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Hong Kong, China: bad atmosphere for public health

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After deliberations lasting no less than 6 years, the government of the special administrative region of Hong Kong finally announced new tobacco control measures last October. After such a long wait and in view of Hong Kong’s previous record as a public health leader in the region, there was bound to be disappointment at anything less than a model package. Unfortunately, several strange clauses found their way into the final law, and as the fifth annual conference of the International Society for the Prevention of Tobacco Induced Disease (ISPTID-http://www.hku.hk/ptid/) convened in Hong Kong a month later, the new measures came in for intense discussion by experts from around the world.

As previously reported in these pages, individuals with tobacco industry links are to be found embedded in many important institutions in Hong Kong, and it often seems that business interests dominate even when life and death issues are debated by local politicians (Tobacco Control 2005;14:151–2; and 2003;12:10–11). Some major loopholes in what could and should have been an industry-proof policy for Hong Kong, and a model for the region, have done nothing to dispel this impression.

First, brand-stretching promotions are to continue, allowing the sort of advertisements that greet international visitors as soon as they arrive at Hong Kong airport. Having fought their way from Hong Kong being an adventure playground for young tobacco advertisers in the 1980s, to a near promotion-free zone, health experts were bitterly disappointed by this omission. They spent years explaining to politicians that tobacco companies do not spend vast sums of their shareholders’ money advertising non-tobacco products with cigarette brand names unless it benefits cigarette sales. Yet, in this business-dominated region, even business-related arguments such as this failed to be heard against the constant black noise of tobacco industry propaganda.


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Hong Kong: how outdoor advertising used to be—public health workers fear the return of massive iconic advertisements now that the government has decided to allow continued cigarette brand-stretching promotions.

Second, and probably generating even more adverse comment in the media, was the exception whereby bars and certain other leisure venues, such as massage establishments and mah jong parlours, could register to continue allowing smoking until 1 July 2009. Apart from seeing this as a licence to poison hospitality industry workers for another 2½ years, creating a messy legal quagmire on a now unequal playing field, public health workers feel certain that the tobacco industry will use the exemption period to lobby for it to be made permanent. Ominously, as if pointing to the door on which the industry should push, the government said it will study the feasibility of smoking rooms in restaurants and entertainment venues. It is hardly as if this has not been studied around the world for years, always with the same conclusion, provided that the studies were not funded by tobacco interests.

Interestingly, another related public health story dominated local media throughout the ISPTID conference: mounting concern about air quality. Thousands of factories across the border in China belch out toxic fumes, with much of the pollution drifting over Hong Kong. The government has continually tried to reassure the public, while medical researchers publish data showing increasing respiratory problems in children and other adverse health consequences.

It remains to be seen how receptive to health arguments about air quality the Minister for Environment, Transport and Works, Sarah Liao Sau-tung, turns out to be. In 1990, she obtained substantial funding to study air quality in Hong Kong; but the funding was from Philip Morris, via the largely tobacco-funded Centre for Indoor Air Research. However, even if business interests and arguments impress her more than health statistics, there is little hope of an early solution. Observers say that the government’s inaction is not so much a fear of upsetting the mainland, as the fact that so many of the culprit factories burning low-grade fuels are owned by Hong Kong businesses.


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Hong Kong: a Marlboro clothing advertisement greets passengers arriving at Hong Kong’s Chek Lap Kok international airport.

So perhaps the solution to environmental problems lies with other sectors of the business community. As press coverage about air pollution continued to grow, the international financial management and advice company Merrill Lynch recommended investors to sell Hong Kong property and buy Singaporean instead because of Hong Kong’s poor air quality. Those who thought that this might be treated more seriously than health arguments were again disappointed. It was rubbished by the government, which stated that life expectancy in Hong Kong was one of the world’s highest, and claimed it was the most environmentally friendly place for executives. There was no mention, though, of the health of the executives’ workers, or the workers’ families. So while many fathers in the hospitality industry will continue to work in smoke-filled bars, their children will continue to breathe heavily polluted air, while being brainwashed into associating cigarette brand names with the good things in life.

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