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Tobacco control target needed

By Hu An'gang and Hu Linlin (China Daily)
Updated: 2010-10-14 07:57

Smoking is one of the biggest threats to people's health and causes large direct and indirect economic losses

Guaranteeing the country's 1.3 billion people public security and extending them a longer, healthier and happier life has always served as a primary target in the Chinese government's campaign to build a moderately well-off society.

However, smoking is one of the most fatal threats to the health of Chinese people. China has the world's largest smoking population and statistics show that the number of people who die of tobacco-related diseases is more than that of any other individual country. Currently, there are 300 to 350 million smokers in China, 30 percent of the world's total smoking population.

Of the world's 6 million people who die of tobacco-related causes every year, 72 percent live in the middle and low-income countries, including 20 percent in China.

In 2000, more than a million people died of smoking-related diseases in China, 12.2 percent of the country's total number of deaths. The number was greater than the number who died of AIDS, tuberculosis, traffic accidents, and suicide combined. About 100,000 people in the country die from secondhand smoking every year.

Given that the diseases and fatalities resulting from the use of tobacco have an obvious time lag, the number of people likely to be killed by smoking in the future is expected to increase. If effective measures are not taken to curb the widespread prevalence of smoking, it is estimated that the number of deaths directly related to the use of tobacco will reach 2 million in China by 2025, 15.8 percent of the country's estimated 12.64 million deaths.

The use of tobacco not only harms people's health, it also results in an enormous medical bill for the country and a huge loss of labor. Studies indicate that China's medical spending directly related to smoking amounted to 166.56 billion yuan ($24.95 billion) in 2005, about 19 percent of the country's total medical outlay that year.

China signed the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) as early as 2003, and the document began to formally take effect as of January 2006. As the guidelines for worldwide tobacco control, the FCTC contains some specific stipulations on tobacco control for signatories, including pricing and taxation, fighting tobacco trafficking, and a ban on tobacco sales to non-adults.

During the 11th Five-Year Plan period (2006-2010), the Chinese government adopted a series of effective measures to facilitate the fulfillment of the WHO convention, and some positive effects have been achieved. However, more forcible measures need to be introduced to curb the country's expanding smoking population and the prevalence of smoking.

No binding national-level law has so far been promulgated to ban smoking in public places, except some administrative rules by local governments for this purpose. Due to the lack of a legal document to ban tobacco advertising, promotion and sponsorship, various kinds of advertisements for tobacco sales are common on the radio, TV and the Internet, and in print media. As a result, the smoking population has not been reduced in China despite government and non-governmental efforts in recent years and the volume of tobacco production and sales has been steadily growing.

The 12th Five-Year Plan period (2011-2015) will be a crucial period for the country to realize its ambitious goal of building an all-round well-off society by 2020, one of whose core targets is ensuring people can enjoy a healthy life, with an average life expectancy of 77.

However, the reality is that the incidence of some of the chronic diseases related to smoking has become more frequent and the number of tobacco-related deaths continues to increase. Direct and indirect economic losses caused by smoking have further increased and smoking has already become the biggest threat to the health of both smokers and the 700 million-strong passive smoking population.

To curb this momentum, it is suggested that the Chinese government should adopt a comprehensive tobacco control strategy in its 12th Five-Year Plan. It should introduce active measures to transform China from the world's largest tobacco producer and consumer, into a country with a series of viable tobacco control measures in place. To this end, the government should make some open commitments to comprehensive tobacco control to highlight their long-cherished "people first" concept and the idea that people's health is placed high on the government's agenda.

The Standing Committee of the National People's Congress should make regular reviews of the implementation of the FCTC by the State Council and its relevant State agencies and make public the results. Also, a comprehensive tobacco control target should be included in the government's 12th Five-Year Plan as one of the key indices to measure whether governments at various levels are working for people's heath.

The country should also promulgate a law that bans smoking in public places as soon as possible, in a bid to control the damage caused by passive and secondhand smoking. At the same time, a national tobacco control agency should be set up under the National Development and Reform Commission or the Ministry of Health to undertake specific administrative functions to facilitate the country's tobacco control campaign.

Hu An'gang is director of the Center for China Study under Tshinghua University and Hu Linlin is a researcher with School of Public Policy and Management also underTsinghua University.