Can larger anti-smoking labels on cigarette packs change smoking habits in China? Picture: A label on a cigarette pack sold in Taiwan warns that tobacco endangers the health of the smoker's family. (File Photo/Huang Guo-shu)
Chinese and overseas health experts in Beijing are urging China's tobacco industry to print large warning pictures on cigarette packs.
Dr Sarah England, a technical officer at the Tobacco Free Initiative of the WHO Representative Office in China, said Thursday at a seminar in Beijing that people have a fundamental right to information about the harms of tobacco and countries have a legal obligation to provide it.
"However, in China, only 23.2% of adults believe that tobacco can cause strokes, heart attack and lung cancer," England said.
According to a recent WHO report, graphic health warning labels on tobacco packaging and mass media campaigns have both been shown to reduce tobacco use. "Most tobacco users are unaware of the harm caused by tobacco use and up to half of all tobacco users will die from a tobacco-related disease," the report said.
Tobacco gift culture is a major obstacle for tobacco control in China, however, where cigarettes are a symbol of social status and are often given as gifts. Anti-tobacco groups believe that printing graphic health warnings on packages will help to change this custom.
China signed the WHO Framework Convention on Tobacco Control in 2003, which requires health warning labels on tobacco packaging to be approved by a "competent national authority." It also specifies that the labels should cover no less than 30% or more of the face of the cigarette packaging and be "large, clear, visible and legible."
However, cigarettes sold on the Chinese mainland still lack pictures and specific warnings.
"The only improvement in China's commitment to the WHO's FCTC on packaging is the ambiguous warning 'Smoking is Harmful' that has been printed on the front of cigarette packs since October 2008," according to Jiang Yuan, deputy director of the Chinese Center for Disease Control and Prevention (CDC).
Jiang added that the size of the text of the warning is small and it does not contrast strongly with the color of the packaging.
"Packaging is of critical importance for tobacco merchants," said Wu Yiqun, executive vice director of the Think Tank Research Center for Health Development, adding that it can be used to tempt especially younger people and women to start smoking.
China's hygiene and health authorities have no say in the design and implementation of warning labels for tobacco packaging. The Tobacco Monopoly Bureau, led by the Ministry of Industry and Information Technology (MIIT), has the final say in matters regarding tobacco sales in China.
Health experts claim that the government uses a double standard for tobacco packaging. Some believe that health warnings are deliberately weakened on the Chinese mainland for the sake of the Tobacco Monopoly Bureau's profits. On the other hand, graphic health warning labels have to be printed on packs when the same tobacco products are sold in Hong Kong, Macao and Taiwan.
China's tobacco-control pioneers are entering a critical period, as the MIIT is scheduled to revise its tobacco packaging regulations by the end of this year. "Government authorities plan to increase size and number of the warnings, but graphic labels might not be included," Wu said.
The government included a public smoking ban in its 12th five-year plan (2011-2015), which was created in March. Some Chinese cities have also been passing legislation to control second-hand smoke.
A local draft law that bans indoor smoking in public areas was passed in late May in Harbin in northeastern China and is considered an important milestone in tobacco-control legislation. Indoor smoking control regulations in the cities of Tianjin, Chongqing, Nanchang, Shenzhen and Shenyang are also under discussion or awaiting a vote.
According to the WHO, tobacco continues to be the leading cause of preventable death worldwide, killing nearly six million people every year.
Jiang Yuan 姜垣
Wu Yiqun 吳宜群
Thinktank Research Center for Health Development 新探健康發展研究中心