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Women on the front line in battle against smoking

14 Jan 2015

Tribune News Service

Females tiny minority among smokers and are leading the charge for tougher laws on tobacco

Nearly every day on the mainland women go to work in smoke-filled offices, exposed to the fumes of cigarettes smoked mainly by male colleagues. After work is over many go home to breathe secondhand smoke created by husbands or other members of their family.

China is known as the Smoking Dragon, but its addiction to tobacco is not shared between the sexes. According to the most recent national survey, 288 million men smoked regularly in 2010, compared with 13 million women.

Lately, however, women have been striking back. The State Council proposed last autumn the nation’s toughest restrictions yet on indoor smoking and the marketing of tobacco. The announcement was a major victory for the tobacco-control movement, which includes several women who have been on the front lines for decades.

“This is a very important step,” said Yang Gonghuan, an epidemiologist who has been documenting tobacco’s toll on public health since the 1980s.

“It is very difficult to push for these kinds of changes on a national level. It has taken many, many years.”

Although the mainland is known for its smog and other environmental problems, no public health issue poses more of a threat than tobacco. An estimated one million people die each year from lung cancer and other smoking-related diseases across the country.

The nation’s anti-smoking movement includes many prominent men. Former NBA basketball player Yao Ming and other celebrities have lent their names to the cause. An activist named Li Enze filed a lawsuit in 2013 against the country’s tobacco monopoly, alleging that it had fraudulently marketed a low-tar cigarette brand called Black Tiger.

Yet in government and among tobacco-control groups, women are leading the charge. National health commissioner Li Bin has been outspoken in seeking a national indoor-smoking ban. Li sits on a top-level panel that drafted the restrictions unveiled in November. Two of her key deputies are women.

Among academics, Yang is known for her extensive research into tobacco use and disease. Brookings Institution researcher in the United States, Li Cheng, said Yang had played a crucial role in the country’s anti-smoking campaign, particularly by co-authoring an influential 2011 report that documented the health effects.

Chinese have smoked tobacco for centuries and up until the early 1900s women regularly could be seen with men puffing on pipes. But with the advent of cigarettes, Chinese intellectuals and foreign missionaries started frowning on women who smoked. According to Carol Benedict’s book Golden-Silk Smoke: A History of Tobacco in China, 1550-2010, society started to describe female smokers as “modern women”, a label also given to the promiscuous and unpatriotic.

As a result, women quit smoking, even as leaders such Mao Zedong and Deng Xiaoping smoked openly in public, encouraging the habit among men.

Today, the mainland is the world’s biggest consumer of tobacco. It is also the largest manufacturer, producing more than 2.3 trillion cigarettes yearly, nearly half the world’s total.

Unlike in the United States, private companies such as Philip Morris do not dominate the market. Instead, China National Tobacco, an arm of the State Tobacco Monopoly Administration, controls nearly all the cigarette brands sold.

That puts the central government in an unusual dual role: one arm, the health ministry, tries to restrict tobacco use and warn of its dangers, while other government agencies benefit from tobacco’s profits and tax revenues, which totaled nearly US$120 billion in 2012.

“This is why tobacco control in China happens so slowly,” said Yang, a professor of medicine in Beijing. “The tobacco industry is very powerful.”

In recent years, attitudes towards smoking have started to shift. Top leaders in the Communist Party are either nonsmokers or are careful not to be spotted lighting up in public. Late in 2013, the party banned government officials from smoking in public or giving cigarettes as gifts. Individual cities have enacted their own restrictions on tobacco.

The draft regulations unveiled in November, if enacted and enforced, would take the mainland into another realm. The proposed rules would ban indoor smoking and make private businesses responsible for enforcing the ban, subject to fines if they did not do so. It would further limit the marketing of tobacco and require larger warning labels on cigarette packs.

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