BACKGROUND: In Hong Kong, the smoking prevalence is already-low and the proportion of smokers lacking motivations to quit increases. Despite smoke-free legislation, cessation services and health warnings at the best-practice levels, the decline in smoking prevalence has decelerated in recent years. For almost a decade, the tobacco tax was frozen before a 32% increase each in 2023 and 2024. We investigated whether tax increase motivated smokers in Hong Kong to smoke less.
METHODS: Territorially-representative surveys collected data from 1,597 current smokers (weighted mean age 50.7±15.5 years; 82.6% male) in 2022, 917 current smokers (53.4±13.5 years, 88.9% male) in February 2024 (after 2023 tax increase and before 2024 tax increase) and 1,482 current smokers (48.6±14.6 years, 81.5% male) between March and May 2024 (after 2024 tax increase). The frequency of smoking and daily cigarette consumption in the past 30 days, and any intention to quit were reported. Data were weighted to represent smokers in the Hong Kong population.
RESULTS: In 2022, 84.8% of current smokers smoked daily. The proportion reduced to 69.8% (p<0.001) after the 2023 tobacco tax increase, and further to 54.1% (p<0.001) after the 2024 tax increase. In daily or almost-daily smokers, the average cigarette consumption reduced from 14.4 sticks per day in 2022 to 11.5 sticks per day (p<0.001) after the 2023 tax increase, and remained similar (11.4 sticks per day) after the 2024 tax increase. Similar trends were observed in smokers not intending to quit.
CONCLUSIONS: Tobacco tax increase may at least motivate smoking reduction if not quitting in Hong Kong. This dispels the doubts over the effectiveness of tobacco tax increase in settings with low smoking prevalence and smokers lacking motivations to quit, and lends support for further tax increase in Hong Kong.