Smoking remains one of China’s burning problems

Workplace tobacco use remains widespread but local initiatives are starting to turn the tide
National habit: about half of men in China are regular smokers © AFP/Getty Images

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Working at a state-run hotel in China’s Sichuan province in the 1990s, Wu Luorong recalls cigarette smoke filling the lobby, restaurants and corridors. “We couldn’t say anything even if we didn’t feel happy with people smoking in the office,” she says.

Now a hospital administrator, Wu, 49, says things have changed. “There is a smoking area for staff and patients’ families. Especially in the respiratory department, we tell smokers to go there,” she says.

China is home to some 300m smokers, more than any other country; about half of men are regular smokers. However, there is a lack of national legislation to ban smoking in workplaces. The World Health Organization estimates that a complete nationwide ban on smoking in the country’s workplaces would reduce prevalence of smoking among Chinese men by 13m, averting 6m premature deaths.

But Wu’s experience reflects a national trend: local campaigns are beginning to turn the tide against workplace smoking, experts say, even while enforcement remains uneven. The statistics are startling: more than 54 per cent of Chinese people who work indoors witnessed smoking in their workplaces in 2015, according to a government survey. But that number represents a fall from about 60 per cent in 2010.

Likewise, nearly 40 per cent of people surveyed in 2015 had witnessed smoking in government buildings, and more than 35 per cent had seen smoking inside hospitals. But that was an improvement on 2010, when the figures were 55 per cent and 37 per cent respectively.

Public health observers say that even though a national ban has been delayed — apparently because of the influence of the Chinese tobacco industry, a major source of government revenue — there has been a shift in attitudes, with greater opposition to smoking.

This has been driven by aggressive public health campaigns highlighting the risks of second-hand smoke, and by individual cities launching legislation aimed at reducing smoking indoors.

In 2015, Beijing’s municipal authorities passed the toughest anti-smoking legislation in China’s history, making smoking in offices, restaurants, hotels and hospitals punishable with fines. Businesses that fail to rein in smoking on their premises can be fined up to Rmb10,000 ($1,530) and repeat offenders can have their licences revoked. Individual smokers can be penalised Rmb200. A hotline was set up for public complaints, and teams of inspectors were enlisted.

Many were sceptical about enforcement when the law came into effect, citing the difficulties of changing long-entrenched habits. But a year later, Bernhard Schwartländer, head of WHO China, said the enforcement had “exceeded expectations”. The city said it had collected more than Rmb1m in penalties.

Groups of smoking workers are now a common sight huddled outside office buildings in Beijing, Shenzhen and Shanghai — the latter two cities having followed suit with similar laws in January and March this year.

“You can only smoke on the platform outside on the second floor or on the ground floor,” says Stella Sun, who works at a brokerage in the Shanghai World Financial Center, a 101-floor skyscraper in the city’s Pudong district. “There are smoke detectors everywhere in the building,” she adds.

Dressed in a sharply ironed white shirt and naval-style hat emblazoned with China’s national emblem, sanitation inspector Zhang Jun is one of the officials tasked with enforcing the rules in Shanghai. A black satchel holding a badge and a bundle of papers for handing out fines bounces around his waist.

“Sanitation department, here for an inspection,” he says, flashing his badge at a receptionist in the lobby at a hospital. Zhang walks through the corridors, checking that no-smoking signs are properly displayed, sniffing the air for smoke and peering into bins for tell-tale cigarette butts.

“There were a lot of calls to the hotline at the beginning after the law went into effect,” Zhang explains. “But the number has decreased now,” he adds, attributing the drop to greater self-regulation. “Usually when a smoker sees us in our uniforms, they will put out their cigarette. In that case we will just give them a warning.”

But inspectors are overstretched, with just five to cover a population of tens of thousands, Zhang says, adding that they have additional duties, such as checking water quality in swimming pools.

“We haven’t given out many fines since March, to be honest, because often by the time we get to a place where there has been a complaint we are too late,” says Li Yuna, another inspector.

Enforcement is even less reliable in the 20 or so other cities that have introduced various laws against indoor smoking. Shenzhen, Beijing and Shanghai have very strong laws, but we don’t see that across the whole country — it really depends on the locality,” says Kelvin Khow Chuan Heng, of the WHO’s Tobacco Free Initiative, a global programme to reduce death and disease from smoking.

“A lot of the problem with these laws is that they don’t have resources put into enforcement,” he says. “We still struggle with some venues, especially entertainment venues, karaoke bars — these are also workplaces. Those venues we definitely find much more problematic.”

Even hospital worker Wu says that enforcement can be lax in the small city of Mianyang where she is employed. “Some doctors will smoke in non-smoking areas — like, offices — sometimes, but once the leaders come investigating, they will move to a smoking area,” she says.

State-owned tobacco companies remain an influential group, hindering efforts to introduce a national smoking ban. A draft law circulated last year was watered down, public health observers say, allowing for “smoking rooms” in offices.

Some initiatives by individual companies have helped. Internet giant Baidu committed to smoke-free office environments in 2011, thereby protecting the health of some 40,000 employees.

Chinese and US health authorities launched a joint initiative in 2012 to promote smoke-free workplaces in China. The programme to educate the public and promote cessation services at workplaces follows earlier efforts that have also targeted workplaces. “One thing is legislation and the other implementation. What an enterprise can contribute is vital,” said Wang Ke’an, head of the Research Center for Health Development, a think-tank and one of the Chinese groups involved.

There is also space for bottom-up pressure from employees. Newspaper illustrator Zhao Liang says his attempts to give up smoking were hampered by colleagues who have turned parts of the workplace into a “smoking centre”. “If I quit smoking, I won’t be able to tolerate anyone smoking in my office ever again,” he adds.

Additional reporting by Wang Xueqiao

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