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September 25th, 2011:

HK on track to becoming first smoke-free city

South China Morning Post — 25 Sept 2011

Just 11pc of adult residents use tobacco after steep falls in the habit thanks to restrictions on lighting up, tax increases and peer pressure, health experts say

The dwindling number of smokers in Hong Kong is setting the city on course to become the rich world’s first “smoke-free” city.

The current level of 11.1 per cent of people aged 15 or above who smoke in Hong Kong – the outcome of higher taxes, social factors and effective anti-tobacco campaigning – is believed to be the lowest in the developed world. The figure, released in August, is the result of a Census and Statistics Department survey of 13,375 households conducted from October to December last year.

Experts say the downward trend will continue as new tax increases take effect, sending smoking levels into single digits as the habit becomes more socially unacceptable.

The momentum could make Hong Kong the first city in the developed world to achieve “smoke-free” status – a level at which smokers make up 5 per cent or less of the adult population, a target set by countries including New Zealand and Finland.

Insurers consider someone who has consumed tobacco just once in the past 12 months to be a smoker, but Hong Kong health officials define a smoker as someone who smokes at least one cigarette a day. Those who smoke only on weekends are thus not considered smokers.

Dr Judith Mackay, a senior adviser to the World Lung Foundation and the World Health Organisation who has worked closely with the Hong Kong government on tobacco control since the 1980s, said there had been a profound change in attitudes.

“When I started with this work, you could smoke anywhere in Hong Kong,” she said. “There were massive billboards, advertising on TV, advertising on the radio and ubiquitous advertising and promotion.

“There were no smoke-free areas. You could smoke in cinemas, on buses, you could smoke anywhere. This has just been an incredible public health move.”

Three decades ago, nearly one in four adults smoked. Today, Mackay said, the city may be nearing an “end game” with the tobacco industry.

One reason for the low smoking rate is that it combined relatively low male smoking rates similar to Western countries with extremely low female rates of 3 per cent to 5 per cent – common to Asian countries.

But government initiatives took much credit for the recent, sharper downturn in smoking levels, Mackay argued. “What Hong Kong has done most recently is introduce the whole smoke-free-areas initiative plus the fact we have had tax increases – it’s as simple as that,” she said. “Plus, we are seriously beginning to introduce assistance with quitting for smokers.”

Mackay said a backlash from the tobacco industry was inevitable and pointed out legal actions had been launched globally to challenge moves towards declaring smoke-free areas.

Dr Raymond Ho Lei-ming, head of the Department of Health’s Tobacco Control Office, agreed that going below 10 per cent of smokers in the adult population could be a significant turning point. “We are trying to set a new cultural norm,” he said. “There will be more pressure on smokers to quit or at least to reduce if they can’t quit immediately. More importantly, it will help stop the next generation from taking up smoking.”