Smoking related conditions account for four of the five leading causes of death in China. And, of all of the cigarettes smoked in the world, 1/3 are consumed in China, with both of these statistics according to the World Health Organization.
However, an owner of a cafe in Beijing had only this to say "Our whole restaurant is the smoking section," he said. "Maybe we'll try to ask people to go outside, but in the end, the customer is God."
So, why even make a legislation in the first place? And why had the legislation made great progress in areas like the United States as compared to the speculation around China attempting to install the same practice?
Along with China having the sheer greatest number in its population, there is also as expected the greatest number of smokers. The smoking population in China has reached 300 million at this point. This entire movement was sparked by a treaty that the State Council of China signed with the World Health Organization in 2006, in which they were expected to enact legislation to control the rampant tobacco use within 5 years. However, up until now all campaigns to try and achieve this goal have been overridden by various ill circumstances and excuses. China is already 5 months past this deadline.
The way that this legislation works is that if establishments do not comply with the regulations that take effect tomorrow, then they will be charged 30,000 yuan or $4600. However, the problem with the standing legislation is that restrictions are unclear, and so violations are also unclear. With all of these gray areas, enforcement looks bleak.
Something to consider though is how much smoking is a part of the Chinese culture. In America, the trend had already been dying out a bit before it was mandated in public places. However, in China, this is still a mainstay of business men in their transactions as well as normal people trading cigarettes as gifts because it has been a symbol of class and social settings for a long time. And, education stands to be an issue seeing as according to a survey, only approximately 23% of the adults in China would understand that smoking can lead to cancer and other various illnesses.
It is yet to be determined how individual municipalities will interpret the law, and then how this will be reinforced.
I think this is a really good article on how legislation and public health often don't work well together. Because public health is concerned with getting people to make the correct choices and behavior changes, it is the people themselves, not the government, that sometimes have to be the main target of public health work.
ReplyDeleteI think one of the best ways for China to break its tobacco addiction is to focus on the youth. Here in US we had so much information thrown at us growing up about the harms of smoking it is no wonder that many of our age group don't smoke. Nationwide programs like DARE do a great job of really educating young people on the dangers of smoking and drug use.
Especially with the rise of China's middle class, I think one of the best things public health workers can do is work to educate the people their children on the dangers of smoking
This seems to be a really complicated issue in China. Considering the history of the United States and smoking, we also have an interesting perspective from the downhill side of smoking use. There seem to be many barriers preventing the reduction of smoking in China--legal, cultural, economic, social and educational. It seems to me that education would be a first step. Even if it does not cause an actual behavior change, it will lay a foundation for other programs. For example, a smoking ban sounds very ineffective to me considering that 75% of the people do not understand the dangerous health effects of smoking. People do not tend to want to follow rules that they do not understand. Either way, it seems as though this problem will take a very long time to sort out.
ReplyDeleteThis legislation is another example of a country enacting laws in order to comply with WHO treaties, which ultimately allow them to remain on good terms with the countries that they rely on for trading, money, etc. It is sad that so often public health officials simply fall back on mandates and regulations. With this example, clearly, the legislation is not going to be completely effective. As Mike said, the education of why smoking is bad simply is not there. These laws are much less effective than combinations of education programs and incentives that allow people to make the decisions for themselves, which are going to have much better results. While laws are helpful, it is sad when the programs that will be the most effective are overlooked.
ReplyDelete