Generation 40s – 四十世代

Good articles for buddies


Leave a comment

Tobacco merchants of death are killing a bid to save lives in Hong Kong

CommentInsight & Opinion
2017-04-28
Yonden Lhatoo is appalled by what the tobacco industry and its political allies are doing to stop the government from upgrading warnings on cigarette packets

I was at a 7-Eleven convenience store the other day when two young women walked in to buy cigarettes. There was a bit of a hold-up at the counter because they wanted the packet with the least repulsive graphic warning label.

After some back and forth with a store clerk who was both amused and annoyed, they finally settled for one that didn’t remind them too much of what their internal organs will look like when smoking finally kills or maims them.

They, like many smokers in our city, may not be aware of it, but a suffocating war – unprecedented in skullduggery and Machiavellian manipulation – is being fought over their health in the city’s legislature. I’m talking about Hong Kong’s bid to slap bigger warning labels as well as more warnings on cigarette packs, along with a hotline number to help smokers quit.

Hong Kong is one of more than 100 jurisdictions to have put graphic warning labels on cigarette packets, but has fallen far behind many of its peers as there has been no upgrade since it started the practice in 2007.

The government finally tabled an amendment bill in the Legislative Council on Wednesday to increase the size of the warning label from 50 per cent to 85 per cent of every cigarette packet. Sounds simple enough, but try getting it passed by an already deeply divided legislature being lobbied and pressured, no holds barred, by powerful vested interests.

One of the world’s foremost anti-tobacco advocates, the irrepressible Judith Mackay, broke it down for me.

“The process has been toxic – I’ve never, in the last three decades, seen such opposition, lobbying or filibustering of a tobacco bill in Legco,” she said. “An army of tobacco executives, lawyers and their allies have descended on Hong Kong to try to obstruct, delay and prevent the legislation going through. One veteran legislator confided to me that he, too, had never witnessed such intense lobbying on any topic. He said that he himself felt the pressure and that this was having a ‘chilling effect’ on even those who were supportive of the bill.”

That’s quite something, coming from a tobacco-control expert whose global and Hong Kong-based campaigning against smoking has earned her death threats, offers of 24-hour police protection and the label of one of three “most dangerous people in the world” by the industry.

She also introduced me this week to another prominent anti-tobacco expert, Geoff Fong, who has been citing solid research evidence showing the effectiveness of bigger warning labels and the need to revise them so that the desired impact does not wear out.

Mackay’s rhetorical question summed it up: “With about 7,000 deaths a year from smoking in Hong Kong, should the tobacco industry and a few legislators be blocking a public health measure that involves no cost to government, and which works, and which will save lives?”

If the government’s inability to really take on the merchants of death stems from its lack of both will and political backing in the face of their money and influence, the maths still demands a far tougher approach. The cost of smoking to Hong Kong is estimated to be in the tens of billions of dollars every year, dwarfing the amount it reaps from tobacco duty.

What’s there to be so afraid of? Public opinion is in favour of clearer and tougher warnings on cigarette packs – 80 per cent of non-smokers, ex-smokers and smokers themselves support the move, according to the last count.

Probably not those two young women at the 7-Eleven counter fussing over the aesthetics of warning labels on their cigarette packets, but hey, there’s no denying the impact.

Yonden Lhatoo is the chief news editor at the Post


Leave a comment

Hong Kong’s plan for bigger health warnings on cigarette packs is backed by solid research

CommentInsight & Opinion
2017-04-27
Geoffrey Fong says studies over the years and in many countries demonstrate the effectiveness of bigger warning labels and a ‘quitline’ in empowering smokers to give up, while motivating youth not to take up the harmful habit

Tobacco products cause more deaths in Hong Kong and throughout the world than any other single preventable cause. Governments have a legal and moral responsibility to warn its people about the extreme dangers of these products. Warning labels – particularly large warnings with graphic images – have been proven to raise awareness of the harm of tobacco and second-hand smoke, increase motivation among smokers to quit, and discourage youth from taking up smoking.

In 2007, Hong Kong became one of the first jurisdictions in Asia to implement graphic warnings on tobacco packaging, occupying 50 per cent of the pack. However, these warnings have remained unchanged on the pack for a decade.

But this is about to change. This week, the Hong Kong government is tabling a law calling for an increase in size of its warnings from 50 per cent to 85 per cent of the pack, doubling the number of warnings, from six to 12, and adding the hotline number for smokers who want to quit.

Studies from the International Tobacco Control Policy Evaluation Project provide evidence supporting these proposed changes. Beginning in 2002, the project has conducted research in 28 countries, covering over half of the world’s population, including China, South Korea, Thailand, Malaysia, India, Bangladesh, Australia and New Zealand within the Asia-Pacific region, to evaluate the impact of tobacco control policies. We have conducted over 60 studies of the impact of warning labels, and a number of these studies have measured what happens when governments revise their warnings, such as introducing graphic images, changing the positioning of the warnings on the pack, and increasing the size.

First of all, there is a clear need to revise the warnings in Hong Kong because of the “wear-out” effect – messages that are repeated over time lose their impact and need to be refreshed. The studies showed the wear-out effect of warnings across a diversity of countries, including Canada, the United States, Australia and Mauritius. Canada was the first country to introduce pictorial warnings in 2001, when it implemented 12 graphic warnings taking up 50 per cent of the pack. But from 2002 to 2011, noticing the warnings dropped by over 25 per cent, their impact on thinking about the risks of smoking dropped by 35 per cent, and the impact on thinking about quitting dropped by nearly half.

However, when Canada revised its warnings in 2012, including increasing their size from 50 per cent to 75 per cent of the pack, the number of smokers reporting that the warnings made them think about quitting doubled.

Hong Kong’s warnings have remained unchanged for nearly a decade, well beyond the two to three years that the World Health Organisation and leading authorities recommend as the interval for revising warnings. Indeed, of the 12 jurisdictions that had introduced graphic warnings by 2007, Hong Kong is the only one that has not revised them. Thailand has revised its graphic warnings three times; Panama has done so six times.

Second, there is strong research evidence corresponding with common sense that larger warnings have greater impact. Experimental studies conducted by the Canadian government demonstrated that increasing warnings from 50 per cent to 75 per cent, 90 per cent and 100 per cent enhanced their impact. Larger warnings were rated by adult smokers, youth smokers, and youth non-smokers as being more effective for communicating health risks, changing social attitudes towards smoking, reducing smoking initiation, and helping smokers to quit.

Countries that have increased the size of their warnings have been challenged by the tobacco industry. In a recent high-profile case, Philip Morris International brought a challenge against Uruguay under a bilateral investment treaty to nullify the increased warning size from 50 per cent to 80 per cent, claiming there was no evidence that increasing the size of warnings was effective. The dispute was heard by a panel of the World Bank’s International Centre for Settlement of Investment Disputes.

A study of the Uruguay warning labels, which was presented to the panel, found that the increase in warning size was associated with a significant increase in the impact of Uruguay’s warnings.

In July 2016, the dispute centre rejected the company’s claims, ruling in favour of Uruguay. It also required the company to pay all court costs as well as Uruguay’s legal defence costs.

Hong Kong’s proposal to add the “quitline” number to the warnings is also strongly supported by the international evidence. Studies from Canada, the Netherlands, Australia, New Zealand and Brazil show that adding the number to warning labels led to significant increases in call volumes. In turn, counselling programmes that have been implemented through such numbers have been shown to increase the percentage of smokers making attempts to quit and reduce the probability of relapse.

Warning labels are a proven effective, and cost-effective, measure for empowering smokers to quit and motivating youth not to start smoking. The long-overdue proposed enhancements to the warnings in Hong Kong are not radical – they are well-justified and have strong support from international studies. Their implementation will make Hong Kong a global leader once again in this critically important public health measure.

For those who believe that enhancing warning labels is inappropriate, this rhetorical question from a Canadian tobacco control expert is right on target: “What warning labels would be appropriate for a consumer product that kills half of its regular customers?”

Geoffrey T. Fong, PhD, is professor of psychology and public health at the University of Waterloo in Canada, and senior investigator at the Ontario Institute for Cancer Research. He is the chief principal investigator of the International Tobacco Control Policy Evaluation Project


Leave a comment

Swallowing their pride: How Hong Kong officials missed an opportunity to show some humility in lead-in-water scare

South China Morning post
Comment›Insight & Opinion
2015-11-03

Gary Cheung

Gary Cheung says the Hong Kong government shouldn’t have been so quick to ban officials from drinking the water at estates hit by the lead scare

The days following the opening of Hong Kong International Airport in July 1998 saw flight delays, passengers waiting hours for their baggage and the shutting down of operations of air-freight handler Hong Kong Air Cargo Terminals.

In early 1999, a report compiled by a commission of inquiry did not blame any officials. Another report released by a Legislative Council select committee held Anson Chan Fang On-sang, the chief secretary at the time, and three key airport officials responsible for the fiasco.

After the release of the two reports, a senior official told me that Hongkongers should not be too harsh with those officials named in the Legco inquiry as “they had done their best”.

My memories of what the official said were rekindled recently when Chief Secretary Carrie Lam Cheng Yuet-ngor defended “diligent civil servants” amid criticism of district councillors pressuring officials into drinking water from public housing estates where excessive levels of lead had been found.

Speaking in Legco during a debate two weeks ago on two motions to launch an inquiry into the contaminated water scandal, Lam said at least two officials had been pressured by district councillors into drinking allegedly tainted water.

Lam, who admitted inadequacies in the system of monitoring the quality of drinking water, said she had ordered officials not to be pressured into drinking the water, to safeguard the government’s dignity. Lawmakers eventually rejected the motions.

I have several family members who are retired and serving civil servants. I have no lack of respect for the professionalism and diligence of civil servants. And, there is no denying that some politicians have spared no effort to make political capital from the contaminated water saga.

But that doesn’t mean we should easily dismiss the worries of the public housing tenants who have had to use buckets to collect drinking water after excessive levels of lead were found in tap water in their neighbourhoods.

History is littered with examples of officials eating food or drinking water from troubled areas to boost public confidence and show concern for the people.

In April 1997, Taiwanese president Lee Teng-hui ate a pork knuckle before cameras to reassure his people who were plagued by an outbreak of foot-and-mouth disease that was devastating pig herds on the island. In October 2013, Japan’s Prime Minister Shinzo Abe visited a fishing port in Fukushima, which was hard hit by the nuclear crisis in 2011, and ate locally caught seafood to demonstrate its safety.

Even some mainland officials will put themselves in the shoes of the people they govern. In July, Guangzhou mayor Chen Jianhua swam in the Pearl River to show that the water quality of the once heavily polluted river has significantly improved.

You may argue these men did so as public relations stunts and these incidents are different from Hong Kong officials being forced into drinking possibly contaminated water. But I can’t see what harm would be done if they did drink water before cameras to show their empathy with affected residents, as long as they did not do it under duress.

Undersecretary for Transport and Housing Yau Shing-mu and assistant Observatory director Sharon Lau Sum-yee were the two senior officials who drank from cups offered by district councillors in July. Yau, who grew up in a public housing estate, may know more about politics than Lam.

As the chief secretary claimed credit for having the “guts” to risk being criticised for seeking justice for civil servants, a chance for officials to show humility was squandered.

Gary Cheung is the Post’s political editor


Leave a comment

Expired: Hong Kong government’s ideas about Chinese medicine are clearly past their sell-by date

South China Morning Post
Comment›Insight & Opinion
2015-10-26

Philip Yeung

Philip Yeung says despite a stated goal to nurture this traditional industry, Hong Kong’s fossilised thinking and a lack of coordination between officials mean we’re falling behind the competition

For ages, traditional Chinese medicine has lived in the shadows as alternative medicine. But overnight, with a Chinese medicine researcher anointed as this year’s Nobel co-laureate for medicine, it has acquired a halo of legitimacy.

In Hong Kong, however, Chinese medicine seems about to enter the dark ages. Designated as a new pillar industry, it never got anything except governmental lip service. After six years of inaction under Donald Tsang Yam-kuen, the government is now set to impose tough regulations on proprietary Chinese medical products. More than 8,000 Chinese remedies face being taken off the shelves unless they are standard-compliant, threatening to squeeze the life out of the industry.

Insiders blame the government for three strategic blunders. First, it asks thousands of Chinese herbal remedies to meet tough European standards as Western drugs, not health products, forgetting that ours is too small a market for manufacturers to bear the cost of compliance.

Our medical bureaucracy is top-heavy with Western-trained doctors who do not know that multi-herb formulations are too complex for their active ingredients to be isolated by Western procedures.

To apply US Food and Drug Administration-style requirements on herbal medicine is to cause its death by regulatory strangulation. Why not emulate Canada and treat Chinese herbal medicines as “natural health products”?

Second, the idea of integrating the Chinese medicine market within Greater China has never occurred to our leaders, though our tiny market size can’t sustain its healthy development. China has its own regulatory body for Chinese medicinal products. It makes no sense for Hong Kong to go its own way.

Third, oversight and resource allocation are in the hands of the Food and Health Bureau, while the Commerce and Economic Development Bureau is reduced to being a bystander. This has led to bureaucratic insanities.

For years, the Trade Development Council has co-organised the annual Chinese medical products exhibition. But the Food and Health Bureau forbids any display of unregistered proprietary Chinese medicines. Unable to take samples home, foreign traders leave empty-handed and deal-starved. As the Chinese Medicine Ordinance prohibits sales outside licensed premises, traders are also shut out of e-commerce in this age of the internet. Clearly, Hong Kong doesn’t know the first thing about nurturing industries.

In Macau, by contrast, common sense prevails. The University of Macau’s Institute of Chinese Medical Sciences has state-of-the-art research facilities, while Hong Kong officials fought Baptist University tooth and nail over a parcel of land targeted for a Chinese medicine hospital.

Last week, the University of Macau signed an agreement with the Guangdong-Macau Traditional Chinese Medicine Technology Industrial Park Development Company to jointly develop pharmaceutical products and promote Chinese medicine, with four proposed centres.

Hundreds of Hong Kong’s manufacturers and traders of traditional Chinese medicine are threatening to relocate to the Hengqin industrial park, where the promise of integration with the mainland market beckons.

Will Hong Kong learn from Macau and not consign the industry to the critical list?

Philip Yeung is consultant to the vice-rector for academic affairs at the University of Macau. Dr Albert Wong, from the University of Wisconsin, and founding president of the Modernised Chinese Medicine International Association, also contributed to this article