Can the habit be stubbed out? Pallavi Aiyar | The Hindu | May 31, 2007
http://www.hindu.com/2007/05/31/stories/2007053102051100.htm EYES SHINING and lips aquiver, the bride stands along with her family at the entrance to a five star hotel in downtown Kunming, the capital of China's Yunnan province. Outfitted in layers of meringue- like white lace, she hands out welcome gifts to the wedding guests who pull up in a steady stream of flashy cars. The gifts consist chiefly of cigarettes. Later on in the festivities the bride lights the cigarettes of all the male guests, a common ritual at Chinese weddings that is supposed to auger well for the newly wed's ability to have children. Chinese society today is in a crisis. The crisis is to do with the health of the world's most populous society and the culprit is tobacco. With an estimated 350 million smokers, China is both the largest producer and consumer of tobacco, accounting for a third of the world's smokers. According to official statistics, the country sells around 1.6 trillion cigarettes a year. The WHO says smoking related diseases kill one million Chinese annually and if unchecked this number could double by 2020. With incomes in China rising steadily over the last few decades, so has the average daily consumption of cigarettes per smoker from around four in 1972 to 10 in 1992 to nearly 15 today. Smokers are also beginning to develop the habit at ever younger ages with a staggering 100 million smokers estimated to be under the age of 18. But despite the alarming evidence, many in the Chinese government claim the country cannot afford to quit smoking, given the value of the tobacco industry to the Chinese economy. Cigarette companies not only generate tens of thousands of jobs (up to 100 million Chinese are directly or indirectly dependent for their livelihood on the tobacco industry) but are also among the top tax payers, contributing $30 billion or eight per cent of total central government revenue in 2005. The dilemma In fact, the pivotal dilemma for the Chinese government is that it is itself the country's biggest tobacco producer with a virtual monopoly of the industry. Thus the same government whose health department struggles to impose curbs on smoking is also the boss of an industry that seeks to maximise profits. This is akin to a cricket match where the umpire and team captain are the same person. Thus proposals by anti-smoking lobbyists at this year's annual session of the Chinese Parliament, the National People's Congress, to raise taxes even marginally on cigarettes, were met by stonewalling from senior members of the government. The deputy chief of the State Tobacco Monopoly Administration (the regulator, manager, and chief strategist of the tobacco industry) thus told Parliament in March that attempts to rein in smoking could "destabilise" the country. Tobacco is most important to the more impoverished parts of the country like Yunnan, where over 50 per cent of the economy depends on the industry. Money from cigarette manufacturers like the Hongta Group has funded sports stadia, highways, and hydroelectric dams in the province. Bai Enpai, the province's top Communist Party official and an avid smoker, recently said in a television interview that he wouldn't "dare not to smoke." The debate over tobacco, in fact, meshes with the broader debate that China's authorities are currently grappling with: the necessity of continued rapid economic growth versus the need to address the social and long term costs of this growth. In recent times, Beijing seems to have begun to lean towards giving greater priority to the latter, with leaders stressing repeatedly that a single-minded focus on growth at any cost is no longer feasible or desirable. Convincing local officials of the logic and wisdom of this reasoning is, however, a formidable challenge. "The government has to make a choice do I want easy, short term gains or am I taking a more long term view," says Henk Bekedam WHO's China chief. "Beijing, I think, has finally made that choice but there is naturally resistance from the provinces where 60 or 70 per cent of the revenue comes from tobacco," he says. As a sign of the central government's new resolve to fight smoking, Dr. Bekedam points to China's ratification of the WHO's Framework Convention on Tobacco Control (FCTC) in 2006. The FCTC requires a ban on tobacco advertising, larger health warnings on cigarette packs, and a ban on smoking in public places. But as Dr. Bekedam explains, "The FCTC is just a law and in itself will change little. The real challenge is altering behaviour." In China smoking is not only socially acceptable but even required on many social occasions like weddings. It is common for doctors and athletes to smoke and some of the country's top sportsmen have endorsed cigarette companies in the recent past. The country's top leaders including revered figures like Mao Zedong and Deng Xiaoping were heavy and public smokers. China's current Health Minister, Gao Qiang, is also a smoker. There are, however, two trends that Dr. Bekedam believes will have a positive effect on China's smoking-generated health crisis in the future. First, the rapid growth of the Chinese economy has meant that the proportional contribution of tobacco to tax income has begun to fall as other industries rise. Already tobacco's contribution has dropped from ten per cent of total tax revenues a few years ago to eight per cent today. Secondly, as the government begins to move towards providing better health-care coverage for its citizens, it is likely to feel the pinch of smoking-related health costs more acutely. A 2006 study in the journal Tobacco Control put the cost of smoking-related medical fees and lost productivity from premature deaths at $5 billion. Other studies have placed it even higher at $6.5 billion. It is not an easy road ahead for the Chinese government as it weighs the costs of short term job and tax revenue losses that curbing tobacco use would necessitate against the long term loss to life and productivity that smoking is associated with. In Kunming, Wang Feng, a 24-year-old government employee looks at his lit cigarette contemplatively. "Yes, I should quit I know," he says grinning sheepishly, "But I'm not sure my friends would let me." He pauses for a second before continuing, "Besides by smoking I show my support for Yunnan." May 31 is World No Tobacco Day.
