China’s Ministry of Health has announced revisions to its guidelines on smoking in public places, banning smoking in indoor public places from 1 May. China ratified the World Health Organization’s Framework Convention on Tobacco Control in 2005 but missed the 9 January 2011 deadline to ban indoor smoking.
The move has been welcomed by tobacco control activists and public health experts. “This is a very significant move, as it comes from the central government. It’s a very important step to denormalise smoking and to protect people from the serious hazards of secondhand smoke,” said Tai-Hing Lam, head of the Department of Community Medicine at the University of Hong Kong’s School of Public Health.
Some cities have already implemented their own bans on smoking in indoor public places, including Beijing, Shanghai, Hong Kong (as a special administrative region of China the city falls under China’s commitments under the framework convention), and some smaller cities, but the regulations are riddled with ambiguities, lack detail, and are not backed up with adequate enforcement and public education, said Professor Lam.
He said, “All regulations so far have such defects, in varying degrees. But the fact that more cities have such regulations is a major step forward. Passing such
regulation has been difficult, with much debate, but it has also aroused the interest, support, and involvement of more people supporting tobacco control.”
The 1 May ban on indoor smoking has one major flaw: it does not include workplaces. Judith Mackay, a senior adviser to the World Lung Foundation and a leading advocate of tobacco control in Asia, said, “This is a serious omission. After all, smoke free is essentially labour legislation: to provide a safe, carcinogen free workplace to protect the health of workers. They will be included, I believe, in 2015.”
China’s parliament, the National People’s Congress, recently approved a commitment to promote a ban on smoking in all public places by 2015. This was the first
time that tobacco control has been included in China’s five year plan.
On other issues of workers’ rights local government officials have never proactively moved to protect workers, and ultimately it will be the emergence of a stronger civil society and a grassroots movement for smoke free workplaces that will ensure that a ban on smoking in the workplace is enforced at the local level, said Geoffrey Crothall, director of communications for the labour rights organisation the China Labour Bulletin.
“A smoking ban will only really work if the people it affects are the ones who make a fuss about it,” he said. “If a group of workers are very determined to have a smoke free environment they’re the ones who will have to push for it, because it certainly won’t come from the management or local government officials.”
The annual total number of deaths in China caused by tobacco use has been estimated at more than one million; current trends indicate that the figure is estimated to double by 2030 and treble by 2050 (BMJ 1998;317:1411-22).