香港西醫工會對於
「禁止電子煙，預防勝於治療」
的新聞稿
二零一八年十月五日
致新聞界朋友們：
擁有近二千名會員的香港西醫工會，是香港唯一根據工會註冊條例，由公營及私營醫生聯合組成的工會組織；香港西醫工會不單關注會員的權益及其僱傭關係，更以提升醫生的專業水平，達致民康為己任。
作為醫生，我們接受訓練去治療疾病，以減輕市民的病痛和幫助維持他們的健康狀態。在病菌感染盛行的年代，我們不斷研究和開發更強的抗生素來殺死新出現的病菌，我們在過去幾個十年間已取得了成果。今時今日，傳染病死亡率下降，相反心血管系統慢性疾病、癌症和意外傷害的死亡率則有上升的趨勢。在許多情況下，導致死亡或殘疾的源頭可能已經從微生物轉移到人本身上 ; 帶病毒的水源或昆蟲轉移到充滿脂肪，卡路里和鹽份的膳食 ; 汽車; 或毒品等。一些慢性疾病的風險，與人類的習慣建立了新的關係並喚起了第二次公共衛生革命的決心。
即使香港是世界上人均壽命最長的地方，我們每年亦有一定比例的市民早逝，即是在 65歲之前死亡。如果人們成功採取更健康的生活方式，可以預防多達四分之三的早逝人口比率。透過早期發現及介入，免疫和生活方式行為上的改變，我們可以減低45%心血管導致的死亡、23%的癌症死亡及超過50%的糖尿病併發症。這三個病症在當前的醫學事務中佔主導地位並有著良好的預防系統及措施，為醫生參與促進健康提供了理想的條件。通過更好地控制不多於十個的風險因素，例如不良飲食，運動不足，使用煙草和藥物，濫用酒精，不安全駕駛以及其他一些因素，我們可以防止40％至70％的早死個案。超過三分之一的急性殘疾和超過三分之二的慢性殘疾可以通過改善風險行為來預防。
鑒於這些數據，醫生要更加關注患者的健康及幫助患者採取健康的生活方式，這絕對是醫生的巨大挑戰。醫生如果介入參與現代醫學，如用現時的診斷及治療設施是不足夠的。我們還必須建議患者改變他們的風險因素，幫助他們戒煙，幫助他們採用適當的運動計劃，採用更安全的方法駕駛及性行為等。雖然不久之後患者便會忘記了自己的醫生有參與輔導工作，而其益處，幫助將會於很多很多年以後才能被量度到。
最近我們看到政府迅速採取措施防止超級颱風山竹破壞香港。從政府高層官員的建議確實在減輕整個城市的危險方面發揮了關鍵作用。由這一點出發，我們的醫生在健康保障方面應該處於更好的位置。
除了子宮頸癌的巴氏塗片檢查外，兩年前開始的大腸癌篩查計劃的進展一直順利，亦成功在無症狀長者中檢出6-7%有異常症狀。政府的資助及私營醫生的協作使計劃得以成功地推行。其他的癌症疾病亦應推行類似篩查及治療計劃。
另外心血管疾病的篩查亦十分值得做。在過去兩年，本會為香港市民進行心血管疾病的篩查檢驗，結果非常驚人，透過我們的關心謹腎大行動檢測出相關數目的高血壓，糖尿病和高膽固醇血症的陽性病例。隨著明年初推出政府資助的社區健康中心計劃，我們應該能夠減少現在常見疾病的發病率和減少其禍害。
現在，政府應該堅持禁止電子煙及加熱煙產品進入香港。我們對政府通過“香港配方奶及相關產品和嬰幼兒食品銷售守則”及提倡相關促進兒童健康和兒童發展的舉措及在政府的鼓勵下，設立愛嬰醫院表示讚賞。但是，我們不得不反對政府進口電子煙、加熱煙及新煙草產品到香港的政策，而且事實證明了該類煙草製品會對未來各地年輕人做成極大傷害。香港西醫工會已經從2000名會員中收集了500多個簽名同意全面禁止電子煙和其他新煙草產品進入香港。但根據政府的說法，這個數字還不足以支持禁止電子煙及加熱煙產品進入香港。我們需要更多的簽名來表明我們的決心。現在，隨著禁電子煙大聯盟的成立，我們將共同努力，禁止在香港進口新的煙草產品。我們希望政府盡快實施禁令，並制定一個具體的時間表，以達到無煙香港。
楊超發醫生
有關查詢，請致電九零一三六四七八或電郵 hkdumail@gmail.com / hkdumail@hkdu.org聯絡香港西醫工會會長楊超發醫生。
Press Statement of Hong Kong Doctors Union on
“Ban e-Cigarettes, Prevention is better than Cure”
5th October 2018
Dear Reporters,
Hong Kong Doctors Union is the one and only trade Union specially designed for all doctors in Hong Kong whether working as employee or self-employed. Our primary objectives have changed from the basic task of supervising allocation of public housing estate clinics in the very beginning to higher ideals of safeguarding the welfare and rights of doctors. Our transformation from Estate Doctors Association Ltd. into Hong Kong Doctors Union Ltd. in 2000 proclaimed our final evolution into a strong and committed community to serve all doctors in Hong Kong, to cater for their legitimate rights and welfare, their recreation, continuous education and development. To mark the final stage of evolution, Hong Kong Doctors Union adopted its present name officially in 2002.
As doctors, we are trained to treat diseases to relieve the sufferings of people and upkeep the healthy status of Hong Kong citizens in particular. Since the older days when infections prevailed, we have been developing better antibiotics to kill emerging germs and we have been quite successful in the last decades. Nowadays the declining mortality rate from infectious diseases intersected the rising mortality rate from chronic diseases of the cardiovascular system, cancer, and unintended injuries. In many instances, the agent responsible for death or disability has shifted from the microorganism to the person; the vector has also shifted from contaminated water supplies or insects to diets laden with fat, calories, and salt; likewise the automobile or drugs. The relationship between human behaviour and increased risk for certain chronic diseases is well established. Awareness of the “new morbidity” has summoned the call for a second public health revolution.
In Hong Kong, even with the longest life expectancy in the world, we do have certain percentage of our citizens who die each year prematurely, that is, before the age of sixty-five. If people were successful in adopting healthier behaviour and life style, as many as three-quarters of these premature deaths could be prevented. Through early detection and intervention, immunization, and motivated change in individual behaviour, we could have eliminated an estimated 45 percent of cardiovascular deaths, 23 percent of cancer cases and over 50 percent of the disabling complications of diabetes mellitus. These three conditions dominate the current practice of medicine and, with the enormous areas for prevention, offer an ideal entry for health providers' involvement in health promotion. With better control of fewer than ten risk factors such as poor diet, inadequate exercise, the use of tobacco and drugs, the abuse of alcohol, driving unsafely, and a few others, we could prevent between 40 and 70 percent of all premature deaths. More than one-third of acute disabilities and over two-thirds of chronic disabilities are preventable by improving risky behaviour.
Given these data, the great challenge for doctors is to pay more attention to helping patients to adopt healthy behaviour. Doctors’ desire to intervene with the power of modern medicine, with the diagnostic and therapeutic armamentarium now at hand, is insufficient. We must also counsel patients to understand and modify their risk factors, help them quit smoking, help them initiate an appropriate exercise program and engage in safer practices in driving, sex, etc. The counselling benefits will be documented and appreciated many, many years later – long after patients have forgotten their doctors' involvement.
The immediate effect we had seen recently was the result from Government's prompt measures to prevent and alleviate damages from the Super typhoon Mangkhut which salvaged Hong Kong lately. The advice from the top Government officials had been playing a pivotal role in minimizing the damages of the whole city. With that in mind, we doctors should be in a better position when it comes to health hazards.
Apart from Pap smear screening for Carcinoma of Cervix, the Colorectal Carcinoma screening programme started two years ago has been doing a good job in sorting out 6 to 7 % abnormalities in asymptomatic elderly citizens. The success is due to the cooperation from our private colleagues under adequate funding from the Government. Further programmes should be brought up to screen and treat other types of cancers.
Another screening test worth much doing is that for the cardiovascular events. Hong Kong Doctors Union has been screening Hong Kong citizens for the last two years and the result is quite alarming, exposing positive cases for hypertension, diabetes mellitus and hypercholesterolemia through our screening programme initiated by the Heart Kidney Care Alliance. With the launching of the community health centre early next year and with the funding from the Government, we should be able to decrease the occurrence and harmful consequences of these common diseases of the modern world.
Now comes the import of e-cigarettes and Heat-not-Burn new tobacco products into Hong Kong which illogically the Government tends to insist. We have applauded the Government in the work of safeguarding health and in promoting breastfeeding among all newborns and children by the Hong Kong Code of Marketing of Formula Milk and Related Products, and Food Products for Infants & Young Children. With the encouragement from the Government, there is establishment of a number of Baby friendly Hospitals and initiatives in supporting child health and child development. However, we have to argue with the Government against her intended import of such new tobacco products with solid evidence from the harm already done to our younger populations elsewhere. Hong Kong Doctors Union has collected more than 500 signatures from among our 2000 members in supporting a total ban of e-cigarettes and other new tobacco products. This number, according to the Government, is not good enough to achieve our mission. We need more signatures from the city to show our determination. Now, with the establishment of the Total Ban e-Cigarettes Alliance, we shall work together against the import of new tobacco products into the city. We wish the Government will implement the ban as soon as possible and to formulate a concrete timeline to achieve a smoke free healthy Hong Kong.
Dr. Yeung Chiu Fat Henry
President
Hong Kong Doctors Union
For enquiries, please contact Dr. Yeung Chiu Fat, President, HKDU at 9013 6478 or Email: hkdumail@gmail.com / hkdumail@hkdu.org