Smoking in Hong Kong. Smoking in Hong Kong. Female Smoking. Policies and Strategies to tackle Smoking and Drug Abuse in Hong Kong

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1 Conference on Lifestyle and Health, Geneva, Switzerland July 6-8, 2009 Policies and Strategies to tackle Smoking and Drug Abuse in Hong Kong Professor S.H.Lee Emeritus Professor of Community Medicine, the Chinese University of Hong Kong Smoking in Hong Kong Smoking in Hong Kong Year Adults 23.3% 14.9% 14.4% Men % Women % Smoking in Hong Kong Year Female smokers 78, ,000 ( 64%) Young female smokers (Aged 15-19) Years Youth 1994 to 1999 by 3.4% 2,700 7,700 ( 18.5%) Female Smoking Smoking trends in Form 1 to 3 female students 1994 and 1999

2 Smoking trends in Form 1 to 3 male students 1994 and 1999 Smoking Mortality Smoking associated deaths: 5,500 a year More than 15% of total deaths Cost of Smoking! The Hong Kong Hospital Authority estimated the total cost incurred to treat three major smoking related diseases (Lung cancer, bronchitis / emphysema, ischemic heart disease) in 2000 was HK$774M (US $10M) Tobacco Control Policy Tobacco Control Policy Multi-pronged Strategy: Taxation Legislation Education Cessation Research Policy Implementation Government Departments Health, Welfare and Food Bureau Police Customs and Excise Department of Health (Tobacco Control Office) Hospital Authority

3 Statutory Body Policy Implementation Hong Kong Council on Smoking and Health (COSH) NGOs and Academic bodies The Hong Kong Tuberculosis, Chest and Heart Diseases Association The World Association of Chinese Public Health Professionals The Pan Pearl River Delta Region Association on Tobacco Control Other NGOs medical associations and academic bodies Policy Implementation Regional and International organizations WHO APACPT CDC, US, etc General Policy on tobacco taxation Tobacco Taxation in Hong Kong Adopts a free-trade policy Tobacco levy was primarily for fiscal reason rather than for tobacco control purpose Increase in tobacco tax each year mainly follows the trend of inflation Government reluctant to introduce substantial increase in tobacco tax for fear of aggravating cigarette smuggling Use of tax intervention in tobacco control Increase tobacco tax by 300% (retail price of a pack of cigarette increases from HK$3.5 to HK$5.6). Additional revenue: HK$900M Increase tobacco tax by 200% but because of strong opposition by tobacco industry, it was finally reduced to 100% Impact of tobacco tax increase

4 Reduction in smoking rate Smoking prevalence in comparison with the increased retailed price of cigarette packs in Hong Kong ( ) 1983 (300% tax increase) Smoking rate reduced from 23.3% in 1982 to 19.9% in 1983 Increase in number of smokers willing to quit! Household survey in 1984 indicated more smokers (27.7%) quitting smoking because of high cost of cigarettes! Important factors: Efforts need to be sustained Impact was less obvious in when the annual increase was marginal (less than 10% each year) Increase in general revenue Tobacco tax increase Revenue increase Year % 100% 150% 35% The trend of increase in revenue generally follows the trend of tobacco tax increase Revenue collection compared with the increase In retailed price of cigarettes ( ) Cigarette smuggling in Hong Kong Cost of cigarette Contraband HK$30 per pack HK$8-10 Routes of smuggling: By sea: Containers Fishing Vessels Trading vessels Methods of illegal sate: street peddling mobile vans telephone orders Over land: Cross-boundary goods vehicles Itinerant passengers Return residents

5 Number of illicit cigarettes seized (million sticks) Other problems of Tax Increase in Tobacco Control in Hong Kong Reluctance of Government to introduce high tax increase for fear of aggravating cigarette smuggling Strong position of tobacco industry in Hong Kong Movement of population and increase volume of travel between Mainland China and Hong Kong and the marked cost difference in cigarette price between the two areas Latest development on tobacco control legislation in Hong Kong Latest development on tobacco control legislation in Hong Kong Smoking (Public Health) (Amendment) Bill 2005: Objective: To provide for protection against secondhand smoking in indoor workplace and public places Latest development on tobacco control legislation in Hong Kong Proposed amendments (1) Statutory smoking ban to be extended to cover: Restaurants, bars, other hospitality premises Educational and welfare intuitions Indoor workplace/public places

6 Latest development on tobacco control legislation in Hong Kong (2) Advertisement and Promotion of tobacco products: Displaying of tobacco advertisement Drive board and price marker Sale of tobacco products in association with other products Tobacco sponsorship Latest development on tobacco control legislation in Hong Kong (3) Packaging and Labeling of tobacco products: Health warnings Misleading descriptors (4) Law Enforcement: Tobacco Control Office, Department of Health Managers of statutory no smoking areas

7 Latest development on tobacco control legislation in Hong Kong (5) Enforcement of New Legislation Generally, the new legislation comes into operation on the 90th day after the publication in the gazette Exceptional arrangement to be granted to licensed hawkers / smaller retailers of 1 year period Encouraging Community Participation Community Participation in smokefree healthy environment Healthy Schools Healthy Cities Healthy Estates Healthy Workplaces Healthy Universities Healthy Hospitals Training of the Trainers Professional Diploma Course in Health Promotion and Health Education Master Degree Programme in Health Education and Health Promotion!"#$%&'($)&'($ %#*+,"-$./"&&+0$12*34$./"#5# Tseung Kwan O Healthy City

8 Kwun Tong District Health Promoting Universities! Universities can do many things to promote and protect the health of students and staff, to create health-conducive working, learning and living environments, to protect the environment an promote sustainability, to promote health promotion in teaching and research and to promote the health of the community and to be a resource for the health of the community. There is considerable interest and enthusiasm in the concept of health promoting universities. Some universities in Europe e.g. the University of Central Lancashire in UK have started this project. (Source: Health Promoting Universities by Agis D Tsouros) The Chinese University of Hong Kong %#*+,"-$ 6&378+*/# %#*+,"-$ 6&378+*/# Capacity building of individuals

9 Press Cuttings of Youth Press Cuttings of Youth COSH Partnership with NGOs Hong Kong Tuberculosis, Chest and Heart Diseases Association Quit-Winners Club Chinese Association on Smoking and Health Pan-Pearl River Delta Association in Tobacco Control Asia-Pacific Association on Tobacco Control (APACT) Lifestyle Management Centre, Hong Kong Adventist Hospital. Media Partnership on Tobacco Control Partnership in Health Involving the Media Medical Journalism Course

10 The Role of the Asia-Pacific Association for the Control of tobacco (APACT) The Hong Kong Declaration APACT 2001 " In addition, the 432 participants from 34 countries to this 6 th APACT Conference on Tobacco or Health give full support to Hong Kong s current legislative proposals, particularly the recommendations for 100% smoke-free workplaces and restaurants. The Pan Pearl River Delta Region Association on tobacco control

11 Hong Kong s Anti-drug Policy Policies and Strategies to Tackle Drug Abuse in Hong Kong Legislation & Law Enforcement 5 pronged approach Preventive Education & Publicity Research External Co-operation Treatment & Rehabilitation Action Committee Against Narcotics Action Committee Against Narcotics Action Committee Against Narcotics Composition! Headed by a Chairman Preventive Education & Publicity Treatment & Rehabilitation Research! Comprised both official and unofficial members! Comprised 17 unofficial members, chosen for their experience and expertise in various fields of social, community and other professions Action Committee Against Narcotics Terms of Reference 1. To advise the Government on the policies to be adopted to interdict the illicit traffic in dangerous drugs into and through Hong Kong and to keep these policies under regular review. 2. To advise the Government on the measures necessary to eradicate drug abuse from the community. 3. To these ends, to be the channel for advice to the Government on the appropriate allocation of resources to ensure the implementation of Government s policies. 4. To ensure coordination and cooperation between Government departments and voluntary agencies in Hong Kong working towards the implementation of these policies and to enlist public support for them. Action Committee Against Narcotics Terms of Reference 5. To keep under review programmes and projects being undertaken by Government departments and voluntary agencies directed at implementing Government s policies to ensure that they are effective. 6. To draw the attention of the Government to those policies, programmes, projects, laws and procedures which in the opinion of the committee should be changed in order to implement Government s policies more effectively. 7. To advise on any matter referred to it by the Government, or from any other appropriate source, which may be concerned either directly or indirectly with the implementation of Government s policies.

12 Narcotics Division " Part of the Security Bureau of the Government of the Hong Kong Special Administrative Region " Coordinate anti-drug and anti-money laundering policies and measures in Hong Kong " Headed by the Commissioner for Narcotics History Central Registry of Drug Abuse Established in 1972 A system to collect and collate information from reporting agencies regarding drug abusers Objectives Monitor changes in trends and characteristics of drug abusers in Hong Kong and provide basic data to facilitate Drug Abuse Trend No Drug Abuse Trend Percentage Distribution of Drug Abusers by Sex, Percentage 100% 75% 50% 92% 91% 89% 88% 88% 87% 87% 87% 84% 85% 25% Below and 2000above % 8% 9% 11% 12% 12% 13% 13% 13% 16% 15% 9::; 9::< 9::= 9::> 9::? 9::@ 9::A 9::: ;BBB ;BB9 Drug Abuse Trend No. of heroin / psychotropic substance abusers Drug Abuse Trend Drugs most commonly abused (2001 compared with 2000) No. of persons No All ages No Aged under Heroin Psychotropic substance Note : More than one type of drug may be reported for each individual drug abuser. 425 Heroin Heroin Ketamine Ecstasy Cannabis Methylamphetamine Triazolam/ Ketamine Ecstasy Cannabis Midazolam Methylamphetamine Organic solvents

13 Drug Abuse Trend Reasons for current drug use of reported drug abusers in 2001 Reasons for current drug use Reasons for current drug use Avoid discomfort of its Peer influence/ absence to identify with peers Peer influence/ 43.3 Curiosity 43.4 to identify with peers To seek euphoria or Curiosity 24.6 sensory satisfaction 39.3 Aims Preventive Education and Publicity To educate the public on - harmful effects of drugs Relief of boredom / depression / anxiety 23.0 Relief of boredom / depression / anxiety importance of healthy life To seek euphoria or sensory satisfaction For self-medication Avoid discomfort of its absence Under influence of the partner 1.8 To involve the community in anti-drug initiatives Under influence of the partner For self-medication (%) (%) All ages Note : More than one reason for current drug use may be reported for each individual drug abuser. Aged under 21 Preventive Education and Publicity Major Targets Youths--Students Parents Teachers and social workers Preventive Education & Publicity Preventive Education & Publicity District Campaigns School curriculum Seminars and Workshops for Teachers and Social Workers Multi-faceted approach Drug Education Talks for Students Mass media Multi-faceted approach Territory-wide anti-drug activities Resource Centre Anti-drug Abuse Hotline Leaflets Posters Internet Resource Centre Volunteer Group

14 Preventive Education & Publicity Objectives of Drug InfoCentre To serve as a focal point of drug information, past and present, local and overseas To provide support to professionals and workers in the drug field To involve the community and cultivate rapport for achieving the goal of a drug-free HK FGOP CDEFGH IJKLMN Treatment & Rehabilitation External Cooperation Substance Abuse Clinics Compulsory drug addiction treatment programme United Nations Commission on Narcotic Drugs Financial Action Task Force on Money Laundering Multi-modality Approach Voluntary out-patient methadone treatment National Council Against Drug Abuse Asia/Pacific Group on Money Laundering Counselling service for young abusers and their parents Voluntary in-patient treatment Guangdong, Hong Kong and Macau Conference on Policy to Tackle Drug Abuse and Trafficking Time 8-10 November 2001 Aim enhance mutual understanding of the anti-drug policies, especially in the areas of legislation and law enforcement, treatment and rehabilitation as well as preventive education and publicity. Task Force on Psychotropic Substance Abuse established in early 2000 multi-discipline interdepartmental task force recommended comprehensive strategies along the 5-pronged approach the report released in mid 2002

15 Beat Drugs Fund Beat Drugs Fund HK$350M (US$45.4m) (Capital base) "established in 1996 "administered by Beat Drug Fund Association "Investment Sub-committee formed in May 1997 "2 investment managers appointed in February projects Beat Drugs Fund approved so far HK$350M (US$45.4m) HK$113.7M (Capital base) (US$14.6M) Preventive Education & Publicity Treatment & Rehabilitation Research Way Forward ANTI-NARCOTICS WORK Thank Strengthen law enforcement & legislation Enhance preventive education & publicity Improve Treatment & rehabilitation services Continue research & international cooperation You