by Michael Woodhead
The Chinese government has recently announced sweeping measures to ban smoking in public areas of government facilities such as offices, schools and sports grounds. Government officials have also been ordered to take the lead in promoting smoking bans. This is a welcome and long overdue move, but without enforcement it won't work. In the past China has enacted many laws and regulations against smoking but they have not been enforced. People smoke with impunity in 'no smoking' areas because there are no inspectors to enforce the rules. There is very little publicity given to the dangers of smoking and the health benefits of quitting - and very little promotion of smoking cessation. China has also lacked smoking cessation services to cater for those who do want to quit.
Tobacco control experts from China and Hong Kong have said that the new measures will require a huge workforce of anti-smoking inspectors to enforce compliance. Take Hong Kong as an example. The city has 650,000 smokers and has needed 100 full-time enforcement officers issuing 8000 fine tickets a year to adequately enforce its 2007 anti-smoking legislation. Based on these figures, with a population of 300,000,000 smokers, China will need 46,000 full-time enforcement officers and about 4 million penalty tickets issued annually to enforce smoking bans.
Writing in the American Journal of Epidemiology, Dr Lam Tai Hing and Dr Yao He say China will also need to put funds into publicity and enforcement of anti-smoking campaigns. At present, the ratio of Chinese government expenditure on tobacco control to annual tax revenue is 20 million Yuan to 424 billion Yuan, or 0.005%, which is one of the lowest in the world.
Until more funding and enforcement of anti-smoking measures are implemented, China's smoking cessation clinics will continue to be empty.