Smoking in China is common, because the People's Republic of China is the world's biggest consumer and tobacco producer: there are 350 million Chinese smokers, and China produces 42% of the world's cigarettes. China National Tobacco Corporation (??????????????????????????????????????????????????????????????????????????????????????????? ????????????????????????????????????????????????????????????????????????????????????? The monopoly in Mainland China generates between 7 and 10 percent of government revenue.In Chinese guanxi systems, tobacco is still a welcome gift everywhere, especially outside urban areas, tobacco control laws exist, but law enforcement is rare outside the most internationalized cities, such as Shanghai and Beijing Outside the mainland, strong enforcement in the special administrative area of ​​Hong Kong, outside of China's largest cities, smoking is considered socially acceptable anywhere anytime, even if it is technically illegal.
Chinese Association of Tobacco Control (????????????????????????????????????????????????????????????????????????????????????????????????? ????????????????????????????????????????????????????????????????????????????????????? ????????????????????????????????) academic, social and mass organizations, due to the firm enforcement of tobacco control legislation which is not supported by the Chinese Government.
Yang Gonghuan, deputy director of China's National Disease Control Center, said that progress in tobacco control does not move quickly because the government derives substantial tax revenues from tobacco sales, and the industry employs a lot of manpower. The ministry said that as a "medium-term goal, all health administration and half of state health facilities should be smoke-free by the end of 2010". Almost 60% of Chinese male doctors are smokers, which is the highest proportion in the world. China has no legislation to punish health care facilities, medical workers and health officials who violate smoking bans, and instead rely on Chinese media to act as overseers.
Smoking is a social custom in the PRC, and giving cigarettes to social interactions is a sign of respect and friendliness.
Video Smoking in China
Tobacco control law
On May 20, 2009, the Chinese Ministry of Health issued a formal decision to ban smoking entirely in all medical administration and medical facilities in 2011. With a growing smoking population in China of more than 350 million, the enactment of the May 20 Initiative is an important milestone in commitment China's tobacco control. However, because of the complicated relationship of the Chinese government with tobacco policy (for example, many regions rely on tobacco tax revenue as a substantial source of income), there are many concerns about the practicality of national policy enforcement.
In addition to the May 20 measures, many provincial and municipal governments in China have also enacted policies to control the prevalence and health effects of smoking in the past decade.
Impact of the WHO Framework Convention on Tobacco Control
On October 11, 2005, China became the 78th country in the world to ratify the WHO Framework Convention on Tobacco Control (FCTC), an international treaty aimed at reducing tobacco-related illness and death. Under FCTC conditions, China is required to completely prohibit "promotions and sponsorship on radio, television, print and the Internet within five years," as well as to prohibit tobacco companies sponsoring international events or activities. China has also decided to ban all cigarette vending machines, as well as smoking in indoor workplaces, public places, and public transport vehicles.
Although China has a wide and complex smoking problem, the FCTC ratification in China is a significant commitment to tobacco control in international public health policy. According to Dr. Shigeru Omi, WHO Regional Director for the Western Pacific Region, "implementing the Convention will not be easy, because smoking is a deeply ingrained habit in China... but the Government has affirmed its commitment to take action." Given the FCTC, concerns about the international image, and the strong support of both citizens and domestic health authorities, the Chinese government is increasingly involved in tobacco health-related health promotion and health promotion programs.
Ministry of Health report
Before enacting a national smoking ban, the Ministry of Health has maintained an active involvement in denouncing the negative effects of smoking and struggling to reduce the prevalence of tobacco use. On May 29, 2007, the Ministry released a 2007 (2007 ?????????) China Control Report report) detailing the level of exposure to secondhand smoke smoke (affecting more than 540 million Chinese citizens), recommendations for legislation, legislation to reduce the dangers of passive smoking, and the feasibility of imposing a public smoking ban based on voting data. In particular, the report agreed with the international scientific consensus on second cigarette smoke, citing many findings from public health authorities in other countries. to emphasize the conclusion that "no level of exposure is safe against passive smokers", that ventilation equipment is ineffective in reducing the dangers of exposure to secondhand smoke, and that the most effective public health protection measures against smoking is a legislative ban on smoking in public places. With the explicitly stated goal of "building a smoke-free environment for the sake of enjoying a healthy life", this report received strong support and praise from the Campaign for Tobacco Free Children, a US-based health advocacy group based in Washington, D.C.
In addition, this report demonstrates the strong possibility for successful implementation of a complete public smoking ban in seven major urban areas on the basis of widespread broad support for such action. According to an analysis by the Campaign for Tobacco Free Children, voting data in the Ministry of Health report reveals:
"Exceptional public support for non-smoking public spaces... support for total smoking bans outstrips support for partial smoking bans... Among smokers, polls found that 93.5% support the total smoking ban in all schools, 75.5% support total restrictions in hospitals, and 94.3% support total restrictions on all public transport Among non-smokers, 95.1% support total bans in all schools, 78.1% support total ban in hospitals and over 93.8% support public transportation restrictions About 70.6% of non-smokers support some types of smoking bans in bars and restaurants.
National ban
Although China still lags behind many countries in implementing tobacco control policies, the May 20 initiative of the Ministry of Health helps to establish more unified smoking controls and codify public health authorities at a large administrative level. From 2009, the Project sponsored by the Bloomberg Initiative and directed by Yang Tingzhong was designed as the first program to ban all forms of smoking on university campuses in China. "Decisions" The ministry formally requested local government units to "regulate the Multi-Agency FCTC Implementation Leading the Small Group" to assist with regional enforcement strategies, with the explicit aim that:
"In 2010, all medical administration offices, both military and non-military, and at least 50% of all medical and health institutions should be non-smoking units, so the purpose of the total smoking ban b> in all administrative offices health and medical and health institutions can be fulfilled in 2011. "
The "Decision" also encourages health administration offices to utilize mass media resources and utilize large-scale publicity campaigns such as World No Tobacco Day to "actively promote the importance of applying a total smoking ban in military and civilian administrative offices and medical and health institutions."
Popular opinions
As a poll from the 2007 Ministry of Health report shows, there is widespread public approval of smoking bans among urban dwellers. Various health experts, activists and public advocacy groups consider efforts to improve Chinese government policy on tobacco policy as "definitely good news for the country's smoking control progress." Significant support also exists within the political scope of representation; allegedly, political advisers from the CPPCC have even gone so far as to call for a smoke-free legislative session.
However, apathy and tacit acceptance of smoking policies tend to dominate most of the Chinese population. China has a relatively low level of social rejection - according to the International Tobacco Control Policy Evaluation Project (ITC), "only 59% of smokers think that Chinese people do not approve of smoking, the fourth lowest of the 14 ITC countries surveyed."
Disapproved and unresolved issues
Given the complex and diverse nature of the political agenda in China, the public interest in public health is often in conflict with economic interests. Since tobacco remains an important source of both health and income risks for city and national government agencies, Chinese specific tobacco control policies in different contexts can betray ambivalence positions or overall inconsistencies. For example, local exceptions for indoor smoking ban are often made for small businesses, especially in restaurants and entertainment industries. Uncertain enforcement of public health regulations that are clearly defined in practice may limit the impact of the national smoking ban de jure. In practice, there are often only a few government offices, schools, museums, hospitals, and sports venues that function effectively as non-smoking areas. In addition, the smoking culture base in China presents a significant barrier to the de facto acceptance and integration of smoking control policies. According to Li Xinhua, an expert on publicity of tobacco control and education at the Ministry of Health, "about 60 percent of medical workers and professors are smokers [and thus breaking laws calling for a complete smoking ban]... Some of them even smoke bravely in hospitals or schools. "This is problematic because, regardless of whether these professionals continue to smoke out of habit, social habits, or" clear neglect "for evidence of smoking risks, they are still expected to" behave and be good examples for others in control tobacco, "Li said.
In addition, enforcement of national tobacco control policies is still very rare in rural areas, where the state-owned China National Tobacco Company has had much influence in tobacco production and marketing. In response to the FCTC's recommendations for reduced access and tobacco regulation on the supply side, the Ministry of Health is now targeting farmers to leave the tobacco plantations and trying to "convince them that the tobacco industry can be replaced by other healthier industries." , sustainable and profitable. "
Another possible obstacle is the lack of perseverance of the Chinese tobacco industry to comply with nationally defined policies regarding the presentation of the correct warning labels on cigarette packs, which should be easily visible and cover at least 30% of the visible packaging area. Wu Yiqun, executive vice president of Beijing-based Thinktank Research Center for Health Development, criticized China's tobacco industry watchdog authorities for "[failing to oversee Chinese tobacco producers"] in this aspect.
In addition, the International Tobacco Control Policy Evaluation Project raised the following persistent smoking issues in its China-focused report in 2009:
- In addition to "strong social pressure placed on Chinese men to smoke", it is also expected that smoking in women will become "more socially acceptable because the tobacco industry is increasingly targeting smokers."
The current tobacco control legislation in China does not explicitly address the gender or social basis for smoking.
- Smoking cessation "is relatively rare in China, and most smokers quit smoking because of chronic disease." Indeed, "awareness about the health risks of smoking is low in China.Only 68% of smokers believe that smoking causes lung cancer in smokers (compared with more than 90% in Western countries) and 54% believe that smoking causes lung cancer in smokers Only 37% of smokers are aware that smoking causes coronary heart disease and only 17% are aware that smoking causes a stroke. "
To maintain a strong and sustainable tobacco control effort, China will need to focus on the role of public health education in the prevention of smoking and health promotion.
- "Taxation is a very effective method of reducing tobacco use, but very few smokers (5%) in the ITC China Survey report thinking about prices as an excuse to stop smoking - a sign that the price is too low."
The current tax legislation in China's tobacco control policy is limited, inconsistent, and is tied to the structural complexity of domestic ownership and control of tobacco production and distribution.
Restrictions in electronic media
On February 12, 2011, the State Administration of Radio, Film and Television, announced that they will ban inappropriate scenes of smoking in movies and TV shows. The announcement said the smoking scenes did not match the country's stance on tobacco control, and mislead the public, especially minors. Because it prohibits cigarette brand scenes, people smoke in non-smoking places, children buy and smoke, and other smoking scenes associated with minors. Once the announcement is complete, the ban is effective immediately.
All regional and city initiatives
Shanghai
Given his preparation for hosting the World Expo 2010, the city of Shanghai recently upgraded its anti-smoking law. The Shanghai People's Congress passed the city's first smoking control law in March 2010. The law bans smoking in 12 types of public places including indoor smoking in schools, hospitals, sports stadiums, public transport vehicles and internet cafes. Anyone caught smoking will first be warned and then face a fine of 50 to 200 yuan if they refuse. According to Li Zhongyang, deputy head of the Shanghai Health Promotion Committee, the smoking ban is in place to protect the health of citizens and also promote the image of Shanghai as a cosmopolitan city.
According to a report by the Fudan University Media and Public Opinion Research Center, 93.5% of the 509 people they interviewed supported the smoking ban at all the Shanghai Expo 2010 pavilions and also felt that smoking should not be allowed in restaurants or shopping centers near the Expo area. Another survey conducted by public health experts from Fudan University involving 800 hotel guests and about 4,000 customers and employees of restaurants, shops and entertainment venues in Shanghai found that about 73 percent of hotel guests said Shanghai should impose a ban on smoking in public places, 84 percent of guests restaurants reported exposure to secondhand smoke, and 74 percent of them were plagued by smoke and supported smoking controls. While many interviewers found passive smokers themselves toxic and damaging to citizens 'health, the main reason behind popular support for smoking bans relates to citizens' concerns for the image of Shanghai. According to a citizen, a public health expert from Fudan who was interviewed, "Smoking has been banned in public places in some countries.We should do the same, at least during the Expo, because this is a cosmopolitan event and of course, for the sake of the public who will visiting. "For the organizers of the Expo, there is also a hypocrisy issue if they do not deal with the Chinese smoking problem as part of their" Healthy Exhibition ".
Despite popular support for smoking bans in Shanghai, many are skeptical of the true implementation of law. Shanghai residents point out that although many shopping centers and all subway and subway stations have actually been banned from smoking before this law, there is low compliance and people often smoke directly in front of NO SMOKING signs. One of the most basic concerns that Shanghai residents have about the ban is the lack of clarity on who will do the fines and who will report the violations. Public health experts agree that it would be difficult to enforce a strict ban on the number of smokers in Shanghai.
In addition to passing a smoking ban, Shanghai legislators have designed a website "Smoke Free Shanghai" to raise awareness of anti-smoking. Also, the most concrete measure that has been taken is that the Expo organizers rejected the 200 million yuan ($ 29.3 million) donation from the Shanghai Tobacco Company last year to maintain their "healthy Expo" attitude.
Beijing
Given the passing of national tobacco initiatives and international publicity for the 2008 Summer Olympics, the Beijing municipal government extended the public smoking ban on May 1, 2008 to include sports venues and all indoor areas of government offices, transport stations, schools and hospitals. The ban has a powerful impact, with polls showing that the majority of Chinese people (69% of over 10,000 respondents) "are not only aware of smoking bans in Beijing, but [95% of respondents] also hope that the authorities promote this step national. "
Menurut China Daily News:
"The survey also showed that 81.6 percent of respondents were eager to quit smoking, or had heard about family members and friends who were considering kicking the habit." I am delighted with the encouraging support of the community, it will help to promote legislation to control tobacco use, '[said] Jiang Yuan, deputy head of the tobacco control office under the China Centers for Disease Control and Prevention. "
The Beijing government has also adopted a policy of persuasion, combined with a fine of up to 5,000 yuan ($ 730) for violating the ban, in an attempt to further encourage citizens to reduce smoking in public places.
The immediate positive public health impact of Beijing's smoking ban has been manifested in the fire prevention arena. According to People's Daily,
"The smoking ban has cut the number of fires in the city triggered by cigarette butts more than half... In the first week of this month, Beijing fire brigades issued eight cigarette-related fires, averaging 1.14 per day. New daily averages [after an extended smoking ban] are less than half of what is reported in the first four months of this year, when city firefighters must extinguish 325 fires caused by cigarette butts, or 2.7 per day. "
Guangdong Province
In 2007, Guangzhou and Jiangmen became the first two cities in Guangdong for experimental enforcement of total smoking bans in some public places. Public areas for smoking bans include restaurants, entertainment outlets, schools, supermarkets, and government offices. However, in March 2010, the Guangzhou Municipal People's Congress was ready to lift a smoking ban at work, including offices, conference rooms and auditoriums.
Hubei Province
In 2009, authorities in Gongan district attempted to increase the consumption of locally produced cigarettes, demanding local officials smoke up to 23,000 packs of Hubei branded cigarettes per year. This measure is intended to bring much needed revenue to local companies; quotas are issued by the local government for offices under its jurisdiction, which in turn are fined if they fail to consume the quota of cigarettes demanded, or if they are found purchasing another brand of tobacco products. This decision was reversed after public protests and coverage by the international press.
Other cities
Congress of Hangzhou people has agreed to ban smoking in public and workplace in early 2010; smoking can be banned in some places and offenders can be fined up to 3000 yuan. Yang Tingzhong of Zhejiang University conducted a campaign and project sponsored by the Bloomberg Global Initiative to ban smoking on university campuses on a national scale.
According to Medical News Today, seven provincial capitals in China are taking steps to ban smoking in the workplace and public places. The seven cities are Tianjin, Chongqing, Shenyang, Harbin, Nanchang, Lanzhou and Shenzhen. Despite several smoking restrictions in places in these cities, government officials have noticed that low compliance rates and plans to issue strict bans.
The new ban will be run as a pilot project under the joint support of the Centers for Disease Control and Prevention (CDC) and the International Union against Tuberculosis and Lung Disease (UNION). Responding to criticism of the current law is not well enforced, Wang Yu, director of the Chinese CDC explained that "The project will make strict legislation to ensure public places and workplaces are 100 percent smoke-free and seek decent work mechanisms and strong to enforce a smoking ban. "
Maps Smoking in China
Chinese Chinese and smoking
Tobacco use has been identified as an increasingly popular phenomenon in China, and Chinese doctors have been found to exhibit high smoking levels as well. This practice is controversial because some believe that medical professionals should function as role models of healthy behaviors for their patients, while others believe that doctors should have the right to smoke because it is a personal matter.
Prevalence
A 2004 study conducted among 3,500 Chinese doctors found that 23% were regular smokers. There are significant gender differences, with 41% of male doctors reporting to be smokers but only 1% of female doctors. More than a third of smokers currently smoke in front of their patients and almost all smoke during work shifts.
Male surgeons are found to smoke more than other specialties. A study conducted among 800 Chinese male surgeons in 2004 found that 45.2% were smokers and 42.5% smoked in front of their patients.
Smoking rates from these independent studies are lower than those reported by Chinese government-run newspapers. An article published in 2009 interviewed a source who claimed that 60% of Chinese male doctors were smokers, a higher percentage than any other state physician in the world.
Comparison with other populations
The smoking rate among Chinese male doctors is comparable to the country's general population, although the overall doctor's level is lower. Chinese physicians have a much higher prevalence of smoking than doctors in the United States (3.3%) or the UK (6.8%). They have slightly higher rates than Japanese doctors (20.2%) and Japanese doctors have a smaller gender difference with 27% of men and 7% of women smoking.
Cause and effect
High tobacco use among doctors may be caused by several factors. In Chinese culture, smoking is linked to masculine identity as a social activity practiced among men to promote feelings of acceptance and brotherhood, which explains why more Chinese male doctors smoke than women. In addition, physicians in particular may use tobacco as a coping mechanism to deal with day-to-day stress associated with long working hours and difficult patient interactions.
A surgeon in Kunming (Yunnan province) described smoking as a phenomenon that is an integral part of Chinese medical culture and that improves job performance:
Smoking is a big part of being a doctor here. Our hospital director smokes. The secretaries were smoking. My department chair is smoking. And every time I go into the office, most of my coworkers smoke. And to tell the truth, with such stressful work, smoking is helpful, sometimes soothing, sometimes energizing, sometimes helping me focus on preparing a complex operation or facing a pile of 10:30 papers in the night day.
Effects on patient care
A doctor's smoking habit has been shown to affect his attitude to the dangers of tobacco. Doctors who smoke less tend to believe that smoking has a harmful effect on health compared to nonsmokers. Fewer smokers also believe that doctors should serve as role models for their patients and that indoor smoking in hospitals should be banned. Almost all Chinese doctors (95%) believe that active smoking causes lung cancer and most believe that passive smoking causes lung cancer (89%), but current smokers are less likely to hold this health belief than nonsmokers.
Arguments that support the doctor's choice to smoke
It can be said that as a responsible and knowledgeable adult, Chinese doctors should be given the choice of whether or not to smoke. Their background in science and medicine allows them to know more about the effects of smoking on the body than on the general population, so the decisions they make about tobacco are probably more educated.
In addition, smoking may be considered a personal matter that should not be relevant to the workplace. Some people suggest that as long as a cigarette does not interfere with a doctor's ability to diagnose and treat a patient, smoking should be allowed among health care practitioners. In fact, Chinese doctors who smoke may be able to form closer relationships with patients because of the role of tobacco in local culture as a commodity that promotes unity and friendship.
Arguments against doctors' choice to smoke
Others may argue that since doctors affect the welfare of the general population, their high level of smoking serves as an unhealthy role model for Chinese citizens. Many believe that doctors should function as copies, as a source of information about quitting, and as a provider of support and encouragement for those who try to live healthier by quitting smoking.
Doctors who smoke may also have a bias that prevents them from providing accurate information about the negative health effects of tobacco to patients. Or, the quit smoking advice offered by the smoking doctor may seem hypocritical to the patient trying to quit.
The economic motivation of a doctor's smoking may be a social loss caused by tobacco use. Resources spent on medical school and hospital training may not be fully realized if doctors die prematurely from higher levels of smoking.
Gender
In 2014, two thirds of Chinese men smoke. Women smoke a lot less. In 2010, smoking caused nearly 1 million (840,000 men, 130,000 women) died in China.
Smoking in Hong Kong
Smoking in certain public places in the Special Administrative Region of Hong Kong has been banned since 1 January 2007 under the revised Government Health Act (Cap. 371), first enacted in 1982 with some subsequent amendments. Recent amendments enlarge the smoking ban to include indoor workplaces, public places including restaurants, Internet cafes, public toilets, beaches and most public parks. Several bars, karaoke bars, saunas and nightclubs were released until July 1, 2009. The ban on smoking in elevators, public transport, cinemas, concert halls, airport terminals and escalators began between 1982 and 1997. The ban in shopping malls, department stores, supermarkets, banks and arena games have been around since July 1998.
Overall daily smoking rate in Hong Kong is 11.8% (HK Department of Census and Household Thematic Survey Statistics 36) with 25% of men smoking while in China 63% of men smoke.
The government has cited a ban on tobacco imports in full and smoking is technically possible in Hong Kong at the time of the budget launch in 2009. However, due to the drop in daily smoking rates in recent years mainly due to increased tobacco taxes, the current government has no further plans to control tobacco sales in addition to adjusting taxation.
Smoking in Macau
See also
- Smoking Act (Public Health)
- Health in China
References
Further reading
Martin, Andrew, "China's Government Gets Rich Selling Cigarettes", Bloomberg Businessweek , December 11, 2014.
External links
- Chinese Association of Smoking Control
- ???????
- Cigarette Retail Trade in China Underwent Drastic Changes
- STMA and China cigarette industry
- US. Report on China Tobacco Production
- Smoke Free Hong Kong
- The Most Effective Smoking Alternative
- "The smoking ban begins in Hong Kong". International Herald Tribune. December 31, 2006.
- "Hong Kong wakes up for smoking ban". 2 Jan 2007.
- China Today: Health and Medical Information
- Chinese Cigarette Threat
Source of the article : Wikipedia
0 Comments