Hong Kong Council on Smoking and Health (COSH) has been proactively advocating the Government for strengthening the tobacco control policies to contain the proliferation of tobacco use. However, tobacco control in Hong Kong has remained stagnant without major breakthroughs in recent years. The scrutiny work on the Smoking (Public Health) (Amendment) Bill 2019 (The Bill) was discontinued and the latest smoking prevalence of Hong Kong has slightly increased to 10.2% which are alarming. COSH advocates the Government to step up tobacco control efforts and conduct a comprehensive review to strengthen tobacco control policies, as well as impose a total ban on alternative smoking products promptly in order to lower the smoking rate in Hong Kong.
 
Mr Antonio KWONG, COSH Chairman emphasized, “We are now facing unprecedented threats on tobacco control in Hong Kong. The tobacco industry invented and marketed alternative smoking products targeting both smokers and non-smokers. The smoking prevalence of Hong Kong in the latest survey has slightly increased and the numbers of people using e-cigarettes and heat-not-burn (HNB) tobacco products have raised significantly in the past two years. Primary and secondary school students who have never smoked also tried to use these products and started smoking which is alarming. We are highly concerned that a period of legal vacuum was created for alternative smoking products entering the market and targeting the youth as the Bill stops. Therefore, COSH urges the Government to review and strengthen the tobacco control policies, resume the legislation for a total ban of alternative smoking products and develop a bold schedule for Tobacco Endgame goal as soon as possible, to prevent tobacco epidemic in the next generations.”
 
According to the Thematic Household Survey Report No. 70 released by Census and Statistics Department, the smoking prevalence of Hong Kong was 10.2% in 2019, a slight increase from 10.0% in 2017. There were around 20,300 daily users of e-cigarettes and HNB tobacco products, which is a 2.5-fold increase as compared to 2017. A survey conducted by the Federation of Parent-Teacher Associations in 18 districts in June 2018 showed that 69.1% of parents found alternative smoking products appealing to youngsters and worried their children would start using. A majority (81.8%) of parents supported a total ban of alternative smoking products. Mr Henry TONG, Chairman, Committee on Home-School Co-operation with Federation of Parent-Teacher Associations in 18 districts said, “Parents should be aware to help their teenagers and children identify the smoking hazards, and set good role models by staying away from all forms of tobacco products. The Government and the Legislative Council have the responsibility to ban alternative smoking products from entering the market and posing health risks to the public.”
 
A school-based survey on smoking was commissioned by the Food and Health Bureau and conducted by the School of Public Health of The University of Hong Kong during October 2018 to July 2019. According to the survey, around 20% to 40% of secondary school students who have never smoked lighted up their first cigarette by using HNB tobacco products and e-cigarettes. Besides, over 70% of secondary school students became dual-users of both conventional cigarettes and alternative smoking products. Mr TAM Kim-hung, Honorary Treasurer, Hong Kong Subsidized Secondary Schools Council, said, “Alternative smoking products are marketed as trendy items. They are promoted via social media and used celebrities as spokespersons, becoming a gateway to smoking. In the U.S. where only regulations applied, youth e-cigarette use has become an epidemic with more than 5 million secondary school students using e-cigarettes. We should take the lessons and remind our youngsters to stay alert on the marketing strategy targeting at them. Mr Tommy LO, Member of Executive Committee, The Hong Kong Association of the Heads of Secondary Schools, said, “We are concerned that the public and students might mistake the discontinued scrutiny work of the Bill as alternative smoking products are less harmful and being recognized, so they will easily get tempted to start smoking. The Government should enact a total ban on alternative smoking products promptly and strengthen education to prevent its epidemic in Hong Kong.”
 
According to the survey, 2,530 and 1,510 primary school students have ever used e-cigarettes and HNB tobacco products respectively, in which more than half (51.5%) and 34.9% of them were never smokers. Ms Kathy CHUNG, Chairman of Hong Kong Aided Primary School Heads Association pointed out, “Tobacco industry launched alternative smoking products with novel designs and flavours to downplay the hazards which attract youngsters and children. Parents and teachers may also be misled and have overlooked the health risks imposed.” Ms CHAN Man-yin, Treasurer of Subsidized Primary Schools Council said, “The education sector was shocked that 0.8% and 0.1% of primary school students have ever used and currently using the HNB tobacco products respectively despite these products have not officially enter the Hong Kong market yet. This will result in irreparable harms once youngsters and children lighting up their first cigarette.” And Mr Langton CHEUNG, Vice-chairman of Hong Kong Primary School Leaders Association emphasized, “The Legislative Council discontinued its scrutiny work on the Bill right before the summer holidays. Tobacco industry may take the chance to promote the alternative smoking products and surge the usage exponentially, constituting an obstacle in a total ban of these products and tobacco control works at the cost of sacrificing the health of our next generations.”
 
Meanwhile, alternative smoking products provide alternative choices for smokers instead of considering smoking cessation. Mr OR Man-mo, Champion of the 10th “Quit to Win” Contest shared, “Quitters should be aware of the trap set by the tobacco industry. There is no conclusive evidence that alternative smoking products can help quitting. I tried using them as cessation tools but resulted in more frequent and intense tobacco consumption, thus became a dual user and adversely affected my health. I successfully quitted by counselling and using Chinese acupuncture.” Mr Jerry CHENG, Champion of the 8th “Quit to Win” Contest and Mr Doy KWONG, a successful quitter also reminded the public to quit smoking as soon as possible and stay away from any forms of tobacco products which are hazardous to health. COSH would remind the mass public to stay alert on the misleading claims of alternative smoking products and should use recognized smoking cessation methods or services.
 
COSH advocates the Government to review and strengthen the multi-pronged tobacco control policies, as well as to resume the legislation work of the Bill as soon as possible. COSH also suggests the Government to include the conventional cigarettes in the legislative framework and set a bold schedule for Tobacco Endgame goal in order to lower the smoking rate to 5% or below for achieving the Tobacco Endgame and protect public health.
 

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