Hong Kong Council on Smoking and Health (COSH) held a press conference today (3 August), together with the academia from The University of Hong Kong to announce the first evidence on escalating risks of respiratory symptoms in adolescent heated tobacco product (HTP) users, which were even higher than those in cigarette smokers. Meanwhile, the latest findings show that less than 10% of current smokers had an intention to use HTPs, and two-thirds of the Hong Kong population supported banning all alternative smoking products (ASPs). Therefore, COSH urged the Legislative Council (LegCo) to pass the Smoking (Public Health) (Amendment) Bill 2019* (the Bill) promptly in the current session to enact a total ban on all ASPs including HTPs and electronic cigarettes (e-cigarettes).
According to the Thematic Household Survey Report of the Census and Statistics Department, the prevalence of ASP use was higher in adolescents than in adults and the prevalence was surging in Hong Kong. Mr Henry TONG, COSH Chairman said “There is strong consensus among two-thirds of the general public for a total ban. However, it was almost 3 years since the Policy Address first announced to ban ASPs. A Committee Stage Amendment was recently proposed by a Legislative Council member to regulate HTPs instead of banning them outright in Hong Kong. COSH reminds that health risks associated with the use of HTPs have been identified by global researches. Local studies also debunk the misleading claim by tobacco industry that HTP’s marketing strategy is not targeting youth. Regulating HTPs will lead to more loopholes being exploited to hinder progress towards the tobacco endgame goal. To safeguard public health and avoid rekindling the tobacco epidemic, COSH strongly urges the LegCo to push ahead with the implementation of a total ban on all ASPs including HTPs and e-cigarettes in the current session.”
The University of Hong Kong investigated the association between HTP use and persistent respiratory symptoms in adolescents. Escalating risks were found in adolescent HTPs users. Dr Daniel Sai Yin HO, Associate Professor, The School of Public Health, The University of Hong Kong, pointed out “Among adolescents who had never used cigarettes, 88% higher risk of persistent respiratory symptoms for at least three months (such as cough, congestion or phlegm, which are the symptoms of chronic bronchitis) was found in current HTP users versus never HTP users. Also, the risk of persistent respiratory symptoms was 46% higher in exclusive ever HTP users than exclusive ever cigarette users.” The findings showed that HTPs are also harmful and could not reduce the health risks associated with smoking. In contrast, it could be more harmful than conventional cigarettes. The research results had been peer-reviewed and published in an international medical journal.
Some opponents of the total ban claimed that HTPs could help smokers quit or offer them a less harmful alternative. However, according to COSH’s Tobacco Control Policy-related Survey conducted during March to July 2020, less than one-tenth (9.9%) of current smokers had an intention to use HTPs. Besides, a majority (70.9%) of HTP users were dual users of both HTPs and conventional cigarettes, indicating HTPs could not help quit cigarettes, but pose health risks with nicotine addiction. Dr Kelvin Man Pang WANG, Associate Professor, The School of Nursing, The University of Hong Kong remarked, “Two-thirds of citizens supported a total ban on ASPs including HTPs and e-cigarettes, including 40% of current smokers. The survey revealed no imminent demand for HTPs and other ASPs in Hong Kong and the claims made by tobacco companies that ASPs help quit smoking was unsubstantiated.”
In addition, sales regulations can only be applied to the heat sticks or capsules of HTPs, but not the devices under the current tobacco control framework. Hence, other new forms of ASPs could enter the Hong Kong market through these loopholes. In Japan and Korea, hybrid products of HTPs and e-cigarettes are already available, containing both heat sticks and e-liquid. Also, the tobacco industry is using celebrities to promote the HTP devices via social media, which indirectly promotes the tobacco brands and encourages smoking. Obviously, mere regulating measures could not nip it in the bud and prevent youngsters from starting HTP use. Ms Vienna LAI, COSH Executive Director, stressed that a regulatory approach on HTPs is impractical and difficult for monitoring. Tobacco companies can invent multifarious smoking products sneaking into the local market in the name of HTPs. Meanwhile, the Government will have to pay a higher cost for regulation.
COSH reiterates that all forms of smoking are hazardous to health. Banning ASPs will not be the endpoint of tobacco control. Hong Kong should aim at a complete ban on tobacco, curbing all ASPs from entering the market, strengthen comprehensive tobacco control measures, help smokers quit, and prevent smoking uptake, particularly among children and youth. Thus, COSH strongly advocates the LegCo to take a pragmatic approach in passing the Bill immediately to enact the total ban on ASPs. COSH also urges the Government to strengthen tobacco control measures on all fronts to reduce the smoking prevalence to 5% or below as soon as possible for a tobacco endgame in Hong Kong.
COSH and the academia from The University of Hong Kong urge the Legislative Council to pass the Smoking (Public Health) (Amendment) Bill 2019 promptly in current session.
Mr Henry TONG, COSH Chairman stated two-thirds of the general public supported the Bill and researches found that health risks were associated with HTPs use.
Dr Daniel Sai Yin HO, Associate Professor, The School of Public Health, The University of Hong Kong shared the first evidence on escalating risks of respiratory symptoms in adolescent HTP users.
Dr Kelvin WANG, Associate Professor, The School of Nursing, The University of Hong Kong pointed out the majority of current smokers had no intention to use HTPs in Hong Kong.
Ms Vienna LAI, COSH Executive Director stressed a regulatory approach on HTPs will lead to more loopholes being exploited and difficult for monitoring.
* 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, heated tobacco products and herbal cigarettes.