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The Chinese government is ramping up efforts in preventing young people from using tobacco.
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Stores in China are putting up signs announcing no e-cigarette sales to minors.
The theme of World No Tobacco Day 2024, “Protecting Children from Tobacco Industry Interference,” aligns with China’s ongoing efforts to control youth smoking and promote smoke-free schools. In recent years, China has emphasized creating a supportive anti-smoking environment involving schools, families, and the whole of society. This has fostered a mindset and behavior of “refusing to smoke the first cigarette, including e-cigarettes” among young students from an early age.
The Chinese government has always taken actions to strictly control smoking, and has successively introduced laws and regulations such as the Advertising Law, the Interim Measures for Tobacco Advertising Administration, and the Implementation Rules of the Administration Regulations on Public Place Health, providing legal and institutional support for smoking control. The Healthy China 2030 initiative, issued in 2016, for the first time solemnly proposed the goal of reducing smoking rates among people aged 15 and above to 20%.
With a focus on smoke-free environment creation, enacting smoke-free legislation, building smoking cessation service systems, as well as publicity and guidance, China’s smoke-free population continued to increase in recent years, and the exposure rate of non-smokers to second-hand smoke continued to decline. According to statistics, 44 cities in China have introduced or revised city-level smoking control regulations, 24 provinces have introduced provincial-level smoking control regulations, and 254 cities have implemented city-level smoking control regulations.
In this context of creating a “smoke-free environment”, China has implemented some additional measures and guarantees to “protect young people from the harm of tobacco”.
Establishing legal barriers
In addition to the smoking control regulations mentioned above, China has also formulated the following multiple regulations to focus on protecting young people from the harm of tobacco. For instance:
- Article 59 of the Law of the People’s Republic of China on the Protection of Minors stipulates that no tobacco, alcohol, or lottery sales outlets shall be set up around schools or kindergartens. It is prohibited to sell cigarettes, alcohol, lottery tickets or redeem lottery bonuses to minors. Tobacco, alcohol, and lottery operators shall prominently display signs prohibiting the sale of tobacco, alcohol, or lottery tickets to minors; if it is difficult to determine whether they are minors, they should be required to present their identification documents. If the relevant operators violate the provisions of Article 59 of this law, the departments of culture and tourism, market supervision and administration, tobacco monopoly, public security, etc., shall, in accordance with their respective responsibilities, order them to rectify within a specified period of time, issue a warning, confiscate their illegal gains, and may also impose a fine of not more than RMB50,000. Those who refuse to make corrections or cause serious circumstances shall be ordered to suspend business for rectification, have their business license revoked, or have their relevant permits revoked, and may also be fined no less than RMB50,000 but not more than RMB500,000.
- Article 18 of the Administration Measures for E-Cigarettes stipulates that “sales outlets for e-cigarettes shall not be set up in the vicinity of ordinary primary and secondary schools, special education schools, secondary vocational schools, specialized schools, and kindergartens.” Article 22 stipulates that “it is prohibited to sell e-cigarettes to minors. E-cigarette operators shall set up signs in prominent positions that do not sell e-cigarettes to minors. If it is difficult to determine whether they are minors, they shall be required to present their identification documents.”
- Notice on Prohibiting the Sale of E-Cigarettes to Minors co-launched by the State Administration for Market Regulation and the State Tobacco Monopoly Administration (STMA) also strictly prohibits market entities from selling or displaying e-cigarettes to minors. The Notice on Further Protecting Minors from the Infringement of E-Ciga-rettes issued by the two authorities also requires that manufacturers and dealers of e-cigarettes should be urged to close the online sales website or apps in a timely manner; e-commerce platforms should be urged to close the stores selling e-cigarettes in a timely manner; e-cigarette products should be taken off the shelves in a timely manner; and e-cigarette manufacturers and dealers should be urged to withdraw the online e-cigarette advertisements.
STMA also explicitly stipulates that stores as business entities on the premise of legally holding a tobacco monopoly license must post warning slogans in prominent positions that “prohibit primary and secondary school students from smoking and do not sell cigarettes/e-cigarettes to minors”. If consumers encounter any behavior of selling cigarettes/e-cigarettes to minors in the store, they can promptly call the 12313 hotline to file a complaint and report.
Using effective measures to build a youth tobacco control network
For a long time, China’s National Health Commission (NHC) has attached great importance to the problem of youth smoking and worked together with multiple departments to take measures to build a tobacco control and protection network for them.
Firstly, there is a focus on monitoring. The monitoring system for youth tobacco epidemics was established to regularly monitor youth tobacco use and release relevant survey data.
Secondly, policies are being enhanced. The Ministry of Industry and Information Technology and STMA promote the supervision of e-cigarettes in accordance with relevant regulations on cigarettes, prohibiting the sale of flavored e-cigarettes other than tobacco and open system e-cigarettes.
Thirdly, there is a focus on strengthening science popularization. Making full use of various media platforms and opportunities such as World No Tobacco Day, Spring Festival, and other holidays are leveraged to hold activities such as tobacco control science popularization and debate competitions. These aim to widely popularize knowledge about health risks of to-bacco, and encourage students to develop smoke-free habits.
Fourth, efforts are made to create a smoke-free environment. NHC works with the Ministry of Education and the All China Women’s Federation to carry out the establishment of smoke-free schools, smoke-free families, and other smoke-free environments to create a healthy educational environment and family atmosphere for young people.
Fifth, special rectification actions are implemented. STMA and the State Administration for Market Regulation launched a special initiative named “Guarding Growth” to protect minors from tobacco-related violations for three consecutive years. This effort targets shops near primary and secondary schools, kindergartens, large supermarkets, and amusement parks. The focus is on inspecting illegal operations involving e-cigarettes and cigarettes, including the sale of e-cigarettes that do not meet national standards (such as those containing drugs like etomidate), loose cigarettes, cigarette packs, and promotional materials to minors, and whether there are warning signs prohibiting the sale of cigarettes/e-cigarettes to minors, establishing a dynamic supervision ledger to further enhance law enforcement capabilities. While increasing inspection intensity, law enforcement personnel also strengthen legal publicity and education, educating retailers about tobacco monopoly laws and regulations, and the Law on the Protection of Minors. They emphasize the legal responsibilities that need to be borne when selling cigarettes/e-cigarettes to minors, aiming to raise retailers’ awareness of law-abiding operations, guide them to consciously assume social responsibilities, and jointly protect minors.
Some cities also periodically carry out promotional activities to enforce bans on selling cigarettes/e-cigarettes and alcohol to minors. Inspectors visit business premises such as supermarkets, grocery stores, and restaurants near schools in their jurisdiction, focusing on checking whether the business entities within a 50-meter radius of the schools hold tobacco monopoly retail licenses, whether prominent slogans such as “No Smoking for Primary and Secondary School Students” and “No Selling of Tobacco and Alcohol to Minors” are posted in the store, and whether there are illegal and irregular behaviors such as selling cigarettes to students, especially sales of loose cigarettes.
Beijing, Shanghai, and Shenzhen, three cities currently known for their relatively strict smoking control policies in China, have made significant progress in tobacco control. Their experiences highlight stricter supervision and punishment in areas with more youth activities. Take Shenzhen for instance. This city imposed the first RMB30,000 fine for selling cigarettes to minors as well as the first RMB30,000 fine for inadequate smoking control measures in internet cafes.
Results
The active legislative efforts and smoking control measures across the country have been continuously upgraded, leading to significant results in China’s smoking control work. As of 2022, the smoking rate among the population aged 15 and above in China was 24.1%, down by 1.7% compared to 2020. At present, this figure in Shenzhen has dropped to 16.9%, 19.9% in Beijing, and 19.4% in Shanghai, achieving the targets set by the Healthy China 2030 initiative ahead of schedule.
Significant progress has also been made in youth smoking control work. The China Center for Disease Control and Prevention has been monitoring tobacco use and exposure to secondhand smoke among Chinese youth since 2014. According to data in 2023, the smoking rate among Chinese youth in 2021 was 6.9%, with 16.7% having experimented with smoking. The proportion of middle school students experimenting with cigarettes decreased by 5% compared to 2014. There also was a decrease in high school students compared to 2019. The exposure to second-hand smoke among youth also decreased compared to previous surveys. It is worth noting that the smoking rate among youth in some cities is far lower than these average data. For example, the usage rate of e-cigarettes among middle school students in Shanghai is 1.7%, and that of cigarettes is only 1.0%, the lowest among 31 provinces in China.
The latest 2021/2022 HBSC (the largest campus survey initiated by WHO to date) survey data shows that approximately 37 million children aged 13 to 15 worldwide use tobacco. In 2022, the smoking rate among youth aged 11 to 15 reached 13%, but that figure among Chinese youth was significantly lower.