BACKGROUND AND IMPLEMENTATION CHALLENGES: Since April 2022, Hong Kong has banned the import, promotion, manufacture, sale, or possession for commercial purposes of electronic cigarettes (ECs) and heated tobacco products (HTPs). The most intensive tobacco industry opposition and interferences were encountered throughout. The proposed ban was almost replaced by a regulation regime exempting HTPs.
INTERVENTION OR RESPONSE: As the statutory tobacco control organisation in China’s Special Administration Region, Hong Kong Council on Smoking and Health (COSH) counteracted the interferences from the tobacco industry and its allies, especially some legislators connected to the industry. COSH led and organised extensive publicity campaigns, such as community exhibitions and school talks, to raise public awareness of the harms of ECs and HTPs especially to children, reveal tobacco industry tactics, and explain the importance of the ban to protect the next generation from smoking and nicotine. COSH actively engaged the medical, health and education sectors, and parent, patient and youth groups in press conferences and briefings, petitions, rallies, and lobbing to legislators to gather the strongest support possible for a total ban with no exemption throughout the six-year war.
RESULTS AND IMPACT: The multi-sectoral and massive collaborations, with solidarity and perseverance, were unprecedented in the public health history of Hong Kong. The strongest demands from schools, parents and students were most compelling and instrumental in successfully combating industry interferences, urging government to stand firm on banning, and urging legislators to pass the proposed ban and reject opponents’ amendments to exempt HTPs. The cigarette smoking prevalence decreased from 9.5% in 2021 to 9.1% in 2023, while EC and HTP use remined low.
CONCLUSIONS: Persistent and concerted efforts across society to protect the next generation were the key to counteracting tobacco industry interferences and passage of the ban. The post-ban reduction in the smoking prevalence, although small, implied that neither ECs nor HTPs are essential for tobacco control.