The evidence of impaired lung function in catering workers had serious implications for their current and future health. All exemptions should end, including smoking patios and terraces, which are a health risk for waiters and others in such places.”

Professor Tai Hing Lam, director of the Public Health Research Centre, School of Public Health, The University of Hong Kong said, “All sectors of the community must now be involved in tobacco control and particularly the elimination of involuntary exposures to tobacco smoke. Tobacco tax should be increased to support smoking cessation in Hong Kong to reduce illness and premature deaths from smoking and secondhand smoke.”

Professor Anthony Hedley said “We thank the government for supporting the study. We hope that government leaders would take careful note of the study results and adopt a more pro-active and consistent approach to the incorporation into policy and legislation of the overwhelming scientific evidence on health risks of SHS. The new study is an important demonstration of the need for accountability in all public health and environmental regulations.”

For media enquiries, please contact Ms Winnie Lam (Tel: 2809 5102 / 9107 1676) or Mr Terence Poon (Tel: 2819 9305 / 9316 6267) of The University of Hong Kong Li Ka Shing Faculty of Medicine.


Croatia Bans Smoking In Most Public Places

Associated Press | 17 October 08 ZAGREB, Croatia – Smoking in most indoor public places in Croatia will soon be prohibited.

Croatia’s parliament approved a government bill Friday prohibiting smoking in offices, bars, restaurants, schools, hospitals and cafes. The ban has one exemption – psychiatric clinics. The government did not provide a reason why it gave them an exemption.

The Health minister is reported as saying smokers are all nuts anyway.

The ban will be enforced in schools and hospitals later this month, while restaurants and bars will be given time to adapt until April.

About 30 percent of Croatia’s 4.5 million people are believed to be smokers.

Copyright 2008 Associated Press

No Butts As Anti-smoking Minister Targets Bollywood Star

S. N. M. Abdi – SCMP – Updated on Oct 03, 2008

The Indian government’s campaign to curb smoking has spilled over into a very public spat between a crusading minister and Bollywood’s reigning superstar.

From yesterday, a new law bans smoking in public places, including bars and restaurants. In his zeal to wean smokers off the habit – which kills more people in India than in any other country – Health Minister Anbumani Ramadoss has targeted chain-smoking actor Shah Rukh Khan.

“The clash between the politician and the film hero throws a spotlight on the landmark Prohibition of Smoking in Public Places Rules, 2008, which empowers state-appointed watchdogs for the first time to slap fines ranging from 200 to 1,000 rupees (HK$32 to HK$160) for lighting up virtually anywhere except parks, roads and homes,” said columnist Rajat Roy.

“Khan is known for his addiction to cigarettes in real life as well as smoking scenes in many a super-hit film. So targeting one of India’s most high-profile smokers makes a lot of sense.”

Mr Ramadoss has ordered a non-governmental organisation in Mumbai to bombard the actor’s palatial house daily with pamphlets highlighting the effects of cigarettes. The minister has also instructed the NGO to flood the actor’s wife and son with letters and e-mails warning them about the threat nicotine poses to his health.

“Shah Rukh must stop smoking both on and off screen because our studies show that popular actors and actresses exercise a big influence on teenagers and youths of both sexes. He is a role model for the young generation, which is increasingly getting addicted to cigarettes. I expect him to kick the habit for the sake of the country,” says Mr Ramadoss who boasts that he is waging a war against smoking.

“While I appreciate the minister’s concern, I do not like anyone telling me what to do and what not to do,” an unfazed Khan retorted.

“I will quit smoking if I decide to. I might give up smoking – and I might not. I’m fully aware of the consequences of inhaling nicotine. But it’s a personal issue between me, my family and my doctor, and I thoroughly disapprove of it being made a public issue.”

The acclaimed actor – who has featured in more than 100 smoking scenes since 1991 and tops a recent list of Bollywood’s “serial offenders” compiled by the World Health Organisation – is even more critical of the minister’s attempts to ban smoking scenes in films and television serials.

“Contrary to claims, films do not glorify murder, rape, robbery or smoking and drinking. These negative aspects are depicted because they are a reality. Films reflect what’s happening around us. So cinema can’t portray only good things as everyday life is a mix of the good and the bad.”

Mr Ramadoss refuses to buy the argument. “India has the highest number of smokers who get addicted between the age of 13 and 15 in South Asia,” he says. “And the biggest culprits are films and superstars. Tragically, more and more youngsters and women are using tobacco because films glorify smoking. Some 15 million Indians go to the movies every day. So one can imagine the magnitude of the incitement.

“Our data shows that 52 per cent of children smoked their first cigarette under the influence of film celebrities.”

Besides Khan, Mr Ramadoss has also attacked former Bollywood superstar Amitabh Bachchan for popularising what he derisively calls “the cancer stick”.

The minister, whose campaign is reportedly backed by India’s teetotal prime minister, Manmohan Singh, and ruling Congress Party president Sonia Gandhi, says that the new legislation and targeting Bollywood’s smoking stars are in the public interest because 1 million Indians die annually from smoking-related diseases.

The latest National Family Health Survey shows that 33 per cent of men across India aged 15 to 49 are smokers. In urban areas, 31 per cent of women in the same age bracket are addicted to cigarettes. The trend is particularly alarming because, in 1995, only 10 per cent of women smoked.

His drive, Mr Ramadoss insists, also makes economic sense: while the tobacco industry is worth 350 billion rupees, the government is forced to spend 360 billion rupees annually on treating and preventing tobacco-related diseases.

As of yesterday, anyone lighting up in government and private buildings, including workplaces, cafes, restaurants, schools, hotels, pubs, discos, stadiums, railway stations, airports, hospitals and bus stands, will be fined.

The new law also bans matches, lighters and ashtrays from public spaces. However, airports, hotels with more than 30 rooms and restaurants seating more than 30 diners, are permitted to have a smoking bay.

“We have excluded roads and parks from the list of no-smoking zones although, strictly speaking, they are public places. Homes, too, are exempted but I expect smokers to seek the permission of their spouse and children before lighting up in their residence,” Mr Ramadoss said.

A survey conducted five days before the clampdown by Mumbai’s Healis Sekhsaria Institute of Public Health showed that 92 per cent of respondents in the four largest cities – Mumbai, New Delhi, Calcutta and Chennai – are in favour of smoke-free public spaces and workplaces, while 99 per cent want smoke-free restaurants.

“The public evidently can’t wait for the implementation of the new law, whose prime objective is to protect non-smokers from second-hand smoke,” said Monika Arora, convenor of the Advocacy Forum for Tobacco Control, an NGO fighting for tougher anti-smoking regulations.

But the tobacco and hotel industries are up in arms against the new law and are apparently planning to sue the government in the Supreme Court. An Indian Tobacco Company spokesman said that the ban on smoking in workplaces could be easily challenged because it includes private offices like a lawyer’s chamber or a painter’s studio.

Similarly, the Indian Hotels Association has objected to the banning of matchboxes and lighters in restaurants.

“I would not be able to organise a candlelit dinner. I cannot even use matchboxes if there is a power cut,” complained one association spokesman.

But Ms Arora says that the hospitality industry had no reason to worry. She cited research from Australia, Canada and the US that shows anti-smoking legislation had no negative impact on sales, revenues or employment in restaurants, bars and hotels in the long run.

Mr Ramadoss has also read the riot act to powerful politicians.

He told a TV channel that Buddhadev Bhattacharya, West Bengal’s chain-smoking chief minister, should not light up in Writer’s Building, the administrative headquarters of the state government. Mr Bhattacharya remains defiant, saying he has no plans to quit smoking.

Passive Smoking Ups Risk Of PAD By 50% CME

News Author: Lisa Nainggolan – CME Author: Laurie Barclay, MD – From Heartwire — a professional news service of WebMD | September 22, 2008

Chinese researchers have reported, for the first time, a link between exposure to passive smoke and peripheral arterial disease (PAD) in a cohort of women who have never smoked. Dr Yao He (Chinese PLA General Hospital, Beijing, China) and colleagues publish their findings today in Circulation [1].

“We found that compared with women who were not exposed to secondhand smoke (SHS), among women who were exposed to SHS, the risk of intermittent claudication was increased by 87% and risk of PAD — assessed by ankle-brachial index < 0.90 — was increased by 47%, with significant dose-response relationships for both number of cigarettes exposed to and duration of exposure,” they state.

In line with previous studies, He et al also found an increased risk of both coronary heart disease and stroke in the women exposed to passive smoking, with this being the first study to specifically report a positive association between SHS and ischemic but not hemorrhagic stroke.

“In China, only 4% of women are current smokers, but more than 50% of women are exposed to SHS,” they note. “But most people [there] are unaware of the serious health hazards of SHS. Thus, urgent public health measures are warranted to protect individuals from exposure to SHS.”

Passive smoking linked with ischemic, but not hemorrhagic stroke

The researchers explain that China is the largest producer and consumer of tobacco in the world, with its 350 million smokers puffing their way through 30% of the globe’s cigarettes. But awareness of the health hazards of either active or passive smoking is still low.

They set out to examine the relationship between SHS and cardiovascular diseases, particularly PAD and stroke, in older Chinese women (60 years or older) who had never smoked from a population-based cross-sectional study in Beijing. SHS was defined as exposure to another person’s tobacco smoke at home or in the workplace.

“Because the vast majority of women were never smokers (87%) we had a unique opportunity to evaluate the association of SHS with risk of CVD [cardiovascular disease], particularly PAD,” they note.

After adjustment for 13 potential confounding factors, they found that women who had been exposed to SHS had a significantly higher risk of coronary heart disease (CHD; adjusted odds ratio [OR] 1.69; p<0.001) and ischemic stroke (OR 1.56; p = 0.035) than those never exposed to SHS.

The adjusted OR’s of PAD defined by intermittent claudication (IC), by ankle-brachial index (ABI) < 0.90 and by either IC or ABI < 0.90 were: 1.87 ( p=0.001), 1.47 (p=0.018) and 1.67 (p<0.001) respectively.

Dose-response relationships were found between SHS exposure amount (cigarettes per day) and duration (minutes per day) and increasing prevalence of CHD, ischemic stroke and PAD.

“Our finding of a dose-dependent association of SHS with CHD is consistent with the literature,” He et al explain. They also note that their findings with regard to stroke support previous studies, but that many of these did not investigate subtypes of stroke.

“This population based study is the first to report a positive association of SHS exposure with ischemic stroke but not hemorrhagic stroke among Chinese female nonsmokers.”

PAD underdiagnosed and undertreated in China

An important advantage of the study, say He et al, was that PAD was diagnosed by ABI measurement. They explain that PAD is an underdiagnosed and undertreated condition in China: previous studies have shown almost 50% of PAD patients are asymptomatic and most of them are unaware of their condition.

“To the best of our knowledge, this is the first study showing an increased risk of PAD with increasing SHS exposure,” they note, adding that they believe their results are generalizable to similar populations in China.

“SHS exposure in women is highly prevalent in China. In addition to being a causal factor for CHD, SHS should be considered an important risk factor for ischemic stroke and PAD in Chinese women who never smoked,” they conclude.

This study is supported by research grants from the National Natural Science Foundation of China, Beijing Natural Science Foundation, and the Health Service in the Health Ministry of China. Dr Hu was partly supported by an American Heart Association Established Investigator Award. Coauthor Dr. He was partly supported by the Gordon Wu and Cheng YuTung Exchange Professorships in the Faculty of Medicine at the University of Hong Kong. The other study authors have disclosed no relevant financial relationships.


1. He Y, Lam TH, Jian B et al. Passive smoking and risk of peripheral arterial disease and ischemic stroke in Chinese women who never smoked. Circulation. 2008:doi: 10.1161/CIRCULATIONAHA.108.784801.

Clinical Context

There is strong evidence to date that SHS exposure is a causal factor for CHD. However, the relationship between SHS exposure and ischemic stroke and PAD is still unclear.

Several studies suggest a positive association between SHS and the risk for stroke. There have been recent estimates of the prevalence of PAD attributable to active smoking in a Chinese population, but no study to date has reported on the association of SHS with PAD.

The complete contents of Heartwire, a professional news service of WebMD, can be found at, a Web site for cardiovascular healthcare professionals.

Medscape Medical News 2008. ©2008 Medscape

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Exposure To Environmental Tobacco Smoke And Health Effects Among Hospitality Workers In Sweden

Larsson M, Boëthius G, Axelsson S, Montgomery SM. – The Department of Respiratory Medicine, Orebro University Hospital, Orebro, Sweden. | Aug 2008

TOPIC: Exposure to environmental tobacco smoke and health effects among hospitality workers in Sweden–before and after the implementation of a smoke-free law.

OBJECTIVES: This study attempted to identify changes in exposure to environmental tobacco smoke, as well as symptoms and attitudes among hospitality workers after the introduction of extended smoke-free workplace legislation.

METHODS: A total of 37 volunteers working in bingo halls and casinos (gaming workers) and 54 bars and restaurant employees (other workers) in nine Swedish communities participated in the study. Altogether 71 of 91 persons (14 daily smokers and 57 nonsmokers) participated in both the pre-ban baseline survey and the follow-up 12 months after the ban. Exposure to environmental tobacco smoke, smoking habits, respiratory and sensory symptoms, and attitudes towards the ban were recorded, and spirometry was carried out.

RESULTS: The frequency of reported respiratory and sensory symptoms was approximately halved among the nonsmokers in both occupational groups after the introduction of the ban. Initially 87% had exposure to environmental tobacco smoke that was over the nicotine cut-off level chosen to identify possible health risk ( <0.5 microg/m3) while, after the ban, it was only 22%, a relative risk of 0.25 (95% confidence interval 0.15-0.41). The risk decreased in both occupational groups, but gaming workers experienced the highest pre-ban exposure levels. Attitudes towards the legislation were largely positive, particularly after the ban. However, there was no notable change in lung function, and there was no notable reduction in the number of cigarettes consumed by smokers.

CONCLUSIONS: The introduction of smoke-free legislation was associated with a substantial reduction in respiratory and sensory symptoms, as well as reduced exposure to environmental tobacco smoke at work, particularly among gaming workers.

The Health of Catering Workers in Hong Kong

Professor Anthony Hedley from the University of Hong Kong, Department of Community Medicine is carrying out a survey on The Health of Catering Workers in Hong Kong.

In the survey, they need the workers to complete a simple questionnaire about their health and workplace. They would also like them to perform a lung function test. At last, they will collect a urine sample from each worker. As an appreciation, each participant will be compensated with a cash payment of HKD100 upon completion of the survey. The health report will be sent to each worker afterwards.

In addition, they wish to recruit 3-4 non-smoking workers (preferably waiter/waitress) in each venue visit.

Please find the relevant information (both English and Chinese version) for your reference here.

The attached booklet includes:

  1. Information sheet to the catering workers about details of our survey
  2. Informed Consent Form
  3. Questionnaire
  4. Sign up sheet for the incentive payment
  5. Brochure for off-site interview

The brochures will be distributed to the catering workers who are unable to participate during their work shifts. They have reserved several community centers from 7 districts and would like to invite the catering workers to visit any of these venues after their work shifts :

Community Centres

If you have any questions please contact Ms. Ada Ho at 2819 9901.

Case Links Death To Environmental Tobacco Smoke

A young asthmatic woman who collapsed and died shortly after arriving for her shift as a waitress at a bar may be the first reported death to be reported nationally from acute asthma associated with environmental tobacco smoke.

This case report by a Michigan State University physician, published in the February edition of the American Journal of Industrial Medicine, not only outlines circumstances under which the woman died, but also raises a number of issues regarding safety in the workplace.

The report states the woman arrived at the bar in Michigan and, according to co-workers, seemed happy and healthy. About 15 or 20 minutes later she collapsed and within a few minutes died.

“This is the first reported acute asthma death associated with work-related ETS,” said Kenneth Rosenman, an MSU professor of medicine and chief of the Division of Occupational and Environmental Medicine. “Recent studies of air quality and asthma among bar and restaurant workers before and after smoking bans support this association.”

In 2006, the surgeon general’s report concluded that ETS causes coronary heart disease, lung cancer and premature death. But at that time there was little hard evidence linking ETS to the exacerbation of asthma in adults.

However, Rosenman and colleagues believe this case provides plenty of evidence to link secondhand smoke to this death.

“The autopsy clearly indicates she died from asthma,” Rosenman said. “There was no other cause of death. Her death is consistent with what we know about exposures in bars like this. We know asthmatics are more susceptible to irritants and other particulates in the air.

“We know that particulate levels from secondhand cigarette smoke in bars like this reach sufficient levels to set off an asthma attack.”

As an occupational and environmental health physician, Rosenman said he also is concerned about the long-term effects of ETS on all employees, not just those with pre-existing conditions like asthma.

“As a consumer, I don’t have to go into that bar,” he said. “But is it a safe environment for the employees? We have federal laws that say employers have to provide a safe and healthy workplace. This was clearly not a safe and healthy workplace for this employee.

“This death dramatizes the need to enact legal protections for workers in the hospitality industry from secondhand smoke.”

In the United States, 23 states have already banned smoking in restaurants and bars. A number of other states, including Michigan, are considering it.

While many bar and restaurant owners say a smoking ban would hurt business, Rosenman argues that just the opposite is true.

“Consider that 75 percent of the population doesn’t smoke,” he said. “Banning smoking could actually serve to increase business. Studies of restaurants and bars in Boston, New York City, San Francisco and Washington D.C. all show business up since they banned smoking. Chicago went smoke free the beginning of this year.

“We’re behind the times if we want to attract tourists and help businesses be more profitable.”

Source: Michigan State University