Foreword by the Secretary for HealthForeword by the Secretary for Health
The detrimental effects of tobacco products on health are widely recognized. Smoking is one of the most important yet preventable risk factors for death and various chronic diseases such as heart disease and multiple types of cancers. With an aging population and increasing prevalence of chronic disease in the community, the healthcare system is facing an enormous challenge. Secondhand smoke generated by smoking is equally harmful and can lead to various chronic diseases, as well as negative impacts on the public and society. Smoking causes premature death in at least one out of every two regular smokers, as well as in non-smokers exposed to second-hand smoke.

The Government’s tobacco control policy has evolved with time through a multi-pronged approach with legislation, publicity, education and promotion of smoking cessation. In 1982, to safeguard public health, the Government had the Smoking (Public Health) Ordinance enacted to underpin our tobacco control work with multiple amendments over the years. Forty years after the enactment of the Ordinance, the smoking prevalence in Hong Kong has reduced significantly from 23.3% in 1982 to the prevailing 9.5%. That said, there are still nearly 600 000 everyday smokers in Hong Kong currently. As the population ages and the number of patients with chronic diseases increases, the healthcare system is now facing an enormous challenge. If we do not sustain our efforts in tobacco control, the smoking prevalence would rebound and bring direct impact on the citizens’ health.

We have set a target of lowering the smoking prevalence rate to 7.8% by 2025 in the Towards 2025: Strategy and Action Plan to Prevent and Control NCD in Hong Kong. This consultation document focuses on four major tobacco control strategies for collecting to the public’s views on the next phase of tobacco control, so as to move steadily towards the vision of building a vibrant, healthy and tobacco-free Hong Kong, safeguard public health and tackle the heavy health and economic burden to society due to tobacco use.

We trust that the four tobacco control strategies proposed in this consultation document will shed light on the focus and pace of the next phase of our tobacco control. Let’s seize the opportunity to forge consensus and create a vibrant, healthy and tobacco-free society in the long run.
Secretary for Health
Prof. LO Chung Mau, BBS, JP
Professor Chung-mau LO, BBS, JP
Secretary for Health
Goals of Public ConsultationGoals of Public Consultation
Overall smoking prevalence
According to the World Health Organization, the tobacco epidemic is the biggest public health threat the world has ever faced, killing more than 8 million people a year, including around 1.2 million deaths from exposure to second-hand smoke. It causes premature death in at least one out of every two regular smokers, as well as in non-smokers exposed to second-hand smoke. On a societal level, tobacco use leads to loss of productivity, drains healthcare resources and pollutes the environment. Smoking is more prevalent in the population of the lower socio-economic stratum whose expenditure on purchasing tobacco products has taken up a relatively high proportion of their household income. The expenditure on purchasing tobacco products by the lower income group, as well as the healthcare costs and loss of income due to their health problems, has direct effect on widening the gap between the rich and the poor.

According to the Thematic Household Survey Report No. 75, although the smoking prevalence in Hong Kong reached a historical low of 9.5% in 2021, some 580 000 people still smoke daily. There is still quite a distance from the targets of achieving a smoking prevalence of 7.8% in 2025 set by the Government in the “Towards 2025: Strategy and Action Plan to Prevent and Control Non-communicable Diseases in Hong Kong” and creating a smoke-free society steadily. Amongst others not only did the smoking prevalence of female fail to follow the decline in overall smoking prevalence, but the actual number had indeed increased.

The Government is now initiating a public consultation to invite your views on the strategies and measures in moving towards a vibrant, healthy and tobacco-free Hong Kong. Based on the views received from different stakeholders, we will formulate detailed proposals for the next phase of tobacco control work. Your comments are vitally important to our work on this front.
Smoking Situation in Hong KongSmoking Situation in Hong Kong

Tobacco Products Inflict Heavy Burden on the Healthcare System

Tobacco smoke contains more than 7 000 chemicals, including some 70 that can cause cancer, and causes diseases in almost all body organs and systems. Smoking is the most important yet preventable risk factor which accounts for the main causes of death and chronic diseases. Tobacco use not only increases healthcare expenditure and but also causes loss of productivity. Globally, smoking contributes to 16% of all deaths from non-communicable diseases such as heart diseases, cancers, diabetes and lung diseases. The incidence and mortality rates of lung cancer were the highest among all types of cancers in 2020 in Hong Kong. Studies show that about 80% of lung cancer deaths result from smoking, and clinical research shows that 9 out of 10 lung cancer deaths result from smoking or exposure to second-hand smoke. Furthermore, a local study conducted in 2011 revealed that nearly 7 000 fatalities are related to tobacco annually and the economic loss resulting from tobacco-induced health problems was estimated to be about HK$5.5 billion (at current price) every year. Concurrently, exposure to second-hand smoke for non-smoking spouses of smokers increases their risk of developing lung cancer by 20-30%.

Examples of diseases induced by smoking

Examples of diseases induced by smoking

Double Jeopardy of Smoking and Ageing Population

There is a direct relationship between smoking and incidence of chronic diseases, such as heart diseases, cancers, diabetes and lung diseases. With a gradual increase in the age of smoking population, the actual number of smokers aged 50 or above indeed increased from around 231 300 in 2000 to 294 200 in 2021, representing an increase of nearly 30%, which accounts for over half of the total smoking population. Despite the overall declining smoking prevalence in Hong Kong, the burden on the healthcare system brought by additional health risks on elderly smokers due to smoking should not be neglected.

Eliminating the Advertisement and Appeal of Tobacco

Tobacco companies make use of different promotion strategies to increase the attractiveness of their products and stimulate consumption. According to the statistics from the Tobacco and Alcohol Control Office under the Department of Health, there is an increasing number of illegal tobacco advertisement cases over the past few years. Evidence shows that the packaging and display of cigarettes are important means of marketing. The graphics, wording and colours of tobacco packaging can manipulate the consumers’ risk perception and directly influence their purchase decisions.

Restricting Access to Tobacco Products by the Youth

Prevention of smoking in the youth has always been one of the top priorities in the Government’s tobacco control efforts. According to a survey conducted by the School of Public Health of the University of Hong Kong in 2021, the current smoking prevalence among Secondary 1 to 6 students was 1.2%, lower than the 1.5% recorded in the survey in 2019. Such decline in the smoking prevalence should be attributed to the concerted efforts made by various parties (such as non-governmental organisations, schools, teachers and parents) and the Government which have protected the youth from tobacco hazards. Nevertheless, it is observed that the prevalence of ever smokers among Secondary 1 to 6 students was 7.4% (i.e. which constitutes over 24 000 secondary school students), reflecting that there are still a significant number of students who would experiment with smoking out of curiosity. Statistics from the TACO show that while the number of cases related to illegal tobacco advertisements has increased over the past few years, teenagers are still exposed to tobacco products through direct and indirect means. We also noted the increase in the market launches of tobacco products (including cigarettes and waterpipe tobacco) with various flavours such as menthol and fruits that are designed to increase palatability and appeal to teenagers.

Restricting Access to Tobacco Products by the Youth

Smoking Cessation Services

The Government also strives to help smokers to quit smoking. From 2009 onwards, DH provides subventions to non-governmental orgnaisations every year for providing free, community-based smoking cessation services to the public. Various treatment modalities, including counselling, pharmacotherapy and Chinese medicine acupuncture are adopted. To expand the coverage of smoking cessation services and cater for the needs of different smokers, a variety of service delivery modes, including smoking cessation clinics, workplace outreach services, mobile clinics, youth quitline and cessation services targeting people of diverse races and new immigrants, etc. are used. The annual number of people receiving smoking cessation services gradually increased from about 700 in 2009 to over 6 500 in 2016. However, there is a decreasing trend in the number of people receiving such services in recent years, with the number dropping to below 5 000 in certain years. We need to review the existing smoking cessation services and the relevant training provided for healthcare professionals in order to motivate and help more smokers to quit smoking.

40 Years of Tobacco Control40 Years of Tobacco Control
  • Total ban on import, promotion, manufacture, sale or possession for commercial purposes of alternative smoking products
  • Passage of amendment in the Legislative Council to enlarge the size of pictorial health warnings from 50% to 85% of the cigarette pack area, and increased the number of forms of health warning from six to twelve.
  • Setting up of Youth Quitline
  • Launch of “Quit Smoking” mobile application
  • Full smoking ban in all indoor public places
  • Enactment of the World Health Organization Framework Convention on Tobacco Control
  • Establishment of Tobacco Control Office, Department of Health (Now known as Tobacco and Alcohol Control Office, Department of Health)
  • Prohibition of sale or giving of tobacco products to persons under the age of 18
  • Establishment of the Hong Kong Council on Smoking and Health
  • First designation of statutory no smoking area
  • Implementation of the Smoking (Public Health) Ordinance
  • First implementation of health warnings
Vision and MissionVision and Mission
Reduce cases of disease
and deaths due to tobacco
Tobacco jeopardises health of both smokers and non-smokers. The strategies in the consultation document will reduce the tobacco consumption continually, so as to reduce the cases of diseases and deaths related to smoking, as well as prevent human and social losses due to tobacco consumption.
Safeguard public health,
especially the
young generation, and
prevent them from smoking
Due to the addictive nature of tobacco products, preventing the public, especially the youth from accessing and creating dependence on tobacco products are crucially important. Strengthening tobacco control measures will give a clear message to the public on hazards brought by smoking and encourage them to stay away from tobacco products.
Protect general public from
the impact of tobacco hazards
The hazard brought by tobacco products affects not only individuals, but also the society as a whole. The health issues of smokers may bring negative impacts on their families, their neighbourhood and the whole society. The Government has a responsibility in protecting public interests and safeguarding public health by preventing the harm on the public caused by second-hand smoke.
Reduce long term burden
on healthcare system
by smoking
Smoking is one of the greatest risk factor for chronic diseases such as cancer and heart diseases. Strengthening tobacco control measures can reduce tobacco consumption and chronic diseases caused by tobacco, and allow re-allocation of public healthcare resources to other areas, such as disease prevention and improvement of healthcare facilities.
Four Major Tobacco Control StrategiesFour Major Tobacco Control Strategies
Regulate Supply,Suppress Demand
Ban Promotion, Reduce Attractiveness
Expand NSAs, Mitigate Harm
Enhance Education, Support Cessation
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