Enact a total ban on alternative smoking products promptly to protect public health and the next gen

To safeguard public health, the Government proposed the Smoking (Public Health) (Amendment) Bill 2019 to prohibit the import, manufacture, sale, distribution and advertisement of alternative smoking products, including electronic cigarettes, heat-not-burn products (HNB products) and herbal cigarettes. Legislative Council had formed a bills committee to review the bill and three deputation meetings were held. Hong Kong Council on Smoking and Health (COSH) urges the Legislative Council to pass the bill promptly in order to prevent these products from becoming the gateway to smoking and avoid the health risks posed to the public, especially the next generations.

COSH Chairman Antonio KWONG remarked, “In view of the prevalence of using alternative smoking products is still low but in a rapid growth, Hong Kong should enact a total ban as soon as possible to nip it in the bud. Majority of the public supported the total ban of alternative smoking products, over 100 thousand signatures were collected in a signatory campaign launched by COSH with various associations and organizations. Also, majority (around 65%) of submissions to the bills committee from different social sectors supported the bill. Opportunity knocks but once, COSH urges the Legislative Council to pass the bill with no further delay to protect public health.”

Alternative smoking products are marketed as trendy products and targeted at non-smokers especially the youth, becoming the gateway to smoking. Some smokers may switch to these products and become dual users instead of quitting smoking. Prof Judith MACKAY, Director of Asian Consultancy on Tobacco Control and Senior Policy Advisor of World Health Organization (WHO) said, “There are diversified flavours and designs of alternative smoking products, making them grow rapidly in the global market. Similar to the promotion tactics of traditional cigarettes in the past, these products are marketed through different channels such as social media and using celebrities as spokespersons. Tobacco industry opened HNB products flagship stores, cafés and sponsored public events such as concert and auto racing around the world, which are alarming. Smoking behavior is renormalized as a trendy lifestyle, posing a severe threat to public health globally. WHO recommended that HNB products should be banned or at minimum be subject to the same regulatory measures applied to all other tobacco products.”

At least 16 countries including Singapore, Thailand and Brazil, have imposed a total ban on new tobacco products, which shows a global trend. Prof CHIA Kee-seng, Professor of Saw Swee Hock School of Public Health, National University of Singapore shared, “There is still no conclusive evidence that new smoking products can help smoking cessation. According to the modeling analysis done in Singapore, new smoking products use may lead to an initial decline in smoking prevalence but it will be reversed, making the smoking prevalence increase finally. Singapore imposed a complete ban on new smoking products, including e-cigarettes, HNB products and shisha in 2018 to prevent them from normalizing smoking behavior. Singapore has also developed various tobacco control policies to reduce the risk of tobacco epidemic including increasing the legal age for purchasing cigarettes to 21 and implementing plain packaging.”

Though some countries considered the less harmful claims of alternative smoking products and yet to ban their sale, Prof LAM Tai-hing, Chair Professor of Community Medicine cum Sir Robert Kotewall Professor in Public Health, School of Public Health, The University of Hong Kong emphasized, “Despite some claim alternative smoking products may reduce exposure to harmful substance, it is not equivalent to reduction in harm to health or in risk of tobacco-related diseases. Statement of European Respiratory Society pointed out that nicotine and tar levels of HNB products are found to be almost identical to a conventional cigarette, and the potentially carcinogenic substance acenaphthene is found to be almost three times higher than in conventional cigarette. In fact, the public should be alerted that the tobacco industry intends to conceal the health risks of tobacco products by misleading marketing strategy to sustain their market profit throughout the years.”

COSH commissioned the School of Nursing of The University of Hong Kong to conduct the Tobacco Control Policy-related Survey and revealed the rapid growth in prevalence of using e-cigarettes and HNB products in a short period of time. Dr Daniel HO, Associate Professor of School of Public Health, The University of Hong Kong said, “The survey showed the prevalence of HNB products ever use doubled from 0.9% in 2017 to 2.1% in 2018 and prevalence of current e-cigarette use (in past 30 days) surged from 0.2% in 2017 to 0.7% in 2018. The rates are higher among the youngsters (aged 15-29). The survey also showed that majority (around 60%) of citizens supported the total ban. Hong Kong should impose a total ban while the prevalence of using alternative smoking products is still low to prevent its epidemic.”

Different sectors and the general public expressed concern on the health risks of alternative smoking products posed to public, especially the youngsters. Survey showed that 75% of responded parents agreed a total ban while over half of the smoking parents (56%) also supported. COSH advocates to enact a total ban of alternative smoking products as soon as possible before they become popular, as well as to stop these products from being a gateway to smoking. To safeguard the health of the public as a primary concern, COSH also urges the Government to develop long-term tobacco control policies to formulate a bold goal and timeline for a total ban of smoking, in order to further lower the smoking prevalence for a smoke-free Hong Kong.

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COSH urges the Legislative Council to enact a total ban on alternative smoking products promptly in order to prevent its epidemic in Hong Kong.