WHO Framework Convention on Tobacco Control in China: barriers, challenges and recommendations

Hu, Teh-wei; Lee, Anita H.; Mao, Zhengzhong

doi:10.1177/1757975913501910

Cited by 41 publications

(24 citation statements)

References 25 publications

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“…Ideally our findings should inform policymakers and legislators who aim to develop and implement more effective tobacco control policies, especially with respect to restricting cigarette production and regulating the marketing of tobacco products. As Hu et al (2013) and others have noted (e.g., Malone, 2010), the pace of progress in tobacco control in China is too slow. Most tobacco control policy research in China has largely had an econometric focus and paid little attention to environmental causes of smoking.…”

Section: Resultsmentioning

confidence: 94%

“…Given the importance of tobacco production in the China's economy, there is a fundamental conflict between the goals of economic development and those of health improvement (Wang, 2006;Hu et al, 2013). Pro-tobacco forces, both at central and regional levels, continue to stress the economic contribution of the tobacco industry as an economic pillar of China and a social currency that contributes to political stability.…”

Section: Resultsmentioning

confidence: 98%

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The impact of regional economic reliance on the tobacco industry on current smoking in China

et al. 2015

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 98%

The impact of regional economic reliance on the tobacco industry on current smoking in China

et al. 2015

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“…State ownership is viewed here as an impediment to effective tobacco control via which the government's economic interest in the tobacco industry is in essential conflict with its obligation to protect the health of its population by reducing tobacco consumption;20–22 if a government has a major stake in the tobacco industry, it can be expected to be less willing to implement policy which may reduce consumption and consequently, its tobacco-related income. This informs several analyses contending that privatisation of SOTCs would be positive for tobacco control 23 24…”

Section: Conflict Of Interest State Ownership Of Tobacco and Public mentioning

confidence: 70%

State-ownership of tobacco industry: a ‘fundamental conflict of interest’ or a ‘tremendous opportunity’ for tobacco control?

2015

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Despite state-owned tobacco companies (SOTCs) accounting for over 40% of global production, the significance of state-ownership for tobacco control strategies has received limited academic and policy attention. The complex interests associated with SOTCs present diverse challenges for tobacco control policy, particularly in implementing Article 5.3 of WHO's Framework Convention on Tobacco Control (FCTC). Based on a review of existing literature, this paper examines current challenges and potential opportunities presented by governmental participation in the tobacco industry, identifying three contrasting perspectives from academic and policy sources. The first two perspectives centre on recognising that economic interests inherent in an SOTC are in tension with a government's public health responsibilities. This conflict can be perceived as either fundamental and fixed ('intrinsic conflict') or as amenable to either exacerbation or amelioration via organisational mechanisms ('institutionally-mediated conflict')-as suggested by the contrasting examples of China and Thailand. A third, less prominent perspective (which we refer to as 'interest alignment') suggests that it may be possible to radically alter the objectives and behaviour of SOTCs in order to advance tobacco control. Finally, we draw on this analysis to consider policy options for advancing tobacco control in countries with SOTCs. Guidance on implementation of Article 5.3 demonstrates strategic ambiguity by including elements of all three perspectives described above. We argue that legislative separation of tobacco control from SOTC oversight provides a desirable alternative to industry privatisation, and that radically realigning the goals of SOTCs to reduce tobacco consumption could make an important contribution to endgame strategies.

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“…There are two possible explanations for why, all else equal, smokers may attach greater value to cigarettes in Tier 2 than in Tier 1. First, cigarettes in the highest tier are most commonly purchased as gifts in China,1 therefore the majority of smokers may not value cigarettes in this tier as much when purchased for self-consumption. Second, most consumers of very expensive cigarettes may use them as a type of ‘status good’,11 that is, to signal that person's economic and social status to others, rather than for normal everyday consumption, which would limit the occasions in which very expensive cigarettes may be needed or yield very high utility.…”

Section: Resultsmentioning

confidence: 99%

“…A key provision of the FCTC is to raise the price of cigarettes through taxation, in recognition of smokers’ sensitivity to cigarette prices. Nevertheless, the Chinese government has been reluctant to raise cigarette prices through taxation, evidenced by the fact that the government enacted a complicated reclassification of cigarette price levels and tax rates in 2009, but explicitly banned producers from passing the tax increase onto consumers 1. One barrier with respect to raising the cigarette tax is the belief among some Chinese political leaders that cigarette taxes place an unfair burden on low-income smokers 2…”

Section: Introductionmentioning

confidence: 99%

The heterogeneous effects of cigarette prices on brand choice in China: implications for tobacco control policy

White

et al. 2015

Tobacco Control

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Background China has long kept its tobacco taxes below international standards. The Chinese government has cited as two rationales against raising tobacco tax, namely the unfair burden it places on low-income smokers and the ability of consumers to switch to cheaper brands. Objective This study examines how different socioeconomic subgroups of Chinese smokers switch brands in response to cigarette price changes. Methods We model smokers’ choice of cigarette tier as a function of tier-specific prices. We examine heterogeneous responses to prices by estimating mixed logit models for different income and education subgroups that allow for random variation in smokers’ preferences. We use data from three waves of the longitudinal ITC China Survey, collected in six large Chinese cities between 2006 and 2009. Findings Low-income and less educated smokers are considerably more likely to switch tiers (including both up-trading and down-trading) than are their high-socioeconomic status (SES) counterparts. For those in the second-to-lowest tier, a ¥1 ($0.16, or roughly 25%) rise in prices increases the likelihood of switching tiers by 5.6% points for low-income smokers and 7.2% points for less educated smokers, compared to 1.6% and 3.0% points for the corresponding high-SES groups. Low-income and less educated groups are also more likely to trade down compared to their high-SES counterparts. Conclusion Only a small percentage of low-income and less educated Chinese smokers switched to cheaper brands in response to price increases. Hence, the concern of the Chinese government that a cigarette tax increase will lead to large-scale brand switching is not supported by this study.

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WHO Framework Convention on Tobacco Control in China: barriers, challenges and recommendations

Cited by 41 publications

References 25 publications

The impact of regional economic reliance on the tobacco industry on current smoking in China

The impact of regional economic reliance on the tobacco industry on current smoking in China

State-ownership of tobacco industry: a ‘fundamental conflict of interest’ or a ‘tremendous opportunity’ for tobacco control?

The heterogeneous effects of cigarette prices on brand choice in China: implications for tobacco control policy

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