Next Magazine (Second opinion A004, 2012.10.11)

I have never smoked tobacco. Well that is not quite true. When I was
about 10 years old, my 10 year older big sister, who was a nurse,
forced my younger sister and I to take a puff. We choked. I don’t
think either of us have smoked anything since.That was big sister’s
intention. She was a smoker herself, but as a medical person, she knew
the potential health problems and wanted to leave us a legacy of
aversion to the habit.

The odor of tobacco had never troubled me much, but does disturb some
a lot. As a long fan of Tolkien, I have always found the romance of
the tobacco pipe seductive, but could not overcome the aversion to
tobacco inculcated by my sister.Big sister probably did me a favor.
However, although my parents left me no genetic big brother, I find
that, courtesy of the Hong Kong government, I have one anyway. The
Tobacco Control Office in the Department of Health has a mandate to
enforce the control of tobacco laws across Hong Kong and to educate us
about the health risks of that particular weed. This substitution of
the state for the wisdom of the family can be offensive. Wandering
through the picturesque botanical gardens recently I was confronted
with massive banners everywhere from the tobacco controllers decrying
the evils of smoking. These detracted from the natural environment in
the reserve. I am sure that the guardians of the reserve would not
permit commercial advertising in the same area. Why the double
standard that allows offensive promotion from a government
agency?These anti smoking messages are increasingly pervasive, but
beyond undermining the esthetics of public places they also come at a
cost. The Department of Health advised the Legco that it budgets
spending $155 mn on tobacco control in 2012-3. This spending has grown
enormously over the past five years from just over $55 mn in 1997-8.
This is a 22% compound annual growth, well above the rate of
inflation. Why such growth? Is smoking a problem that is getting worse
in Hong Kong?

Not according to the figures from the Office of Tobacco Control
itself. The prevalence of daily smokers has dropped from 23% of the
population in 1982 to 11% in 2010, with most of the reduction
happening before we had an Office of Tobacco Control, with its array
of legislation and enforcers. Indeed it seems that tobacco consumption
changes with different work patterns and declines as countries become
more prosperous. Most decline does seem to be driven by big sister
rather than by big brother – it is amongst men that the decline is
largest. There are growing social pressures on people who smoke to
consider the comfort of those who do not. There always have been.
Smokers have been relegated from the kitchen to outdoors for decades
and the sanction of many women preferring non smoking partners has
provided a powerful incentive for change.Little of this requires multi
million dollar budgets from the government. All that is required is
more knowledge, common sense and the disciplines from living with our
families and friends.It is perverse that as tobacco use declines, we
spend more money on the same issue with declining effectiveness.
Surely if advocates believe their programs are effective, they should
have a tangible plan to eliminate that spending when it has served its
purpose. Resurgence of smoking seems unlikely. Evidence and attitudes
have changed. I however rather doubt that big brother will exercise
self-restraint. Those who want control over the lives of others will
always want to expand their power. Wintness Mayor Bloomberg’s recent
move to dictate what size soda that New Yorkers are allowed to drink.
It will no doubt be argued that the government gets value for money
from manipulating people’s smoking behavior, for instance, saving
health care costs. Yet surely this is an argument to make sure people
see the costs of their own health care rather than impose them on
fellow taxpers. Where does behavior modification to save money or
promote the national interest stop?Big brother has gone far enough in
Hong Kong.

Bill Stacey is in his 10th year as a resident of Hong Kong and is Chairman of the Lion Rock Institute.

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