Smoking In China: Lacking In Effective Cigarette Cessation

Like with emissions control and human rights, the Chinese government will publicly say one thing and then do another. Reducing cigarette smoking is in that same camp.   China is the world's largest producer and consumer of cigarettes, with more than 300 million smokers. The annual cigarette related death toll of 1.4 million (which includes approximately 100,000 deaths blamed on second-hand smoke) is expected to triple by 2050. 

Like with emissions control and human rights, the Chinese government will publicly say one thing and then do another. Reducing cigarette smoking is in that same camp.  

China is the world's largest producer and consumer of cigarettes, with more than 300 million smokers. The annual cigarette related death toll of 1.4 million (which includes approximately 100,000 deaths blamed on second-hand smoke) is expected to triple by 2050. 

Ten articles just published in a supplement of the journal Tobacco Control report findings from research conducted in China by the University of Waterloo's International Tobacco Control Policy Evaluation Project (ITC Project), a 23-country partnership led by Waterloo professor Geoffrey T. Fong that examines the impact of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). China joined the FCTC in 2006 

In collaboration with the Tobacco Control Office of the China Center for Disease Control and Prevention, the ITC Project conducted surveys of more than 5,000 adult smokers and 1,000 non-smokers in seven cities in China in 2006, 2007-08, 2009, and 2011-12. In one paper, authors estimate that China's decision to implement text-only health warnings, rather than pictorial warnings resulted in an estimated 28.5 million fewer smokers noticing the warning. This estimation is based on ITC comparative surveys in Malaysia showing a 12.5 percent increase in noticing warnings after they were changed from text to pictorial warnings, compared to an increase of only 3.1 percent in China.  

Another study reports people were smoking in more than two-thirds of restaurants visited by smokers, and more than half of indoor workplaces, indicating ongoing high levels of second-hand smoke exposure in public places. Smoking bans in Ireland and France led to a decrease of smoking in restaurants from over 70 percent to less than 5 percent. In China the largest decrease was from 93 percent in 2007-08 to 67 percent in 2011-12 after Beijing implemented a partial smoking ban in restaurants.  

The authors recommend a broader smoke-free law, pictorial health warnings, and strong controls on misleading marketing. They also recommend putting an end to harmful cigarette design practices. China banned descriptors such as light, mild, or low tar on cigarette packages in January 2006 in accordance with Article 11 of the FCTC, and the maximum tar yield on cigarettes was lowered in 2011, but the authors claim other marketing strategies are deceptive. They list white or light blue package colors suggest to Chinese people that will mean the cigarettes are less harmful. Changes in cigarette design are being used to meet reduced tar limits. 

The supplement can be downloaded at: http://tobaccocontrol.bmj.com/content/24/Suppl_4.toc

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