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Support a Total Ban on Electronic Cigarettes
2015.03.30
Electronic cigarettes* (“e-cigarettes”) has a rapid growth with hundredfold increase in global sales in recent years. Hong Kong Council on Smoking and Health (“COSH”) found that a wide variety of e-cigarettes are easily accessible in Hong Kong which are mainly targeting the youngsters. The promotion normalizes smoking behaviour and may lead to tobacco epidemic. COSH Chairman Antonio KWONG remarked, “COSH has serious concern on the spread of e-cigarettes. To protect public health, we advocate the Government for a total ban on e-cigarette to prevent its prevalence among the youngsters and stop it from becoming the gateway to smoking.”

According to the Pharmacy and Poisons Ordinance (Cap 138) in Hong Kong, any e-cigarettes with over 0.1% of nicotine are categorized as pharmaceutical products and must be registered with the Pharmacy and Poisons Board of Hong Kong before sale or distribution. Currently e-cigarettes for sale in Hong Kong are labelled as nicotine-free. However, School of Public Health, The University of Hong Kong pointed out that e-cigarettes contain toxic chemical substances like propylene glycol, glycerin, formaldehyde and acetaldehyde which can bring health risks to human.

Prevalence of e-cigarettes use in Hong Kong

The global sales of e-cigarettes surged exponentially by over 120-fold to a total of US$2.5 billion in 2014 from US$20 million in 2008. Currently there are over 8,000 flavours targeting the youngsters who are curious and crave for novelties. COSH conducted the Tobacco Control Policy-related Survey 2014 and interviewed 2,419 citizens including 819 never smokers, 800 ex-smokers and 800 current smokers by telephone through random sampling during May to September 2014. The survey found that 75.4% of respondents had heard of e-cigarettes but only 1.8% of respondents had used e-cigarettes. The findings showed that rate of youngsters (aged 15-29) used e-cigarettes (4.4%) was higher than people aged 30 or above (1.0%). They cited various reasons that had caused them to try e-cigarettes, including peer influence and they thought e-cigarettes were modern and novel.

The Secondary School Smoking Survey 2012/13 conducted by the School of Public Health of The University of Hong Kong interviewed 45,847 secondary one to six students from 75 randomly selected schools by anonymous questionnaire from September 2012 to April 2013. The results showed that 1.1% of secondary school students had used e-cigarettes. It was also found that e-cigarette users were more likely to have respiratory symptoms. Prof LAM Tai-hing, Chair Professor of Community Medicine and Sir Robert Kotewall Professor in Public Health, School of Public Health, The University of Hong Kong said, “The findings of both surveys showed the usage of e-cigarettes is still low in Hong Kong. However, e-cigarettes are hazardous to health. A complete ban should be enforced to prevent an epidemic of its use.”

Marketing strategies targeting youngsters

Youngsters are the main target of the marketing strategies adopted by Hong Kong and overseas e-cigarette suppliers and sellers. The price is set at an affordable level for them. The flavours, designs and packaging of e-cigarettes available in Hong Kong are diverse and all appeal to the youth. The flavours include fruits, soft drink and tobacco. Most e-cigarettes are sold on consignment at retail outlets and shopping centres specializing in trendy items, or through online platforms such as social media which many youngsters view frequently. It is very difficult to monitor the safety claims of products sold and verify the buyers’ ages at online platforms.

Similar to the marketing strategies of traditional cigarettes in the past, e-cigarettes are promoted through different channels and celebrities are invited as spokespersons for the products which normalize smoking behaviour among the mass public, especially the children and the youth. Social media are also commonly used to reach the youngsters. Besides, most e-cigarettes do not provide details on their ingredients and only address the variety of flavours. They are marketed as non-addictive, aid for smoking cessation, accredited and environmentally friendly which mislead consumers on their safety and attract the youth to use.

World Health Organization (WHO) urges to regulate e-cigarettes

Insufficient evidence has been identified so far to support the claim that e-cigarettes help smokers kick the habit, says the World Health Organization (WHO). To safeguard the public against the potential harm of e-cigarettes, WHO urges countries to regulate e-cigarettes, as well as its advertising, promotion and sponsorship to minimize the risk of exposing the youngsters and never smokers to e-cigarettes. Currently thirteen countries have imposed a complete ban on e-cigarettes, including Singapore, Thailand and Brazil which is a global trend.

A diverse range of e-cigarettes targeted at youngsters are available in Hong Kong. The potential health risks should not be underrated and its ingredients, safety, sales and promotion are not yet subject to any monitoring. To safeguard public health, COSH urges the Government to impose a total ban on the sales, advertising, promotion and sponsorship, distribution, importation and manufacturing of e-cigarettes in Hong Kong. In the meantime, COSH will spare no effort in publicity and education, as well as research on e-cigarettes to prevent its epidemic in Hong Kong.

*Remarks:
Electronic cigarettes
Electronic cigarettes (e-cigarettes) are the most common prototype of electronic nicotine delivery systems. The battery-activated heating element in e-cigarette heats up a cartridge of solution. The e-cigarette then produces vapour inhaled by the user. The solution usually contains propylene glycol, glycerin, and flavourings. The e-cigarette solution and emissions contain other chemicals, some of them considered to be toxicants. Some e-cigarettes look like tobacco products (e.g. cigarettes, cigars, pipes or shishas). Some may be produced in the form of everyday items such as pens and USB memory sticks.

Photo captions

COSH advocates the Government for a total ban on e-cigarette to prevent its prevalence among the youngsters and stop it from becoming the gateway to smoking.
COSH advocates the Government for a total ban on e-cigarette to prevent its prevalence among the youngsters and stop it from becoming the gateway to smoking.

E-cigarettes contain toxic chemical substances which can bring health risks to human.
E-cigarettes contain toxic chemical substances which can bring health risks to human.

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