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Should The Full Smoking Ban Be Delayed?

Dec 17th, 2008
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SCMP – Updated on Dec 17, 2008

Judith Mackay (Talkback, December 11) has a serious problem in her quest to eliminate cigarette smoking but there is absolutely no justification to target a small group of businesses that provide a service for those who wish to smoke.

Licensed bars and entertainment places are private premises to which customers are invited at a manager’s discretion and are not public places with right of access.

Smoky bars are, therefore, not places with “indoor air pollution” to which the public or even “catering workers” are forced to venture.

Nobody disputes that nicotine is an addictive drug and smoking kills, but like it or not, hundreds of millions of people worldwide still choose to smoke.

Governments are sensible enough not to attempt to outlaw tobacco because quite apart from not wanting to lose billions of tax dollars, the memory of the attempted alcohol ban in the US in the 1920s – Prohibition – is still too fresh.

No-smoking regulations already applied to shopping centres are weakly enforced, so what hope have you of enforcing even stricter regulations for private premises?

The chairman of the Clear the Air (Talkback, December 12) group, Christian Masset, should check his facts. I am still a life member of the group.

I submitted a resignation some years ago, which was never acknowledged and the group has continued to send me members’ notices. I have also asked him as Clear the Air chairman to have a members’ general debate on the smoking issue, which was ignored.

The anti-tobacco lobby in Hong Kong and elsewhere has not been doing too well in recent years. Its weary message of doom for smokers is as stale as the lingering smell of smoke in an empty bar.

Clear the Air has unfortunately permitted itself to be hijacked by anti-smoking campaigners, seeking to reinforce their flagging message.

Most supporters believe in a far more noble cause than penalising smokers.

We believe the priority is to clean the filthy and unhealthy outside air we are compelled to breathe without choice.

This is what air pollution is really all about.

If Dr Mackay and Clear the Air get their way, they will drive smoking dens underground.

Or worse still, we will have larger groups of people hanging around on the pavements, blowing smoke into the faces of passers-by.

Leave the bars and entertainment spots alone.

P. A. Crush, Sha Tin

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Should The Full Smoking Ban Be Delayed?

Dec 17th, 2008
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Dec 17 2008 – SCMP

I continue to be perplexed by claims of those such as Lam Kwok-tung (Talkback, December 13) that there is a “right” to smoke in Hong Kong. Nicotine is a listed poison and deliberately applying poison to another person with the intent to harm is against the law.

Smokers know that second-hand smoke causes harm because in Hong Kong we usually blow the exhaled smoke as far away from our faces – and our friends’ faces – as possible.

It is also considered polite to hold a lit cigarette far away from friends’ faces – and direct it instead towards strangers.

Lam Kwok-tung is mistaken in believing that deliberately poisoning people is part of a civilised society.

It is a contravention of Chapter 212, which has the charming title of Offences Against the Person Ordinance.

His best choice, in order to stay within the law and reduce air pollution, is to quit.

Annelise Connell, Stanley

Should The Full Smoking Ban be Delayed?

Dec 11th, 2008
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11 Dec 2008 – SCMP

It beggars belief that anyone who claims to be concerned about air quality (P. A. Crush) should campaign for clean outdoor air while actively dismissing the impact of tobacco smoking on indoor air pollution (Talkback, December 6).

Both aspects of air pollution were highlighted and debated throughout the recent Clinton Global Initiative in Hong Kong and participants agreed that both were important and required attention in this region.

Dr Judith Mackay, director, Asian Consultancy on Tobacco Control

Should The Full Smoking Ban be Delayed?

Dec 11th, 2008
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SCMP – Updated on Dec 11, 2008

There has been much debate about whether or not the current exemptions that permit smoking in many bars should be extended.

The fact is, however, that many of these establishments are really restaurants, which also serve drinks.

They have somehow managed to get around the laws banning smoking in restaurants – the sooner that anomaly stops, the better.

There is little point in prohibiting smoking in restaurants if this simply results in groups of smokers lighting up on the street immediately by the open frontage of a restaurant. Their noxious fumes permeate the restaurant even though they may be technically outside. Regulations need to be introduced here, as they have been in other jurisdictions, banning smoking in the close vicinity of bars and restaurants.

Passers-by on the street are now subject to the smoke emitted by groups of smokers loitering outside almost every restaurant in town.

As you approach offices these days, those shirking work for a cigarette pollute the entrances and, incidentally, give an unfortunate first impression of the company that employs them.

Perhaps a way needs to be found for those determined to hurt themselves by smoking to be able to do so without subjecting passers-by to the known health dangers of passive smoking.

It is surely an absurdity for cigarettes to be sold tax-free at our frontier checkpoints, which not only deprives the government of that lost tax income but can be seen as offering encouragement to smokers who travel. The government loses twice over, because smokers are likely to cost the health services a lot when the deadly effects of their habit hit home in later years.

Let us be clear about the matter. Other dangerous drugs (Ice, heroin) are banned. That’s because taking them kills people. But for historical reasons, taking the almost equally dangerous tobacco products is still regarded by many as acceptable.

But smoking also kills people, thousands a day worldwide. While one person may choose to risk his health by smoking, he does not have the right to risk the health of others – passive smokers, that is – whose comfort and health he selfishly ignores.

It is high time more stringent measures were introduced to help limit the number of Hong Kong people who will die from smoking-induced illnesses.

Paul Surtees, Mid-Levels

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

Dec 9th, 2008
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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.

Recommendations:

  • 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.

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Should The Ban On Smoking In Bars Be Delayed?

Dec 6th, 2008
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Dec 06, 2008 – SCMP

James Middleton, chairman of the anti-tobacco committee of Clear the Air (Talkback, December 2), takes issue with the Entertainment Business Rights Concern Group (Talkback, November 28) and accuses it of wanting to profiteer by failing to protect catering workers from harmful cigarette smoke in bars and entertainment facilities which still permit smoking.

I, too, am a member of Clear the Air but have long argued that its remit should be cleaning up Hong Kong’s polluted atmosphere and the air pollution on our streets.

Smoking indoors is mainly a personal health issue, not a major pollution issue.

Clear the Air uses emotive language to try to convince the world that only it is right about indoor smoking in bars, to wit, “This flagrant attempt to abuse workers’ rights is typical and akin to the Liberal Party’s disregard for the health of workers in the catering industry”.

What Clear the Air ignores is that these workers and customers should also have the right to smoke if they so wish, provided they are in “smoking” premises.

I have a very small residual interest in an English pub and I can state truthfully that over 23 years, 95 per cent of the staff were smokers and wanted to smoke while on duty.

During this time not one of our customers was ever forced to come into our premises and inhale second-hand cigarette smoke. They had a choice – not to come in.

This never, incidentally, stopped the eminent Clear the Air tobacco group chairman, Mr Middleton, from visiting our premises.

The answer to this problem is not “separated smoking areas”, as now being considered by the government (this would not work), but “smoking” bars and entertainment facilities and “non-smoking” premises, depending on a business owner’s choice.

P. A. Crush, Sha Tin

What Do You Think of The Smoking Ban?

Dec 5th, 2008
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SCMP – Updated on Dec 05, 2008

It is unbelievable and embarrassing to read legislator Tommy Cheung Yu-yan’s claim that it is a human “need” to keep smoking, and that no law should ignore that need. (Talkback, May 14). His letter shows that he is still out of touch with reality, and is simply trying to hold on as long as possible to the support of the threatened tobacco lobby. His main constituency is the catering industry, and part of the reason for his claim that the recent smoking ban is painful to some of his members is because the government has yet again failed to live up to its moral obligations.

Smoke is a pollutant, and it also happens to be cancer-causing, not only to those who smoke but also to bystanders who inhale the exhaust from those who disregard themselves and others in their surroundings. In every city in the world that has – out of moral civic duty – installed a smoking ban, the catering industry has actually benefited.

The majority of the world is non-smoking, yet smokers end up ruining it for the rest of us, and we therefore do not patronise the venues which allow smoking. The catering industry should therefore benefit by catering to the majority. This is not rocket science.

The government’s weak stance to allow exemptions to the smoking ban has caused Mr Cheung’s constituents to lose out because there is not a level playing field.

If the government had done what was right for its citizens, and protected them from pollution and significant health risks, as the smoking ban was meant to do, then every catering establishment would have been equal. In an equal world, they can compete based on the quality of their food and service, which is what their main business is meant to be in the first place.

Customers will not stop eating just because the venues which allow them to carry out their “need” to smoke have been changed. Instead, the majority of the population, which the government seems to keep forgetting, can come out to eat because they can breathe. An economic analysis of these benefits is something Mr Cheung needs to carry out.

K. Lim, Wan Chai

Smoking Threatens Millions In China

Oct 5th, 2008
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Al Jazeera and agencies | 5 October 2008

Tens of millions of Chinese will die of lung diseases over the next 25 years unless the government takes action to combat smoking and the indoor burning of fuel, scientists have warned.

The study*, published on Saturday in the British journal, The Lancet, said chronic respiratory illness would kill 53.3 million, while lung cancer would leave another 13.5 million dead.

Half of Chinese men smoke and more than 70 per cent of Chinese households use solid fuels, such as wood, crop residues and coal for heating and cooking, providing a potent source of indoor air pollution, according to the study.

The paper – written by scientists from the Harvard School of Public Health in the US state of Massachusetts – said that smoke from tobacco products and indoor fuel use would be the cause of more than 80 per cent of all deaths from respiratory disease.

However, it suggests that a number of measures could be taken to dramatically reduce the risk, including building proper chimneys, air circular stoves with chimneys ending outside the house and ventilated ground stoves to reduce the toxic chemicals circulating indoors.

“There are proven ways to reduce tobacco smoking and to provide homes with clean-burning energy alternatives. China can save millions of premature deaths from respiratory diseases in the next few decades if it … implements these interventions,” Majid Ezzati, senior author of the study, said.

‘Tobacco epidemic’

Dr Sarah England, the technical officer at World Health Organisation’s Tobacco Free Initiative in China, told Al Jazeera that at least one million people were dying from tobacco related causes every year in China.

“The Chinese experience is particularly severe because there haven’t been enough steps taken yet to curtail the tobacco epidemic,” she said.

She noted that though the government had signed the global convention for tobacco control, the country still dominates sales and production.

“We see that China has a vested interest in tobacco production and marketing, and that is a tough thing for China to come to grips with as it tries simultaneously to curb the horrible health impacts that tobacco is exerting on the Chinese people,” she said.

More than 900 million of the world’s 1.1 billion smokers currently live in low-income and middle-income countries and about one half of the world’s population uses biomass and coal for household energy.

* Harvard University report published in the Lancet on 4 Oct 2008: Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China: a time-based, multiple risk factor, modelling study
BY Hsien-Ho Lin, Megan Murray, Ted Cohen, Caroline Colijn, Majid Ezzati

Nicotine Nation

Feb 20th, 2008
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SCMP David Eimer
Feb 20, 2008

A pall of smoke has been hanging over mainland cities for the past two weeks and, for once, it’s not pollution. Instead, it’s the acrid residue of the millions of fireworks and cigarettes that go up in smoke every Lunar New Year. The tobacco industry gets a massive boost during the holiday season, with cigarettes a favoured gift, and fireworks remain enormously popular despite the many deaths they cause.

In fact, it’s a surprise that more people don’t die from stray rockets. In Foshan last week, 15,000 cartons of fireworks exploded in a blast equal to a 1.1 magnitude earthquake that was felt as far away as Guangzhou. Typically, the explosion was caused by carelessly discarded cigarettes. But fireworks deaths are nothing compared with the 1 million people who die of smoking-related diseases each year. With 350 million smokers on the mainland, that death rate is expected to rise to more than 2 million by 2020.

All of which is at odds with the ethos of the Beijing Olympics. The arrival of the Games in China was supposed to herald a new age in public health, according to Vice-Minister of Health Gao Qiang . At the end of last year, he vowed to use the Olympics to improve public health. Last week, the World Health Organisation called for a concerted anti-smoking campaign.

So far, all authorities have done is ban smoking in the Olympic Village, as well as at the competition venues and the hotels where people involved with the Games will stay. But banning smoking in the Olympic Village is like banning razors in Afghanistan; it is unnecessary. Instead, it’s on the streets of Beijing and other cities that the government needs to concentrate its efforts.

It is true that Beijing’s taxi drivers face fines of 200 yuan if they are caught smoking in their cabs, but, like the much-vaunted 50-yuan fine for spitting, in practice no one gets penalised. Nor has the idea of making restaurants in the capital non-smoking been greeted with enthusiasm. At Beijing’s first smoke-free eaterie, customers have taken to locking the waitresses out of the VIP rooms while they have a quick puff.

Such is the lack of awareness about using the Olympics to spread the non-smoking message that a recent sohu.com survey showed almost 8 per cent of respondents still think smoking isn’t harmful. It also showed that half of all smokers couldn’t contemplate giving up as they were afraid of offending people who offered them a cigarette at times like the Lunar New Year.

Some would say this ignorance suits the government. After all, the mainland is responsible for one-third of the world’s tobacco production, all government controlled and worth 500 billion yuan a year. But putting revenue ahead of the public’s health is cynical in the extreme. With the Olympics less than six months away, it’s time the authorities put the same effort into combating smoking that they have into building a Beijing fit for the Games.

David Eimer is a Beijing-based journalist

US Anti-Tobacco Efforts

Jan 10th, 2008
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U.S. falls short in anti-tobacco efforts – report

Thu Jan 10, 2008 12:00am EST – Reuters
By Maggie Fox, Health and Science Editor

WASHINGTON, Jan 10 (Reuters) – The U.S. Congress and President George W. Bush have stymied efforts to tighten regulation of tobacco and discourage smoking and states have not spent nearly enough to battle cigarettes, the American Lung Association said on Thursday.

The group implied that heavy lobbying and spending by tobacco companies was influencing at least some politicians and urged Congress to give the Food and Drug Administration the authority to regulate cigarettes.

“While many states have failed to make meaningful progress at protecting their most vulnerable citizens, the tobacco companies are spending billions of dollars annually marketing their deadly products,” the report reads.

“A report issued by Common Cause and the Tobacco-Free Kids Action Fund found that the tobacco industry made almost $3 million in Political Action Committee contributions to federal candidates during the 2005-2006 election cycle, including more than $1.7 million in contributions directly to federal candidates,” it adds.

“The Institute on Money in State Politics found that tobacco companies and retailers gave over $96 million to state-level candidates, committees and ballot measure campaigns during the 2005 and 2006 election cycle.”

In 1998, states reached a settlement with tobacco companies in which they received $246 billion over 25 years to pay for the costs of smoking-related illnesses.

But anti-smoking campaigners say states have raided these and other tobacco-prevention funds to cover budget deficits, build roads or pay for non-tobacco related projects.

PRESIDENTIAL VETO

“While the American Lung Association applauds the U.S. Congress for increasing the federal cigarette excise tax by $0.61 to $1.00 per pack, unfortunately it was vetoed by the president and will not take effect,” the report read.

“The increased tax would have resulted in current smokers quitting and fewer children starting to smoke.”

The report praises efforts by some states.

“Twenty-one states, the District of Columbia and Puerto Rico have now approved comprehensive smoke-free air legislation,” it reads.

“In 2007, seven states — Illinois, Maryland, Minnesota, New Mexico, New Hampshire, Oregon and Tennessee — significantly strengthened their smoke-free air laws. Tennessee is the first traditional tobacco-growing state to pass strong restrictions on smoking in public places and workplaces.”

But states are slower to raise tobacco taxes — which several studies show can deter smokers. And they also do not spend nearly as much as is recommended on programs to prevent smoking and to help smokers kick the habit, the Lung Association complained.

“More than half of states have not passed comprehensive laws prohibiting secondhand smoke in workplaces and other public places,” the report reads.

“Until the political will can be found to implement the proven and effective policies graded in this report, over 438,000 people each year will continue to die from tobacco-related diseases.”

The Lung Association report accuses tobacco companies of marketing to youths and even to children with new flavored cigarettes and brightly colored packaging.

Nearly 21 percent of Americans smoke — a total of 45 million people, according to the U.S. Centers for Disease Control and Prevention.

(Reporting by Maggie Fox, editing by Todd Eastham)

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