Hong Kong started to collect smoking prevalence data from 1982. Male smoking prevalence in Hong Kong is decreasing, from 39.7% in 1982 to 19.9% in 2010. Thus, Hong Kong's smoking trend for male smokers appears similar to those of Australia and the USA. It is likely that our male smoking is at present at stage 3 of the model, in which although smoking prevalence is decreasing, the smoking attributed mortality will be increasing. While longitudinal data on smoking attributable mortality are not available in many developing countries and their cities, the experience of developed countries, as summarised in this model, is very helpful in communicating to policymakers the likely impacts of future disease effects of smoking. This model is a useful reference for the planning of smoking related services and programmes. In view of the situation of Hong Kong, and the fact that smoking cessation can greatly reduce mortality rates, it is reasonable to focus efforts in Hong Kong on encouraging male smokers to quit. This should slow the increase of smoking attributed mortality.

For female smoking, the rate in Hong Kong is also decreasing slowly, from 5.6% in 1982 to 3.0% in 2010. We agree that the female smoking trend of the developed countries is not applicable to our city, and it is difficult to predict when or if women will begin smoking in large numbers. In order to prevent the possible increase and the burden this will bring, we in Hong Kong have launched various educational and publicity programmes targeting female smokers with the main purpose of discouraging the uptake of smoking. The response is good; therefore, we are confident that the female smoking rate will remain at a plateau or even further decrease in the coming years.