Beijing is working toward being “tobacco free” by the end of 2015, said the Chinese capital’s health authorities, who are planning to make all public spaces, including work sites and public transport, no smoking zones by the end of 2015.
An article in the state-run China Daily published on Monday reports that the Beijing Health Bureau is also aiming significantly to reduce the proportion of men who smoke.
In 2005, the Chinese goverment estimated there were 350 million smokers in China, including 60% of Chinese men and 3% of women, and that the number of children and young female smokers was on the rise.
While the Beijing Health Bureau has yet to reveal details of its plan, last week they released the results of a survey that interviewed 2,100 of the city’s dwellers aged from 10 to 89 years.
The survey showed that more than 95% of those interviewed said they knew that smoking could cause lung cancer.
It also showed that nearly 60% of interviewees knew smoking could lead to “apoplexy” (cardiovascular and heart problems). This is considerably more than the 16% nationwide figure, suggesting that the 22 million people in China’s capital are more aware of the potential harms of smoking than their 1.3 billion fellow countrymen.
The survey also found that 11.5% of teenagers aged under 18 said they smoked. This is more than the 9.1% figure reported by the Beijing Center for Disease Control and Prevention earlier this month.
According to Du Hong, an official from the Health Bureau, this year they sent out more than 25,000 posters and 20,000 handbooks promoting smoke-free living to hospitals, residential clinics and medicine stores.
The Health Bureau also completed a pilot project earlier this year to train GPs in how to offer advice about how to become tobacco-free to patients in their communities.
Called “Three Minutes Stop Smoking”, the project ran from March to June and is reported to have had a “marked effect” on the GPs involved.
Doctor Zhang Junwei, who works at the Wangjing residential clinic, said doctors can play a crucial role in helping smokers quit.
China Daily said the clinic is considered a model of success in the tobacco-free campaign, during which more than 5,000 smokers attended the three-minute anti-smoking advice slots.
Zhang described the case of an elderly patient who had been smoking about 20 cigarettes a day for 40 years who managed to give up in 5 weeks.
He said the patient had high blood pressure and other chronic conditions, made worse by the smoking.
With his doctor’s medical guidance, he stopped smoking and felt better than ever,” said Zhang, adding that the patient then brought his friends along to get help with quitting.
Beijing’s health authorities estimate that to date, nearly 80 per cent of doctors in residential clinics have now been trained in how to help patients quit smoking.
However, although the campaign may have achieved some successes, the wider picture is not all rosy.
Beijing’s smoking rate has gone up slightly since 2002. And there are still many people who do not seek help.
Du told the press that:
“The number of people who will seek medical help to give up smoking is fewer than a quarter and fewer than a half of smokers have received anti-smoking advice from a doctor.”
However, perhaps the more challenging hurdle will be getting doctors themselves to quit.
Last year, Reuters reported that the Chinese authorities were urging the country’s male doctors, more than 50% of whom smoke, to quit the habit and set an example to their patients.
Another area of challenge appears to be the workplace.
In a study reported in BMJ in August this year, where they analyzed the results of a survey conducted in six Chinese counties, researchers revealed that few workplaces in China have implemented policies to restrict smoking, and even where they exist, workers report lack of compliance.
However, the researchers stressed it was worth persevering with smoking cessation policies because where compliance was strong, it resulted in workers smoke fewer cigarettes per day.
Yang Gonghuan, director of China’s National Office of Tobacco Control, said in an interview published by China Daily in May this year that tobacco control faces great opposition in China.
“The Ministry of Health has published an annual tobacco control report and there have been campaigns to increase the tobacco tax and warnings added to packaging,” she said.
Yang also said that most smokers in China have no plans to quit, and the rate of giving up is very slow. Also:
“Tobacco control is not mentioned at all as a priority in the health reform plan, and the budget we have only accounts for 0.5% of the total budget for disease control and prevention,” she added.
According to the World Health Organization (WHO), China joined the global war on smoking in 2005, when a Standing Committee of the National People’s Congress ratified an international treaty aimed at curbing tobacco-related diseases and deaths.
The WHO Framework Convention on Tobacco Control (FCTC) requires that China ban the advertising, promotion and sponsorship of tobacco on radio, television, print media and the Internet within five years.
From Yang’s account, China is having problems meeting these requirements.
For example, she said the regulations on cigarette packets that took effect in January 2009 “fall well short of the requirements” of the treaty, which requires that “warning signs should cover 50% of the display area,” but the “Chinese regulations require only 30%, and the warnings are in tiny characters”.
Also, the WHO treaty requires that health warnings state plainly the harms that tobacco can cause, but the Chinese cigarette packet warnings only state “Smoking harms your health”, and “Quitting smoking early helps reduce the risk”, she added.
Another part of the problem is the power of the tobacco companies in China and the relentless vigour with which they target young people.
Yang gave an example of a primary school that was rebuilt after the Sichuan earthquake, with funds given by a tobacco company. The school was named the “Sichuan Tobacco Hope Primary School”, and the school walls bear the inscription:
“Talents are brewed by intelligence; tobacco helps you grow up and become accomplished.”
China is the world’s largest consumer and producer of tobacco, where it kills 1.2 million people a year.
After traffic accidents, seven of the top eight causes of death in China are smoking-related, said Yang.
Sources: Yang Wanli (27 Dec 2010), “Beijing hopes to stub out smoking”, China Daily; Web Exclusive (31 May 2010) “Tobacco control faces great opposition in China”, China Daily; Jiemin Ma et al. (Aug 2010), “Workplace smoking restrictions in China: results from a six county survey”, BMJ; Nick Macfie (2 Mar 2009) “China urges smoking doctors to quit the habit”, Reuters; WHO (2005) “China joins the global war on smoking”, press release.
Written by: Catharine Paddock, PhD