1.34 billion reasons to say ‘No Smoking’

by Dr Bernhard Schwartländer, WHO Representative in China, and Dr Geoffrey T. Fong, Principal Investigator, International Tobacco Control Policy Evaluation Project

Opinion piece

A generation ago, smoking was common across the world. People smoked in restaurants, bars and workplaces – as you see in many parts of China today. Even if you didn’t smoke, you were often forced to breathe the second-hand smoke of others. Many countries have now moved to fix this problem, in light of the unequivocal scientific evidence of the harms caused by exposure to tobacco smoke.

Yet in China, close to 740 million people – including 182 million children – are exposed to second-hand smoke once a day in a typical week. While Chinese women have much lower rates of smoking than men, they have some of the highest rates of exposure to second-hand smoke in the world. An estimated 100,000 people die every year in China because of second-hand smoke, in addition to the 1 million who die as a direct result of tobacco use.

Science has told us for decades that tobacco kills – 6 million people every year, to be precise. The science is equally clear about the harms of second-hand smoke: there is no safe amount. Every time you breathe in second-hand smoke you are inhaling 7,000 chemicals and 69 known carcinogens, and risking lung cancer, heart disease and stroke. In babies and children, second-hand smoke can cause sudden infant death syndrome, low birth weight, respiratory problems and ear infections.

This is an urgent public health problem in China. But the good news is that it is a problem with a readily available solution: a national smoke-free law.

Our new report lays out the case for a national smoke-free law in China. Around the world, smoke-free laws have resulted in dramatic improvements to health. For example, Ireland’s national smoke-free law led to deaths from heart disease decreasing by 26 per cent, and stroke deaths by almost a third just three years after the law came into effect.

In China, 14 cities across the country have adopted smoke-free laws, but many of these laws are not nearly as effective as they could be: because of weaknesses in the laws themselves – for instance, loopholes that allow smoking in some indoor public places – and a lack of sufficient enforcement. Where this is the case, exposure to second-hand smoke remains high.

However, Beijing’s new smoke-free law is a game changer. The capital now requires all indoor public places to be 100% smoke free, without exception. The Beijing law is fully compliant with Article 8 of the WHO’s Framework Convention on Tobacco Control (FCTC), and as such sets a new high-water mark for smoke-free laws in China.

It is now time to extend the benefits of clean air and protection from exposure to second-hand smoke to everyone in China.

The data presented in our new report show smoke-free laws are extremely popular with Chinese people, even smokers. Public support for a national law is therefore likely to be very strong. Smoke-free laws are also good for the economy, because they help to create a healthier workforce and reduce the financial burden of tobacco-related illness on businesses.

Right now, China stands on the cusp of a quantum leap forward on tobacco control. Three-quarters of a billion non-smokers are forced to inhale toxic tobacco smoke every day. Each day, hundreds die as a result. Exposure to second-hand smoke is deadly – but unlike other dreadful diseases which claim thousands of lives, we have a cure: making all indoor public places 100 per cent smoke-free. Beijing has shown us how it can be done. It is now time to convert Beijing’s momentum into national action – and adopt a national smoke-free law that will give the gift of clean indoor air to all of China’s 1.34 billion people.

Note: An edited version of this opinion piece was published in China Daily.

About the World Health Organization

WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.

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Ms WU Linlin
WHO China Office
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