Effects of strong government measures against tobacco in Hong Kong.

Mackay, Judith; Barnes, Glen

doi:10.1136/bmj.292.6533.1435

Cited by 19 publications

(15 citation statements)

References 2 publications

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“…Several factors could have contributed to high reactivation risks in Hong Kong compared to the United Kingdom : nutrition (likely to have been unsatisfactory in Hong Kong prior to 1950) ; smoking (peaked during the 1970s in Hong Kong compared the 1950s in the United Kingdom and Western populations, although the overall consumption was similar in the two settings [21][22][23]) ; genetics (if tuberculosis arrived recently in South East Asia, then the prevalence of susceptibility genes for tuberculosis disease may still be high [24]) ; predisposing co-infections or environmental conditions (e.g. silicosis, which is a strong risk factor for tuberculosis [25], was the second most commonly notified occupational disease during the 1990s in Hong Kong [26]) ; or the pathogen itself (most of the isolates of M. tuberculosis found among Asian tuberculosis cases belonged to the Beijing family of strains [27,28], although its association with the risks of developing disease remains unclear).…”

Section: Discussionmentioning

confidence: 99%

Limited impact of tuberculosis control in Hong Kong: attributable to high risks of reactivation disease

Vynnycky¹,

Borgdorff

Leung³

et al. 2007

Epidemiol. Infect.

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SUMMARYOver 50% of the global burden of tuberculosis occurs in South East Asia and the Western Pacific. Since 1950, notification rates in high-income countries in these settings have declined slowly and have remained over ten-fold greater than those in Western populations. The reasons for the slow decline are poorly understood. Using an age-structured model describing the incidence of Mycobacterium tuberculosis infection and disease applied to notification data from Hong Kong, we illustrate that in Hong Kong, a high prevalence of M. tuberculosis infection among older individuals and a high risk of disease through reactivation (e.g. up to 17-fold greater than that estimated for infected males in the United Kingdom) may explain this slow decline. If this feature of the epidemiology of tuberculosis is widespread, the WHO directly observed treatment short-course (DOTS) strategy may have a smaller impact in Asia in the short term than has been implied by recent predictions, all of which have been based on disease risk estimates derived from Western Europe. As a result, it may be difficult to meet the targets for tuberculosis control, which have been prescribed by the UN Millennium Development Goals.

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Section: Discussionmentioning

confidence: 99%

Limited impact of tuberculosis control in Hong Kong: attributable to high risks of reactivation disease

Vynnycky¹,

Borgdorff

Leung³

et al. 2007

Epidemiol. Infect.

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“…In Hong Kong, however, cigarette consumption in men had already reached 10 a day by the early 1970s, 4 5 which, although 20 years later than the United States, was 20 years ahead of mainland China. In 1955 about 21% of all US male deaths in middle age and 5% of those at older ages were attributable to smoking 7.…”

Section: Discussionmentioning

confidence: 99%

“…In the largely (95%) Chinese population of Hong Kong, however, the prevalence of cigarette smoking reached its peak about 20 years earlier than in mainland China (but about 20 years later than in the United States), 4 5 and the present case-control study assesses the mortality currently associated with smoking among them.…”

Section: Introductionmentioning

confidence: 87%

Mortality and smoking in Hong Kong: case-control study of all adult deaths in 1998

Lam

Hedley³

et al. 2001

BMJ

169

121

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Objective To assess the mortality currently associated with smoking in Hong Kong, and, since cigarette consumption reached its peak 20 years earlier in Hong Kong than in mainland China, to predict mortality in China 20 years hence. Design Case-control study. Past smoking habits of all Chinese adults in Hong Kong who died in 1998 (cases) were sought from those registering the death. Setting All the death registries in Hong Kong. Participants 27 507 dead cases (81% of all registered deaths) and 13 054 live controls aged >35 years. Main outcome measures Mortality from all causes and from specific causes. Results In men aged 35-69 the adjusted risk ratios (and 95% confidence intervals) comparing smokers with non-smokers were 1.92 (1.70 to 2.16) for all deaths, 2.22 (1.94 to 2.55) for neoplastic deaths, 2.60 (2.10 to 3.21) for respiratory deaths (including tuberculosis, risk ratio 2.54), and 1.68 (1.43 to 1.97) for vascular deaths (each P < 0.0001). In women aged 35-69 the corresponding risk ratios were 1.62 (1.40 to 1.88) for all deaths, 1.60 (1.33 to 1.93) for neoplastic deaths, 3.13 (2.21 to 4.44) for respiratory deaths, and 1.55 (1.20 to 1.99) for vascular deaths (each P < 0.001). If these associations with smoking are largely or wholly causal then, among all registered deaths at ages 35-69 in 1998, tobacco caused about 33% (2534/7588) of all male deaths and 5% (169/3341) of all female deaths (hence 25% of all deaths at these ages). At older ages tobacco seemed to be the cause of 15% (3017/20 420) of all deaths. Conclusions Among middle aged men the proportion of deaths caused by smoking is more than twice as big in Hong Kong now (33%) as in mainland China 10 years earlier. This supports predictions of a large increase in tobacco attributable mortality in China as a whole.

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“…Tobacco advertising and sponsorship are prohibited; however, the display of cigarettes at retail outlets is allowed, and indirect tobacco promotions in movies have been documented 4. Free smoking cessation services are provided and the government has pledged to promote a smoke-free Hong Kong through comprehensive smoke-free legislation, banning tobacco promotions, and public education 5. Nonetheless, the government currently has not laid out a plan for ending tobacco use.…”

Section: Introductionmentioning

confidence: 99%

The tobacco endgame in Hong Kong: public support for a total ban on tobacco sales

Wang

Lam

et al. 2013

Tob Control

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A total ban on tobacco sales was supported by most respondents. Ex-smokers and current smokers also voiced substantial support, although less than never smokers. A total ban on tobacco sales before 2022 should be the goal as it is supported by most of the respondents. Interim tobacco control measures, such as tax increases, expansion of smoking cessation services and plain packaging should be implemented to help current smokers quit and reduce smoking initiation before implementation of the ban.

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Effects of strong government measures against tobacco in Hong Kong.

Cited by 19 publications

References 2 publications

Limited impact of tuberculosis control in Hong Kong: attributable to high risks of reactivation disease

Limited impact of tuberculosis control in Hong Kong: attributable to high risks of reactivation disease

Mortality and smoking in Hong Kong: case-control study of all adult deaths in 1998

The tobacco endgame in Hong Kong: public support for a total ban on tobacco sales

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