Dan Washburn

Versions of this story appeared in the South China Morning Post (subscription only) and that’s Shanghai magazine.

by DAN WASHBURN

SHANGHAI — Song Hai Pei’s front teeth are stained brown from smoking cigarettes. A pack of Red Double Happiness rests at the ready in his breast pocket. He often offers smokes to the patrons of the small restaurant he owns in northern Shanghai. Song, 47, has been a smoker for 25 years. Not once has he thought about quitting. No reason to, he claims, as long as he feels healthy and can afford the financial burden of his habit. When asked whether he believes cigarettes are addictive, he responds: “No. I can go without smoking for one whole day without feeling a thing.”

Mr. Song’s answer is emblematic of the tobacco epidemic — or “brown plague,” as some have taken to calling it — burning its way through China, the world’s largest tobacco producer and consumer. The statistics are staggering. Two-thirds of Chinese people think smoking does little or no harm, yet smoking is blamed for more than 2,000 deaths in China every day, a figure that is expected to quadruple by 2050. An estimated 3 million Chinese start smoking annually, and experts say of the 300 million Chinese males currently under the age of 30, at least 100 million will die from a smoking-related disease. China is home to approximately 350 million smokers, and they inhale 1.7 trillion cigarettes a year — four times the amount smoked in the United States, the world’s No. 2 cigarette market.

So it was big news in early November when China became the 77th country to sign the Framework Convention of Tobacco Control, a bellwether treaty introduced at the 56th World Health Assembly in May. It requires signatories to adopt strict policies involving advertising, marketing, pricing and taxation of tobacco products. Chief among the proposals — which still needs to be approved by China’s top legislative body, the National People’s Congress — would be mandatory health warnings on cigarette packs. The warnings would include pictures and words and cover at least 30 percent of the printed surface. Currently, most cigarette packs in China carry one simple sentence: “Smoking hurts your health.”

But whatever measures are taken, activists are in for a long, hard slog when it comes to curbing tobacco use in China, where two-thirds of the male population smokes and cigarettes can cost as little as 12 cents a pack. “I can’t see (warnings) making much of a difference,” said Paul French, whose Shanghai-based Access Asia market research firm has studied the Chinese tobacco industry for nearly two decades. “Price is more the issue in getting people to quit, and there are no signs of price hikes yet. I just don’t believe smoking works like that. For a start, a large percentage are confirmed smokers — addicts — and I’m not sure what good signs do them. The issue is stopping people from starting. So instead of the packs, why not some more overt signage such as billboards or TV ads to discourage youngsters?”

Outside Song’s restaurant, 46-year-old Zhang Guo Qiang sits by the curb and sucks down cigarette after cigarette. His pack of Double Happiness doesn’t have a big warning label on it. And he’d still smoke its contents even if it did. “It’s no use worrying about my health,” said Zhang, well into his second pack of the day. “I know it’s not good for my health. But I can’t quit. The more I want to quit, the stronger my addiction gets.” Zhang began smoking like most Chinese men begin smoking: They do it because everyone else does. At a dinner, at a business meeting, it’s considered rude not to offer cigarettes around the table. It’s worse not to accept. “In China, smoking is very much a way of establishing personal relationships,” Song explained. “Also, cigarettes are very good diplomatic tools. When you need a favor, it’s always easier if you offer cigarettes.”

Although smoking tobacco is by no means a Chinese innovation, the Chinese have shown an unrivaled affinity for the avocation since tobacco first made its way into China, by way of either Japan or the Philippines, in the 16th century. By the mid-17th century, philosopher Fang Yizhi observed “everyone now carries a long pipe and swallows the smoke after lighting it with fire.” (Of course, Fang later observed that years of smoking “scorches one’s lungs.”) Chinese cigarette smoking saw a huge spike after the Communists took over in 1949. Popular party patriarchs like Mao Zedong and Deng Xiaoping were smokers, often seen with cigarettes in hand. And the average number of manufactured cigarettes smoked per man per day went from one in 1952 to 15 in 1996. Not too long ago, physicians in China would actually tell patients that smoking could help soothe a variety of symptoms. Even today, according to the most recent World Health Organization statistics, 61 percent of male doctors in China smoke.

One in three cigarettes smoked in the world are smoked in China. And, not surprisingly, many of those are smoked in the country’s most populous city, Shanghai, which earlier this year was named the “lung cancer capital of China” by a Chinese cancer-awareness group. Seventy-five of every 100,000 Shanghai residents have the disease, the highest such ratio in the country, and there are at least 5,000 new cases each year. The culprit, experts say, is Shanghai’s culture of smoking. China’s most international city is a sanctuary for smokers, who puff away whenever and wherever they please: restaurants, offices, busses, theaters. “No Smoking” signs are put up with a wink … and a cough.

“A lot needs to be done,” said one manager of a Shanghai health clinic who declined to give her name. “One is to educate the people and the other is to set some regulations. I think the city government knows the problem. But I think maybe they are too busy. I don’t know. There is a Chinese proverb: fa bu zhi zhong. Maybe they think too many people smoke, and it will be too hard to stop people from smoking in public areas.”

In September, the Hong Kong government announced plans to ban smoking in most public places, including restaurants and bars. It’s a move that no doubt will be met with much resistance. It’s also a move that would be next to impossible to pull off in Shanghai. Imagine at least 6 million angry citizens. “I would feel quite annoyed,” said Flora, a 23-year-old Shanghai smoker and part of the 4 percent of Chinese women who smoke. “I would feel like I’m in America. Just have a look at those trembling gentlemen smoking in the corner of high-rises in Manhattan.”

But the main reasons strict anti-smoking regulations wouldn’t fly in Shanghai — or any other city in Mainland China — are financial. “There’s one big difference,” French said. “The Hong Kong government doesn’t really make that much money off cigarettes, whereas it’s a big earner for China’s tax bureau. They’d stand to lose a hell of a lot of money.”

If anything is healthy, it is the Chinese tobacco industry, which coughs up a tenth of China’s tax revenues. That figure soars to a whopping 70 percent in top tobacco producing provinces like Yunnan. Located in China’s rural southwest, Yunnan is home to the Yuxi Hongta Group, which manufactures Hongtashan cigarettes, the most valuable brand in China — regardless of industry.

For the first half of 2003, the State Tobacco Monopoly Administration said the tobacco sector generated RMB 86.67 billion (US$ 10.56 billion) in taxes and profits, an increase of RMB10 billion ($US 1.2 billion), or 13 percent, over the same period in 2002. And although foreign tobacco companies have long salivated at China’s massive cigarette market — and import tariffs dropped from 65 to 25 percent since China joined the World Trade Organization in late 2001 — domestic brands continue to have the industry virtually locked shut. They are known. They are cheap. And they can be purchased almost anywhere.

“There’s not much in the way of an anti-smoking campaign in China,” French said. “Cigarettes are still widely available. The distribution channels are amazing. They’re just everywhere. Now and down the line, this is going to be a major, major headache for the health system. You’ve got a large number of smokers in rural areas. And after SARS, we know how inadequate the health system is out there. It is a time bomb.”

Additional reporting by Johnson Zhang.