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Stubbing Out the Cigarette
China Today
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Stubbing Out the Cigarette

Old Chen took a drag on his cigarette, watching his three-year-old granddaughter woddle around in a small park in western Beijing. Whenever the toddler came near, he would stretch out his hand holding the cigarette as far away from her as possible. Still, the smell of smoke was perceptible even at arm’s length. “Smoking is no good, my wife complains about it every day,” he acknowledged. “But I am too old to quit,” he said, giving a familiar excuse. Like many men of his generation, the 67-year-old first picked up the nicotine habit from his peers, fellow factory workers in his case. He has noticed that fewer people of his age are smoking today. “Smoking is no good,” he reiterated. 

According to the World Health Organization, tobacco kills more than eight million people every year. More than seven million of those deaths are the result of direct tobacco use, while around 1.2 million are the result of non-smokers being exposed to second-hand smoke. China is the largest tobacco producer and consumer in the world, with 350 million smokers, according to a 2022 report on the health damage caused by smoking. A 2018 survey on tobacco use among Chinese adults found that 26.6 percent of people aged above 16 had picked up the habit. The rate was 50.5 percent for men, 2.1 percent for women, 28.9 percent in rural areas, and 25.1 percent in the city. Though these numbers have been on a slow but steady decline over the past several years, they remain alarmingly high. 

It is believed that tobacco growing in the Americas was first brought into China’s coastal region Fujian in the 16th century during the Ming Dynasty (1368-1644), through the Luzon Island. It was soon planted domestically, and sold across the country. According to Wu Li Xiao Shi (Small Encyclopaedia of the Principle of Things), a collection of science essays dated 1643 by Fang Yizhi, “Danbagu (based on the Spanish word for tobacco) was brought into Zhangzhou and Quanzhou (in today’s Fujian Province) at the end of the Wanli period (1573-1620)... and gradually spread to the nine frontier military bases... It was consumed by lighting up a long pipe...A ban was imposed on the plant during the reign of Emperor Chongzhen (1628-1644), but with little effect.” 

In the Qing Dynasty (1644-1911), snuff became popular among the upper class, including the royal family. Its prevalence even gave rise to the art of inside-painted snuff bottles, which is now an intangible cultural heritage item of Beijing. In 1897, when Emperor Guangxu was on the throne, cigarettes entered China, brought into Shanghai by an American retailer. 

Knowledgeable Chinese had realized the harm of smoking to human health soon after the appearance of tobacco in China. Wu Li Xiao Shi mentioned that long consumption of the plant would cause lung damage, for which there was no medication, and that it would lead to sudden death after the patient began vomiting yellowish liquid. Some Ming and Qing doctors classified tobacco as a poisonous weed. 

Advances in medical science during the following centuries led to better understanding of the perils of tobacco use, and governments across the world, including in China, began to take action against it. In 1991 the National People’s Congress, China’s top legislature, adopted the first national law on tobacco – The Law of the People’s Republic on Tobacco Monopoly, which came into force on January 1 of the following year. It includes an article stipulating that the state shall strengthen public education on the harm of smoking, prohibit or limit smoking on public transport vehicles and in public spaces, dissuade young people from smoking, and ban it among primary and middle school students. 

In May 2003, the 56th World Health Assembly adopted the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), the first international pact on tobacco control. China ratified it in 2005, and the treaty came into legal force in the country in 2006. In its spirit, the Standing Committee of the People’s Congress of Shanghai passed the Regulations on Smoking Restrictions in Public Spaces in 2009, the first provincial-level legislation of its kind on the mainland. In 2011, the Ministry of Public Health released the revised rules for the implementation of the Regulations on Hygiene Management in Public Places, introducing a smoking ban in indoor public spaces. Two years later the General Offices of the CPC Central Committee and the State Council issued a circular requiring leading officials to take the lead in stopping smoking in public spaces. It also prohibits the use of cigarette products during official activities, and their use, sales and provision in office buildings of Party and government agencies. 

In March 2022, the Institute of Law under Chinese Academy of Social Sciences released the Report of Legislative Progress in Tobacco Control. It said that all the four municipalities directly under the central government – Beijing, Shanghai, Tianjin, and Chongqing – and 22 of the 27 provincial capitals on the mainland had promulgated specific tobacco control statutes. By 2021, about 600 smoking cessation clinics had opened across the country, and 30 provincial-level regions had launched support hotlines.

The national capital, for instance, launched the Healthy Beijing – Support for Quitting Smoking campaign in 2017, extending support services to thousands of people through healthcare facilities, hotlines, and online platforms. Data over the past years show that more than half (52 percent) of the people who visited cessation clinics successfully stopped smoking within three months. 

New technologies are providing fresh ammunition to the combat against tobacco use. In May 2021, the Chinese Center for Disease Control and Prevention launched a national online platform in partnership with WHO’s China office to help smokers kick the habit. Accessible on both the center’s website and the popular social media app WeChat, the platform pools together information of various smoking cessation facilities, services, and other resources in all the 31 provincial-level administrative regions on China’s mainland, and offers customized guidance for people who want to quit cigarettes. By putting in the intensity of tobacco use and other personal data, one is presented with a detailed schedule to gradually break the habit, and even receive prompts for them to meet daily targets. 

These efforts are paying off. Surveys show that the share of smokers in the Chinese population aged above 15 had fallen from 33.9 percent in 1984 to 26.6 percent in 2018, and then dropped further to 25.8 percent in 2020. China plans to reduce this rate to 20 percent by 2030. A factor crucial for realizing this goal is to prevent the young generation from picking up the bad habit in the first place. 

A 2021 study by the Chinese Center for Disease Control and Prevention found that 16.7 percent of middle school students in China had tried smoking, with the rate being 23.2 percent for boys and 9.5 percent for girls. These figures were however slightly lower than two years before, by 1.2 percentage points for the whole group and 2.8 percentage points for male students. 

In November 2020, the 13th National People’s Congress, China’s top legislature, adopted the revised Law on the Protection of Minors, which entered into effect on June 1, 2021, the International Children’s Day. With new additions on tobacco control, the legislation was lauded as “a milestone event” by the vice chairman of Chinese Association on Tobacco Control Tong Lihua. The earlier version of this law included an article saying that businesses are subject to administrative penalties if they sell alcohol and tobacco products to under-age people, or do not set up prominent signs banning sales of these products to this group of people on their premises. But the law didn’t specify how much the penalties would be or how to execute them. It was therefore deemed “toothless.” The revised law makes it clear that violators could face a fine below RMB 500,000 or even have their business licenses revoked. 

It is also the first law prohibiting sales of e-cigarettes to minors. Coming in various designs and flavors and promoted by certain Internet celebrities, e-cigarettes are gaining popularity among teens and young people. In 2021, the Health Communication Institute of Fudan University conducted a research on 2,405 young students in Shanghai, Guangzhou, and Chengdu, three of the most populous cities in China. It found that as many as 94.3 percent of the respondents had heard of e-cigarettes, and 4.5 percent had used them. The age of first use is between 10 and 15. A third of the respondents had seen e-cigarette advertisements during the past month. 

To tackle this problem, relevant authorities are taking multi-pronged measures, including the creation of a monitoring system for tobacco use among teens and young people, tightening e-cigarettes regulations, increasing public education, encouraging society-wide participation, and organizing dedicated campaigns. 

For many decades, smoking has been a mechanism to maintain and strengthen kinship bonds and social relationships and to enhance a sense of belonging. Cigarettes are still offered at wedding banquets across China and exchanged as gifts by many people. A token of sophistication and masculinity, they were widely seen in earlier movies and TV dramas in the mouths of soldiers in the lull between combats, farmers toiling in crop fields or scholars burning the midnight oil. This has changed after regulations were introduced to ban smoking scenes and cigarette-related content on the screen. 

But to address a problem associated with cultural norms and social etiquettes, it takes extensive, persistent efforts in all aspects of society over an extended period of time. After decades of public education and government action, this issue has gained broader attention and greater traction. It was again raised in many proposals and suggestions by law makers and political advisors at this year’s “two sessions.” On tobacco control, China is moving in the right direction, and is seeing encouraging results.

China TodayGu Yetao

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