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Clearing the Air Attack on Smoking Begins

"China’s Ministry of Health is taking action to address the soaring costs of China’s seemingly insatiable appetite for smoking.

Mao Qun’an, a spokesman for the Ministry of Health (MOH), said that a panel of MOH officials and experts is revising a set of government regulations on public health.

In part, this reflects the country’s efforts to fulfil its commitments as a signatory to the World Health Organization’s WHO Framework Convention on Tobacco Control (WHO FCTC), the world’s first international treaty to control smoking and its ill effects, and it is also meant to provide for a smoke-free Olympic Games in 2008.

China began fulfilling its commitment to the treaty in January 2006. The treaty requires the banning of tobacco advertising, promotions and sponsorships via radio, television, the print media and the Internet within five years; prohibiting tobacco sponsorships of international events and activities; forbidding the selling of tobacco to under-age consumers; and many other detailed stipulations. China is obligated to submit a report to the World Health Organization (WHO) detailing how it has honoured the treaty in 2008.

“Complicated questions and interwoven interests relevant to the tobacco sector, such as raising prices and taxes, forbidding tobacco advertising or sponsorships, placing alerts on tobacco packs and anti-smuggling cannot be covered by a regulation, therefore, a special law is necessary,” said Cui Xiaobo, a professor at Capital Medical University and member of the preparatory panel. “The WHO Framework Convention on Tobacco Control we signed has the status of international law, and a new code is needed to implement this international law in the form of domestic law.”

The “regulation” Cui refers to is the Regulations on Health Management in Public Areas issued by the State Council in 1987, which contains scattered mentions only of limited smoking controls in public places. 

“China, as a signatory to the WHO FCTC, began implementing relevant commitments from January 2006, which needs the support of corresponding domestic laws,” said Tao Jin, chief of the Department of Maternal and Child Health Care and Community Health of MOH, “but due to the time-consuming procedures of law-making, what we can do right now is revise and optimize the existing 1987 regulations.”

Mao said revision of the Regulations on Health Management in Public Areas, is under way. The revision will be submitted to the central government for examination and approval.

“Educational and medical institutions, and places offering services to children will be among the first places with smoking bans,” he said.

Gains from Tobacco Offset by Losses

Beijing adopted local rules banning smoking in public places in May 1996, but the ban has been effectively enforced by airline companies only, which have prohibited smoking on all domestic and international flights. Smoking remains rampant and unchecked in other public places such as restaurants, cinemas, offices and railway stations despite numerous “No Smoking” signs.

Lax control of smoking has resulted in serious consequences for society. China incurred losses of 250 billion yuan (US32.5 billion) from smoking in 2005 balanced against negative gains of only 240 billion yuan (US$30.9 billion) in tax revenues, according to a November 15, 2006, report released by Peking University’s China Center for Economic Research.

About 350 million smokers in China consume one-third of the world’s cigarettes, and they are imposing second-hand smoke on more than half of the non-smokers in China.

As one expatriate restaurateur in Beijing said, “I would have no objection to banning smoking in my restaurant. It fouls the air for everyone in the restaurant. I can hardly wait to get home at night to get out of my stinking clothes. I can’t avoid it.”

In addition to its consumption, China and its tobacco industry is responsible for one-third of the world’s tobacco output.

Although the tobacco industry is one of the biggest contributors of tax revenue, more than that of any other industry and accounting for nearly 10 percent of the fiscal revenue of the central government, the social costs of smoking are offsetting the value of the tax revenues, said Yang Gonghuan, deputy director of the Chinese Center for Disease Control and Prevention. The costs are most obvious in increasing medical expenses nationwide. The value of tobacco taxes will be dissolved in increased medical costs, labour losses and other social expenses, said Yang.

The health costs associated with treating 23 smoking-related illnesses amounted to about 166.6 billion yuan (US$21.4 billion) in 2005, accounting for almost 1 percent of the country’s gross domestic product (GDP); while the indirect costs of smoking (second-hand smoking, fires, environmental problems and others) was estimated at 86.1 billion yuan (US$11.1 billion) to 120.5 billion yuan (US$15.5 billion).

That is why China participated in the initiation and implementation of the WHO FCTC.

However, just the revision of the existing regulation has encountered wide-ranging resistance from the tobacco industry.

Zhang Bin, deputy director of the Ministry of Health’s Department of Maternal and Child Health Care and Community Health, said tobacco enterprises commonly held a negative attitude towards the revision when he met with them to discuss the revision of the regulations about smoking control in June 2006.

“According to the treaty, every cigarette package should be marked with eye-catching alert signs covering more than 50 percent (no less than 30 percent at the least) of the visual part. And just this single article has been strongly opposed by tobacco producers, who claim it would seriously affect the sale of cigarettes and cause heavy losses to the tax revenue of the state,” said Zhang. “And they also hold strong opinions against the expansion of public place identifications (where smoking control is eligible) like the covered spaces outside of restaurants.”

Some producers are trying to lower the thresholds contained in the new law concerning the use of marketing terms such as “low-tar”or “light” on cigarette packages. “These are all lies,”said Cui. “These expressions are all going to be banned by the special law as we have to strictly abide by the convention.”

Ensuring a Non-Smoking Olympics

Aside from assisting the implementation of the WHO FCTC treaty, the revision is also designed to offer policy support in the run-up to a smoke-free Beijing Olympic Games in 2008.

As early as 2004, in his meeting with World Health Organization Director-General Lee Jong-Wook, Chinese Premier Wen Jiabao said a smoke-free Games is at the top of the agenda in the country’s preparations for a Green Olympics.

Zhang, in a May 2006 press conference, said the MOH is cooperating with the Beijing Organizing Committee for the Games of the XXIX Olympiad (BOCOG) to ensure a smok-free Games.

Smoking will be banned at all designated hospitals offering Games’ service by the end of 2007, Zhang said. And the ban will also be expanded to public places like public transportation pools and offices, with places that offer services to children a top concern.

A “Smoke-free Olympics Action Plan” (draft) was also passed at a symposium held in September in Qingdao, a co-host city of the 2008 Games.

The plan established the goals of designating non-smoking venues; banning tobacco advertising and sponsorships at venues; designating competition venues, restaurants, hotels, bars, cafes and entertainment venues in the Olympic Village as smoke-free places; designating the six host cities non-tobacco-advertisement cities; revising local rules about banning smoking in public places; establishing smoke-free zones in hotels, restaurants and entertainment places and banning smoking in parks, malls, and on public transportation in hosting cities; increasing smoke-free institutions in hosting cities.

The MOH has learned from the practice and experience of previous Games hosts which anti-smoking measures to take and how to do it, Zhang said. But he also warned that considering the country’s large smoking population, China faces many obstacles in its work to provide a smoke-free Olympics.

The concept of a “smoke-free” Olympic Games was initiated in 1988 and was first implemented in Barcelona, Spain, in 1992.