The annual death toll from tobacco-related illnesses in China could triple over the next two decades, health experts warned ahead of a deadline for the country to implement international commitments to curb smoking that activists say Beijing has failed to meet.
Chart revenue from taxes and sales by China's state-owned tobacco monopoly, and compare cigarette market sizes by retail value in China and the U.S.
In a report issued Thursday, a group of 60 Chinese public-health experts, officials and economists argued that state ownership of the tobacco industry continues to stymie real progress in fighting tobacco—despite the mounting health and financial costs.
"While the national government may know it has a problem, it still doesn't understand that the long-term costs of this problem outweigh the revenue pulled in from tobacco sales," said Zhao Ping, deputy director general of the Cancer Foundation of China, who contributed to the report. The report's authors also include Hu Angang, an economist at Tsinghua University in Beijing, and Yang Gonghuan, a deputy director of the Chinese Center for Disease Control and Prevention.
China has an estimated 300 million smokers, nearly a quarter of its 1.3 billion population and by far the largest number of any country.
China is not only the world's largest tobacco consumer, but it is also the largest producer. Its main tobacco companies are state-owned and feed revenue into state coffers, which activists have long said conflicts with the country's efforts to address smoking's harmful effects.
A report by Chinese and foreign experts says China must take radical measures to restrict smoking in order to avoid a national health disaster. Video courtesy of Reuters.
Thursday's report, "Tobacco Control and China's Future," said that tobacco-related illness killed about 1.2 million people a year in China as of 2005. It warned that the number could rise to 3.5 million a year by 2030 if stricter measures aren't taken.
The report was published ahead of a Jan. 9 deadline to ban smoking in public indoor venues, workplaces and public transportation that Beijing agreed to in 2006, when it signed the World Health Organization's 2005 Framework Convention on Tobacco Control. The treaty's 168 signatories, including China, agreed to restrict smoking by 2011, in part through bans, price increases and taxes.
China has fallen far short of meeting the deadline, health experts say. While it has made some significant efforts, they have come too late and enforcement has been spotty. Authorities announced only last year a ban on smoking at primary and secondary schools. It wasn't until May that they created a smoking ban in state-owned hospitals and government buildings.
Compliance has been lax, said Gan Quan, a senior project officer with the International Union Against Tuberculosis and Lung Disease. Smokers are still rampant in hospitals and government offices, Mr. Gan said.
Attempts to ban advertising for cigarettes on radio, television and newspapers have also largely failed. Cigarette companies have found loopholes in the restrictions, placing their logo on advertisements for other companies' products, the antismoking experts said.
The group called for more comprehensive national laws to widen indoor smoking restrictions and reduce second-hand smoke exposure.
China's State Tobacco Monopoly administration is responsible for tobacco production and sales as well as implementation of antismoking laws, creating an inherent conflict of interest.
The tobacco industry pulled in nearly 600 billion yuan ($90.66 billion) from sales and taxes in 2010, up from 513 billion yuan a year earlier, according to the State Tobacco administration.
Health costs related to tobacco accounted for nearly 62 billion yuan last year, the report said, and are expected remain a burden on the government. The State Tobacco administration collects all tax revenue from tobacco, and it isn't known how much of that revenue Beijing allocates to curbing tobacco addiction or smoking-related health costs.
Men remain tobacco's target consumers. Nearly 60% of China's adult male population smoke, according to the report.
"A snapshot of China's smoking problem now looks like America in the 1940s," said Mr. Zhao of the Cancer Foundation of China at a media briefing. "People just don't know the health risks."
The report also comes as China's government is preparing its next five-year economic plan, due to be finalized by the National People's Congress in March. The Chinese Center for Disease Control and Prevention recommends that the government allocate more funding to tobacco control, including law enforcement and public awareness.
The report's authors advised the government to increase cigarette taxes. The Chinese government has raised cigarette taxes four times over the past 20 years, according to China's Ministry of Finance and State Administration of Taxation.
In 2009, it raised the tax on premium cigarettes, those costing more than 7 yuan, to 56% from 45%. The tax on lower-grade cigarettes jumped to 36% from 30%. The median price of a pack of cigarettes in China, including the tax, is 5 yuan, or 76 U.S. cents. The average tax on cigarettes in the U.S. is $1.45 a pack, according to Campaign for Tobacco-Free Kids.
China's failure to comply with the WHO's antitobacco treaty will not result in WHO penalties or affect its membership, says said Sarah England, head of the Tobacco-Free Initiative at the WHO in China. "China voluntarily signed the framework, and the government is aware that smoking is a problem," Dr. England said.
Several municipal governments have tried to impose their own smoking laws, adding to national efforts. Nanchang, a city in southeastern China, attempted last month to ban indoor smoking in all public places, restaurants, bars and offices. Lawmakers were unable to pass the ban, which would have fined individual and corporate violators and would have been the strictest law of its kind in China.