Hong Kong
Hong Kong leads mainland in war to cut smoking
http://www.ejinsight.com/20161209-hong-kong-leads-mainland-in-war-to-cut-smoking/
When a person goes to buy a packet of cigarettes in Hong Kong, he or she faces two obstacles. One is the price — Double Happiness at HK$43 and Marlboro at HK$57 — the result of a tobacco tax up to 68 per cent of the price.
The other is the hideous image on the packet of the worst consequences of smoking.
A survey by the Economic Intelligence Unit earlier this year ranked Hong Kong as the eighth most expensive city in the world for a packet of branded cigarettes, at US$7.48.
Top was London with US$14.30, followed by New York with US$13.67 and Singapore with US$9.15.
These two measures, along with the creation of smoke-free areas in public and work places, have been effective in cutting the number of smokers.
According to government figures, the percentage of daily cigarette smokers aged 15 and above in Hong Kong in 2015 was 10.5 percent, down from 10.7 percent in 2012 and 23.3 per cent in the early 1980s.
The mainland, the world’s largest tobacco market with 316 million smokers in 2015, has only recently started to learn the lessons of Hong Kong.
Since 2010, the number of smokers has increased by 15 million and cigarette production risen by 35 per cent.
The health warnings are written, not visual, and appear modestly at the bottom of the packet. They would not frighten any first-time user.
In 2015, China increased the tobacco tax to 40 per cent. Consumption tax from tobacco in 2015 was 536 billion yuan, an increase of 60 billion from a year earlier. The recommendation of the World Health Organisation (WHO) is that the tax should be 70 per cent of the retail price.
“There is certainly room for future tobacco tax increase,” said Jian Shi, director of the information office of the Taxation Research Institute at the State Administration of Taxation in Beijing.
“In some western countries, the tobacco tax rate has reached 70-80 per cent. The room for the increase needs to be considered based on the development goal of the industry and the condition of national revenue.”
Health professionals argue that increasing the tobacco tax is the quickest and most effective way to cut smoking — by both preventing young people from starting and encouraging smokers to quit.
According to WHO figures, each increase of 10 per cent in the price will cause 3.7 per cent of adults and 9.3 per cent of teenagers to stop smoking.
Antonio Kwong Cho-shing, chairman of the Hong Kong Council on Smoking and Public Health, said that selective or modest hikes would not make much of an impression on smoker numbers in Hong Kong.
“Only a 100 per cent increase in tobacco tax would induce people to quit smoking,” he said. If the government accepted this proposal, an average pack would cost HK$119.
The Department of Health has proposed an enlargement of the health warning.
It said on Nov. 23 that the area of the graphic health warning shall be of a size that covers at least 85 percent of the two largest surfaces of the packet or the retail container and that the number of forms of health warning should be increased from six to 12.
The situation in the mainland is years behind. The biggest obstacle is that the State Tobacco Monopoly Administration (STMA), the world’s biggest manufacturer of cigarettes, is also the industry regulator.
This is despite years of lobbying by China’s health professionals, the WHO and the norms practised around the world. They argue that the two must be separate institutions.
According to WHO figures, 1.2 million die each year in China from smoking-related diseases; this number will double by 2025.
Jian Shi put it succinctly. “The major difficulty lies in that the related departments have quite different views on this matter, and it is difficult for them to reach agreement on this matter. That will cause obstruction to policy making and implementation.”
The STMA opposes graphic health warnings and higher taxes because they would hurt its sales and profits. Yet, simply due to global population expansion, there will be more smokers in 2040 than there are today, so it is difficult to believe that this concern is genuine.
The health lobby has had some success, in the modest increase in tobacco tax and restrictions on smoking in indoor public areas and workplaces and some outdoor areas introduced in Beijing in June 2015. Other mainland cities have taken similar measures at different times.
On Dec. 6, the Beijing Commission of Health and Family Planning said that more than 2,700 people had been fined for violating these restrictions, with total fines of 142,500 yuan, as of Nov. 30 this year.
Professor Dr Judith Mackay, based in Hong Kong and Asia’s leading anti-tobacco campaigner, said that the price of cigarettes in China is still extremely low.
“The latest small tobacco tax increase, while laudable, will not have a serious, sustained effect on reducing smoking. It is time to review the whole tobacco tax structure in China, significantly increase the price of cigarettes and thus protect the health of the Chinese people.
“In Australia, there is a regular increase of 12.5 per cent tobacco excise tax every year. The cost of a packet could soon rise to A$40 (HK$230). Hong Kong and China should both consider long-term tobacco tax planning in this way, so that tobacco control proceeds in an orderly form, and immense energy and time is not wasted year by year in campaigning for a tax increase. Otherwise, thousands will die.”
Dozens quit smoking thanks to HKU service hotline
Dozens of smokers have successfully kicked the habit with the help of a hotline set up by the University of Hong Kong.
Altogether, 1,147 people have used the service in the past five years, of whom 233, or 23.5 percent, have stopped smoking, the Hong Kong Economic Journal reports.
The success rate was achieved within six months.
Project director Dr. William Li said the average age of participants was 19.9 years.
Three in five were students including three in 10 who used to smoke more than 10 cigarettes a day.
Just 10 percent of the help seekers have cut down on their tobacco intake.
Li said the situation is “quite worrying” but some cases are promising.
Ah-Tung, 18, started smoking a year ago because of pressure from school and personal relationship issues.
He used to consume half a pack of cigarettes a day.
An avid runner, he decided to seek help after noticing his health had deteriorated.
“I could only complete two laps on the jogging track when I was a smoker, but soon after I quit, I was capable of doing a lot more laps,” he said.
Li said Ah-Tung’s case is typical.
About 43 percent of the people who called the Youth Quitline said they suffer from emotional stress.
Li said those who are emotionally disturbed are more easily influenced by their peers would usually find it more difficult to quit smoking.
HKU School of Nursing also found that 60 percent of young smokers who tried to quit smoking have switched to electronic cigarettes (e-cigarettes), according to Ming Pao Daily.
The percentage was even higher among younger smokers.
Among e-cigarette smokers aged 25 and below, 43 percent are between 15 and 17 while those aged between 18 to 20 make up 35 percent of the group, followed by those from 21 to 25, which makes up 14 percent.
Lam Tai-hing, chair professor of the School of Public Health of the HKU Li Ka Shing Faculty of Medicine, said the success rate among traditional cigarette and e-cigarette smokers is more or less the same.
The figures suggest that e-cigarettes do not help smokers get rid of nicotine addiction, Lam said.
He said more effort is needed to educate the public about the dangers of smoking.
Lam also called for legislation to ban e-cigarettes.
Youth Quitline (5111 4333) targets smokers aged 25 and below.
E-cigs ‘no help to youths’
Younger smokers are more prone to the lure of e-cigarettes, a University of Hong Kong study suggests.
http://www.thestandard.com.hk/section-news.php?id=176207&story_id=47118855&d_str=20161111&sid=4
HKU researchers interviewed 469 of the 622 participants who joined the Youth Quitline between January 2014 and last April on their knowledge, attitude and practice of using e-cigarettes. About 60 percent have used e-cigarettes, with their mean age at 17.8 years.
Lam Tai-hing, chair professor of community medicine at HKU’s school of public health, said it shows younger smokers are more prone to the threat of e-cigarettes.
It was found they also have lower confidence in quitting and the nicotine dependence level was also significantly higher than for the rest of the youth smokers, which Lam said shows e-cigarettes cannot help smokers quit.
“Basically, other than nicotine, we do not know exactly what other toxic substances may be present,” Lam said, adding that e-cigarettes come in thousands of flavors and whose compositions are unknown.
He called on the government to speed up its work to bring a total ban on e-cigarettes.
Jointly established by the university and the Hong Kong Council on Smoking and Health, the scheme has helped 23.3 percent of participants kick the habit within the six-month follow-up period.
HKU researchers call for total ban on e-cigarettes
http://news.rthk.hk/rthk/en/component/k2/1295926-20161110.htm
Researchers at the University of Hong Kong called for a total ban on the sale of electronic or e-cigarettes on Thursday, warning that they pose a very dangerous health risk, and may entice young children to start smoking.
They interviewed 469 smokers under 25 who had called the university’s smoking cessation hotline, and found children as young as 12 had tried e-cigarettes.
The researchers said e-cigarettes “tend to attract young people much more than adults, and there is actually strong evidence – not from Hong Kong yet, but from other countries – that many non-smoking young people started with e-cigarettes before becoming regular conventional cigarette smokers”.
Secondhand Smoke From Multiple Sources
Secondhand Smoke From Multiple Sources, Thirdhand Smoke and Respiratory Symptoms in Hong Kong Adolescents
Lok Tung Leung, BSc Sai Yin Ho, PhD Man Ping Wang, PhD Tai Hing Lam, MD
https://academic.oup.com/ntr/article-abstract/doi/10.1093/ntr/ntw302/2410723/Secondhand-Smoke-From-Multiple-Sources-Thirdhand
Abstract
Introduction:
Reports on involuntary tobacco smoke exposure in children have focused mostly on secondhand smoke (SHS) from smoking inside the home. We studied the separate and combined prevalence of SHS exposure from multiple sources and thirdhand smoke (THS) and the associations with respiratory symptoms in Hong Kong adolescents.
Methods:
In 2010–2011, 61 810 Secondary 1 (US Grade 7) to seven students reported their smoking status, respiratory symptoms, and exposure to four sources of tobacco smoke in the past 7 days. Weighted prevalence of exposure was calculated. Associations with respiratory symptoms were analyzed in 50 762 never smokers using logistic regression.
Results:
Tobacco smoke exposure at home was 23.2% considering SHS exposure from inside the home, but increased to 33.2% including SHS from neighbors and 36.2% further including THS. Including SHS outside home (55.3%), 63.3% of adolescents were exposed to SHS anywhere or THS at home. In never smokers, SHS from each source and THS at home were linearly associated with respiratory symptoms. Exposure to more sources yielded stronger associations with respiratory symptoms (p for trend<.001).
The adjusted odds ratios (95% CI) were 1.04 (0.97–1.11), 1.12 (1.03–1.22), 1.40 (1.26–1.56) and 1.99 (1.74–2.28) for 1, 2, 3, and 4 sources, respectively.
Conclusions:
Although Hong Kong’s smoking prevalence is among the lowest in the developed world, over 60% of its adolescents were involuntarily exposed to tobacco smoke from one or more sources with a linear association with respiratory symptoms in never smokers. More stringent policies are needed to protect adolescents from tobacco smoke.
Implications:
In a high-density urban setting, involuntary exposure to tobacco smoke in adolescents can be much higher than the smoking prevalence of the general population, especially if SHS exposure from multiple sources and THS are also considered. Such exposures have important health implications as demonstrated by their linear associations with respiratory symptoms. Tobacco control measures effective in reducing smoking prevalence may have little effect in reducing adolescent exposure to tobacco smoke, especially in the private home, in which other public health strategies are urgently needed.
Revamped tobacco law a burning issue
http://www.thestandard.com.hk/section-news.php?id=175435&story_id=47096440&d_str=20161024&sid=4
Hong Kong needs to revamp its tobacco laws to deal with new tobacco and nicotine products, business and public health experts say.
But while business wants a “coordinated” regulatory approach, experts say the government should ban all new products.
Regulations on e-cigarettes in Hong Kong are still pending, while tobacco companies are planning to bring in “heat not burn” products, which they say carry a “reduced risk” when compared with traditional cigarettes.
Philip Morris is hoping to introduce a new product to Hong Kong, one that swept Japan within two years of its initial launch with an estimated 4.1 percent of the market share.
The product is different from traditional cigarettes in that it does not involve burning – users put the specially designed tobacco sticks into a holder which heats it up to about 300 degrees Celsius to generate a nicotine- containing aerosol.
The lit end of a cigarette can reach temperatures of up to 800 degrees, and the high temperature sparks the combustion process that breaks down tobacco into more than 7,000 types of chemicals, many of which are harmful or potentially harmful compounds, said Nveed Chaudhary, scientific communications manager of Philip Morris International.
Heated by a comparatively low temperature, the aerosol of the “heat not burn” product is 90 to 95 percent less toxic than the smoke of traditional cigarettes, Chaudhary said.
James Arnold, external affairs director for reduced risk products at Philip Morris Asia, said although the products can be sold under existing laws, the outdated product classification made it difficult for the product to fit into existing regulations, such as reporting duty and putting on the right health warning labels.
Daniel Ho Sai-yin, an associate professor in the School of Public Health at the University of Hong Kong, said: “We should say ‘no’ to the new tobacco products.”
Instead of plugging the holes every time a new tobacco product comes out, the government should ban them all, he said.
“We cannot be so naive to assume that only the smokers will switch to the ‘heat not burn’ products,” Ho said, adding that the products may appeal to youths and those who have already quit smoking. Resources should be spent to control existing products, by increasing tobacco tax and a makeover of cigarette packaging.
“There is no safe level for harmful substances,” a Hong Kong Council on Smoking and Health spokesman said, accusing the tobacco companies of trying to encourage smoking with the new products.
A Food and Health Bureau spokesman said: “We will closely monitor the development and devise our legislative proposal accordingly.”
Market expert: Regulating e-cigarette “a one-way direction”
http://harbourtimes.com/2016/10/20/market-expert-regulating-e-cigarette-a-one-way-direction/
The Hong Kong government has been urged to reconsider its plan to ban e-cigarettes as they can be a much less harmful alternative to tobacco cigarettes in nicotine delivery – if regulated properly.
Dr Stephen Jenkins, director in regulatory and medical affairs of Nicoventures in the Asia-Pacific region, is in Hong Kong reaching out to lawmakers to garner support for e-cigarette regulation instead of a total ban. Earlier in June, legislator Kwok Wai-keung (郭偉強) of the Federation of Trade Unions revealed that the current administration will propose banning the imports and sale of e-cigarettes in the 2016/2017 LegCo term.
Dr Jenkins stresses that e-cigarette, without tar and the process of combustion, is 95% less harmful than traditional cigarettes and is the most frequently used device to quit smoking, citing much-quoted reports from Public Health England and Royal College of Physicians. He also notes that Canada and New Zealand have recently announced that they will move to regulate e-cigarette, and there is a review undergoing in Australia. The World Health Organisation has also taken a step back by taking out complete ban as a recommended policy option in its latest report on Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS) for the seventh session of the COP (COP7). A more concrete stance from the influential health body is expected after COP7 which will be held in November.
“Our view is electronic cigarettes, as they are in Europe, should have dedicated regulation to ensure that they are available to smokers and not sold to under 18s, with quality standards in place to ensure that the devices and liquids are reliable,” Dr Jenkins puts. “The data and the experience globally is clearly in one direction: that they should be available and they should be regulated. […] I am very happy to have an open discussion with the [Hong Kong] government and be challenged on the evidence.”
Other countries in Asia that already have regulation in place, or are looking into introducing one include South Korea, Indonesia and Malaysia.
Evidence-based
Nicoventures is a company set up in 2010 by British American Tobacco (BAT) which focuses on the development and commercialisation of non-tobacco nicotine products. The company has made written submissions to the LegCo’s Panel on Health Services back in June last year and to Secretary for Food and Health Dr Ko Wing-man (高永文) in early 2016. It has also requested a meeting between Dr Jenkins and government representatives but the invitation was turned down by the government. In response, the Food and Health Bureau stated that it has received submissions from various groups supporting its legislative proposal and the tobacco trade, and that it is in the process of studying the submissions.
Under the Pharmacy and Poisons Ordinance (Chapter 138), nicotine is a Part I poison in Hong Kong and that e-cigarette containing nicotine is regarded as pharmaceutical product and must be registered with the Pharmacy and Poisons Board before sale or distribution. E-cigarette without nicotine is however unregulated under current laws.
“I hope that the government can present more justifications before presenting its proposal of a total ban in front of the LegCo,” Kwon Wai-keung earlier told Harbour Times. “In the meantime there should be amendments to the Smoking (Public Health) Ordinance to keep e-cigarettes away from the minors.”
As Dr Jenkins adds, studies in the UK and Europe have already dismissed the ‘gateway theory’ as less than 1% of e-cigarette users, or vapers, being non-smokers. One study sampling 27,460 EU citizens shows 1.3% of never smokers used nicotine-containing e-cigarettes, with 0.09% reporting daily nicotine use. The report also notes over one-third of current e-cigarette users polled reported smoking cessation and reduction. He warns that a complete ban will only lead to the emergence of a black market flooded with low quality products.
“Even with a ban in place, e-cigarette devices will remain easily accessible to Hong Kong people as more than 90% of them are produced in Shenzhen,” Dr Jenkins argues. “So what we need to do is to ensure that those products coming into Hong Kong are reliable and traceable.”
“From a health policy perspective, [e-cigarette] is quite unique. The speed of change globally around this area is outstanding. People are making choices and looking for the government to help them. This bottom-up approach is encouraging countries to look at the data and opt for regulation,” Dr Jenkins asserts. “I never think it’s too late. The evidence is so strong that I’m sure as soon as people are aware of it, they will have to consider it.”
Biggest seizure of illicit tobacco in 14 years for Hong Kong, as HK$24 million worth of cargo uncovered
The haul was stashed among pillows in a container allegedly destined for Australia
Hong Kong customs officers seized cargo from Vietnam containing HK$24 million worth of illicit tobacco leaves on Monday, marking the biggest haul of its kind in 14 years.
Officers intercepted a container from Haiphong at the Kwai Chung Customhouse Cargo Examination Compound. Import documents claimed the 40-foot container was carrying pillowcases.
“When officers opened the container for inspection, they found about 5,300kg of suspected illicit tobacco that had not yet been rolled into cigarettes, loaded with 146 cartons of pillows and pillowcases,” Romy Cheuk Yu-sing, the divisional commander of the Ports and Maritime Command overseeing containerised cargo, said. She added the haul had a duty potential of about HK$12 million.
It was unclear if Vietnam was the source port, but authorities believed the syndicate used Hong Kong as a transit point and the illicit tobacco was likely destined for Australia.
“Hand-rolled cigarettes are popular in Australia, and the tobacco tax there is double that of Hong Kong’s,” Parry Wu Yan-kit, deputy head of the Revenue and General Investigation Bureau, said.
“Smugglers can avoid about HK$24 million of tax if the products are successfully trafficked into the country,” he added.
Wu said the syndicate adopted a complicated water route so as to avoid surveillance from law enforcement agencies along the way.
No arrests have been made, and local authorities will contact their counterparts in Australia and Vietnam for further investigation.
The case follows two previous busts of tobacco trafficking – one in 2014 and another in 2015. Both hauls totalled 1,113kg in tobacco leaves.
Three similar cases were also uncovered in 2013, involving 7,553kg of illicit tobacco products.
On September 21, customs officers seized illicit cigarettes with a market value of about HK$54 million and duty potential of about HK$38 million in two containers arriving from Haiphong.
Some 20 million Karelia brand cigarettes from Greece were found hidden in two 40-foot shipping containers, believed to be destined for Europe. It was one of the biggest seizures of illegal cigarettes in the city since 2007.
Under the Import and Export Ordinance, the maximum penalty for smuggling is a fine of HK$2 million and imprisonment of seven years.
http://www.scmp.com/news/hong-kong/law-crime/article/2038684/hong-kong-customs-officers-make-second-major-seizure