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Our Financial Secretary John Tsang Chun-wah is prepared to increase the duty on each cigarette stick by 20 HK cents. Soon, an international brand of a pack of 20 will cost HK$54 instead of HK$50.

Dr Carmen Audera-Lopez, the acting team leader of the World Health Organization's tobacco-free initiative in the Western Pacific region, has predicted the price increase and applauded the decision. She commented that the Hong Kong government could increase it even more. She said, "The suggested tax increase is only a moderate one and considering that it has not been increased since 2011, it is probably just compensating for inflation". For tax rises to work, she said, they must occur regularly to make the habit less affordable.

Unfortunately, the hardship will hit the lowest-income group hardest, which happens to have the highest percentage of smokers. A few of them might successfully quit the habit because they cannot afford it anymore; meanwhile, the majority will continue to buy cigarettes at a higher cost, and hence become mired deeper in poverty.

It is an easy decision for our financial secretary to make because it is a popular move and it puts more money into the government coffers. He, of course, has carte blanche to bash smokers because they are perceived to be inconsiderate, addictive villains and most of all, a minority (about 11 percent) in society.

Rhetoric aside, the anti-smoking crusaders' main gripe is the harmful effect of passive smoking, and indeed, smoking in the presence of those who detest the smell or involuntarily suffer ill-health from it is indefensible. The fact that many smokers try defending their behavior makes the situation more offensive. It is no wonder that every issue associated with smoking elicits emotive and vitriolic reactions from the anti-smoking lobby. Anti-tobacco policies backed by the government are generally hostile towards smokers, including raising the tobacco tax over and over again.

In my opinion, there is no place for outright hostility toward anyone addicted to anything. Although perceived as a weakness, addiction is part of human nature, and we are all prone to it. Hostility derived from fanaticism does not win hearts or change behavior. After all, tobacco consumption is legal, and is not the only thing in this world that is killing us slowly.

Hostility breeds hostility, and usually results in defiance and or even illegal counter-measures. The government should brace itself for a surge in smuggling of mainland cigarettes when the tax increment for tobacco becomes effective.

The most unsavory aspect of smoking is that people usually become hooked when they are young and reckless, and it is an addiction which is very hard to kick. For centuries, emperors in China tried banning tobacco smoking among their subjects by imposing punishments as drastic as the death penalty, but without success. I had one patient who was able to kick his heroin addiction, but continued to smoke after numerous attempts to quit. This is the kind of addiction we are dealing with.

Regardless of the price hike, smokers will continue to smoke, and as long as adults smoke and tobacco is available, more youngsters will pick up the habit - a reality cogently illustrated by heroin addiction.

Perhaps there should be a change of tack in dealing with smokers. Instead of concentrating on efforts to punish tobacco addicts by making them pay more for their bad habit, society could do more to help them. The government could orchestrate a campaign to promote responsible smoking behavior, such as abstinence in the company of people who are vulnerable or object to the smoke. If all smokers are considerate of non-smokers, there will definitely be less unsympathetic and hostile anti-smoking crusaders around.

Instead of a prohibitive tobacco tax, which makes life difficult only for smokers who are poor, there should be widespread government-sponsored clinics providing nicotine-replacement therapy, counseling, hypnotherapy, and other effective treatments of proven value. Are we not doing these things for heroin addicts? Should we not show the same compassion for tobacco addicts?

Even Dr Judith Mackay, the matriarch of anti-tobacco crusaders, once said: "I don't hate the smokers, only the smoking."

The author was a consultant pathologist for the Hong Kong government and St. Paul's Hospital before his recent retirement. He was a lecturer at the Medical Faculty of the Chinese University of Hong Kong and a diplomate of the American Board of Pathologists.

(HK Edition 02/28/2014 page9)