Chinese Tobacco Control Policies and Its effectiveness Jiang Yuan Tobacco Control Office China CDC March 20,2011

Main Contents Smoking epidemic in China Chinese Tobacco Control Policies and activities Policies effectiveness 2018/11/8

Smoking free public places ky mo S mok y S Source: GATS 2008-2010

Tobacco control Policies Protect people from tobacco smoke China has no national smoke-free law. Local laws include many exceptions and enforcement is inadequate. Health bureaucracy and medical facilities nationwide should be completely smoke-free by the end of 2011. The government has included the smoking ban in all indoor public places in its 12th Five-Year Plan (2011-2015). The Ministry of Health issued a set of rules in March 2011 on implementation of the Regulations on Hygienic Management in Public Places that had been issued by the State Council. The rules state that smoking is banned in indoor public places. Smoking shall be banned at schools, including primary and secondary schools, vocational schools and child care agencies. Outdoor smoking area can be assigned at regular institutes of higher educations (Guidelines issued jointly by the Ministry of Health and the Ministry of Education Smoking free Olympics 2008 2018/11/8

Tobacco control Policies Tobacco taxation and prices Government increased tobacco taxes in May 2009 but the tobacco industry absorb the increases, so prices have not risen and the tax increase has not produced public health benefits. Health warnings on tobacco packaging Health warnings do not effectively warn smokers about the dangers of smoking. They are text only on a background that is the same color as the rest of the pack, use small type, and communicate just two, nearly identical, rotating messages, which do not spell out specific health consequences of smoking. 2018/11/8

Survey Contents Participants’ general information, Tobacco use (smoking and smokeless), Cessation, Secondhand smoke (SHS), Tobacco economic Media Knowledge, attitudes, and perceptions on tobacco use and SHS 2018/11/8

China’s warning labels changed in Oct 2008 OLD warning: Side of pack Only one message Front/back of packTwo messages 9

Design of the Experimental Study Canada Singapore Hong Kong EU Lung Cancer Mouth Gangrene Clogged Arteries China 2 6 3 10 5 Only text 9 8 1 4 7 Text + Picture 10

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ITC China Survey: Label change had trivial impact 12 12

ITC China Survey: Label change had trivial impact Mauritius introduced larger graphic warnings China introduced larger text-only warnings 13 13

Chinese Government adjust cigarette tax in 2009 Retail price of 21 brand cigarette in 6 cities 2009 tax adjuest Average price (yuan) Nominal price Real price (2007)

Average self-reported cost of 18 top brands of cigarettes (Yuan/pack) Average Price (yuan) 2009 Tax adjust Nominal Price Real Price (2007)

Affordability of cigarettes continues to increase Percentage of smoker who think price is a reason to quit by country Percentage of smoking who said they thought about the financial cost of smoking in the last month 20 20 20

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ITC China Project Supplement in Tobacco Control Released October 6, 2010 11 articles from the ITC China Project team Variety of research methods – ITC China Survey – Air quality monitoring – Analysis of design features of    Chinese cigarettes and assays    of heavy metals – Experimental study of the    perceived effectiveness of the    new (Oct 2008) Chinese warnings 23 23 23 23 23 23

Chinese Language version of ITC China Supplement Released April 8, 2011 All 11 articles translated to Chinese by the ITC China team. BMJ Press allowed us to upload this Chinese-language version of our supplement to the website of Tobacco Control. 24 24