Current Status and Challenges of National Tobacco Free Health System Construction LI Xinhua Director ， Division of Health Promotion and Education ， Department of Maternal and Child Health Care and Community Health, Ministry of Health Director ， Division of Health Promotion and Education ， Department of Maternal and Child Health Care and Community Health, Ministry of Health October, 2011

Overall Working Plan in 2011 Content Main Condition and Results Main Condition and Results of the 1 st Secret Investigation of the 1 st Secret Investigation Background

WHO 《 Framework Convention on Tobacco Control -- FCTC 》 According to the 8 th item and its implementation bylaws of FCTC, our country should forbid smoking in all indoor public places, indoor working places, public transportation vehicles, and other possible (outdoor or quasi-outdoor ) public places before Jan.9, According to the 8 th item and its implementation bylaws of FCTC, our country should forbid smoking in all indoor public places, indoor working places, public transportation vehicles, and other possible (outdoor or quasi-outdoor ) public places before Jan.9, I. Background

Announcement of Overall Forbidding Smoking in National Health System in 2011

Multi-measures to Build Up a Tobacco Free Health System 1. Integrating subsidy allocated by central government, support every region to build up the system 2. Organizing experts to visit and inspect tobacco free health system construction at each province (Region, Municipality)

3. Continue to develop mass media propaganda campaign of tobacco control in China

4. Employ the 3 rd party professional investigation company to carry out secret investigation of national tobacco free city construction 5. Take the lead in building up tobacco free Ministry of Health

II. Main Condition and Results the 1 st Secret Investigation  986 health institutions are covered by subsidy of regional tobacco control projects allocated from central government in 2009 and 2010  randomly select 880 health institutions which achieved the goal of tobacco free by the end of 2010  53 institutions and affiliated organizations of Ministry of Health (including subunits) 1. Investigation Scope

2. Investigation Methods  According to relevant contents of secret investigation regulated by Evaluation Criteria of Tobacco Free Health Institutions issued by Department of Maternal and Child Health Care and Community Health (No.223) in 2009, includes tobacco free environment arrangement, smoking ban of indoor public places.  Entrust the 3 rd party investigation company, using secret shooting and questionnaire. All data have their source of investigation videos.  Tobacco control office of China Center for Disease Control and Prevention provide technical support, experts from China Association for Tobacco Control and Think Tank Research Center for Health Development participated in report composition.

3. Investigation Time  The 1 st stage was scheduled at Oct.11~Nov.10, 2010, which successfully investigated 1781 institutions.  The 2 nd stage was scheduled at Nov.11~12, 2010, which successfully investigated 112 institutions that had strict entrance administration and could not enter directly without letter of introduction.

4. Evaluation Indexes Environmental Index Smoking Status 29 或 or 45 Compreh ensive Score Smoking Ban Symbol Propaganda Material Sale of cigarettes is forbidden of supervised area Outdoor Smoking Area Cessation Outpatient Service Indoor places forbidden smoking working staff is not allowed to smoke wearing overalls. Fixed Bulletin Board Tobacco Control Propaganda Material 3 4 Outdoor smoking area Distinct Instruction 3 2 Discover cigarette ends Found smoker, no one dissuade Found working staff was smoking -2 Tertiary Indes Entrance Waiting Hall Gentlemen’s Elevator Staircase Overall Index Primary Index Secondary Index In order to compare secret investigation results of different institutions easily, calculate score of different indexes and deduct with full mark of that index, so that to get index score percentile.

Score and Ranking of Provinces (regions, cities) 5. Main Results and Existing Problems

Problem 1 ： Smoking Ban Identification Figure 4 ： Smoking Ban Symbol Proportion sat different places set by various institutions （ % ）

Reception OfficeEntranceStaircase ToiletMeeting RoomRestaurant

Problem 2 ： Outdoor Smoking Area Figure 5 ： Outdoor Smoking Area Proportion set by various of institutions （ % ）

Problem 3 ： Complete Indoor Smoking Ban Figure 6 ： Indoor Smoking Phenomenon Proportion （ % ）

Problem 4 ： Tobacco Control Publicity Table 1 ： Tobacco Control Propaganda Material Posted at Various Institutions （ % ） Category Tobacco Control Bulletin Board Tobacco Control Propaganda Material Health Administrative Department Public Health Instructions Medical Institutions National Medical Institutions

1. Oragnize Seminar of National Health Education and Health Promotion III. Introduction of Overall Promotion and Construction of National Tobacco Fee Health System in 2011

2. Organize Supervision of National Tobacco Free Health System Time Task and Requirements Jan. –Dec. AprilMayJune-July By the end of July Dec. or Beginning of Next Year Self-examination and self-monitoring Issue Announcement of Implementation Supervision of National Tobacco Free Health System Construction Issue National Tobacco Free Health System Cross Supervision Evaluation Manual Regional cross supervision evaluation Report the result of cross supervision evaluation to CHINA CDC Construction Work Summarizing Meeting

3. Organize Tobacco Control Training Course among Administrative Officials at different levels Time Training Courses Jan.JuneJulyJulySep.-Oct. Oct.- Dec. The 1 st Regional and Municipal Health Bureau Director Tobacco Control Training Course National Health Supervision Trainer Training Course Shandong Health Administrative Officials Training Course (2 sessions) Henan Health Administrative Officials Training Course Health Administrative Officials Training Course of Xizang and Xinjiang Autonomous Region Regional and Municipal Health Bureau Director Tobacco Control Training Course

4.Integrated with tobacco control project subsidized by central government, continue to support construction work in each region. 5. Organize experts, and strengthen supervision forces. 6. Training and mobilizing media to participate in propaganda and supervision of tobacco free health system

7. Issue 2011 China Tobacco Control Report on World No- Tobacco Day. 8. Prepare and disseminate propaganda materials. 9. Organize and develop 2011 National Secrete Investigation work. 10. Organize summary and commending meeting at appropriate time.

Framework Convention on Tobacco Control. Begin with yourself, integrating innovative thoughts, explore a CHINA Way to follow Framework Convention on Tobacco Control.