Chain-smoking China faces huge task to snub out cigarette habit

By Hazel Parry and Simon Parry Sep 25, 2006, 13:12 GMT

Hong Kong - At the turn of the 20th century, tobacco baron James Duke flicked through a world atlas, stopped at the population figure of 430 million, jabbed his finger at a map of China and announced: 'That is where we are going to sell cigarettes.'

One hundred years on, Duke's prophesy about the potential for cigarettes sales in China, where the population has since grown to 1.3 billion, has been realised on a literally breath-taking scale.

Three out of every 10 cigarettes produced globally are smoked in China. Cigarette production in China increased seven-fold between 1960 and 2003, from 225 billion a year to 1.8 trillion - and 97 out of every 100 of those cigarettes are smoked within China.

More than 300 million men in China are smokers - more than the current population of Duke's home country, the United States. Out of every 100 men, 67 smoke, a higher percentage than anywhere else in the world apart from Yemen and Djibouti.

Judith Mackay, Hong Kong-based policy advisor to the World Health Organisation and co-author of the newly-published second edition of the Tobacco Atlas, says it was the obsession of Duke and his contemporaries that began China's smoking epidemic.

'The leaders of the tobacco industry have had their eyes on China for more than 100 years and they are not taking them off,' she said. 'Duke was interested in China and rightly so in a sense because he could see the population numbers. That interest in China has simply never flagged.'

While it was Duke's company, British American Tobacco, that first gave the Chinese a taste for cigarettes, it is China's own state-owned giant, Honghe, which now ranks as the fourth biggest selling cigarette brand in the world.

Between 2002 and 2005, Honghe sold 108 billion cigarettes almost exclusively within China, according to the Tobacco Atlas, a total exceeded globally only by trans-national brands Marlboro, Mild Seven and L&M. The concern of Mackay and her co-authors is that the attitudes of international tobacco companies will rub off on China.

'It really is quite worrying,' said Mackay. 'Their influence is converting China's national monopoly to behave in a different way, to challenge the evidence that smoking is bad for you, which it never did in the past.

'They are much more sophisticated and this is our worry - that China's own industry will just morph into behaving more like the trans-nationals. That's one of the many negative influences of the trans-nationals penetrating China as they did 100 years ago.'

In a foreword to the report, written as an advocacy tool by anti-smoking campaigners, American Cancer Society chief executive officer John Seffrin warns: 'The world is facing a pandemic of epic proportions because it is under attack by a ruthless industry - the purveyors of tobacco.'

That warning, the authors say, is particularly pertinent to China where they estimate that a third of Chinese men under the age of 30 will be killed by tobacco if current smoking patterns continue and where the direct health costs of smoking are already in the order of 4.29 billion US dollars a year.

The outlook for China might appear bleak, but Mackay emphasised that research had uncovered the first signs of a counter trend. For the first time, she said, there were recordable numbers of smokers in China who had kicked the habit.

'For the first time, there are some ex-smokers,' she said. 'That means there are people who smoked and who have quit. That is our first glimmer of hope for smokers in China. It just appears there is a peak effect, the message is getting through and some smokers are giving up and quitting.

Another significant development is that China is now a signatory to the World Health Organisation's Framework Convention on Tobacco Control which bans tobacco advertising, regulates cigarette packaging, bans the sale of cigarettes to minor and bans smoking in work and public places.

More significantly, however, Mackay believes there are signs on a social as well as a political level that awareness of the dangers of smoking is beginning to hit home in China. 'Fashions can change and I think we are beginning to turn a corner,' she said.

'There are smoke-free areas for the first time and there is the start of a recognition that smoking is harmful. People are becoming less keen to smoke in front of their children. Most people in China now know smoking is harmful to them. What they don't know is how harmful.

'I am hopeful China is on that road now but there is certainly a long haul ahead. It isn't just going to happen overnight.'

Currently, there are around 1.4 billion smokers worldwide and that figure - even taking into account a fall in the ratio of smokers - is projected to rise to between 1.5 billion and 2.2 billion by 2050 because of global population increases, the atlas estimates.

'Tobacco companies have been bleating about how the Framework Convention would drive them out of business, about how people like myself would drive them out of business. But none of these things are going to happen,' Mackay said.

'They are laughing all the way to the bank, principally because their market is inevitably expanding in terms of numbers. Maybe the prevalence figures may come down, but in terms of the absolute number of cigarettes they are selling, their markets will continue to increase.'

Chris Nelson, manager regulatory affairs for Philip Morris Asia, which recently signed an agreement with the Chinese National Tobacco Corporation to produce Marlboro cigarettes in China, argued that tobacco companies could be part of the solution.

'We have a role to play in developing tobacco regulation,' he said. 'Nobody knows our product better than we do.

'We are making an addictive product that causes death and diseases among smokers. But we know, and the Tobacco Atlas points this out, that smoking will continue. People will continue to smoke and something needs to be done about it.

'That is why we think tobacco products need to be regulated ... We want to compete and be successful in a highly regulated environment even if that means taking market share away from our competitors.'