Long march towards a smoke-free China
By Olivia Chung

HONG KONG - With the Chinese government vowing to host a smoke-free 2008 Summer Olympic Games and requiring all cigarette packs to carry health warnings beginning in 2009, the world's biggest tobacco producer and consumer is also being eyed as a huge potential market for people looking to kick the nicotine habit.

However, industry experts and smokers said the demand for anti-smoking aids has not lived up to expectations, due to economic and cultural reasons.

Secondhand smoke can be found almost everywhere in China. Many non-smoking passengers find it hard to breathe inside Chinese buses and trains during long journeys as habitual smokers routinely ignore the no-smoking signs. Children, including babies, are commonly seen sitting just beside a father or grandfather puffing away in a restaurant.

With no anti-smoking laws in China, those bothered by secondhand smoke can do little but endure the fumes or the wrath of a smoker asked to snuff his butt. I know this from first-hand experience after a driver on a bus I was on stopped smoking after passengers complained. However, he got his revenge. Almost all the passengers were shortly thereafter sick to their stomachs during our two-hour journey as the irate, nicotine-deprived driver violently steered the bus over bumps and through turns until it was virtually bucking like a horse.

Only this year did China's Ministry of Health release a report on "Smoking Control in China 2007" that reported that China has 350 million smokers and 540 million non-smoking Chinese exposed to secondhand smoke.

In China, smoking claims 1.2 million lives every year. The death toll is likely to climb to 2.2 million a year by 2020, according to estimates by the World Health Organization (WHO).

More alarming is the rising popularity of smoking among young people. According to a Peking University survey by its Research Center for Child and Teenage Health entitled "Strategy to Stop Young People Smoking" that polled more than 100,000 middle school students, the average age for beginning smokers was 10 years old.

That's one reason why when China signed the Framework Convention on Tobacco Control in 2003 and Prime Minister Wen Jiabao set a goal for a smoke-free Olympics, there were hopes for a smoke-free China. Under the treaty, China has to put strong health warnings on cigarette packs beginning January 1, 2009, and create smoke-free buildings and workplaces beginning in 2010.

And that's why James Liu Zhenxian, president of Beijing Novartis Pharmaceuticals Company, the flagship subsidiary of Novartis in China, was quoted in China Business News as saying that his company sees the potential market for anti-smoking aids in China as worth about 300 billion yuan (US$40.1 billion).

"Presumably, 17% of mainland smokers, which is about 60 million people, want to quit smoking. If each of them spends 500 yuan on giving up smoking, it would mean a market scale of about 300 billion yuan," Liu told China Business News.

He said his company is considering retooling its prescription-only, stop-smoking products into over-the-counter versions to make them easier to sell and added that Novartis is now seeking cooperation from Watson's and Wal-Mart stores on the mainland to sell its anti-smoking aids, such as the nicotine patch it launched in China on October 26.

Novartis has six enterprises in Beijing and Shanghai and one comprehensive research center, with a total investment of $330 million.

Johnson & Johnson, another leading foreign pharmaceutical company that produces stop-smoking products in China, declined to talk about its products.

Despite Liu's optimistic forecast for the future of Novartis's products, industry experts and China's heavy smoking culture have virtually snuffed out the thought.

In the 1990s, tobacco-control clinics were set up in about 10 hospitals in Beijing, but only two of them remain open at present.

A clerk in a shop in Guangzhou, the capital of southern China's Guangdong province, said their anti-smoking products were poor sellers due to low public awareness of the dangers of tobacco and the government's failure to implement smoke-free policies.

Ben, a Hong Kong stock broker and smoker, who migrated to Hong Kong in 1989 from the mainland, said it's very hard to promote no-smoking in China. He tried in vain to quit smoking twice but resumed after taking business trips to China where offering cigarettes to others, as well as accepting them, is regarded as "face-giving" etiquette.

"Offering cigarettes is regarded as a goodwill gesture on the mainland at so many social functions, so how can you turn it down? If you do so, you make people think you are not giving face," Ben said.

A "wedding cigarette" is also a necessity for guests at proper Chinese wedding ceremonies. "The brand of cigarettes the groom offers is even regarded as symbolizing how much respect he shows to his guests," Ben said.

Ben candidly described himself as a "diehard smoker" - though perhaps one in severe denial as to the health hazards of his habit. He said he did not believe the statistics about the ill effects of smoking. "Barbecue smoke is more dangerous to people's health than cigarette smoke," he said.

Aside from the country's strongly entrenched love affair with tobacco, China's other large challenge is economic. Stated-owned tobacco companies contributed 240 billion yuan to the central government, accounting for about 7.5% of revenue received by the country in 2005. And the tobacco industry is a major economic pillar in poorer regions such as Yunnan province in southwest China.

According to "Top 500 Chinese enterprises of 2007", published in September, 10 tobacco companies are included and the Hongta Group, China's top tobacco producer is in the top 100.

Cui Xiaobo, a member of the Ministry of Health who was involved in the drafting of China's Public Facility Health Management Rules, may also be in denial considering China's severe economic conflict of interest when it comes to smoking. He believes the biggest challenge towards comprehensively banning all forms of tobacco advertising, promotion and sponsorship by 2011 is not economic, but "cultural".

"Smoking is very popular in China and has become a cultural influence. In order to change it, state legislation is a good start," Cui said.

Olivia Chung is a senior Asia Times Online reporter.

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Anti smoking campaigns have done nothing for smokers. By the time a person has had their first cigarette, they know the dangers: cancer of the lung, mouth, throat, heart disease, circulation problems, liver problems, etc etc. There are only a few things that make a smoker want to quit.

1. price of cigarettes
2. restriction of access to smoking
3. fear of death/illness

I am an ex-smoker. I didn't like the cost and thought about quitting. They were getting ready to pass a law to prevent people from smoking in bars and restaurants. Where did I smoke? Bars and restaurants. I thought about quitting again. I started to have ill effects from smoking. It scared the bejesus out of me. I went to my doctor and got the pill. Now, I've been smoke free for 3 years. I had smoked for 17 years 1 1/2 packs a day. I firmly believe, without the last one, a person won't quit, and even so, may still smoke until their last puff. Advertisements won't prevent people from smoking, but if it becomes a social stigma or it's more difficult to smoke, it will be all the preventative a young person needs.