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    Greater China
     Jun 1, 2005
Curing the doctor in China
By Antoaneta Bezlova

BEIJING - If one in five Chinese doctors smokes, how can China's army of 350 million smokers be persuaded to kick the habit?

China, the world's biggest producer and consumer of tobacco, marked the 18th annual "World No Tobacco Day" on Tuesday by announcing the first batch of national no-smoking hospitals and calling on medical personnel to quit smoking. The theme of this year's event was "health professionals and smoking control". More than 23% of Chinese doctors smoke daily, only about 1% lower than the average rate of the population. As many as 57% of Chinese male medical professionals smoke, and in some areas of the country, less than half of doctors truly understand the medical dangers of smoking, or techniques to help people quit smoking. These alarming facts were revealed in a survey carried out by the Tobacco Control Office of the Chinese Center for Disease Control and Prevention.

After the Chinese government signed a landmark international convention on tobacco control in 2003, officials have shown more determination to address a mounting public health crisis, but they appear to be ill-equipped to deal with the problem. "If there are large numbers of smokers among doctors, teachers and government officials, that makes it even more difficult for common people to drop the habit," said Jiang Yuan, an official from the Tobacco Control Office.

China's anti-smoking campaign faces an uphill battle, with the number of smokers estimated to be growing by 2% a year. Nearly 70% of China's tobacco addicts are male but an increasing number of women - some 20 million now - are picking up the habit too. Overall, China burns 1.7 trillion cigarettes a year.

Smoking is believed to kill about 1.2 million people in China every year. By 2050, the World Health Organization estimates that figure could rise to more than three million, putting an even greater burden on China's overburdened health care sector. Official figures show that economic costs to China from early deaths, lost productivity and rising health care bills as a result of smoking now account for nearly half of the tobacco industry profits. In 2000, China's tobacco industry generated 105 billion yuan (US$12.6 billion) in pre-tax profits. The same year, economic losses caused by tobacco-related illnesses totalled 48.6 billion yuan.

The government's vested interests in the tobacco industry have long frustrated efforts to curb smoking in the country. The state has a monopoly on tobacco production and distribution and the industry represents the single-largest source of state revenue. In the south-western province of Yunnan, where some of China's major tobacco growers are located, tobacco taxes account for 70% of government revenues.

China became a signatory to the World Health Organization's Convention on Tobacco Control but has delayed ratifying it for fears that restrictive measures prescribed by the agreement - covering the advertising, marketing, pricing and taxation of tobacco - would disrupt the ongoing reshuffle of the tobacco sector. "The purpose of the reshuffle is to help domestic tobacco companies deal with mounting competition from big foreign corporations," said Hu Xinhua, an official with the State Tobacco Monopoly Administration (STMA). Competition between domestic and foreign tobacco companies has heated up since China entered the World Trade Organization in 2001. China's tobacco administration plans to establish 30-50 key enterprises through mergers and acquisitions in three years, and foster the development of big cigarette brands.

The WHO's convention on tobacco control, which took effect on February 27, calls for the governments to increase taxes and prices over a three-year period, ban cigarette advertising within five years and, among other steps, put more detailed warnings on products. But government officials openly admit that WHO curbs on smoking would have little immediate effect on China. "Although it is required by the treaty, I see no price or tax increase in the near future," Zheng Fugang, general secretary of the China Tobacco Society told the media recently. "The Chinese law on [the government] tobacco monopoly states that the industry has to ensure financial income for the nation, while protecting the rights of consumers."

Nevertheless, the Chinese government has pledged to ratify the convention within one year of it coming into effect. "We have received clear signals from the government that they are aware of the magnitude of the health crisis and committed to work toward ratifying the convention," said Wu Yanwei, an official with the WHO's mission in Beijing.

China's new top leaders, President Hu Jintao and Premier Wen Jiabao, have portrayed themselves as health-conscious and clean living. Unlike their predecessors, communist founding fathers Mao Zedong and Deng Xiaoping, whose chain-smoking images dotted the country in the 1980s, Hu and Wen are never seen on television or in newspaper photos smoking. It is perhaps this personal example that health officials are seeking when calling on Chinese doctors to stop lighting up.

But curbs alone are unlikely to persuade the nation's millions of tobacco addicts to quit smoking. The habit is deeply ingrained in the Chinese society. Lighting up cigarettes for others is a show of courtesy and offering cigarettes is seen as a demonstration of friendliness.

(Inter Press Service)


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