China: A smoker's paradise
By Wu Zhong, China Editor
HONG KONG - China's state monopoly of the tobacco industry, which makes
staggering profits and contributes huge revenue to the government, and its
smoking friendly social environment are major obstacles to tobacco control in
the country.
To mark the "World No Tobacco Day" on May 31, China's Ministry of Health
pledged to strengthen tobacco control in the country with the world's largest
smoking population. However, tobacco control may prove to be beyond the control
of health officials as long as the tobacco industry remains a state monopoly.
For, as long as state monopoly stays, the government cannot but play a dual
role in the tobacco market. On the one hand, it is
virtually the sole producer and wholesaler of cigarettes and other tobacco
products and, naturally, seeks maximum profits. On the other hand, it has to
somehow fulfill its duty to carry out tobacco control, particularly after it
signed the World Health Organization (WHO) Framework Convention on Tobacco
Control in November 2003 (which, though, was not ratified by China's
parliament, the National People's Congress (NPC), until about two years later).
This is somewhat like in a football match where the team captain also acts as
the referee. There cannot but be a serious conflict of interests.
Therefore, unless the Chinese government is willing to give up its monopoly and
open the tobacco industry to private and foreign investment, any serious
tobacco control effort cannot but meet with strong resistance from government
bodies and officials who oversee or run or directly or indirectly benefit from
the tobacco industry.
Strong resistance will also come from the numerous employees working in
cigarette factories and shops, as well as from farmers who rely for their
living on growing tobacco. According to an official estimate, about 100 million
Chinese now depend, directly or indirectly, on this enormously profitable
industry.
Officials with the Ministry of Health, which oversees the implementation of the
World Health Organization convention on tobacco control, have to do their job
in any case. Therefore, on May 29, two days ahead of the "World No Tobacco
Day", the ministry released a report on tobacco control and health, using
statistics to advise people that smoking cigarettes is hazardous to health,
inducing lung cancer.
According to statistics from the Ministry of Health, 35.8% of those aged 15 and
older, smoke cigarettes, which means there are 350 million smokers. And most
smokers are male. Of men aged 15 or older, 66% smoke cigarettes while the rate
for women of the same age group is only 3.1%.
What is more alarming is that the average age of the smoking population tends
to get younger and younger, suggesting more and more teenagers and youths are
joining this gigantic army of smokers. Statistics show that the number of
smokers aged between 15 and 24 is on the rise. In 1984, the average age of
starters was 22.4, dropping to 19.7 in 2002. Contrary to the world trend,
well-educated individuals make up a large proportion of male smokers.
According to the statistics, half of the male medical doctors and teachers
smoke. China, perhaps, tops other countries in the world in terms of the
proportion of smokers among male doctors.
With such a huge addicted population, China naturally is a superpower in terms
of cigarette production and consumption. According to information provided by
the Ministry of Health, each year some 1.6 trillion cigarettes are sold in
China. As such, Chinese smokers consume one third of cigarettes produced in the
world. To emphasize that smoking is hazardous to health, the ministry reported
that 1 million people died of diseases directly or indirectly related to
cigarette smoking. And it is estimated the death toll would double to 2 million
by 2020.
The Ministry of Health said it was drafting regulations to strengthen control.
Priority would be given to banning smoking in hospitals, schools, kindergartens
and other places providing services for children. The ministry also advocated a
smoke-free Olympic Games in Beijing in 2008. But the proposal was very sketchy.
The only concrete measure it unveiled was that hospitals designated to serve
the Games would be smoke-free by end of 2007. Since all hospitals in China are
under its supervision, one can believe that this could be implemented.
However, in face of the enormous economic interests generated by the state
monopolized industry, the Ministry of Health at best appears to be a "toothless
tiger". According to data from the State Tobacco Monopoly Administration,
China's tobacco industry contributed about 240 billion yuan (US$30 billion) to
the state coffers in profits and taxation in 2005, accounting for 7.6% of the
government's total revenue (3.16 trillion yuan) that year.
According to the State Administration of Taxation, of its list of China's top
100 tax-paying enterprises in 2004, 35 were from the tobacco industry, which
paid 107.7 billion yuan in taxation, up 23% from the previous year, and which
also accounted for 35% of the total taxation paid by the top 100.
With such huge economic interests, the government is in a dilemma over tobacco
control. However, it would be unfair to say that it encourages its people to
smoke. It would be closer to the truth to say that it does not strongly
discourage people from smoking. Surely, if the government is to give up its
monopoly and privatize the tobacco industry, it can act as a regulator to
impose stricter control measures such as sharply increasing tobacco taxes to
make cigarettes much more expensive. Or it could ban smoking in many public
facilities and places.
But there is not the slightest indication that the government is willing to
give up its monopoly. In addition to concern over possible loss of revenue, it
may also fear that privatization of the tobacco industry may lead to
unemployment of many who rely on it for their living, which could lead to
social disability. For the government, maintaining social stability is above
anything else.
In reality, Chinese society is very smoke-friendly, which makes tobacco control
a very difficult, if not impossible, task. People in China are encouraged to
smoke by their social customs. In China, offering cigarettes to friends, guests
or visitors is still regarded as a courtesy. Moreover, many former or current
leaders are heavy smokers.
Late leaders Mao Zedong and Deng Xiaoping were well-known chain smokers. It is
not a secret that many current leaders are also smokers, though they now
refrain from smoking in public. Minister of Health Gao Qiang is a smoker. Also,
almost all heroes in Chinese movies or TV dramas are smokers. So much so that
in the movies or TV dramas, a police detective cannot solve a case without
smoking, a scientist cannot make a discovery without a puff, or officials
cannot make the right decision without burning packages. Growing up in such an
environment, one can hardly resist the temptation to smoke.
In such a smoke-friendly environment, any tobacco control can be easily
neutralized. Consequently, if China is serious about tobacco control, such
smoking friendly customs must be changed to create a new social environment
that is against smoking. But change of social customs may take a long time.
With a somewhat inactive government and a smoke-friendly social environment, it
seems tobacco control in China still has a long way to go.
