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China, Cigarettes, and the Rise of the Smoking Industry

By: Lauren Webb Throughout much of the 20th century, smoking was part of the American culture. Beyond being socially acceptable, it was practically encouraged as part of adulthood—advertisements portrayed the “Marlboro Man” and smoking soldiers as both manly and uniquely American, cigarettes were an encouraged gift; and young women saw it as an assertion of their equality.[1] As time has progressed, however, concern over the estimated 443,000 tobacco-related deaths each year has dominated the dialogue.[2] Campaigns, taxes, and laws throughout the U.S. now seek to decrease smoking. One would expect this to be the natural consequence of medical technology in the 21st century, which has increased knowledge of the effects of smoking on the human body. But do countries in a different stage of industrialization benefit from this same process?

When one looks at statistics of China’s tobacco use, America seems tame in comparison. Over 350 million people smoke in China (the U.S. population was just over 311 million in 2011) and around 1 million die each year due to tobacco-related causes.[3] Much like America sixty years ago, this is caused by both a lack of knowledge about the health dangers of smoking, limited intervention by the state to curb smoking, and the cultural acceptance of smoking in China.

Research has shown that publications in any country can help decrease the public acceptance of smoking through both a reduction in pro-tobacco advertisements and an increase anti-smoking coverage by the media.[4] But within China, an anti-smoking consensus has not emerged in the media. Although news coverage of tobacco and tobacco-control related issues has increased over the past decade—progress in itself—not all of these articles were anti-smoking. Most articles (50.4%) between 2000 and 2010 were anti-smoking, but 10.5% of coverage was still clearly pro-smoking and letters to the editor had a large number of pro-tobacco positions.[5] This is made more startling by the fact that, despite the high number of tobacco-related deaths, only roughly 23% of the Chinese adult population views smoking as a deadly habit.[6]

Local news outlets were less likely to take an anti-tobacco stance, a trend which the study authors attributed to “local economy protectionism.” One way in which tobacco companies in China have ingratiated themselves with the Chinese public and government has been through money in philanthropy and tax payments alike. This can be seen particularly in towns where tobacco is produced, such as Yuxi. In these towns the tobacco industry is considered an economic savior, rather than a medical enemy. The tobacco companies provide jobs and a major production boost but also go beyond that to donate furniture and money to schools.[7] Moreover, the entire Chinese tobacco industry contributes the equivalent of US$13.6 billion in taxes. According to Li Xiaoliang, executive director of the Pioneers for Health Consultancy Center, the economic impact of the tobacco industry “has hampered tobacco control work, and also has had a positive impact on teenagers’ attitude towards the industry.”[8]

The growth of the smoking industry and its acceptance is encouraged by China’s gift-giving culture. Cigarettes are considered a valuable and traditional gift, with more expensive brands frequently given to government officials, doctors, and elders.[9] Even those who don’t smoke may keep cigarettes in the house just to offer important visitors.[10] Such an important social norm may discourage those who would otherwise quit smoking.

Although the numbers are dismal, hope remains in the long-term situation, with the assistance of international organizations and programs, including the China Tobacco Control Partnership at the Emory Global Health Institute. Funded by the Gates Foundation, the program works at the city level to promote education about the impact of tobacco smoking (including youth prevention and education about second-hand smoke) and research at Chinese universities and institutes.[11] And public health advocates within China continue to promote anti-smoking plans and government intervention as well. Following a survey of Chinese teenagers’ smoking habits and perception of the industry, Li Xiaoling had hope for increased government intervention, citing attention from government workers, who “now have realized the health of youth is being affected.”[12]

All-in-all, it is worth remembering the decades it took for America to make the progress we have in viewing smoking as a public health issue, as well as the progress we still have to make. China’s current level of tobacco use and the level of influence wielded by tobacco companies are major problems for China’s public health situation. But not too long ago the United States had a similar cultural acceptance of tobacco. Hopefully, China is on a similar path.

Lauren Webb is a junior at Emory University majoring in Political Science and History. Her research and academic interests focus on India, China, and Japan, with a particular interest in the U.S.-Asia relationship. Lauren is spending the summer as an Archive Intern with Southwest Airlines and will be studying at Kansai Gaidai University in Hirakata, Japan during the Fall semester.


[1] To see a collection of some of these older, “morally questionable” advertisements, see http://wellmedicated.com/lists/40-gorgeous-vintage-tobacco-advertisements/

[2] CDC’s Office on Smoking and Health, “Smoking and Tobacco Use; Fact Sheet; Adult Cigarette Smoking in the United States;,” Smoking and Tobacco Use, n.d., http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/.

[3] “Tobacco: Strategy Overview,” Bill & Melinda Gates Foundation: Global Health Program (November 2011).

[4] Junling Gao et al., “The Growth in Newspaper Coverage of Tobacco Control in China, 2000-2010,” BMC Public Health 12, no. 1 (March 7, 2012): 160; Harry Clarke and Bao Jia Tan, “Tobacco Use Control Policies in China,” Economic Papers: A Journal of Applied Economics and Policy 30, no. 4 (2011): 490–496.

[5] Gao et al., “The Growth in Newspaper Coverage of Tobacco Control in China, 2000-2010.”

[6] Holly Korschun, “Emory Global Health Institute-China Tobacco Control Partnership Announces Programs of Excellence,” Emory University- Global Health Institute, April 26, 2010, http://shared.web.emory.edu/emory/news/releases/2010/04/china-tobacco-control-partnership-announces-programs-of-excellence.html#.T_E0_sXcgrh.

[7] “Efforts Called to Block Students’ Access to Smokes,” China Daily (Kunming, May 31, 2012).

[8] Ibid.

[9] Korschun, “Emory Global Health Institute-China Tobacco Control Partnership Announces Programs of Excellence.”

[10] Ian Johnson, Wild Grass : Three Stories of Change in Modern China (New York: Pantheon Books, 2004).

[11] Korschun, “Emory Global Health Institute-China Tobacco Control Partnership Announces Programs of Excellence.”

[12] “Efforts Called to Block Students’ Access to Smokes.”

Works Cited

Clarke, Harry, and Bao Jia Tan. “Tobacco Use Control Policies in China.” Economic Papers: A Journal of Applied Economics and Policy 30, no. 4 (2011): 490–496.

“Efforts Called to Block Students’ Access to Smokes.” China Daily. Kunming, May 31, 2012.

Gao, Junling, Simon Chapman, Shaojing Sun, Hua Fu, and Pinpin Zheng. “The Growth in Newspaper Coverage of Tobacco Control in China, 2000-2010.” BMC Public Health 12, no. 1 (March 7, 2012): 160.

Health, CDC’s Office on Smoking and. “Smoking and Tobacco Use; Fact Sheet; Adult Cigarette Smoking in the United States;.” Smoking and Tobacco Use, n.d. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/.

Johnson, Ian. Wild Grass : Three Stories of Change in Modern China. New York: Pantheon Books, 2004.

Korschun, Holly. “Emory Global Health Institute-China Tobacco Control Partnership Announces Programs of Excellence.” Emory University- Global Health Institute, April 26, 2010. http://shared.web.emory.edu/emory/news/releases/2010/04/china-tobacco-control-partnership-announces-programs-of-excellence.html#.T_E0_sXcgrh.

“Tobacco: Strategy Overview.” Bill & Melinda Gates Foundation: Global Health Program (November 2011).

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