"Healthy China 2030" Planning Outline clearly points out that by 2030, the smoking rate of people over the age of 15 will be reduced to 20%, so a series of smoking ban measures have been introduced in various places. However, according to the reporter’s investigation, since 2017, China’s cigarette sales have stopped falling and rose. According to industry insiders, the situation of adolescent smoking and second-hand smoke is still serious, and new types of tobacco, such as e-cigarettes, are "cultivating" young smokers. At the same time, the tobacco control bonus brought by the tax increase on tobacco products has been "eaten up" and the "tug-of-war" of tobacco control continues.
After thirteen years of smoking control, cigarettes are sold more and more.
It is understood that the WHO Framework Convention on Tobacco Control came into effect in China in January 2006. In order to fulfill the Convention on Tobacco Control, in 2015, China raised the tobacco consumption tax, which led to the decline of cigarette sales in 2015 and 2016, and achieved the effect of controlling tobacco consumption. However, according to the official data of Tobacco Monopoly Bureau, in 2017, the sales volume of cigarettes in China stopped falling and rose, with 47.378 million boxes sold in the whole year, up by 0.8% compared with 2016.
The reporter’s investigation found that under the general trend of national tobacco control, the tobacco authorities are still actively seeking how to expand sales and increase tobacco consumers. For example, an insider of Jinan Tobacco Monopoly System published a paper "Analysis on the Factors of Cigarette Sales Growth in Jinan Market", suggesting that "for ordinary wage earners, activities such as buying a certain number of cigarettes to give away other necessities of life, such as giving away laundry soap, towels, etc., can be carried out, and the consumer can use the original expenditure on daily necessities to buy cigarettes, thus increasing cigarette consumption expenditure and giving him the opportunity to cultivate new consumption habits."
Tobacco companies are actively exploring new rural markets. Among the outstanding papers of Guangxi Tobacco in 2016-2017, there is a paper saying that "the current tobacco control regulations have not had a great impact on the rural market, and the smoking environment in rural areas has not been greatly restricted, and the consumer groups and smoking habits are relatively stable, which provides a favorable environment for improving sales volume and structure", "Guangxi Baise Company & HELIP; … Deeply tap the potential of rural market, and achieved certain results. In 2015, the sales volume and structure of the rural market maintained growth. When the total sales volume of the whole city was basically the same as that of the same period of last year, the rural market sold a total of 37,235 boxes of cigarettes, an increase of 645 boxes year-on-year, an increase of 1.8%. "
Teenagers’ "first cigarette" is easier to get.
According to the statistics of the State Tobacco Monopoly Bureau, the sales volume of Double Happiness in the first half of 2017 was as high as 1,935,000 boxes, followed by Yunyan, Liqun and Hongtashan, and the prices of their main varieties were all around 10 yuan. According to CDC statistics, 50% of smokers spend no more than 9.9 yuan on a box of cigarettes, and there is no difference compared with 2015. The proportion of the cost of purchasing 100 boxes of cigarettes to the per capita GDP in the same year decreased from 2.0% in 2015 to 1.5%.
According to the reporter’s investigation, low-priced cigarettes "occupy" the vast market, and many young students have also become consumers of low-priced cigarettes. At present, China only counts smokers over the age of 15, and the relevant anti-smoking propaganda is mainly aimed at this group of people over the age of 15. However, teenagers under the age of 15 have been able to contact and buy cigarettes, especially many left-behind children can control their living expenses independently, and their parents’ supervision is insufficient. At the same time, some tobacco companies have also introduced "low tar content" cigarettes to promote their little harm and lure teenagers to try.
Wan Xia, an associate researcher at the Institute of Basic Medicine, China Academy of Medical Sciences, said that it is "convenient" and "cheaper" for teenagers to buy cigarettes. Some cigarette shops even unpack cigarettes and sell them individually, and each cigarette costs only a few cents, so teenagers can buy the "first cigarette" in their lives and may become addicted from now on.
Some new tobacco products are becoming popular, such as e-cigarettes, heated non-combustible cigarettes, and so on. These products are playing advertisements that are harmless to health. These new tobacco products are used in the same way as traditional cigarettes. Some researchers have found that a large proportion of new tobacco users will gradually take up traditional cigarettes, and "e-cigarettes" are cultivating new smokers.
Tobacco control urgently needs "strong medicine"
On the one hand, it is public health, on the other hand, it is rich profits, and the "tug-of-war" between the two sides of tobacco control interests is becoming more and more fierce. According to the Survey Results of Adult Tobacco in China in 2018 released by CDC, the smoking rate of people aged 15 and above in China was 26.6% in 2018, including 50.5% for men, 2.1% for women, 28.9% for rural areas and 25.1% for cities. Compared with the previous survey results, the smoking rate shows a downward trend, but it is not the same as achieving the tobacco control goal of "Healthy China 2030" — — There is still a big gap between "the smoking rate of people over 15 years old will drop to 20% in 2030".
According to industry insiders, while China’s economy is developing rapidly and residents’ income is increasing, tobacco prices are relatively "stable", which leads to the "tobacco control dividend" brought by the tax increase on tobacco products in 2015 being "eaten up".
A team study by Professor university of international business and economics and Zheng Rong, director of the WHO Center for Tobacco Control and Economic Policy Cooperation, found that during 2001-2016, China’s ability to pay for cigarettes continued to increase because the income of China residents increased more than the price of cigarettes. The reporter also learned from the investigation that the consumption level of students has improved, and many of them have smoked more than a dozen or twenty cigarettes.
Experts believe that the most powerful tobacco control weapon that the government can use is taxation. It is suggested that China’s tobacco tax should be changed from ad valorem to specific quantity, and the price of low-priced cigarettes should be raised, which is more obvious for low-income people and teenagers. These two groups of people are more sensitive to price because of their limited income. This is also the most important target group for tobacco tax increase to achieve the effect of tobacco control, which can not only reduce the "first smoke" of teenagers, thus reducing the number of new smokers, but also reduce the smoking volume of low-and middle-income smokers.
In addition to the lag in tax adjustment, experts believe that China’s tobacco control efforts and policies are not enough. For example, the World Health Organization’s Framework Convention on Tobacco Control stipulates that China should adopt legislative measures to achieve 100% smoke-free indoor public places, workplaces and public transport within five years of its entry into force. The Convention came into effect in 2006, and the Regulations on the Control of Smoking in Public Places (Draft for Comment) just issued in Wuhan in May even suggested setting a three-year "buffer period" for smoking bans in entertainment, restaurants and other places. This also means that smoking in these places will be restricted within three years, and smoking will be completely banned after three years, which not only runs counter to the spirit of the Convention, but also indoor smoking areas have become the source of second-hand smoke.
Experts believe that the law must impose heavy penalties for violating the smoking ban, especially indoor smoking ban. Zhou Ning, an associate professor of cardiovascular medicine in tongji hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, said that setting up smoking areas can’t eliminate the harm of second-hand smoke. The results of the technical feasibility study of the smoking room in Hong Kong University of Science and Technology show that any engineering technology, such as exhaust, ventilation and designated smoking areas, can not avoid exposure to tobacco smoke, effectively protecting public health.
The role of health education also needs to be strengthened. Cui Xiaobo, vice president of Beijing Smoking Control Association and a professor at Capital Medical University, said that while reminding health risks and reducing the willingness to smoke, warning pictures of cigarette cases will effectively curb the current trend that many high-end cigarettes are given as gifts. There are 118 countries/jurisdictions in the world that have finally determined that tobacco packaging must adopt the requirement of picture warning, covering 58% of the world population, which is an achievement of global public health.
"In the Internet and self-media era, tobacco advertisements have spread to new media such as WeChat and Tik Tok. Therefore, banning tobacco advertisements in new media and carrying out health education on tobacco hazards are likely to affect a large number of young people and prevent them from becoming new smokers." Ma Jun, director of Peking University Children and Adolescent Health Research Institute, said.
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