Fertile and fresh fields for tobacco in China

This op-ed in The Lancet again highlights that China, while streets ahead of most western countries on some important indicators, has a long way to catch up in other respects, here particularly with regard to the scourge of tobacco.

It sounds like a public health nightmare: a country where smoking is socially acceptable, people can smoke in public places, cigarettes are cheap, cigarette packets are devoid of effective health warnings, government officials use public funds to buy expensive cigarettes as gifts, and the tobacco industry sits on public bodies charged with tobacco control. But this is, in fact, the reality in China today, as detailed in a new report by the Chinese Centre for Disease Control and Prevention.

Given this situation, the statistics contained in the report are, perhaps, unsurprising. China has 300 million smokers and around 740 million non-smokers who are exposed to secondhand smoke: tobacco is the country's biggest killer.

China did ratify WHO's Framework Convention on Tobacco Control (FCTC) in 2005. But the signing of the FCTC seems largely symbolic. The report finds that the country is doing poorly with implementation, with a performance score of only 37 points of 100 possible points. Underpinning this poor performance is lack of political will to tackle tobacco control and the tobacco industry.

According to the report, the tobacco industry in China has a Counterproposal and Countermeasure Scheme against the FCTC, it has distorted the Chinese version of the framework, denied the scientific evidence on the health hazards of smoking, abused public powers of government to counteract tobacco control, and encouraged tobacco consumption through covert advertising and sponsorship.

China's Government has allowed this situation to prevail because the country's tobacco industry is seen as a major taxpayer and employer. Although this is true, the report states that an integrated benefit analysis shows the net benefit generated by the tobacco industry is already below zero. In other words, the rapidly growing medical expenditures and loss of productivity from tobacco-related illnesses outweigh the economic benefits of the industry.

China has shown it can address health threats such as avian influenza and the HIV/AIDS epidemic. It is now time China tackles tobacco—its biggest health hazard and a serious economic threat.

For the Chinese Centre for Disease Control and Prevention report see http://www.chinacdc.cn/n272562/index.html

It will be interesting to see how China fares in its struggle against the blood-sucking pushers of tobacco, whose resilience against public health measures in the west has been legendary.