China has 300 million smokers, 30 percent of the world's total smoking population. China's death toll from tobacco-related illnesses reached 1.2 million each year and the number is expected to reach 3.5 million by 2030 at the current growth rate, says the Tobacco Control and China's Future report.

Given the variety of bans from different levels of governments, however, no exact plan of national legislation has been seen. The tobacco industry, which contributes nearly a 10th of the country's tax revenues, is thought to be a "pillar of the economy" in some provinces and regions. And that's the fundamental reason for the failure of tobacco control work in China, according to the report.

Local lawmakers in Nanchang in Jiangxi Province conceived the country's "toughest" anti-smoking regulation in 2010, but it was finally watered down due to various obstacles.

The original version of the regulation banned smoking in government offices, restaurants, bars, and other entertainment venues—a first for a Chinese city.

The revised draft, however, eases the smoking ban in office buildings to include only "public areas" and delays the implementation of a total ban in ticket offices and waiting lounges from 2011 to 2015. Moreover, the ban on smoking in restaurants, bars and entertainment venues is delayed until 2015 from the original 2013.

Chen Huilin, a lead drafter, said the regulation was revised to make its implementation easier.

Tangled situation

The State Tobacco Monopoly Bureau and the state-owned China National Tobacco Corp. immediately organized a research team consisting of 70 tobacco industry experts to come up with countermeasures to every article of the FCTC, which China, at that time, was still in negotiations to join in, said Yang Gonghuan, Deputy Director of the Chinese Center for Diseases Control and Prevention (CCDCP) who led the production of the Tobacco Control and China's Future report.

Finally they finished a counter plan to the FCTC, according to Yang.

"The State Tobacco Monopoly Bureau has taken advantage of its power to make the counter plan a national policy. The state regulation about tobacco packing standards are exactly derived from the counter plan, even the language is the same," said Yang.

Due to the lack of legal bills to ban tobacco advertising, promotion and sponsorship, various kinds of advertisements for tobacco sales are common on radio, TV and the Internet, and in print publications.

The cigarette packages also fail to meet the requirements of the FCTC, which suggests the warning signs and information about smoking should be no less than 30 percent of the visible part of the package and better be more than 50 percent.

And there's the problem of low taxation making cigarettes very affordable. Though China has levied 5 percent more taxation on tobacco wholesales since 2009, the price remains low compared to other countries: a Marlboro costs $2.04 in China while it's $9.39 in Singapore and $11.48 in Norway.

Experts including Yang believe tobacco control should be listed as a strategic campaign in the country's 12th Five-Year Plan (2011-15) and should draw attention from the Central Government, which is suggested to separate tobacco enterprises from government management.

As the tobacco industry reportedly generated more than 513 billion yuan ($77 billion) in taxes in 2009, accounting for 7.5 percent of total government revenues, "the bloody truth that lung cancer cases in China have jumped nearly 400 percent since 1980 shouldn't be ignored by decision-makers," said Zhi Xiuyi, head of the Lung Cancer Diagnosis and Treatment Center of the Capital Medical University in Beijing.

"In the long run, the government has to consider the human and financial costs of tobacco and begin to take substantial actions to reduce them," said Huang Jianshi, a public health expert in Beijing. Huang calls on all stakeholders from different fields such as the law, health, and education, to stick to the "long and hard" task of tobacco control.

Also, the Tobacco Control and China's Future report says a new ministerial-level department should be commissioned to lead the national campaign for tobacco control, replacing the current Ministry of Industry and Information Technology, which also administers China's largest tobacco producer—China National Tobacco Corp..

"The world won't realize the goal of the FCTC unless China fulfills its commitment. The success of China's tobacco control also means the success of the world," says the report. The change may take a long time and experts believe that the next two decades offer a good opportunity for China to regulate its tobacco control policies.

Facts and Figures

- 2.3 trillion cigarettes produced in China in 2009

- 40 percent growth of China's cigarette production in 2009 over 2000

- $9.08 million in medical costs and labor force losses caused by smoking in China

- 1.2 million deaths from smoking-related diseases in China each year

- 738 million Chinese people suffering from second-hand smoke

(Source: Tobacco Control and China's Future)