More Cool PR Happenings in HK: Anti-Tobacco Initiatives

I abhor cigarettes and strongly support any legislation that removes cigarettes and their cancer-causing-stinky-smoke from my life.* I’m also really interested in health communication (thanks in large part to my dad’s influence working on global public health campaigns) so I tend to take notice of anti-tobacco initiatives, which strike me as the most interesting.

Why the most interesting? How about because for years and years now there has been proof that smoking causes irreparable damage to the body – everything from bad skin and stained teeth to dozens of types of cancer and other debilitating, fatal diseases – and this information is readily available to the masses. Smoking has absolutely no benefits and its harmful effects are even outlined on the product packaging. And cigarettes are increasingly expensive. My sister once figured out that with the amount of money she spent on cigarettes over 10 years of smoking she could’ve bought a luxury car. (For those interested, she successfully quit smoking – she is amazing!) So you can waste large sums of money while increasing your odds of dying early, slowly and painfully. Sounds like a great time, right? Yet with all this information and all these reasons not to smoke, every day people make the decision to start smoking…and then get addicted, become unable to quit, and pay the consequences with their health and quality of life. Why do they continue to choose cigarettes? If that’s not a fascinating and challenging problem to solve, then I don’t know what is.

I digress…but that’s the danger of letting me have an internet pulpit to preach from. Anyway, there’s a lot of cool stuff happening in Hong Kong with anti-smoking and health campaigns that I thought I’d share with you.

First off, Hong Kong, like many Asian countries, is a smoking society. In Hong Kong, cigarettes are an integral part of culture – walk into any mahjong parlor and you’ll understand. When something is so ingrained in society and traditions, it is incredibly hard to change behaviors surrounding it. In an earlier blog post I mentioned the ubiquity of city ashtrays on every street corner, and the policing of cigarette butts – drop on one the ground and you’ll get slapped with a ticket. There are also fines for spitting in public (and sorry smokers, you’re the biggest offenders)…so at least it’s a clean city, even if it’s a smoky one.

What I think is pretty awesome are the warning labels on cigarette packages here. Instead of just a small text box, the warning labels cover almost half of the cigarette packaging and contain explicit, graphic images of the health hazards of smoking. There are dozens of different warning pictures and each is equally disgusting and disturbing. One image is very culturally interesting – it shows an old Asian woman with dark and haggard skin yearning for her youth when she had pure, fair skin.

The warning images are the work of the World Health Organization and other partner organizations that are pushing for graphic warnings to become the international standard for cigarette packages. Canada, Australia, several European countries and several Asian countries have adopted these warning labels. The United States, however, hasn’t changed its warning labels – small white and black print on the side of the package – since 1984, according to the WHO. Ah, to be a citizen of Marlboro Country.

The idea behind the graphic warning labels is that images are more emotionally charged than text and may be more likely to evoke behavioral change. Use of these labels has had positive results in Canada and Australia, according to the WHO.

I agree that the images are shocking – but what I think is even more significant about using pictures rather than pure text, is that images are universal and can transcend constraints of language and literacy. For example, in Hong Kong where Cantonese, Mandarin and English are widely spoken in addition to dozens of other Asian languages – how does one decide what language to print warning labels in? Or for the large population of illiterate smokers, especially in developing countries, what good is a warning that cannot be read and understood? The graphic warnings leave no room for misinterpretation that the cigarettes inside the box will cause you harm.

It’s important to point out that this sounds great – and makes me happy – but smokers live in a reality, rather than in the WHO’s innovative campaign vacuum…much as they may wish it were otherwise. For many smokers, the images have become normalized and merely blend into the packaging – just another warning label like any other. There’s also apparently a novelty in collecting the different images…like baseball cards for smokers…and it’s always “exciting” when new images debut on packages. The graphic warnings may be doing more to appease people like myself who are already against smoking (“Oh look at that! That’s good that they’re doing that! Smoking is so bad!”) than to deter smokers from lighting up or convince smokers to quit.

In addition to adding explicit images on cigarette boxes, HK is making moves to eliminate images of cigarettes in popular culture: CoCo Avant Chanel movie posters throughout the city have had the cigarette airbrushed out of Audrey Tautou’s hand. Similar airbrushing has occurred in several countries, including France, interestingly enough.

Finally, and very timely I might add, July 1st (today) a smoking ban went into effect, making it illegal to smoke in nearly all public places in Hong Kong. Leading up to the ban, smoking was prohibited in some bars and clubs, and as of today, the ban has been extended to cover all indoor public spaces such as restaurants and workplaces, even mahjong halls and massage parlors. The same Tobacco Control Officers who issue tickets for throwing cigarette butts will enforce the ban with fines of up to $5,000 HKD ($645 USD). Lobbying groups in opposition of the new legislation argued that the economic slump should be reason enough to postpone the ban – restaurants and bars all already experiencing diminished business due to the economy and the HK Bar and Club Association claims that 90 percent of customers are smokers and the ban will have a devastating effect on business. The Hong Kong government initiated the ban to protect both workers and non-smokers from second-hand smoke, which has all the same harmful effects as smoking does.

It will be interesting to see where Hong Kong is a one, three, five and ten years from now in terms of smoking behavior and health outcomes.



*I feel it is appropriate to explain that I know many wonderful, caring, good people who happen to be smokers – I do not think you are a bad person if you choose to smoke. Everyone should be able to do what they choose to with their body and no one should be able to tell them otherwise. I understand that addiction is a disease in itself - I sympathize with those who struggle with addiction and admire those who overcome it. That being said, I personally believe – and as someone who wants to use communication and public relations to make a positive impact on the world – that individuals should be provided with accurate and easily accessible information about risky behaviors to then be able to make informed, personal choices. The effective delivery and internalization of this information, as well as the protection of individuals who do not smoke and often are exposed to second-hand smoke, is what I am advocating for.

That’s also my Miss America speech, for those of you wondering…