The recently released 2018 China Adult Tobacco Survey, as part of the Global Adult Tobacco Survey, showed that China is making progress in tobacco control in the past eight years, but more actions are needed to effectively decrease the smoking prevalence to 20 percent by 2030, the target set in Healthy China 2030.
According to the 2018 China Adult Tobacco Survey, there was overwhelming popular support for smoke-free indoor places (over 90%). Exposure to secondhand smoke has significantly decreased in various indoor public places from 2010 to 2018, with the most significant decrease occurring on public transport (from 34.1% to 12.9%), followed by in government buildings (from 58.4% to 31.1%) and healthcare facilities (from 37.9% to 24.4%). Even in restaurants where smoking used to be ubiquitous, secondhand smoke exposure has decreased from 88.5% to 73.3%. The same survey also showed smoking prevalence among the age groups of 25-44 years and 45-64 years have decreased significantly. Overall, 26.6% of people aged 15 years and older currently smoke, compared to 28.1% in 2010. Other areas that indicated progress included an increase in quit rate among ever smokers (from 16.0% to 20.1%), and a significant decline in the percentage of adults who noticed any cigarette advertisements (15.0% to 10.7%).
The progress has been driven by tobacco control efforts at national and subnational levels, including the directive for government officials to take the lead not to smoke in public places, the directive for healthcare facilities to become 100% smoke-free, the stronger ban of tobacco advertising, as well as the comprehensive smoke-free policies in cities such as Beijing, Shanghai and Shenzhen.
“This is important progress and I am particularly encouraged by the decrease in exposure to secondhand smoke. However, too many people are still breathing harmful tobacco smoke involuntarily, and there is much room for improvement,” said Dr. Gauden Galea, World Health Organization (WHO) Representative in China.
Currently, around 10% of the Chinese population is protected by a local comprehensive smoke-free law. China can accelerate the progress in smoke-free environments through a comprehensive national smoke-free law to offer equal protection to the entire Chinese population.
Despite the progress, the survey showed a concerning trend--cigarettes are becoming more affordable, with the median cost of 100 packs of manufactured cigarettes being only 1.5% of per capital GDP in 2018 compared to 2.0% in 2010. Increasing tobacco price by raising tobacco tax is the single most effective measure to reduce tobacco use, as shown by evidence and practices from many countries, including China.
Despite the decline in certain age groups, there has been no progress in current tobacco smoking among those aged 15-24, the youngest age group of the surveyed population (from 17.9% in 2010 to 18.6% in 2018).
“Cigarettes are simply too cheap in China,” said Dr. Galea. “This puts young people at risk. On average, one cigarette pack costs merely 10 Yuan, the same as just one school lunch. One of the best ways to protect young people is to make harmful products such as cigarettes expensive, less attractive, and less accessible,” said Dr. Galea.
The Healthy China 2030 Action Plan, which was released by the Chinese government last week, highlighted the importance of disease prevention by promoting healthy behaviours and controlling risk factors of main chronic diseases, such as tobacco use.
“We are pleased to see that the Action Plan included a key action on tobacco control. This provides an exciting opportunity to accelerate the progress and realize a Healthy China,” concluded Dr. Galea.
Note to editors: 2018 China Adult Tobacco Survey, as part of the Global Adult Tobacco Survey
To read the fact sheet of the report: 2018 GATS China Factsheet (Chinese and English)
The China Adult Tobacco Survey was conducted in 200 counties across China during 2018.
The survey measures key indicators of tobacco control among adults. It includes questions about tobacco smoking; smokeless tobacco; electronic cigarettes (e-cigarettes); cessation; secondhand smoke; tobacco prices; tobacco advertising, promotion, and anti-tobacco messages; and knowledge, attitudes, and perceptions about tobacco.
The China Adult Tobacco Survey was conducted by the China CDC and in collaboration with WHO as part of the Global Adult Tobacco Survey.
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