香港有望很快成为无烟区 / Hong Kong: Soon a Smoke-free Zone?

香港有望很快成为无烟区

香港政府统计处(The Hong Kong Census and Statistics Department)近日调查显示,香港成年居民中烟民数量仅余11%。医疗专家将此视为喜讯,但烟草公司却愁眉不展。

籍此,香港已跻身于争创“无烟区”的城市、国家及地区的前列。所谓“无烟区”就是指吸食“魔鬼草”的成年居民少于或等于5%的地区。

在“无烟区”的竞争中,其他跑在前面的对手还包括新西兰(计划于2025年实现目标)和芬兰(目标定在2040年前)。与之相比,弹丸之地、人口稠密的香港无论在公共文化、地理条件还是其他方面似乎都不处于同一个量级。(例如,香港的人口远远超过新西兰和芬兰,即使把这两国的羊和驯鹿都加上也无法相提并论。)

一般情况下,各方的统计口径总是存在着差异。保险公司定义的烟民是指上一年度至少有过一次吸烟行为的人。而香港卫生部门的认定则较为宽松,只把每天至少吸一支烟的人列为烟民。

如今,香港事关吸烟的状况已经比20年前有了明显的改善。当年,香烟广告铺天盖地:排行榜、报纸、电视、广播无孔不入;为保护公众健康设立“非吸烟区”的规定尚未出台;香烟包装上也无需强制印刷“吸烟有害健康”的警示。

飞机、影院、餐馆里,人们喷云吐雾,烟气缭绕。

更严重的是,那时,公众对吸烟可能导致心肺疾病还疏于了解。通过宣传教育,现在这方面已经有所改观。

最近几年,在政府规定的干预下,香烟广告已经绝迹。法定禁烟区已经扩大到海滩、大多数公园、公交车站、酒吧餐馆等,还有专门的“烟警“(我给起的名字)负责给违规者开罚单。

香烟包装上现在都印有吸烟危害健康的图示,抽烟的成本也因政府增加税收,遏制香烟消费而大幅上涨(一包普通香烟如今售价已达50港币)。

另一个难以量化但却重大的控烟因素就是社会压力。当某个社会阶层的戒烟人数占上风时,就会迎来一个拐点,让剩余的烟民压力倍增,对制造二手烟危及邻居、家人和同事的健康产生顾忌,日复一日就会累积出雪球效应。

同时,全球烟草业也将掀起一波法律攻势,捍卫烟草消费,挑战政府扩大禁烟区、增加醒目烟盒包装警示的举措。例如,某些国家甚至考虑在香烟包装上禁止印刷任何品牌标识。

无论这轮反击的结果如何,香港在减少吸烟行为(及吸烟引发的疾病)上有三大成功经验。

首先,政府必须在广告宣传、设立禁烟区、征收烟草税方面通过有效的法规。

其次,政府必须采取切实步骤,保障法规的落实执行。

再次,政府需要长期开展公共宣传教育活动,以便让公众清楚地意识到吸烟以及二手烟对健康造成的危害。

事关禁烟,似乎全世界都站在了烟草公司的对立面,而烟民们受到的冲击就更不用说了。

Hong Kong: Soon a Smoke-free Zone?

The Hong Kong Census and Statistics Department’s recent survey showing that only 11% of Hong Kong resident adults are still smoking will be taken as good news by the medical health profession, but not such good news by the tobacco companies.

It puts Hong Kong into the forefront among cities, countries and territories aiming to achieve “smoke-free” status, a level which is defined as 5% or less of adult residents still puffing on the evil weed.

Other front runners in the race to smoke-free are New Zealand, which has set 2025 as its target year, and Finland, which is aiming to reach the goal by 2040.This puts tiny, densely populated Hong Kong in the somewhat unlikely company of two countries with which it has little in common culturally, geographically, or otherwise. (Hong Kong, for example, vastly outnumbers both New Zealand and Finland in population terms, unless we include sheep and reindeer in their tallies, and even then ….)

As usual, there are varying definitions which apply to the statistics. Insurance companies generally define a smoker as someone who has consumed tobacco at least once in the past year. Hong Kong health officials have a more relaxed view, defining a smoker as someone who consumes at least one cigarette a day.

There are some big, obvious differences surrounding smoking in Hong Kong today versus 20 years ago. In those days, cigarette advertising and promotion was prominent and omnipresent: billboards, newspapers, TV, radio, etc. There were no regulations establishing no-smoking zones for public health reasons; nor were their health warnings about the risks of smoking mandated to be printed on cigarette packaging.

Airplanes, cinemas, and restaurants were all smoke-filled from cheek to jowl.

Importantly, public awareness about the links between smoking and diseases of the lung and cardiovascular system was low in those days. This has changed, through education and advocacy.

In more recent years, cigarette advertising has disappeared due to government regulations. Smoke-free zones by law include beaches, most public parks, bus stops, bars and restaurants, etc.; and these bans are enforced by uniformed “smoke police” (my term) who slap offenders with fines.

Cigarette packaging carries graphic warnings about the health risks of smoking, and the cost of smoking has been ratcheted up (HK$50 for the average pack of cigarettes today) through government taxation specifically aimed at curbing consumption.

Another factor which is difficult to quantify but deemed significant by the anti-smoking advocates is peer pressure. As a turning point is reached and a growing majority of people in any sub-set of the community stop smoking, the remaining smokers are gradually subject to some degree of pressure to stop creating second-hand health risks for their neighbors, family and colleagues. This seems to have a snowball effect over time.

The global battle over tobacco consumption, meanwhile, is likely to see a wave of legal initiatives launched by tobacco companies challenging government regulations expanding no-smoking zones, as well as more explicit health warnings required on cigarette packaging. Some countries are considering legislation which would ban brand identification of any sort on cigarette packaging, for example.

Regardless of the outcome of those challenges, three lessons seem clear from Hong Kong’s success in cutting down on the incidence of smoking (and smoking-related health problems).

First, the government has to pass effective regulations on advertising & promotion, smoke-free zones, and taxation of cigarettes.

Second, they have to take effective steps to enforce these regulations.

Third, a long-term public education and awareness campaign is required to educate people to the clear and obvious health risks associated with smoking, including the health impacts of second-hand smoke on bystanders.

The global trend in this respect seems to be against, rather than with, the tobacco companies, not to mention the smokers.


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