Health services research funding for smoking and related projects, outputs and tobacco control in Hong Kong

Abstract

After several years’ delay and numerous debates, the Hong Kong SAR Government’s proposed amendments to the Smoking (Public Health) (Amendment) Ordinance were passed by the Legislative Council in October 2006. The implementation of a total ban of smoking in restaurants, some indoor workplaces and other public places since 1 January 2007 was an important milestone in tobacco control in Hong Kong. Strong local evidence, derived from many local studies, was used extensively to support more stringent tobacco control proposals. The study results were widely disseminated to promote public awareness of the harm caused by smoking and passive smoking, to solicit support from legislators, the mass media and the public, and to counter opposition. The Health and Health Services Research Fund (HHSRF) has been the main source of research grants for smoking, passive smoking and related projects in Hong Kong. From 1993 to 2006, the HHSRF has funded 13 smoking and related projects with an amount of $2.7 million. The Health Care and Promotion Fund (HCPF) in its early years only, supported 3 such research projects with $2.3 million. 1. Smoking and deaths: A widely cited finding was that about 5700 deaths were attributable to smoking annually in Hong Kong. The results were highlighted in headlines of local newspapers and electronic media and also in the international media, including BBC and CNN in 2001. 2. Secondhand smoke (SHS) and deaths: It was found that SHS was associated with mortality due to cancer, heart disease, stroke and respiratory disease. The finding that secondhand smoke kills about 1324 people in Hong Kong each year was used in a major public health campaign by the Hong Kong Council on Smoking and Health to support smoke-free Hong Kong legislation in 2006. 3. SHS and respiratory health: SHS was found to be associated with excess risk of respiratory ill health, hospitalisation and economic costs in a 1997 birth cohort study. Another study showed a doseresponse relationship between respiratory ill health and SHS exposure in primary school students. 4. Economic costs: Based on the findings above and elsewhere, it was found that the economic loss, excluding the monetary value of a human life, amounted to HK$5.3 billion a year, which was double the amount of tobacco tax revenue. 5. A public opinion survey showed consistently strong and majority support for many stringent tobacco control measures, including a total ban of smoking in restaurants; such a ban would result in an overall increase in patronage. 6. Several randomised controlled trials showed that smoking cessation counselling was effective in improving quit rate. The results have laid solid foundation for training of smoking cessation counsellors and setting up of smoking cessation clinics and telephone quit lines. Many of the studies have resulted in publications in high impact journals and have contributed useful findings to tobacco control internationally, including citations by the World Health Organization. Health services research funding in Hong Kong has made enormous contributions to tobacco control and public health. More and long-term funding and effective translation of scientific evidence into public health advocacy is needed.