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February 18, 2014

Tobacco Control in China: the Time has Come

Judith Mackay, Winnie Chen, Tom Carroll

We just completed an annual partner meeting of the Bloomberg Initiative to Reduce Tobacco Use in Beijing, and closed the meeting with a renewed sense of optimism about the progress made in the past year, and ways in which we can all help to move things even further along in 2014. In particular, in just the past few months, there have been four important developments in China, indicating a groundswell of commitment at a high level.

1. An important Party School publication: The first of these was the publication of Tobacco Control: International Experience and China’s Strategy by the Topic Group of the Party School of the Central Committee of CPC (Communist Party of China). This massive tome (over 240 pages) assesses the history, present situation, and path forward for tobacco control in China. The Party School is the training center for senior officials nationally, as well the think tank for the ruling Communist Party, so this is an extremely important document signifying serious attention to the issue at the highest level. Only once before has the Party School studied a health topic, which was HIV/AIDS about ten years ago, resulting in a higher political profile for HIV/AIDS.

2. The second development was a directive issued in December 2013 by the General Office of the CPC Central Committee and General Office of the State Council: “The State Council / CPC Policy on Officials Shall Take the Lead in Making Public Places Smoke-Free.” This directive outlined several key shifts in policy, proclaiming that:

 

• Government officials should fully understand the importance of taking the lead in making public places smoke-free, strictly follow the rules of smoke-free public places, and become role models – proactively protecting the authority of related regulations and rules.

• Officials should not smoke in smoke-free public places: including schools, hospitals, sports centers/stadiums, public and cultural venues, and public transportation. Officials should also actively provide advocacy, education, and guidance tobacco control, urge business owners of public places to place eye-catching health warnings or no-smoking signs, and discourage (or stop) people from disobeying no-smoking rules.

• Smoking will be strictly prohibited in the official business dealings of the government and the party. Organizers of official events shall not provide tobacco products; the participants in events shall not smoke, offer cigarettes to others, or encourage others to smoke. Paying for tobacco expenditures with official accounts is henceforth officially prohibited.

• The offices of the party and government agencies at all levels shall be built into smoke-free offices. No tobacco products shall be sold or provided in office environments, no tobacco advertisements shall be posted, no smoking is allowed in public working places, and obvious no-smoking signs shall be placed in reception rooms, meeting rooms, corridors, canteens, washrooms. etc. The offices of the party and government agencies at all levels shall encourage staff members to quit smoking. Health and publicity departments shall conduct multiple forms of advocacy and education on tobacco control.

• Officials at all levels shall be monitored by the public and the media and judged by the rigorousness of their tobacco control policies. The party and government agencies at all levels shall strengthen supervision and inspection, and criticize and educate officials who disobey the rules and smoke in public places.

 

Many countries have decreed smoke-free government buildings, but China’s directive is to government staffers – an unusual and welcome step. . It not only indicates government commitment to tobacco control, and protects the health of government officials, but it also paves the way towards the national smokefree law.

 

3. The third development is progress being made on a National Smoke-free Law, which is an extremely promising step. Over 30 cities in China have already enacted various forms of smoke-free legislation, but an overarching national law is currently being drafted by the National Health and Family Planning Commission. Any local legislation that is less rigorous than the national law would be adapted to reflect the more stringent policy. A smoke-free law would prohibit smoking in the workplace and public places, thus protecting millions of Chinese citizens. Other clauses in the law are also being considered. It is hoped that the law will be passed by the State Council in 2014. The law is consistent with China’s obligations under the WHO FCTC Article 8.

4. Ministry of Education Notice Regarding a National Ban on Smoking in Schools
The notice was introduced on Jan 17 as a follow up action of the State Council Notice and includes four areas of tobacco control action:

• Schools should be 100% smoke-free, with smoking at kindergarten, primary school and middle/high school strictly banned. Tobacco advertisements or tobacco industry sponsored school/buildings are strictly forbidden. Tobacco products are not allowed for sale in the school and instruction is required for visitors to prevent smoking in the school.

• Smoking at universities should be strictly limited. Indoor smoking is forbidden and no-smoking signs and a supervision hotline should be posted in prominent places. A few smoking areas at open spaces are allowed but clear instruction and tobacco harm signs should be posted in the smoking area. These areas should meet the fire safety requirement and should be located far away from concentrated public places and regular routes. Help should be offered to smokers at school to quit smoking

• Public education on tobacco harm will be strengthened. All local education bureaus and schools should organize lectures and activities to promote smoke free especially during World No Tobacco Day and freshman orientation week. Contents should include tobacco harm and basic health instruction, in order to help teachers and students to consciously resist tobacco products and SHS, and help smokers treat quitting smoking as a trend.

• A long-term surveillance mechanism needs to be established by local government for school monitoring and reporting those with inadequate implementations. This should include in-school smoke-free inspectors for daily monitoring and should link the performance of duty in implementing smoke-free with the performance evaluation system for both teachers and students.

These developments are indicative of the Chinese government’s commitment to tobacco control on both the individual and organizational level – much-needed interventions that could save the lives of millions. We look forward to continuing progress in 2014!

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