World health matters – China: Tobacco control could save 13 million lives

by Gary Finnegan:  Around 13 million lives could be saved by 2050 if China were to implement comprehensive tobacco-control measures set down by the World Health Organisation (WHO), a new study has claimed. 

China signed up to the WHO Framework Convention on Tobacco Control (FCTC) in 2003 but critics say it has yet to deliver on the anti-smoking policies prescribed by the agreement.

The FCTC calls for beefed-up surveillance and monitoring of tobacco use, the creation of smoke-free environments, treatment of tobacco dependence, tobacco consumption taxation and other price controls, enforcement of health warnings on tobacco packages and marketing bans.

“If the status quo is maintained, China faces a tremendous health burden in the next four decades that could result in more than 50 million deaths related to smoking,” says Dr David T. Levy, a population scientist at Georgetown Lombardi Comprehensive Cancer Center at Georgetown University Centre.

“If the country completely implemented the WHO FCTC policies, almost 13 million deaths would be averted and smoking rates would be reduced by about 40%.”

China is the most populous nation in the world and is home to about a third of the world’s smokers, with male smoking rates of greater than 50%. China is also the world’s largest tobacco product manufacturer through a government-owned tobacco company.

Researchers at Georgetown used a computer simulation program called SimSmoke to model tobacco smoking prevalence, smoking-attributable deaths and the impact of tobacco control policies between 2015 and 2050. The researchers analysed data including China’s adult population, current and former smoking prevalence, and initiation and cessation rates.

Levy says that according to SimSmoke, raising taxes on tobacco products would have the greatest impact on reducing smoking rates.

“In 2009, China raised the tax on tobacco by almost 12%, but the increased cost was not passed along to consumers,” Levy explains. “If China raised the taxes to 75% of the package price and increased the price commensurately, there would be a decrease in smoking of 10% within three years.”

China has banned smoking on public transportation. The country has implemented weak tobacco dependence treatment programmes and some advertising bans that are not strictly enforced, according to Levy. These policies do not meet the FCTC requirements, he says.

“Some of the WHO FCTC policies will cost money to implement, but taxation policies and strong health warnings in particular would be cost effective,” Levy says.