China tries to wean itself from its tobacco habit

Expensive Chunghwa cigarettes for sale in Beijing.
Expensive Chunghwa cigarettes for sale in Beijing. Tim Johnson / MCT

BEIJING — Smoking has no place at the Olympic Games. But Beijing Mayor Wang Qishan is a reluctant anti-smoking crusader. After all, he's a smoker.

He's got company at the Olympic Village, where the chief of the organizing committee of the Olympic Games also can sometimes be seen through a haze of cigarette smoke.

An astonishing number of China's Cabinet members and sports officials are among the 350 million Chinese whose cigarette habits support a state industry that generating more taxes in China than any other industry.

Smoking is common even at the Health Ministry. Deputy Minister Gao Qiang smokes heavily, and surveys show that more than 50 percent of China's male doctors and health workers smoke.

"They are under high pressure, stress, so they smoke to get relief," said Zhi Xiuyi, the non-smoking chief of the lung cancer center at Capital Medical University hospital.

Under growing criticism from the World Health Organization and other international bodies, China is slowly combating tobacco usage. It's agreed to put warning labels on cigarette packs by 2009 and prohibit tobacco-related advertising and promotion by 2011. Last month, Beijing banned smoking in the city's 66,000 taxis.

But the sprawling state tobacco monopoly keeps increasing production; it's on course to crank out more than 2 trillion cigarettes this year. Smokers snap up packs of White Sand, Red Pagoda, Yellow Mountain and some 400 other national brands, adding to state coffers. The tobacco industry contributes $31 billion a year in taxes.

Last March, the deputy chief of the state tobacco monopoly warned anti-smoking campaigners not to press too hard.

"We take very seriously the health dangers of smoking, but not having cigarettes also impacts stability," Zhang Baozen, deputy chief of the State Tobacco Monopoly Administration, told state television.

Cigarette taxes provide Beijing with steady revenue. According to the World Bank, some 8 percent of China's central revenues come from taxes on cigarettes, compared with 3 percent in Britain, 1.8 percent in India and 0.4 percent in the United States.

China has been slow to address health concerns about smoking partly because the government doesn't shoulder much of the health care cost of those who fall ill from tobacco-related illnesses. The nation's socialized health care system has fallen by the wayside, replaced by one in which citizens largely pay for themselves.

Yet there are signs that the central government is embracing limited anti-smoking efforts, wary of being out of step with much of the rest of the world. Last year, Beijing ratified a World Health Organization anti-smoking convention that commits it to curb smoking in public places, such as schools and buses, and further limit cigarette advertising.

"The great number of smokers and passive smokers indicates there's still a long way to go for China to fulfill the requirements of the (WHO) convention," Vice Minister of Health Wang Longde said at the time.

Now, global health advocates are urging China to re-examine the economic burden of health issues related to smoking.

"If a country does their economic analysis properly, it would be in the country's interests to control tobacco," Dr. Margaret Chan, the director of WHO, said during a recent visit to China.

The WHO says that 1 million Chinese a year die from diseases related to smoking and that the toll will climb to 2.2 million fatalities a year by 2020 if current rates continue. It says China faces $5 billion a year in smoking-related health care costs, part of what it calls a "massive tobacco burden."

Perhaps even more surprising, the WHO says that one-third of all Chinese men below the age of 30 today eventually will be killed by smoking-related disorders.

Part of the reason is that Chinese are smoking at a younger age and smoking more per day. In 1984, the average age when people began to smoke was 22.4 years old. By 2006, it had fallen to 19.7 years old.

As incomes rise, Chinese smoke more often. Average daily consumption has risen from four cigarettes in 1972 to 10 cigarettes in 1992 and to about 15 today.

Smoking is deeply ingrained in Chinese culture — male culture, that is.

In China, 63 percent of men smoke, while only 3 percent of women do. At weddings, the bride normally circles the reception hall, offering cigarettes to each man, a rite said to augur well for her eventual childbearing. Cigarettes are also handed out at funerals. Between courses at banquets, male diners frequently pause for a smoke.

"Smoke in the morning, and you'll feel revitalized all day," goes one popular rhyme. Another one goes: "If you smoke in the toilet, the smell will be better." A third says, "Men who don't smoke live in this world in vain."

Many Chinese don't think cigarettes are harmful. Some even say smoking helps their health. They point to the long lives of former paramount leaders Mao Zedong, who died at 82, and Deng Xiaoping, who was 92 at his death. Deng's beloved Panda brand cigarettes are among China's most expensive, about $12 a pack, but are rarely available in stores.

With a pack of Plum Blossom cigarettes costing as little as 30 cents or so, even migrant laborers earning $80 a month can afford to smoke, clustered at roadside stands or squatting on sidewalks after a backbreaking day of hard labor.

China's soaring economy is precisely why some anti-smoking activists see light ahead. They say the state-owned cigarette companies are becoming a smaller portion of total tax revenue for the government, making measures to contain smoking more feasible.

"Interestingly, with the economic progress that China is making, the percentage of tobacco tax of all government tax is dropping quite dramatically, and it will be interesting to see if this weakens the influence of the monopoly," said Judith Mackay, a physician at the World Lung Foundation in Hong Kong.

In a move that pleased anti-smoking activists, China in 2006 ratified the WHO's Framework Convention on Tobacco Control, which requires it to stiffen bans on advertising and promotion.

As a result, Beijing told the television industry to cut down on unnecessary smoking scenes and pledged that the 2008 Beijing Summer Games will be the "smoke-free Olympics." Last month, Beijing taxis started sporting stickers on their dashboards noting the ban on smoking in the vehicles. Fines of up to $26.70 may be imposed.

Mayor Wang didn't provide taxi drivers with a hotline to call to report smokers, and some observers said riders would ignore the regulation and light up.

"I actually have no way to report smoking passengers who turn a deaf ear to me," one taxi driver complained to the state Xinhua news agency.