Breaking the habit
Beijing has committed itself to the WHO convention on tobacco control, but the powerful influence of the industry means efforts to enforce it are half-hearted, writes Mark O'Neill
From today, cigarette packets on the mainland are supposed to change radically - with a warning of a specific disease and a picture that leaves the smoker in no doubt about the possible consequence of his choice.
The change is a result of Beijing having signed up to the WHO Framework Convention on Tobacco Control (FCTC), which came into force on January 1, 2006 and mandated that packaging regulations be implemented after three years.
Mainland China is the world's largest tobacco producer consumer, with 350 million smokers, one-third of the global total. One million people die each year from smoking-related diseases, while 540 million suffer the effects of others' smoking, with 100,000 dying annually from illnesses caused by passive smoking, according to Ministry of Health figures.
Article 11 of the FCTC sets out the rules for the packaging of cigarettes. It provides that packaging must ensure that 'the truth of the effects of tobacco use be properly reflected in the packaging and labelling of tobacco products, including the use of picture warnings that even the least literate members of society can readily understand'.
It prescribes that 30 per cent to 50 per cent of the main display area be covered with a warning, including a picture.
But, when mainland smokers buy their cigarettes today, they will find no disturbing picture or image and just this anodyne wording, in Chinese and English: 'Smoking damages health and to quit smoking can reduce the risk to health.'
There is no reference to lung cancer or any specific disease.
The packaging was designed by the State Tobacco Monopoly (STM), the official government regulator which also happens to be the world's biggest producer of cigarettes.
Mainland public health campaigners say the new packaging contravenes the FCTC regulations and should be changed.
'It is absurd to put the STM in charge of the packaging,' said Yang Gonghuan, deputy director of the Chinese Disease Prevention Centre at the Ministry of Health.
'This should be decided by the Ministry of Health, as it is in other countries. The warning should specify which disease the smoker may contract.
'It is like asking the arsonists to put out a fire.'
Dr Yang pointed out that packets of cigarettes for export carried the requisite photograph and specific warning. 'There is a different rule for Chinese and foreigners,' she said. 'The STM cares for the lives of foreigners but not those of Chinese.'
The row over the packaging is the latest battle in a long-running war between supporters and opponents of the tobacco industry within the central government and the wider society.
On one side is the STM, the mainland's single biggest taxpayer - in 2007, it contributed 388 billion yuan (HK$441 billion) to state coffers, 9 per cent of national revenue - and the 10 million farmers, processors, workers and distributors who work for the industry. China is one of only two countries - the other is North Korea - to have a monopoly producer of tobacco that is also the industry regulator.
Production is increasing. Output in 2007 was 2.14 trillion cigarettes, an increase of 14 per cent from three years earlier.
And the prestige enjoyed by the STM is far higher than that of cigarette producers in any other major country, where it is often a case of overcoming serious image problems.
Last month, the Ministry of Civil Affairs awarded the STM the 'China Charity Award' for being the country's most generous firm. Four other cigarette producers were among the 140 domestic and foreign firms cited.
The award gave the tobacco firms some welcome exposure at a time when they are banned from direct advertising. Fighting the influence of the STM are doctors, health workers and civic groups who argue that the tax revenue it provides is less than the cost of treating those with smoking-related illnesses and their lost productivity, not to mention the distress caused to their families.
It was only after years of lobbying that the central government ratified the FCTC in 2005.
Dr Yang's office has just eight full-time staff and an annual budget of less than 10 million yuan.
Studies show that a majority of mainlanders have a limited understanding of the health risks associated with smoking, because the STM has been successful in limiting discussion in the mass media.
These stark contradictions were in public view at an international conference on smoking held in Durban, South Africa, at the end of November.
The Conference of the Parties to the WHO Framework Convention on Tobacco Control was attended by 600 delegates from more than 100 countries. The convention has 168 signatory countries in total, a record for a UN treaty.
Beijing sent a delegation of 17, including two from the STM, as well as officials of the foreign, finance and health ministries.
The STM delegates expressed their opposition to clauses of the treaty, saying that it was unsuitable to conditions on the mainland. They, along with the Japanese delegation, opposed Article 11, the provision dealing with health warnings on packets.
The delegates pointed out that Chinese packaging showed famous geographic and cultural sites and to put ugly pictures over them 'would insult and be disrespectful to the public', in the words of one delegate.
The STM response to domestic and international pressure is to argue that the anti-smoking movements of the west were inappropriate for the mainland.
'We have 350 million smokers and the number is likely to increase over the next 30 years,' said Zhu Zunquan, a member of the China Academy of Engineering, who is working with the STM.
'A total ban is not suitable to conditions in China. While the government is implementing the FCTC, it is fully utilising the developments of science.
'With the principle of man as the base, this is good for the nation and the people.'
He said that, while mainland gross domestic product had been rising rapidly each year, the percentage of tobacco tax as a share of national tax revenue remained about 9 per cent.
'We must also take into account the 10 million workers and farmers who make their livelihood in the industry,' Mr Zhu said. 'To protect the health of the hundreds of millions of people who do not want to stop smoking and the national interest, the only option for the stable development of the tobacco industry is less-harmful cigarettes.'
Mr Zhu is involved in a research project, in which the STM is investing hundreds of millions of yuan, to produce a 'China-style cigarette' that causes little or no harm to the smoker.
He said that the tar content of a mainland cigarette had fallen from 40 milligrams in the 1960s to 30 in the 1970s and 13.2 now. It would drop to 12 by 2010, he added.
The research is being carried out by scientists and laboratories, to which the government has awarded five patents.
Two well-known brands have already produced 77,384 cases of these low-tar cigarettes, known to many as 'the responsible cigarette', and they have been well received by the market.
Another important provision of the FCTC that was discussed in Durban is Article 13, which mandates a ban on advertising, promotion and sponsorship of tobacco products nationally and across borders.
In light of this clause, it was wrong of the central government to give STM a charity award, campaigners said.
'While tobacco is not classified as a poison, smoking harms the health and life of those who use it and is very similar to a poison,' Li Dun, a member of the China Academy of Social Sciences, wrote in China News Weekly.
'Worse than that, it threatens the health and life of other people, the passive smokers.
'The large profits and donations made by the tobacco companies come from this base.
'What basis did the ministry use for its decision?' he asked.
According to government figures, the STM ranked second in 2006 to Altria - the parent company of Philip Morris - in sales revenue among global cigarette producers, while its US$76.59 billion in assets is more than double that of Altria.