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January, 2009:

Smoking Rise Draws Call To Put Up Duties

Cigarette use up 13.8pc despite restaurant ban

Mary Ann Benitez – Updated on Jan 31, 2009 – SCMP

Anti-tobacco groups are calling on the financial secretary to raise tobacco duties after government figures show a 13.8 per cent rise in cigarette consumption since 2006 despite a smoking ban in restaurants. Low tobacco duties – which have not changed since April 1, 2001 – have made Hong Kong cigarettes among the cheapest available in developed economies.

Customs and Excise Department figures show that 38.2 million more cigarettes per month were consumed last year than in 2006.

The ban on smoking in indoor public places was introduced in July 2007, but some bars and karaoke clubs were given a two-year exemption. That exemption will end in July, but already there has been a movement to postpone the move.

The pressure to raise the tobacco tax is greater this year due to the financial downturn, and anti- tobacco groups say it is high time the government increased tobacco duties to cut consumption, especially among young people.

The Council on Smoking and Health (Cosh) has been using the internet to rally support for a policy that would increase duties by 5 percentage points above inflation.

Cosh said it would submit the virtual signatures from its campaign and its proposal for a so-called health tax policy to Financial Secretary John Tsang Chun-wah before he delivers the 2009-10 budget on February 25.

Customs figures show that smokers lit up 3.79 billion cigarettes last year, compared with 3.33 billion in 2006, the year before the partial ban went into force. In 2007, 3.49 billion cigarettes were consumed.

“The remaining smokers are consuming more. The price is as cheap as in 2001 and they can still go out to pubs and karaokes and nightclubs and smoke to their hearts’ demise,” said Clear the Air’s smoking committee chairman James Middleton.

“The figures in Hong Kong set an example to the world of how not to enact a smoking ban.”

The duty was last raised in the 2001-02 financial year – from 76 cents to 80 cents per cigarette.

Anthony Hedley, professor of the University of Hong Kong’s department of community medicine, said he was “very pessimistic” that Mr Tsang would choose public health over business.

Philip Morris Asia cautioned against excessive increases in the tobacco duty, saying it would support “regular and moderate tax increases” but there should be no change in times of deflation.

A spokeswoman said excessive tax would encourage smuggling, as was seen in the 1990s.

Customs figures show a decline in smuggling attempts in recent years.

The anti-tobacco lobby said census projections for restaurant receipts last year – the first full year the partial smoking ban had been in place – were HK$78.21 trillion, more than 27 per cent up on 2006 receipts. The figures were evidence, the campaigners said, that the smoking ban had not hurt the restaurant trade, as the industry had feared.

Professor Hedley said top officials “need to take tobacco out of Hong Kong business, stop pretending this is like any other business”.

Chinese University department of community and family medicine professor Wong Tze-wai said the government should view tobacco in the same category as petrol.

“We put tax on items that create some harm for other people, such as petrol,” Professor Wong said. “Why do we want to tax petrol? [It is] because we want to discourage its consumption and excessive pollution.”

A spokesman for Mr Tsang said: “Public consultation [on the budget] is in progress now. We welcome all views and we have an open mind.”

Cigarette Consumption Rises in Hong Kong

Cigarette consumption rises in Hong Kong after smoking ban

31 Jan 2009, 0938 – Times of India

HONG KONG: Cigarette consumption in Hong Kong is up almost 14 percent since a smoking ban was introduced in the city two years ago, a news report said on Saturday.

Government figures quoted by the South China Morning Post show that 3.79 billion cigarettes were bought in 2008, compared to 3.33 billion the previous year.

Anti-smoking campaigners quoted by the newspaper said they wanted taxes on cigarettes in the city of 6.9 million raised significantly in the government’s annual budget in order to reverse the trend.

A pack of cigarettes in Hong Kong costs an average of 30 Hong Kong dollars ($3.86), about half the price of a pack in Singapore and Australia.

Smoking was banned in restaurants and bars in Hong Kong in 2006, but karaoke bars, nightclubs and thousands of bars that don’t serve food were granted exemptions until July 2009.

Should The Smoking Ban Be Delayed?

Updated on Jan 30, 2009 – SCMP

Non-smoker Callan Anderson (Talkback, January 23) states that current laws are forcing smokers onto the footpaths. He argues (as would tobacco company spokesmen) for certain establishments to apply for exemptions “so that those who want to smoke can, and those who do not smoke do not have to go in”.

He avoids the point that anti-smoking laws are enacted to protect the workers in all workplace premises and they are legally entitled to a safe working environment.

Because the government granted qualified establishment exemptions under political pressure, Hong Kong smokers now consume 38.2 million more duty-paid cigarettes per month than in pre-ban 2006 while the number of people smoking has actually gone down.

Studies from Duke University [in the US] show that pictures of people smoking stimulate the cravings of people to smoke even when they are trying to quit.

More than 1,300 people die from passive smoking in Hong Kong per year.

Mr Anderson mentions the financial impact of the smoking ban and suggests “full implementation be delayed or amended to help the catering and entertainment industry”.

Again, these are words spouted worldwide by tobacco companies trying to maintain their business by forecasting doom and gloom.

In fact Hong Kong restaurant trade takings were up 30.2 per cent in the third quarter of 2008 compared with the third quarter of pre-ban 2006.

It is strange to read a stated non-smoker quoting Big Tobacco mantras.

He states, relating to the history of opium and tobacco in Hong Kong, that “governments were all too happy to propagate [them] for tax-raising reasons until very recently”.

The treatment of smoking-related illnesses and loss of productivity costs Hong Kong HK$5.3 billion per year versus only HK$3.06 billion collected in tobacco taxation. When loss of life is included, the annual cost of smoking to Hong Kong is HK$73.32 billion.

In the Legislative Council 18 months ago a motion was raised to ban smoking on the street within a set distance of building entrances and this was put on the shelf. It is time it was raised again along with tobacco taxation.

James Middleton, chairman, anti-tobacco committee, Clear the Air

Decreased Aortic Elasticity In Children Exposed To Tobacco Smoke

Childhood exposure to tobacco smoke (verified with serum cotinine levels) decreases aortic elastic properties in healthy children…

Title: Decreased aortic elasticity in healthy 11-year-old children exposed to tobacco smoke

Authors: K Kallio, E Jokinen, M Hämäläinen, M Saarinen, et al.

Reference: Pediatrics 2009; 123: e267-273, http://pediatrics.aappublications.org/cgi/content/abstract/123/2/e267

Reviewer: Joaquin Barnoya, MD, MPH, ProCor contributing editor, Director, Research and Education, Unidad de Cirugia Cardiovascular de Guatemala, Guatemala

Purpose of study: To assess the association of exposure to tobacco smoke with elastic properties of the aorta and carotid artery in children.

Location of study: Finland

Study design: Healthy young (age 11 years) children were selected from a randomized, prospective, atherosclerosis prevention trial (Special Turuk Coronary Risk Factor Intervention Project for Children [STRIP] trial). Smoking habits of all family members were assessed annually with a questionnaire. Aortic and carotid elasticities were determined by using M-mode ultrasound imaging based on measurements of blood pressure and arterial diameter changes during the cardiac cycle. The aortic stiffness index, Young’s elastic modulus (YEM), and distensibility and the respective studies for the carotid artery were calculated. Exposure to tobacco smoke was measured using serum cotinine and classified as no-exposure (undetectable levels), low exposure (cotinine levels 0.2-1.6 ng/ml), and high exposure (levels >=1.7 ng/ml).

Results: A total of 386 children were included in the analysis. A significant increase in aortic stiffness index, YEM and aortic disetensibility was observed across the cotinine levels. After adjustment for BMI and systolic blood pressure, cotinine levels remained a significant explanatory variable regarding all aortic elasticity indices. Carotid elasticity indices were not statistically significant across cotinine groups.

Comment: This study adds to the mounting evidence of the cardiovascular effects of secondhand smoke, this time in healthy young children. One of the strengths of this study is that they used three indices to assess the mechanical properties of elastic arteries and all were found to be associated with cotinine levels. The fact that they did not find an effect of tobacco smoke on carotic stiffness might be a result of the aorta being affected before the carotid artery. This biological data on children add to the mounting evidence to fight for smoke-free environments worldwide.

Should The Smoking Ban Be Delayed?

Updated on Jan 24, 2009 – SCMP

Your correspondents Michael Pieper and Anthony Hedley (Talkback, January 14 and 20) and columnist Christine Loh Kung-wai (“Silence is not golden”, January 15) are misinformed if they believe that only drivers of diesel-powered commercial vehicles and buses are the main culprits responsible for Hong Kong’s atrocious roadside air pollution readings.

I must take issue with their suggestion that petrol-powered cars (or even hybrids) do not emit poisonous gases and particulates in significant quantities.

Fine particulates from petrol engine exhausts may not be as easily visible to the naked eye as the black sooty smoke churned out by old and poorly maintained diesel engines, but these particulates are even more likely to be inhaled and end up deeply embedded in our lungs.

That petrol engines produce greater concentrations of poisonous gases (volatile organic compounds and carbon monoxide) than diesels is not even disputed by scientists. And have your correspondents never heard of a car driver’s contribution to global warming?

Our most traffic-congested areas are usually Central, Causeway Bay and Mong Kok, and it is no coincidence that these are the districts with the highest levels of roadside air pollution.

These are also the very areas with the highest concentrations of private cars, exacerbating the congestion and slowing down other vehicles.

Unless we wish to shut down all commerce, we have to accept that goods vehicles and buses are needed in these areas, but we do not need so many private cars on the streets there. The public transport system is adequate.

If we removed most of the private cars from downtown areas and the cross-harbour tunnels, we could relieve a considerable part of traffic congestion – and this would lower the pollution from diesel trucks and buses that are forced to idle or crawl in slow-moving traffic.

The “near empty” buses some of your correspondents complain about would carry more passengers and the increased fare revenue would then permit the bus companies to upgrade to buses with improved emission standards much earlier.

Private car drivers are contributing more to outside air pollution than any smoker.

Other contributors to these columns have used the word “hypocrisy” for car drivers who think otherwise. I can think of no better description myself.

P. A. Crush, Sha Tin

Should The Smoking Ban Be Delayed?

SCMP – 23rd Jan 2009

I refer to the letter by Winnie Fong (Talkback, January 17) with regard to the no-smoking laws, and take exception to smokers being defined as selfish.

As a non-smoker, I can appreciate that some smokers are less than considerate, but as the new legislation has pushed them all onto our footpaths, it is hardly surprising that we are now more aware of smokers than before.

First, whether you like smokers or not, the current legislation does not prevent people smoking. In fact, it has been reported that smoking among teenagers has increased year on year, not declined.

What the legislation does is put smokers on the street.

One can argue that smoking is an anti-social habit and impacts all those it comes into contact with, but I would argue that I would much prefer to allow (even through a licence, as one would do with alcohol for bars) certain establishments to apply for exemptions so that those who want to smoke can, and those who do not smoke do not have to go in.

Surely this is better than the current situation, where the smoke is pushed outside so we get a good lungful every time we pass a group of stressed-out office workers puffing away.

The chief executive must have considered the financial impact of the smoking ban in the current economic climate, and the possibility that its full implementation could be delayed or amended to help the catering and entertainment industry. This must especially be the case, considering that the British bar and restaurant sectors have been decimated since the country put similar laws into place.

Create legislation by all means, but in their current form the smoking regulations need to be revisited.

Hong Kong was established on the opium and tobacco trade, and although that was a long time ago, we should not go around picking on people for an addictive habit that governments were all too happy to propagate for tax-raising reasons until very recently.

Callan Anderson, Quarry Bay

Smuggling Of Cigarettes To The Mainland

Three convicted over smuggling of cigarettes to the mainland

Loretta Fong – Updated on Jan 23, 2009 – SCMP

The former chairman of Hong Kong-based Nanyang Brothers Tobacco Co and two company officials were convicted in the District Court of pocketing commissions and smuggling cigarettes to the mainland.

Lu Dayong, 60, who has fled the city, and his lover, Ko Kit, 40, a director of Hang Chun Trade Development, were found guilty of a joint charge of conspiracy to accept an advantage from a cigarette trader, Golden Leaf International Development. They received more than HK$7.5 million.

The pair, with Chan Kai-san, 41, a Hang Chun sales manager, were also convicted of a count of conspiracy to defraud Nanyang Brothers. The trio were acquitted of a bribery charge.

Nanyang Brothers, a subsidiary of publicly listed Shanghai Industrial Holdings, made the Double Happiness brand of cigarettes in Hong Kong. Double Happiness was the brand smuggled to the mainland.

The marathon trial of the cigarette smuggling racket, which was delayed for months, finally began last June.

Defence lawyers had contested the legality of the Independent Commission Against Corruption’s investigation, arguing evidence collected by a bugging device was inadmissible because it violated the Basic Law.

Judge Joseph Yau Chi-lap rejected the argument, and a request for a judicial review of that decision was also rejected.

The prosecution said the three were caught during covert surveillance discussing the cigarette shipments or commission payments, and said anti-graft agents found Lu kept a diary on the commission payments and cigarette shipments. The offences happened between December 2002 and February 2004.

The prosecutors said Lu approved Hang Chun and Golden Leaf as overseas distributors for Nanyang Brothers cigarettes. The cigarettes were smuggled to the mainland from Hong Kong via the Philippines, Cambodia and Vietnam, the court heard.

Prosecutors said the commissions were paid through various parties from the mainland in the form of deposits, cash and company or casino cheques to bank accounts controlled by unknown conspirators and Ko. She held the funds on Lu’s behalf in her bank accounts.

Judge Yau said evidence showed Lu controlled Hang Chun, despite Ko being listed as its director. He said Lu concealed the fact that Double Happiness cigarettes were actually being sold to a company Lu controlled and said this was dishonest. Judge Yau said their dishonest act caused economic loss to Nanyang Brothers and put the company at economic risk.

Sentencing for Ko and Chan was adjourned to February 20, pending background reports.

Smoking Exacts a Heavier Toll Than Previously Expected

By Todd Neale, Staff Writer, MedPage Today – Published: January 22, 2009 – Reviewed by Zalman S. Agus, MD; Emeritus Professor – University of Pennsylvania School of Medicine.

DAVIS, Calif., Jan. 22 — Exposure to tobacco smoke may be causing a much greater proportion of cancer deaths than previously estimated, researchers here said.

Among Massachusetts men, selected as a representative sample, there was a close correlation in changes in mortality rates from lung cancer and other cancers, Bruce Leistikow, M.D., of the University of California Davis, and colleagues reported online in BMC Cancer.

This suggested that the fraction of all cancer deaths attributable to smoking was 73%. A 2001 government estimate using data from the Cancer Prevention Study II, placed the fraction at 34%, according to Dr. Leistikow.

“The full impacts of tobacco smoke, including secondhand smoke, have been overlooked in the rush to examine such potential cancer factors as diet and environmental contaminants,” Dr. Leistikow said. “As it turns out, much of the answer was probably smoking all along.”

Action Points

Explain to interested patients that this study suggested that exposure to tobacco smoke accounts for almost three-quarters of all cancer deaths, not just those from lung cancer.

Point out that the study was performed using data from men living in Massachusetts and that the results may not be applicable to other states or females.

Previous estimates of the impact of smoke exposure on cancer death have been made using methods that are not universally applicable across population subgroups and that rely almost exclusively on self-reported smoking measures, according to Dr. Leistikow and colleagues.

The findings suggest “that increased attention should be paid to smoking prevention in healthcare reforms and health promotion campaigns,” he said.

Indeed, recent efforts to prevent smoking seem to be paying off. The rate of deaths from all causes that were attributed to smoking dropped from 288 to 263 deaths per 100,000 people from 1996-1999 to 2000-2004, according to a report in the Jan. 23 issue of the CDC’s Morbidity and Mortality Weekly Report.

Previous estimates of the impact of smoke exposure on cancer death have been made using methods that are not universally applicable across population subgroups, according to Dr. Leistikow and colleagues.

So they used a simpler and more representative and less biased method for assessing the impact that involved examining the associations between mortality rates for lung and all other cancers.

Lung cancer death rate was used as an indicator of cumulative smoke load.

Using data from the National Center for Health Statistics, the researchers examined cancer mortality rates among men living in Massachusetts from 1979 to 2003.

Rates peaked around 1992 and then declined steadily through 2003.

A scatter plot of mortality rates for lung cancer and for other cancers showed a strong association between the two over the study period, which suggests “that tobacco smoke load is a potential cause of most prematurely fatal cancers in this population,” the researchers said.

The percentage of all cancer deaths attributable to tobacco smoke exposure was 73% for all men and 74% for men ages 30 to 74.

In absolute terms, that works out to be 196 deaths per 100,000 men.

The researchers said the study findings were strengthened because of the inclusion of all non-lung cancers, the use of sizeable, representative, and recent male populations, and the use of age-adjusted death rates.

Previous estimates of the impact of tobacco smoke exposure on cancer mortality sometimes used outdated lists of which cancers were related to smoking, relied on smoking status as a measure of tobacco smoke exposure, and involved smaller and racially homogenous populations, they said.

The researchers acknowledged some limitations of the current analysis, including the potential for extrapolation from population-level associations to individual risks to yield inaccurate estimates, the inability to apply the results to females, to residents of other states, or to longer-term trends, and the inability to distinguish between types of smoke exposure.

Future research should focus on developing biochemical measures of individual exposure to tobacco smoke, studying cancer disparities among larger and more racially diverse populations, and examining why the association between mortality rates from lung and other cancers varies in different populations, they said.

Research needs aside, they concluded, “the improved ability to assess the population effect of tobacco smoke damage can be used to better inform cancer control policy, including the regulation of tobacco products and smoking in public places.”

Ex-Tobacco Chief Convicted of Bribery

January 22, 2009 – News.gov.hk

The former chairman of a tobacco manufacturer, charged by the ICAC, was today convicted at the District Court in his absence of bribery and fraud in relation to cigarette-smuggling activities.

Lu Dayong – the 61-year-old former chairman of Nanyang Brothers Tobacco Company – absconded and failed to turn up for the trial last June, and the court issued a warrant for his arrest.

Lu, Hang Chun Trade Development’s director Ko Kit, 40, and sales manager Chan Kai-san, 41, were found guilty of one count of conspiracy to defraud Nanyang Brothers.

Lu and Ko were also convicted of conspiracy for accepting an advantage from cigarette trader Golden Leaf International Development (Hong Kong).

Judge Joseph Yau adjourned the case until February 20 for sentence, pending background reports. Ko and Chan were remanded in the Correctional Services Department’s custody.

The court heard Lu, then Nanyang Brothers chairman, approved Hang Chun and Golden Leaf as overseas distributors for Nanyang Brothers’ cigarettes.

Between November 2003 and February 2004, Lu, Ko and Chan concealed from Nanyang Brothers that Lu had interests in Hang Chun, and caused Nanyang Brothers to supply “Double Happiness” cigarettes to Hang Chun, knowing the cigarettes would be sold in the Mainland, in violation of contracts between Nangyang Brothers and Hang Chun.

Nanyang Brothers subsequently sold $48 million worth of cigarettes to Hang Chun.

Lu and Ko received more than $7.5 million in illegal commissions from two directors and shareholders of Golden Leaf between April 2003 and February 2004 as a reward for causing Nanyang Brothers to sell “Double Happiness” cigarettes worth $42 million to Golden Leaf.

The cigarettes sold to Hang Chun and Golden Leaf were prohibited from sale in the Mainland, but they had been smuggled there through other places including the Philippines and Vietnam.

Should The Smoking Ban Be Delayed?

Updated on Jan 20, 2009 – SCMP

I can understand why P. A. Crush (Talkback, January 10) and Cynthia Henderson (Talkback, January 15) want to try to dismiss my arguments for protection from tobacco smoke as churned statistics, because they would not want this issue to be encumbered with facts.

With more space we could discuss the distribution of the more than 40 tonnes of exhaled and sidestream tobacco smoke in Hong Kong between lungs, furniture, fittings and outdoor air.

In the meantime I am grateful to Mr Crush for his colourful description of one of the consequences of smoking indoors as “yellow filth” which “clings to the walls”. I am confident that a large majority would not regard this as any longer legitimate or want the air space in their building to be threatened by the creation of such a toxic waste dump.

Our parks should be smoke-free for several reasons and Ms Henderson underestimates the impact of tobacco smoke on air quality in the vicinity of smokers. For example, in Finland tobacco smoke particulates in outdoor cafes were 5 to 20 times higher than on pavements of busy streets.

On cruise ships, exposure to cancer-causing tobacco chemicals tripled despite strong wind and unlimited space for dispersion. At the University of Maryland, outdoor tobacco smoke was measurable 7 metres from the source (www.repace.com) .

Ms Henderson does make a strong point about vehicle emissions and we have consistently demonstrated the monetary and health benefits of cleaner air and building railways rather than roads in Hong Kong.

While I certainly regard restriction of private car use as a public health benefit and use public transport whenever possible, Hong Kong’s main traffic polluters are outdated diesels in commercial and public transport which (as Christine Loh Kung-wai points out in her column) the government refuses to regulate on a mandatory rather than voluntary basis (“Silence is not golden”, January 15). Whether my current occasional use of a car amounts to “hypocrisy”, others can decide.

If Ms Henderson wants to campaign for traffic-free zones in Sai Kung or anywhere else I will support her, but she should not be willing to trade off one potent source of pollution for another.

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