China promises to dash hopes of tobacco industry giants
Authors: Jonathan Watts
Journal: The Lancet (2004)

By signing up to WHO's tobacco treaty, China pledges to tighten controls on cigarette industry China, the last great hope of the global tobacco industry, is promising to tighten controls on cigarettes in 2004 to comply with the Framework Convention on Tobacco Control (FCTC), which it signed in November. Although the country makes and consumes more cigarettes than any other in the world, the government plans to challenge the expansion of the tobacco market with tough new regulations on advertising, health warnings, and juvenile smoking At first sight, it is difficult to imagine that the palls of smoke that now linger in many of Beijing's restaurants and bars will be blown away any time soon given the cultural and financial resistance to change But the government insists it will take steps to honour the commitments it made by joining the FCTC, which obliges signatories to tighten restrictions on cigarette marketing and consumption so that more priority is placed on countering the health risks rather than emphasising the tax revenues According to government statistics, China has more than 300 million smokers—about a quarter of the nation. The rates are highest among adult men, of whom two in every three is a regular puffer. Doing without can be a social liability in a country where a common greeting between men is to offer a cigarette. Among women, the proportion of smokers is lower but the trend is upwards. Smoking rates among women have risen from 1% a decade ago to 5% today. With taxation levels low, the prices of domestically produced cigarettes are cheap—starting at a mere 8 pence (US$0·20) per pack. There are also fewer disincentives. Packets do carry health warnings, but they are vaguely worded and printed in relatively small characters on the sides rather than the front of the pack. In these conditions, the number of smokers is growing at the rate of 3million per year. Coming amid an economic boom that is pushing up wages and prices, this growing market is attracting a throng of foreign tobacco industry giants who see China as their best hope to maintain revenues while established markets are being extinguished around the world. For many years, the government has taken the view that the economic activity generated by smoking is more important than its negative effects on health. As the owner of the state monopoly that supplies most of the 1·7trillion cigarettes consumed in China each year, it can hardly afford to take any other view. Add to this the 65% tariffs slapped on increasingly popular imported brands and the government's tobacco income is worth about a tenth of its entire revenue. But there is a growing realisation that the short-term financial boost from cigarette sales can be all but wiped out by the long-term health costs to the nation. According to WHO, 700000 Chinese people die each year from smoking. The number is rising fast. Lung cancer deaths have increased from 30000 in 1975 to 250000 in 2003. Newspapers are carrying more reports about the risks of smoking and government leaders seem to be taking note. Although there is no national law on juvenile smoking, most municipal governments have introduced laws banning the sale of cigarettes to children. Many parts of the country have imposed advertising restrictions, though tobacco firms have found ingenious ways to circumvent the rules. Last year, China's national football team trained for the World Cup at a facility in Yunnan that is run by and named after Hong Ta, the country's largest tobacco company. The firm also sponsored David Beckham and the rest of the Real Madrid team when they toured China this summer. And after its advertisements were banned on state television, the Ningbo Cigarette Factory raised the profile of its Dahongying brand by sponsoring school libraries. By signing up to the FCTC, the government ought to rein in this industry, but doubts remain about its ability and willingness to do so. In the wake of the SARS (severe acute respiratory syndrome) outbreak, the government insists that it has learned the lesson that shortcuts in health care can damage the economy in the long term. Even so—if the allocation of public funds is any guide—big changes cannot be expected any time soon. The state earns 67 billion RMB ($8 billion) from tobacco taxes, yet it spends less than $300000 on educating the public about the risks of smoking. But international commitments have been made. At the next People's Congress in May, health officials must now battle their counterparts in the finance ministry to draw up laws to implement the FCTC. For antismoking campaigners, this is a step forward. But expectations should not be too high considering the influence of the tobacco industry and the difficulty the central government faces in enforcing rules in such a vast nation.