China smoking ban in place

By Dr. Ananya Mandal, MDMay 1 2011

Starting today all bars, restaurants, hospitals and other public places in China are slated to become smoke-free, inside and out. Efforts to ban smoking in public places here have been plagued by false starts and failed campaigns.

China, with the world’s largest population, also has the most smokers. Figures show that more than 300 million smoke in the country and there is a deeply entrenched smoking culture and little awareness among the general public about the health risks.

This new ban was mandated by the State Council, China’s top administrative body, in response to a World Health Organization treaty Beijing signed in 2006 pledging to enact nationwide tobacco-control legislation within five years. China already has missed the deadline by almost five months. China accounts for a third of all cigarettes smoked worldwide, and about 3,000 people die every day here from smoking-related illness, according the World Health Organization. Cigarette smoke contributes to four of the five leading causes of death in China, WHO says.

According to this law there is a mandate of a penalty of 30,000 yuan, or about $4,600, for owners of establishments that do not comply, but it is still unclear who will enforce the ban and what actions will trigger such a steep fine. Public health experts doubt that the ban will be immediately effective, citing legal and education obstacles.

Sarah England, a technical officer at WHO said, “I would be very surprised if it were enforced…The law will need to be interpreted by the local and municipal authorities before it has a real impact.” She also noted the lack of a nationwide public education campaign similar to those in the West, so “only 23 percent of adults believe smoking causes cancer or other health problems.” Since most Chinese haven’t been told about the harmful effects of smoking, they don’t see the need to stop. An added burden is the cost of quitting. The medication that helps with giving up tobacco typically costs more than 1,000 yuan, or about $150, about half a month’s salary for the average worker.

Yang Gonghuan, director of China's National Office of Tobacco Control, welcomed the ban and told state news agency Xinhua that the guidelines made the responsibilities of business owners clearer. "It is realistic to demand a bigger role for these business owners in dissuading smokers," she said. Anti-smoking campaigner Wu Yiqun told China Radio International the government should do more to educate people by putting pictures on cigarette packets showing the effects of smoking.