Electronic cigarette and new tobacco products to ban or to let free?

Abstract

The Hong Kong SAR Government proposed to the Legislative Council more than three years ago (in May 2015) for a total ban of electronic cigarettes (EC). In January 2018, Macao has started a total ban. But in June 2018, the HKSAR Government proposed to regulate, but not ban EC and heat not burn (HnB) tobacco products. If so, this means that such new products would be legalized and on sale everywhere in Hong Kong. The Hong Kong Council on Smoking and Health (COSH), the medical community, and parent, teacher and social service organizations united unprecedentedly and held several press conferences to strongly advocate for a total ban, with massive mass media coverage and public support as shown by several surveys. The EC and the Big Tobacco Companies are pushing their new products most aggressively, using the same old but proven to be highly effective methods in promoting cigarettes decades ago. Together with more sophisticated methods using more advanced information and communication technologies, their sales have been rocketing. Although they claim that they only want cigarette smokers to switch and they do not want children and young people to use their new products, their marketing strategies clearly show that they unscrupulously target young people. In the US, EC use has been increasing rapidly and use in students is out of control. In Hong Kong, young girls aged 6 years have been reported to be smoking EC like playing toys. The EC and tobacco industry and their allies are actively lobbying government and legislators to let free their products with minimal regulations and tax. The main justification for the promotion of EC and HnB tobacco is harm reduction. This could be achieved if smokers can switch from cigarettes to these new products, and eventually quit all. But many smokers who use EC and HnB tobacco have become co-users because they do not feel the need to quit as they misperceive that they can smoke EC and HnB tobacco in places where smoking cigarettes is prohibited and they believe the products are much less harmful. The claim that EC is 95% safer is not based on scientific evidence, but on opinions of experts some of them are related to the industry and/or with conflicts of interests. The claim that HnB is 90% safer is neither valid. Reports of the results were manipulated by the tobacco industry. Some EC supporters now advocate smokers to switch, instead of asking them to quit. More and more reports have revealed more toxic substances and more harms of EC. There is no clear evidence on the effectiveness of EC for quitting, whereas reports showing ineffectiveness has been increasing. The most alarming is the increasing evidence that EC is a gateway to cigarette smoking in young people in countries where EC has not yet been effectively controlled or regulated. New EC tools look like an USB stick, has more addictive nicotine than cigarettes, and has been used to smoke illicit drugs. It is obvious that if EC, HnB tobacco etc. are sold like cigarettes in Hong Kong, no regulations can be effectively enforced to prohibit sale to and eliminate use in young people. Hence, we shall see an exploding epidemic of nicotine addiction in young people (like in the US now), before we see any health benefits in smokers. Even some smokers’ lives may be saved by EC etc., should we sacrifice our young people for some smokers who refuse to quit using the existing free and effective methods and services? COSH is running a signatory campaign to “Support to enact a total ban on e-cigarettes and other new tobacco products, and formulate a timeline to ban smoking”. The campaign is ongoing with increasing number of people and organizations signing every day. To protect our children and young people and for public health, you are urged to sign and urge more people to sign too at www.smokefree.hk/support.