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October, 2006:

Chow Takes Flak Over Smoke Room Idea

Health chief York Chow Yat-ngok has come under heavy fire from pro- democracy lawmakers for the government’s “U-turn” on the controversial anti-smoking bill by proposing that smoking rooms be installed in some public areas.

Caroline Kim and Carrie Chan – Friday, October 20, 2006 – The Standard

Health chief York Chow Yat-ngok has come under heavy fire from pro- democracy lawmakers for the government’s “U-turn” on the controversial anti-smoking bill by proposing that smoking rooms be installed in some public areas.

The secretary for health, welfare and food was even accused of harboring political motives – to the extent of trying to win the catering sector’s votes in next year’s chief executive election.

“The allegations are ridiculous and groundless,” Chow retorted, denying that the “U-turn” was politically inspired.

“Definitely not. First of all, we have had no position on smoking rooms for some time. The concept of smoking rooms differs in different sectors. There are people who think that a smoking room is a place where you can smoke, enjoy food as well as other activities,” he said Thursday. “The proposal that I have now, [on which] we haven’t decided, and that we would like to investigate, is to find a room that might be able to allow people to smoke but would not allow any services or any other activities, something very much like those in the airport. Whether this is technologically and scientifically proven, and also technically feasible, then we have to investigate.”

Chow went on to defend the government’ stance: “If you look at the banned areas now, a lot of people, in particular smokers, would be forced to smoke on the street. Knowing that Hong Kong is such a densely populated area, we might encounter a lot of smokers in certain areas. If we could allow them to smoke in a confined space rather than disturbing pedestrians and non-smokers, then we would be able to more successfully segregate smokers and non- smokers. So, that is the main reason why we think that we need to look at this problem.”

After the bill’s passage, Chow told reporters: “We want the public to know that smoking will decline progressively and now is a good time to quit. The passage of the ordinance marks a historical moment and is a step forward for Hong Kong in becoming a smoke-free city.”

Catering sector lawmaker Tommy Cheung Yu-yan was accused of conspiring with Chow to support his amendments, which proposed adaptation periods of 90 days for restaurants.

But Cheung repeatedly denied the accusations, insisting he was not under political pressure. Although non- smokers will be able to enjoy smoke- free venues, the law is expected to negatively effect restaurants, the catering industry and karaoke operators, which are expected to be hit hardest, with an expected 20 percent loss in revenue.

But Hong Kong Federation of Restaurants and Related Trades president Simon Wong Ka-wo said: “If the people want it, we will find a way to deal with it.”

According to Wong, major restaurant companies have already begun organizing seminars and training frontline employees and executives on how to deal with the new law.

However, Wong said the transition will be most difficult for the city’s 5,500 smaller restaurants where blue-collar workers mostly eat, and smoke. Wong also said he feared that law enforcement will not be adequate, even with the recruitment of 30 inspectors by the Tobacco Control Office.

For Anthony Lock Kwok-on, managing director of one of Hong Kong’s major karaoke operators, California Red, it is a matter of changing a whole culture. “We will try hard to prepare for the changes but it’s more complicated than just replacing ash trays with no smoking signs,” he said.

In addition to all indoor areas and workplaces, smoking will not be allowed in outdoor areas at hospitals, universities and public swimming pools.

Hong Kong Anti-Tobacco Law

20 October, 2006

US judge refuses to let tobacco companies silence Hong Kong anti air-pollution group – agrees to hear Clear The Air arguments

With the Trademark “Marlboro Lights” at risk, Clear The Air may be able to accomplish what the Government and Legco failed to do in yesterday’s Smoking Ordinance amendment. On Oct. 10, Judge Kessler granted the pro-clean air organization permission to be heard in the US court.

The new Hong Kong anti-tobacco law, passed on Thursday, gives Philip Morris until 2008 to take the Marlboro Lights brand off the market. If the US judge agrees with Clear The Air, Philip Morris will be required show no objection to Clear The Air’s application for revocation of the “Marlboro LIGHTS” trademark in Hong Kong and anyone can then sell cigarettes with that name until 2008, destroying the value of the brand to Philip Morris

Smoking Rooms Proposed To Protect Non-Smokers

October 19, 2006 –

Secretary for Health, Welfare & Food Dr York Chow has reiterated the proposed establishment of “smoking rooms” aims to protect non-smokers, adding both the public and lawmakers will be widely consulted if the concept is found feasible.

He told reporters today when the new anti-smoking law comes into effect, many smokers may have to resolve to pursue their habit in open spaces. Non-smoking road users may probably be left without a choice but to become second-hand smokers.

“The primary consideration for setting up ‘smoking rooms’ is for the protection of non-smokers’ interest by separating smokers from non-smokers. The study will take one to two years to complete,” Dr Chow said.

The proposed ‘smoking rooms’ are meant to offer a venue to smokers for the sole purpose of smoking and no other activities. It has to be technically feasible to effectively bar emissions from leaking from the room, so as not to pollute air outside and jeopardise non-smokers’ health.

The bureau has not begun the study. Neither is there any conclusive evidence on its feasibility, nor has any consideration been given to details such as where these rooms should be installed.

If the idea is deemed viable, the bureau will widely consult the public. It will put forward a relevant proposal to the legislature and go through the usual legislative procedures before putting anything in place.

Regarding previous discussions on ‘smoking rooms’ by the Bills Committee on the 2005 Smoking (Public Health) (Amendment) Bill, it was a proposal of a different concept – a room with an independent ventilation system installed in the premises of the hospitality industry for its guests to enjoy the normal activities that the venue offers. At no stage has the bureau taken this proposal on board, and the bureau remains firmly against it.

Smoking Ban Set For Start

Legislators have overwhelmingly passed the controversial anti-smoking bill banning smoking in all indoor workplaces and restaurants and selected outdoor areas such as parks and beaches after a marathon nine-hour debate.

Caroline Kim – Thursday, October 19, 2006 – The Standard

Legislators have overwhelmingly passed the controversial anti-smoking bill banning smoking in all indoor workplaces and restaurants and selected outdoor areas such as parks and beaches after a marathon nine-hour debate.

The vote on the Smoking (Public Health) (Amendment) Bill 2005 – with 52 in favor and two abstentions – paves the way for the ban to come into effect from the start of next year.

The bill, which went through its first and second readings Wednesday, exempts certain places of entertainment such as mahjong parlors, massage houses and nightclubs until July 1, 2009. It will go through its third reading today.

Secretary for Health, Welfare and Food York Chow Yat-ngok shocked lawmakers with a last-minute announcement that the government will, over the next year or two, study the feasibility of allowing smoking rooms at public parks and beaches.

Tommy Cheung Yu-yan, Albert Chan Wai-yip, Andrew Cheng Kar-foo and Kwok Ka-ki introduced further amendments to the bill.

The Democratic Party’s Cheng, who has been advocating a complete ban on smoking at outdoor recreational parks, stuck to his original amendment, which prohibits the sale of tobacco products to people in school uniform.

Kwok, the medical sector representative who has also consistently pushed for a total smoking ban in outdoor recreational parks, expressed concern over exposure to secondhand smoke at theme parks such as Ocean Park, despite previous letters from the park’s management stating that smoking areas have already been designated throughout the facility.

“More than HK$5.3 billion has already been spent on medical care for people with illnesses related to secondhand smoke, while 14,000 people are dying each year from both smoking and secondhand smoke,” Kwok said.

Chow, reiterating his previous stance on Kwok’s amendment, said: “The designated smoking areas are places where there are very few visitors.”

Kwok, questioning the government’s decision to introduce the provision during the last stages of the bill, said: “If you’re referring to smoking rooms in restaurants, that means you’re taking a regressive step when we have spent over 150 hours already on the bill’s review.”

Chow said that “although a trial of newly constructed smoking rooms failed to be viable, we’ll conduct studies within the next one or two years to seek a feasible ventilation system.”

Kwok argued: “The government has imposed the idea of smoking rooms for the sake of industries.”

Hong Kong Federation of Restaurants and Related Trades president Simon Wong Ka-wo said: “The catering industry and customers will get used to a total smoking ban in two years. The introduction of smoking rooms is, therefore, totally unnecessary.

“Creating separate smoking rooms could cost up to HK$500,000 each. It is not viable for small traders,” Wong said.

Both Chan and Cheung withdrew their amendments to smoking rooms following the government’s proposal to conduct a further study on the matter.

“I cannot support this bill because there are just too many loopholes,” Chan said.

The government did not support Chan’s other amendment for a complete exemption for bars, mahjong parlors and other venues, which have been granted a two-year grace period.

“If we want customers to continue patronizing restaurants and bars, the government needs to invest more in education and publicity,” The Frontier’s Emily Lau Wai-hing suggested.

Chow said the government would not support an amendment prohibiting smoking in queues at bus stops and transportation interchanges, as proposed by several lawmakers.

Martin Lee Chu-ming, who has been lobbying for an anti-smoking bill for almost a decade, said Hong Kong should learn from the United States, where a health warning was recently issued against secondhand smoke, saying that inhalation of secondhand smoke can increase the risk of contracting heart diseases and lung cancer by up to 30 percent.

Representatives of the Hong Kong Federation of Trade Unions and the Democratic Alliance for the Betterment and Progress of Hong Kong stressed the importance of individuals’ rights, stating that the law should not deprive people of their freedom and choice.

About The New Anti-Smoking Bill In Hong Kong

Thursday, October 19, 2006 – Tobacco Control Radio

Experts slam ‘half-baked’ anti-smoking bill: Allowing brand promotion on non-tobacco items will mean heavy public health cost, says professor Anthony Hedley.

The city will pay heavily for a bill that still allows tobacco companies leeway to promote their products, anti-smoking experts have said.

Anthony Hedley, chair professor of the University of Hong Kong’s department of community medicine and director of its tobacco control research and policy unit, said he was unhappy that after much delay in scrutinising the anti-smoking bill, it was still not good enough.

“For this city to come out with such a half-baked piece of legislation is just unbelievable. I’m very disappointed. It’s not an effective public health document,” he said.

“What we are seeing is continued and actually successful methods to maintain normality of tobacco in this town. and we will pay for that with public health.”

The Smoking (Public Health) (Amendment) Bill 2005 was still having its second and third readings in Legco last night.

The bill imposes a smoking ban in bars and restaurants on a staggered basis from January 1 next year to July 1, 2009.

All cigarette packets will have to carry a graphic health warning and terms such as “low tar” will be banned from 2008. Tobacco advertising will be banned at all retail outlets from November 1 next year and at all licensed hawker stalls from November 1, 2009.

Last year, the University of Hong Kong estimated the total cost of active and passive smoking was HK$5.3 billion, not including 6,920 deaths last year related to smoking. Professor Hedley warned the delayed enforcement of the law would be costly.

“We can’t say where that figure is now,” he said. “We definitely can say there will be a cost in terms of tobacco promotion and recruitment of young people to nicotine addiction. Because of the brand extension issue, there will be a cost to the health of the hospitality industry’s workers, and there will be a cost which will be attributable to the `light’ and `mild’ terms. If that is not effectively dealt with, then we will still have a large number of people who believe these cigarettes are safer, that they are not as lethal as they really are.”

Professor Hedley singled out the way the government inserted a clause allowing brand extensions – the use of tobacco brand names and logos on non-tobacco products such as clothes and shoes.

“There are very serious questions to be answered about how this [clause] got into the consultation document, why it was not changed, and why the bureau refused to consider it now,” he said.

Judith Mackay, senior World Health Organisation adviser on tobacco, wanted to know why the government took five years to legislate.

The green paper was first tabled in 2001, when the smoking bill had not been amended since 1997.

“Why this huge delay? Was it because of some Legislative Council members? Was it something like Sars? Or was it [government] ineptitude,” Dr Mackay asked.

The next step would be to implement the WHO’s Framework Convention on Tobacco Control. “Hong Kong has to be more vigorous against smuggling,” she said.

Professor Hedley said one measure was to increase tobacco duty, which had not risen for six years. “That is a device which has made our tobacco some of the cheapest in the world now relative to GDP,” he said.

An international brand cost HK$22 per pack, compared with HK$35 to HK$36 before, he said.

“It does not make any sense. This is supposed to be a business-orientated government. It should be making money out of the tobacco industry, not the tobacco industry making money out of the government and the people.”

The much-delayed and amended bill that will ban smoking from January 1 at most indoor workplaces and public places was finally passed into law yesterday.

But controversy continued over the last-minute revelation by Secretary for Health, Welfare and Food York Chow Yat-ngok that the government will study the feasibility of smoking rooms in restaurants and entertainment venues.

The Smoking (Public Health) (Amendment) Bill 2005 was passed 2-1/2 hours after the debate resumed yesterday. The meeting was adjourned after nine hours on Wednesday night as legislators went through 18 amendment clauses.

Dr Chow hailed its passage as “historic”.

“In the end the government managed to find a balance to help Hong Kong move towards a no-smoking society. Today was a historic moment for both the community and for myself,” he said. “It makes Hong Kong one of the most widely controlled smoking areas in the world.”

But before the bill went through its third reading, bills committee chairman Andrew Cheng Kar-foo, of the Democratic Party, pressed Dr Chow as to why there was an apparent U-turn on the government’s position on smoking rooms.

Mr Cheng said verbatim records of the committee’s meetings on three occasions showed Dr Chow’s bureau and the Department of Health insisting that smoking rooms were “unacceptable in the absence of WHO safety standards”.

Dr Chow argued: “The Democratic Party looks at it conspiratorially, whether there is a plot behind it. I would not be influenced by anybody.”

Much of yesterday’s debate focused on Mr Cheng’s amendment to prohibit the sale of tobacco products to children in school uniform.

But catering sector legislator Tommy Cheung Yu-yan, who wore his school colours, said: “We are not legislating to catch vendors selling cigarettes to young people.”

Judith Mackay, director of the Asian Consultancy on Tobacco Control, who watched the debate from the public gallery, said she was disappointed the amendment banning sales to children in school uniform was not passed.

“That seems extraordinary. The vendors are not allowed to ask for ID cards. It would have been much easier for the vendors if there was a ban on school uniforms,” she said.

The Committee on Youth Smoking Prevention, which represents 310 primary and secondary schools and 10 parent groups, said it was outraged. “We would like to register our extreme anger,” it said in a statement. “The government says it wants to discourage children from smoking yet it would not support the school uniform amendment.”

The law empowers the secretary for health to appoint inspectors to enforce the ordinance and removes the statutory requirement for managers to display no-smoking signs. The grace period before licensed hawkers must not display tobacco ads will be extended from one year to November 1, 2009.

Nightclubs, commercial bathhouses, massage establishments, mahjong parlours, designated mahjong rooms in clubs and certain bars must implement the smoking ban by July 1, 2009.

Public parks will have designated smoking zones. The law prohibits the display of descriptive words on tobacco packets and retail containers that may have a misleading or deceptive effect.

Relationship with Amount Smoked and Cigarette Type

Cotinine Concentration in Smokers from Different Countries: Relationship with Amount Smoked and Cigarette Type


This four-country study examined salivary cotinine as a marker for nicotine intake and addiction among smokers in relation to numbers and types of cigarettes smoked. Smoking characteristics of cigarette smokers in Brazil, China, Mexico, and Poland were identified using a standard questionnaire. Cotinine concentration was measured using a saliva sample from each participant; its relationship with numbers and types of cigarettes smoked was quantified by applying regression techniques. The main outcome measure was salivary cotinine level measured by gas chromatography. In all four countries, cotinine concentration increased linearly with cigarettes smoked up to 20 per day[11.3 ng/mL (95% confidence interval, 10.5- 12.2)] and then stabilized as the number of cigarettes exceeded 20 [6.8 ng/mL per cigarette (95% confidence interval, 6.3-7.4) for up to 40 cigarettes]. On average, smokers of regular cigarettes consumed more cigarettes and had higher cotinine levels than light cigarette smokers. Cotinine concentration per cigarette smoked did not differ between regular and light cigarette smokers. Results suggest a saturation point for daily nicotine intake and minimal or no reduction in nicotine intake by smoking light cigarettes. (Cancer Epidemiol Biomarkers Prev 2006;15(10):1799–804)

You can find the complete study on the Relationship with Amount Smoked and Cigarette Type here.