China’s proposed tobacco control policy to save lives

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China has the largest number of smokers in the world (301 million) consuming 38% of the world’s cigarettes in 2009, and is the largest tobacco producer in the world manufacturing 40% of the world’s total cigarettes. Seven out 10 adults are exposed to secondhand smoke.  The total number of deaths attributable to tobacco use in China is approximately 1.3 million annually and is expected to increase to 2 million per year by 2020 unless timely action is taken.

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State Tobacco Monopoly Administration heads the largest manufacturer of tobacco products in the world and is responsible for implementing policies such as those governing warnings on cigarette packaging. Chinese authorities have been hesitant to curtail tobacco production and consumption because the tobacco industry is one of the largest sources of  tax revenue, contributing 7-10% of total annual government revenue over the past decade.

Nevertheless, China signed the WHO Framework Convention on Tobacco Control (FCTC), an international tobacco control treaty, which came into full force in 2006. Progress has been slow to fully implement measures in the WHO FCTC; however, China is one step closer with the recent proposal of the national tobacco control law, drafted by National Health and Family Planning Commission.

The new law would impose smoking bans in most public spaces, ban tobacco advertising, promotion and sponsorship, and introduce graphic warning labels on all tobacco packages. The public commenting period to the State Council is closed and the comments are being analyzed.

For the draft regulations to achieve their maximum impact, the State Council should fully adopt the regulations immediately. National People Congress members are also encouraged to voice their support for the full suite of regulations that can save millions of lives. Meanwhile, NGOs’ efforts to inform the public should be maintained to increase awareness on the topic.

 

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6 Responses to “China’s proposed tobacco control policy to save lives”

  1. ynangwenyi Says:

    Passing a national tobacco control law will be a major achievement especially since secondhand smoking affects such a big proportion of the public. After that, they will need to enforce it. Unfortunately, there are countries with laws on the books that they don’t regulate. I agree with your idea about the role of NGOs–this will involve social and behavior change communication with the public.

  2. rebecca7w Says:

    Tobacco control in China has had a fraught history partly due to the involvement of high-ranking politicians and corruption within the government, e.g. is it a coincidence that “the regulator, the State Tobacco Monopoly Administration, also runs the world’s biggest cigarette maker, China National Tobacco Corp” (http://www.bloomberg.com/news/articles/2011-09-20/china-endorsing-tobacco-in-schools-adds-to-10-trillion-gdp-cost)? It is disturbing that up to 10% of government revenue could be attributed to this industry alone! Raising taxes on tobacco sales to a prohibitive level could be another solution – the World Bank estimates that “on average, a price increase of 10% on a pack of cigarettes would reduce demand for cigarettes by about 4% for the general adult population in high income countries” (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228562/).

  3. Raj Singaraju Says:

    I agree, passage of the law is a major achievement and as you point out it is likely to have have problems with enforcement, at least initially. Perhaps China could look to its neighbors for help and lessons learned. Thailand implemented similar changed in the 1990 and faced similar opposition. This might be a good model. http://www.tobaccocontrollaws.org/legislation/country/thailand/summary

  4. kshim6 Says:

    Chinese government has been putting great effort to regulate the tobacco control although they have faced several political and social factors that made China has failed to properly pursue FCTC policies.
    I agree that introduction of the new law and following implementation would help to reinforce the tobacco control policy. It is just from my personal curiosity but how does Chinese government currently promote NGO’s efforts and activities in reducing the tobacco consumption?

  5. zohaibakhtar2015 Says:

    The prevention of smoking in young Chinese is considered the single greatest opportunity for preventing noncommunicable disease in the world today. About 2/3 of the men become daily smokers before reaching 25 years of age and only few quit smoking which makes makes is important to have strict policies to prevent people from starting smoking. Having a ban on public smoking and limit on advertisement will decrease the desire in Chinese youth to start smoking. Banning in public space will also be beneficial in preventing harm from second hand smoke.

  6. Christian Larsen Says:

    Thank you for highlighting this issue. The ban on overt cigarette use in films in 2011 and the 2014 legislation to ban indoor smoking sends a strong message to the public and provides assurance that the government is not just paying lip service in response to pressure from the WHO (see WSJ article below). In conjunction with changes to the party line, there will need to be an accompanying shift in the publics perceptions of smoking if these laws are are going to have a lasting impact. The Health Belief Model applies well to this scenario. The perceived susceptibility/seriousness of cancer, CVD, and COPD; the knowledge about the health consequences of smoking (including second hand smoke); and the cues to action in their environment, such as peers or family members pursuing smoking cessation, will feed into the final decision to embrace smoking cessation.

    Critical among the cues to action for smoking cessation are the values promoted by healthcare workers themselves. Just out of university, I worked at a Neurosurgery hospital in central Shanghai. My colleagues were fantastic clinicians, but, between operations, would stand outside and share a cigarette with their patients’ families. The patients themselves often came to the clinic late into the course of their illness complaining of severe late stage sequelae. They were working class, and their health literacy was understandably limited. But they held their doctor’s opinion in very high esteem. Beyond legislation, the support of both the western and traditional medical communities will be chief in curtailing China’s rising burden of smoking associated diseases.

    WSJ Article:
    http://www.wsj.com/articles/china-considers-tobacco-advertising-limits-public-smoking-ban-1416879973

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