China’s tobacco epidemic rages on
Tobacco consumption is falling in most countries – but, in China, production and taxes last year rose to record levels, and exports are rising. One third of all the cigarettes smoked in the world are smoked in China – and someone dies every 30 seconds because of tobacco use.
These alarming figures were published this month by the National Bureau of Statistics (NBS). It said that, in 2023, cigarette production was 2.443 trillion, an increase of 0.4 per cent over 2022 and the fifth successive annual increase. Taxes paid by the industry rose 5.6 per cent to 1.52 trillion yuan, accounting for seven per cent of national revenue.
“The taxes played an enormous contribution to the increase in income for the central and local government revenues and promoting the economy and society,” the NBS said.
In the first two months of 2024, cigarette exports were worth US$21.783 million, an increase of 33.5 per cent. They include “Great Wall” cigars produced with Sichuan tobacco.
According to the World Health Organisation (WHO), China is the largest producer and consumer of tobacco in the world, with almost half of adult men current smokers. In addition, over 700 million non-smokers, including 180 million children, are exposed to second-hand smoke (SHS) at least once a day in a typical week. Exposure to SHS causes 100,000 deaths annually.
More than one million Chinese die each year from tobacco-related diseases. If current consumption rates do not fall, this figure will triple to three million by 2050, WHO said. “Tobacco use is the world’s single biggest cause of preventable death and non-communicable disease,” it said.
China has taken tobacco control measures. In 2005, it ratified the WHO Framework Convention on Tobacco Control and implemented it in 2006. It bans advertising of tobacco products, but not their brand names.
The city of Beijing prohibits smoking in public places, indoor workplaces and lines of people outdoor. Shenzhen bans smoking in indoor workplaces and public places, public transport and outdoor areas in schools, parks and medical institutions.
The National Health Commission said that, as of the end of last year, 254 Chinese cities had introduced measures to control smoking.
But it has not taken many measures adopted by other countries. There are no pictorial warnings on cigarette packets, only written ones. For example, the warning on a Shuangxi (雙喜) packet says: “Dissuade young people from smoking, ban secondary and primary students from smoking.”
In the public media, there is almost no discussion of the issue nor coverage of China National Tobacco Organisation, the world’s largest tobacco company, which employs millions of people. As a result, many people are unaware of the health risks they take when they light up.
The government’s judgement seems to be that contained in a report in February 2021 by the China Commercial Industry Research Centre. “Without the taxes and profits paid by the tobacco industry, investment in infrastructure would be insufficient and local industries affected. This would seriously affect national development and improving living standards. Overall, the benefits of the tobacco industry outweigh the disadvantages, in terms of damaging people’s health.”
Health economists, including the World Bank, the Asian Development Bank and the UNDP, totally disagree with this incredulous statement. The costs of smoking to governments, employers, business, the individual smoker and the environment far outweigh any short-term perceived advantage.
Dr Judith Mackay, a senior policy advisor to the WHO, is one of the world’s leading experts on tobacco control. She has lived in Hong Kong since 1967. She said: “The Chinese government controls the world’s largest tobacco company. Political will is the key ingredient to tobacco control. The government must accelerate legislation and regulations on all tobacco, nicotine and vape products, raise tobacco taxes to make cigarettes unaffordable to youth, ban all advertising, promotion and sponsorship and extend smoking bans to more areas.
“It must make tobacco control a just and noble cause, worthy of Confucius and Sun Tzu. The central government can, with political will, effect change rapidly to protect the health of its people,” she said.
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