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Passive Smoking

Is The Smoking Ban Effective?

Do you think the smoking ban is effective?

Jan 12, 2008 – SCMP

But how about taxis?

There is no curb on either drivers or passengers smoking in these small spaces. Hong Kong administrators should note that Japan virtually banned all smoking in taxis whether it be by passengers or the drivers themselves.

It will be a great day when I can drive a few kilometres and not have to witness a taxi driver with his window wide open spilling cigarette ash, and probably the butt as well, on to our roads or pavements, winding up his window and then driving away.

No wonder most taxi cabins smell filthy.

J. R. Paine, Chai Wan

Do you think the smoking ban is effective?

Jan 12, 2008 – SCMP

The smoking-ban legislation has been in force for a year now and I think it has been ineffective. As I am a non-smoker, I sometimes find it hard to breathe on our streets because there are so many people smoking. The law mostly applies to indoor public places. It does not stop people lighting up on the street, and the number of smokers in Hong Kong has not decreased.

The fact is that non-smokers are exposed to second-hand smoke in our streets, and so they continue to face a health risk.

I would like to see a blanket smoking ban, including outdoor areas. This would help protect non-smokers and might help some smokers kick their habit.

Angel Lau Ho-yan, Tung Chung

Smoking in Cars Hazardous

Smoking in cars more hazardous than previously thought 2008-01-04 05:56:55

LOS ANGELES, Jan. 3 (Xinhua) — Smoking inside a vehicle is more dangerous to health than previously thought, health experts said on Thursday.

Smoking inside vehicles makes the air 10 times more toxic than the federal government says is hazardous for breathing, said Kimberly Belshe, secretary of the California Health and Human Services Agency.

She was making the remarks in downtown Los Angeles while launching a campaign to ban smoking inside cars.

The city of Los Angeles enacted a newly enacted state law unveiled on Thursday, which bans drivers from lighting up in the presence of children.

“Our efforts to address the dangers of secondhand smoke in California began over a decade ago,” said Belshe.

“Today, our state continues to be a leader by ensuring that children and youth traveling in cars are not exposed to secondhand smoke,” she said.

Under the “Smoke-free Cars with Minors” law, a violation is punishable by a 100-dollar fine.

Children who are exposed to secondhand smoke have a greater risk of asthma attacks, ear infections, bronchitis and pneumonia, according to state health officials.

Long-term exposure has been linked to heart disease and lung cancer in adults.

“Infants and children are especially susceptible to the harmful effects of secondhand smoke,” said Mark Horton, director of the California Department of Public Health.

“Smoking in a car, or any confined space, increases the level of pollution inhaled by children and adults, thereby increasing the likelihood of suffering from the negative health effects of secondhand smoke.”

In 1994, smoking was banned in California workplaces. Four years later, smoking was banned in bars.

Editor: Yan Liang

It’s Time To Build On Smoking Ban’s Success

LEADER Jan 02, 2008 SCMP

The year-old public smoking ban has, without doubt, saved lives by reducing people’s exposure to second-hand smoke. But as a society, we have not made much headway in encouraging smokers to quit or discouraging others from taking up the deadly habit. The ban, therefore, has only been a partial victory for public health in Hong Kong.

As we report today, tobacco imports for local consumption rose slightly last year compared with the 12 months before the ban was introduced in January last year. Customs seizures of smuggled cigarettes also shot up. Much work lies ahead if we are to reduce the number of smokers in the city and the cost to public health services. Still, what the anti-smoking ban has already achieved deserves recognition and celebration. It has overcome the resistance and scepticism of the food services industry. Many restaurateurs who originally complained about a drop in business from smoking customers now acknowledge that business has returned to normal; many say their establishments now attract non-smoking customers who tended to avoid them in the past. Their experience will, it is hoped, convince operators of massage and mahjong parlours, nightclubs and bars to comply with the law when their exemption from the ban expires on June 30 next year.

But the ban’s most important result is no doubt the number of lives that have been saved from diseases caused by the inhalation of other people’s smoke. Though the ban is only a year old, that number should be significant.

According to the US surgeon general, there is no safe level of exposure to second-hand smoke, which increases the risk of a heart attack by 30 per cent for non-smokers. This is on top of other smoke-related diseases they may develop from exposure.

Two new authoritative overseas studies, cited by the Hong Kong Council on Smoking and Health, find that the number of heart attack admissions to hospitals dropped considerably just one year after a public smoking ban was imposed. Nine hospitals in Scotland experienced a 17 per cent drop in heart attack admissions a year after a ban was introduced in March 2006. New York State hospitals had, in general, an 8 per cent decline in admissions in 2004 after an anti-smoking law was introduced the year before. There is no reason to doubt something comparable has been achieved in Hong Kong with our own smoking ban.

But we need to do more. Food and Health Bureau officials should move quickly to streamline the ban’s enforcement by replacing the current summons system with a fixed penalty. This has widespread support among lawmakers, and its prompt passage by the Legislative Council is virtually guaranteed. What’s more, it will save the courts time and resources in having to handle summonses for smoking violations.

An unfortunate side effect of the indoor smoking ban is that it has pushed more smokers to light up in the streets. This has caused many people to complain frequently about having noxious fumes blown in their faces. In many overseas cities, people are banned from smoking outside main entrances to buildings and other public facilities. A similar ban should be considered in Hong Kong. Some established office buildings have already set aside smoking corners to stop smokers from causing a nuisance at entrances.

As a liberal society, we cannot outlaw smoking, but we should certainly do our best to ban the noxious practice where we can and frown upon it when we can’t.

Hong Kong Smoking Ban

What do you think about the smoking ban after a year?

Published in the SCMP – Updated on Dec 31, 2007

We should look ahead at how to make the prohibition of smoking in restaurants and other places in Hong Kong more effective in 2008 and beyond.

The ban has resulted in smoke-free shops, hotel lobbies and some (but not all) bars and restaurants. Dining out in a smoke-free atmosphere makes for a great improvement but too many bars-cum-restaurants have exemptions, making the visitor obliged to inhale smoke emitted by others.

That carries with it even greater health risks to the unfortunate staff, who are obliged to breathe in second-hand smoke every day at their workplace. The long-term effects of this will sadly mean illness, even death, for some of them.

The sooner these numerous exemptions are withdrawn, the better.

In public areas where smoking is supposed to be prohibited, smokers are often seen indulging their habit. These include train stations and the Central escalator, for example.

More effective enforcement action is clearly needed in such places.

Many restaurants have set up smoking areas outside their entrances, with an open frontage to the street. Consequently, patrons inside are still subjected to smokers’ fumes, blown in off the street. Clearly, such smoking areas should be out of range of the restaurants.

Office building approaches are now littered with discarded fag ends and when you visit an office block, you often have to pass by people smoking heavily on both sides of the entrance. Firms should make provision for smokers on a rooftop or terrace, and there should also be in-house quitting campaigns.

As the intention of the legislation is to see a general reduction in smoking, the duty-free allowance for cigarettes should be withdrawn.

More sustained campaigns against smoking are clearly needed. But this first year of partial prohibition has generally been accepted and is certainly to be welcomed.

What is now needed is to stiffen the provision of anti-smoking methods, as outlined above, with the intention of better safeguarding the health of us all, smokers and non-smokers alike.

Paul Surtees, Mid-Levels

Smoke-Free Policy Legislation Failure

The Editor
South China Morning Post

Dear Sir

Paul Surtees (Talkback 31 Dec) provides an excellent summary of the frank failure of the current smoke-free policy legislation to protect large numbers of people from tobacco smoke. The catering industry ,while not fully supportive of the policy, did ask the government to at least give them a level playing field. They didn’t get it and since then the Department of Health has expended considerable resources trying to deal with manoeuvres to by-pass the legislation.

One way of doing this is simply to change the venue’s name to include the word “bar”. Others pretend they can be non-smoking at certain hours of the day or days of the week when they want to attract different clientele, including families and offer children’s menus. At the same time they defend their exempted status with spurious arguments about the proportion of their revenue from alcohol sales. All this is understandable given the vagaries of the Bill and the unequal constraints placed on their ability to compete for custom.

The government will privately argue that covert deals with vested interests were needed to push through the tobacco control Bill. In doing so they abrogated their duty of care to the workforce and with over 1300 exemptions subjected thousands of workers to irreversible harm to their heart and lung function. The government ignored the overwhelming global evidence that second-hand smoke kills and that comprehensive smoke free policies ultimately benefit the hospitality sector.

Paul Surtees rightly looks to make the policy more effective, but the government is now looking at proposals by The Hon. Tommy Cheung Yu Yan and British American Tobacco to create smoking rooms in catering venues. Nothing could be more
damaging to the industry, workers, patrons and the health care system of Hong Kong.

Anthony Hedley
School of Public Health
University of Hong Kong

Secondhand Smoke Causes Disease in Non-Smokers

This admission that secondhand smoke causes disease is published on the Philip Morris USA website here:

Smoking & Health Issues

Secondhand Smoke

Secondhand smoke, also known as environmental tobacco smoke or ETS, is a combination of the smoke coming from the lit end of a cigarette plus the smoke exhaled by a person smoking.

Public health officials have concluded that secondhand smoke from cigarettes causes disease, including lung cancer and heart disease, in non-smoking adults, as well as causes conditions in children such as asthma, respiratory infections, cough, wheeze, otitis media (middle ear infection) and Sudden Infant Death Syndrome. In addition, public health officials have concluded that secondhand smoke can exacerbate adult asthma and cause eye, throat and nasal irritation.

PM (Philip Morris) USA believes that the public should be guided by the conclusions of public health officials regarding the health effects of secondhand smoke in deciding whether to be in places where secondhand smoke is present, or if they are smokers, when and where to smoke around others. Particular care should be exercised where children are concerned, and adults should avoid smoking around them.

We also believe that the conclusions of public health officials concerning environmental tobacco smoke are sufficient to warrant measures that regulate smoking in public places. We also believe that where smoking is permitted, the government should require the posting of warning notices that communicate public health officials’ conclusions that secondhand smoke causes disease in non-smokers.

No Smoking Area Research Paper

Designated ‘‘no smoking’’ areas provide from partial to no protection from environmental tobacco smoke

T Cains, S Cannata, R Poulos, M J Ferson and B W Stewart

The full research paper can be downloaded here: No Smoking Area Research Paper

Objective: To determine the efficacy of designated ‘‘no smoking’’ areas in the hospitality industry as a
means of providing protection from environmental tobacco smoke (ETS), and whether certain design
features assist in achieving this end.

Methodology: In the greater metropolitan region of Sydney, a representative group of 17 social and
gaming clubs, licensed to serve alcoholic beverages and in which, apart from designated areas, smoking
occurs, agreed to participate. In each establishment, simultaneous single measurements of atmospheric
nicotine, particulate matter (10 mm; PM10) and carbon dioxide (CO2) levels were measured in a general
use area and in a designated ‘‘no smoking’’ area during times of normal operation, together with the
levels in outdoor air (PM10 and CO2 only). Analyses were made of these data to assess the extent to which
persons using the ‘‘no smoking’’ areas were protected from exposure to ETS.

Results: By comparison with levels in general use areas, nicotine and particulate matter levels were
significantly less in the ‘‘no smoking’’ areas, but were still readily detectable at higher than ambient levels.
For nicotine, mean (SD) levels were 100.5 (45.3) mg/m3 in the areas where smoking occurred and 41.3
(16.1) mg/m3 in the ‘‘no smoking’’ areas. Corresponding PM10 levels were 460 (196) mg/m3 and 210
(210) mg/m3, while outdoor levels were 61 (23) mg/m3. The reduction in pollutants achieved through a
separate room being designated ‘‘no smoking’’ was only marginally better than the reduction achieved
when a ‘‘no smoking’’ area was contiguous with a smoking area. CO2 levels were relatively

Conclusion: Provision of designated ‘‘no smoking’’ areas in licensed (gaming) clubs in New South Wales,
Australia, provides, at best, partial protection from ETS—typically about a 50% reduction in exposure. The
protection afforded is less than users might reasonably have understood and is not comparable with
protection afforded by prohibiting smoking on the premises.

More Proof Secondhand Smoke Damages Lungs

Published by WebMD on the 27th of November, 2007

More Proof Secondhand Smoke Damages Lungs

(WebMD) For the first time, researchers say they have evidence that long-term exposure to secondhand smoke can cause structural damage in the lungs that is indicative of emphysema.

Their study also suggests that the modified magnetic resonance imaging (MRI) technique used to detect the lung damage may be able to spot emphysema long before symptoms occur.

The researchers used global helium-3 diffusion MRI to study the lungs of 13 current or former smokers and 45 people who had never smoked. Of the nonsmokers, 22 had heavy exposure to secondhand smoke, meaning they lived with a smoker or worked in a bar for at least a decade. None had symptoms of lung disease.

The modified MRI detected signs of early lung damage in 67 percent of smokers and 27 percent of nonsmokers with heavy exposure to secondhand smoke, says researcher Chengbo Wang, Ph.D., of the Children’s Hospital of Philadelphia.

In contrast, only 4 percent of nonsmokers who had never smoked and had fewer than 10 years of exposure appeared to have signs of early lung damage, he says.

The research was presented here at the annual meeting of the Radiological Society of North America (RSNA).

Modified MRI Detects Lung Damage

Wang tells WebMD that it’s long been thought that prolonged exposure to secondhand smoke can cause lung damage and emphysema, but doctors lacked a way to prove it.

“Previous methods of detection weren’t sensitive enough,” he says.

Helium-3 diffusion MRI offers more detailed images of the lungs than previous techniques, he says.

It works like this: first, helium gas is polarized with a laser; this makes it more visible on MRI.

Then, while lying in a conventional MRI scanner, a person inhales the energized helium. In just six seconds, the scanner collects images showing how the helium gas distributes in the tiny air sacs called alveoli in the lung.

Prolonged exposure to cigarette smoke causes the walls of the air sacs to break down and the air sacs to become bigger and bigger – early signs of emphysema, Wang says.

As a result, helium travels much further in people with enlarged air sacs than in people with healthy alveoli, he explains.

“Using helium MRI, we were able to detect microscopic changes suggestive of emphysema in smokers and people exposed to secondhand smoke,” Wang says.

RSNA spokeswoman Katarzyna Macura, M.D., Ph.D., of Johns Hopkins Medical Institutions in Baltimore, tells WebMD that the modified MRI needs to be studied in larger numbers of people before it’s ready for prime time.

“Accessibility and cost are the two big issues that need to be addressed,” she says. “Before any recommendations can be made, we need solid data and proof that what we are seeing [on the scan reflects lung changes indicative of emphysema].”

Population Attributable Fractions And Costs Of Passive Smoking

Sarah M McGhee from the Department of Community Medicine, School of Public Health, University of Hong Kong has come up with the following statistics in relation to passive smoking and the associated health effects and costs involved in this presentation on: Population Attributable Fractions And Costs Of Passive Smoking.

Smoke Pollution at Water Margin, Discovery Bay

This letter was sent by Nigel Bruce, a member of  Clear The Air Hong Kong, to Lewis Ho and cc’ed to Douglas Louden of Hong Kong Resorts International Ltd in reference to smoking in Discovery Bay’s Water Margin Complex.

Dear Mr. Ho,

You will have seen the article in Sunday’s SCMP. The article omits to mention that an average of 60% of Water Margin tables are outdoors, and rather underestimates the number of Discovery Bay citizens who are fed up with dining through a pall of someone else’s smoke. As I have mentioned, the attraction of the Water Margin lies in its outdoor view and ambience – we know we can sit indoors to escape smoke pollution.

I happen to be a Clear The Air member who has been seeking discussion rather than confrontation, and who has written to you twice to seek clarification on HKRI’s environmental policy re. the combination of smoking and dining it allows to continue on such a large scale.

But I have yet to receive a reply.

I refer in particular to my question:

Also, when you say: “Having said that, however, we would encourage the individual restaurants to allocate non-smoking areas within their leased premises on a voluntary basis so that both the smoking and non-smoking population can enjoy the superb Water Margin outdoor experience”, does this mean that you have not actually entered into any discussions with your tenant restaurants about their smoking policies?

The restaurants in the Water Margin seem to be offering to discuss compromise (as well as taking legal action against Clear The Air!) – why then does Management not take a lead and open discussions with them, as you suggest they might in your reply of 16th October?

Kind regards,

Nigel Bruce