China is facing a public health crisis with over 350 million smokers, representing nearly one-third of all smokers in the world. The World Health Organization estimates that one million smokers in China die from tobacco-related illnesses each year, and this number is expected to rise to 2.2 million deaths by 2020.
Despite these grim facts, more than three-fourths of Chinese smokers have no plans to quit smoking. Furthermore, less than one-third of smokers are aware of the harmful effects smoking has on their health, according to new research based on the International Tobacco Control (ICT) China Survey.
"It is imperative that China starts to implement effective cessation strategies because China currently has the highest smoking rate in the world and the potential loss of life if smokers continue to smoke is enormous," said the authors of a study published in the October 2010 supplement issue of the journal Tobacco Control, dedicated to tobacco control in China.
Raising Awareness of the Dangers of Smoking
More than 60 percent of men and three percent of women in China are smokers, yet only 36 percent of smokers knew that smoking causes heart disease; even fewer (16 percent) were aware that it also causes stroke, according to the ICT China Survey.
Smoking also poses an enormous health risk to non-smokers in China, as it is estimated that 52 percent of non-smokers are exposed to tobacco smoke pollution on a regular basis. However, less than two-thirds of survey respondents agreed that secondhand smoke can cause lung cancer.
It is evident that better education about the health risks of smoking could increase the likelihood that Chinese smokers will quit smoking and remain smoke-free.
Availability of Tobacco Cessation Support for Smokers
In addition to increasing public awareness about the risks of smoking, it is also important to increase smokers' confidence that they can quit smoking.
Research has demonstrated that quitting even after many years of smoking can greatly reduce the risk of cancer, stroke and cardiovascular diseases. However, the majority (76 percent) of smokers in China have no intention of quitting smoking. Only one-fourth of ICT China Survey respondents were confident that they could successfully quit smoking.
It is possible that smokers are not able to quit successfully because cessation services and medications are not widely available in China. Most smokers (74 percent) were aware of stop-smoking medications, but less than six percent had used these medications.
Although traditional medicine is used widely in the United States and other Western countries, few smokers in China were aware of Chinese traditional medicine to aid in smoking cessation. Less than 28 percent of survey respondents knew about stop-smoking acupuncture.
Physicians Should Encourage Smokers to Quit
Evidence has shown that doctors' advice is a powerful motivator to encourage quitting. According to the ICT China Survey, only 48 percent of Chinese smokers had received advice from a physician to quit smoking. Almost no one was given pamphlets or brochures on how to quit, and few had received a referral to another service to help quit.
The study researchers suggested that the reason why physicians are not providing cessation advice may be that the doctors themselves don’t know enough about the harms of smoking, and likely did not receive cessation training in medical school.
Awareness of Secondhand Smoke
The ICT China Survey indicated that Chinese smokers had concern about the effect of their smoking on their family and friends; therefore, increasing awareness of the harmful effects of secondhand smoke may likely encourage smokers to quit.
Close to 45 percent of smokers said that the effect of smoke on non-smokers was a reason for thinking about quitting smoking. More than 40 percent of smokers were concerned with setting an example for children and another 40 percent placed a great deal of importance on their family’s and friends’ disapproval of smoking. The number one reason for thinking about quitting smoking was concern for personal health.
Implementation of Anti-smoking Laws to Encourage Quitting
The majority (75 percent) of Chinese smokers believed that the government should do more to control smoking.
Comprehensive anti-smoking policies in public places—particularly schools, public transportation and hospitals—are widely supported by both non-smokers and smokers in China, according to another study based on the ICT China Survey. Read more at: Support for Smoking Bans Widespread in China.
Another ICT China Survey-based study indicated that health warnings with graphic pictures on cigarette packages are likely to motivate people to quit smoking. Read more at: Cigarette Packs Should Carry Health Warnings with Pictures.
Raising the Price of Cigarettes by Increasing Tobacco Taxes
The price of cigarettes in China is very low. The cigarette tax rate in China is about 40 percent of the retail price (compared to 79 percent in Thailand, another developing country in Asia). The China Tobacco Monopoly subsidizes tobacco factories for their production of less expensive cigarettes, which guarantees a supply of less expensive cigarettes.
A study in the February 2010 issue of Tobacco Control recommended China increase its tax on cigarettes as a cost-effective measure to reduce smoking. Read more at: Increasing China's Cigarette Tax: The Economic and Health Impact of Tobacco Taxation.
References:
- Feng G, Jiang Y, Li Q, et al. Individual-level factors associated with intentions to quit smoking among adult smokers in six cities of China: findings from the ITC China Survey. Tobacco Control 2010; 19: i6-i11.
- Jiang Y, Elton-Marshall T, Fong GT, Li Q. Quitting smoking in China: findings from the ITC China Survey. Tobacco Control 2010; 19: i12-i17.
- Yang J, Hammond D, Driezen P, et al. Health knowledge and perception of risks among Chinese smokers and non-smokers: findings from the Wave 1 ITC China Survey. Tobacco Control 2010; 19: i18-i23.
- World Health Organization. Towards a tobacco-free China. Geneva, Switzerland: WHO, 2007.
- World Health Organization. Report on the Global Tobacco Epidemic, 2008: the MPOWER package. Geneva, Switzerland: WHO, 2008.
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Juan Ramos - Juan Ramos is a health communication specialist based in Boston, Massachusetts, USA. He has worked in the non-profit sector for more than ...
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