On May 20, 2009, the
Ministry of Health of China issued a formal decision to completely ban smoking in all health administration offices and medical facilities by the year 2011. The enactment of the May 20 initiative represented an important landmark in China's commitment to tobacco control. However, due to the Chinese government's complex relationship with tobacco policy (for instance, many localities rely upon tobacco tax revenue as a substantial source of income), there have been many concerns about the practicality of the national policy's enforcement. In addition to the May 20 measure, numerous provincial and city-level administrations in China have also enacted policies to control the prevalence and health impacts of smoking within the last decade.
Impact of the WHO Framework Convention on Tobacco Control On October 11, 2005, China became the 78th country in the world to ratify the
WHO Framework Convention on Tobacco Control (FCTC), an international treaty intended to reduce tobacco-related disease and death. Under the conditions of the FCTC, China is required to completely ban "promotion and sponsorship on radio, television, print media and the Internet within five years," as well as to prohibit tobacco companies from sponsoring international events or activities. China has also resolved to ban all tobacco vending machines, Despite China's own widespread and complex smoking issue, the ratification of the FCTC in China represents a significant commitment to tobacco control in international public health policy. According to Dr.
Shigeru Omi, the WHO Regional Director for the Western Pacific region, "implementing the Convention will not be easy, as smoking is an ingrained habit in China ... but the Government has made clear its commitment to take action." Notably, the report agreed with international scientific consensus about secondhand smoke, citing numerous findings from public health authorities in other countries to assert the conclusion that "there is no safe level of exposure to
second-hand smoke", From 2009, Projects sponsored by Bloomberg Initiative and directed by
Yang Tingzhong were designed as the first program to prohibit all forms of smoking in University campuses in China. The Ministry's "Decision" formally requests local governmental units to "set up multi-agency FCTC Implementation Leading Small Groups"
Dissent and unresolved issues written Tibetan, Chinese and English Given the complex and multifaceted nature of
political agendas in China, governmental public-health related interests often clash with economic interests. Because tobacco remains a significant source of both health risks and revenue for municipal and national governing entities, Such indeterminate enforcements of supposedly well-defined public health regulations in practice may limit the impact of
de jure national smoking bans. In practice, it is often the case that only some government offices, schools, museums, some hospitals, and sports venues effectively function as smoke-free areas. In addition, the cultural basis of smoking in China presents a significant barrier to
de facto acceptance and integration of smoking control policies. According to Li Xinhua, an expert on tobacco-control publicity and education in the Ministry of Health, “about 60 percent of medical workers and professors are smokers [and thus in violation of the law calling for a complete public smoking ban] ... Some of them even smoke boldly in hospitals or schools.”
Restriction in electronic media On February 12, 2011,
State Administration of Radio, Film and Television, announced that it will ban inappropriate smoking scenes in movies and TV shows. The announcement said smoking scenes are out of line with the country's stance on tobacco control, and are misleading to the public, especially minors. Thus it is prohibiting scenes of cigarette brands, people smoking at smoke-free places, minors buying and smoking cigarettes, and other smoking scenes associated with minors. After the announcement was done, the ban was effective immediately.
Regional and citywide initiatives Shanghai In light of its preparations to host the
2010 World Expo, the city of
Shanghai had recently heightened its anti-smoking legislation. The
Shanghai Municipal People's Congress issued the city's first smoking control law in March 2010. The law bans smoking in 12 types of public places including indoor smoking at schools, hospitals, sport stadiums, public transport vehicles and
Internet cafes. Anyone caught smoking would first be given a warning and then face a fine of 50 to 200 yuan if they resist. According to Li Zhongyang, the deputy head of the Shanghai Health Promotion Committee, the smoking ban was enacted to protect citizens' health and also promote Shanghai's image as a
cosmopolitan city. According to a report by the
Fudan University Media and Public Opinion Research Center, 93.5% of the 509 people they interviewed supported a smoking ban at all Shanghai Expo 2010 pavilions and also felt that smoking should not be allowed in restaurants or shopping centers near the Expo area. Another survey done by public health experts from Fudan University which involved 800 hotel guests and around 4,000 patrons and employees of restaurants, shops and entertainment venues in Shanghai found that about 73 percent of the hotel guests said Shanghai should adopt a smoking ban in public areas, 84 percent of restaurant guests reported exposure to second-hand smoke, and 74 percent of them were annoyed by the fumes and support smoking controls. While many interviewers found second-hand smoke itself toxic and damaging to citizen's health, a main reason behind popular support for the smoking ban relates to the citizen's concern for Shanghai's image. According to one citizen that the public health experts from Fudan interviewed, "Smoking has been banned in public places in several countries. We should do the same, at least during the Expo, since it is a cosmopolitan event. And of course, for the sake of the public who would be visiting." One most basic concern Shanghai residents have regarding the ban is the lack of clarity regarding who will do the fining and who will report the offenses. Public health experts agree that it will be difficult to enforce a strict ban with the large number of smokers present in Shanghai. to raise anti-smoking awareness. Also, the most concrete measure that has been taken is that Expo organizers refused a 200 million yuan ($29.3 million) donation from the Shanghai Tobacco Company last year to maintain their "healthy Expo" stance.
Beijing In light of the passage of national tobacco initiatives and international publicity for the
2008 Summer Olympics, the
Beijing city government extended a public smoking ban on May 1, 2008 to include sports venues and all indoor areas of government offices, transport stations, schools and hospitals. The ban had a generally strong impact, with poll results suggesting that a majority of Chinese residents (69% out of over 10000 respondents) are "not only aware of a smoking ban in Beijing, but [95% of respondents] also hope that the authorities promote the move nationwide." According to
People's Daily, "The smoking ban has cut the number of fires in the city sparked by cigarette butts by more than half ... In the first week of this month, the Beijing fire brigade put out eight cigarette-related fires, an average of 1.14 per day ... The new daily average [after the extended smoking ban] was less than half of what was reported in the first four months of this year, when the city's firefighters had to put out 325 fires caused by cigarette butts, or 2.7 per day."
Guangdong Province In 2007,
Guangzhou and
Jiangmen became
Guangdong's first two cities for experimental enforcement of total smoking ban at some public places. The public places for smoking ban included restaurants, entertainment outlets, schools, supermarkets, and governmental offices. However, by March 2010, the Guangzhou Municipal People's Congress prepared to lift the smoking ban in work places, including offices, conference rooms and auditoriums.
Hubei Province In 2009, the authorities of Gongan County attempted to increase consumption of locally produced cigarettes, by demanding that local officials smoke up to 23,000 packs of Hubei-branded cigarettes per year. This measure was intended to bring much-needed revenue to local enterprise; quotas were issued by county authorities to offices under its jurisdiction, which in turn were fined if they failed to consume the demanded quota of cigarettes, or if they were found purchasing other brands of tobacco products. This decision was reversed after public outcry and coverage by international press.
Other cities Hangzhou's people's congress had approved to ban smoking in public and working places in the beginning of 2010; smoking may be prohibited in some places and violators may be fined up to 3000 yuan.
Yang Tingzhong from
Zhejiang University undertook campaigns and project sponsored by Bloomberg Global Initiative to ban smoking in university campuses at a nationwide scale. According to Medical News Today, seven provincial capitals in China are taking steps to ban smoking in workplaces and public places. The seven cities are
Tianjin,
Chongqing,
Shenyang,
Harbin,
Nanchang,
Lanzhou and
Shenzhen. Although there are already some smoking bans in places in these cities, government officials have realized that compliance rate is low and plans to issue a strict ban. The new ban will be run as a pilot project under the joint auspices of the Chinese Center for Disease Control and Prevention (CDC) and the International Union against Tuberculosis and Lung Disease(UNION). Responding to criticism about the current legislation not being well enforced, Wang Yu, director of the China CDC explained that "This project would create strict legislation to guarantee 100-percent smoke-free public venues and workplaces and figure out a feasible and forceful working mechanism to enforce the smoking ban." ==Smoking among physicians==