The "smoke-free" propagandist of Zhaoxia Primary School in Hefei City, Anhui Province made a smoking cessation propaganda sign and used the school time to carry out smoke-free propaganda at the school gate. Xinhua News Agency reporter Liu Junxi photo
Smoking is not allowed to "leave a hole"
Only when smoking is 100% forbidden in indoor public places can the public be protected from the harm of second-hand smoke. Without the support of legislation, the rights of non-smokers will not be protected.
Wang Huarun, a 54-year-old Beijinger, has been smoking for 30 years. He smokes two or three packs a day, and he has quit several times intermittently, but he has not succeeded. Later, when he was diagnosed with high blood pressure, he made up his mind to quit smoking. He tried smoking patches, smoking cessation sprays and electronic cigarettes, but none of them worked.
In February of this year, he took his old father who had smoked for more than 70 years to participate in the first winter camp to quit smoking in Beijing. Up to now, neither father nor son has touched a cigarette.
Known as "the most strictly controlled smoking order in history", the Beijing Smoking Control Ordinance has been implemented for one year. According to the survey data, the number of smokers in indoor public places has dropped from 11.3% to 3.8%, the phenomenon of smoking in restaurants has dropped from 40.3% to 14.8%, and the public’s satisfaction with tobacco control has increased from 42.26% to 81.3%.
Wang Chunhui, a "Youth Movement without Tobacco", was eating in a restaurant and smelled the choking smoke. She found two ladies smoking. Wang Chunhui immediately called the waiter and said that someone was smoking. The waiter went over to dissuade him, and the smoker took the initiative to put out the cigarette. Wang Chunhui said that without the support of legislation, the rights of non-smokers would not be protected.
On September 13th, the "Amendment to the Regulations on Controlling Smoking in Public Places in Shanghai (Draft)" was reviewed for the second time, and supplementary provisions were made to the draft, "Smoking is prohibited in indoor public places, indoor workplaces and public transport. Except for indoor smoking rooms set up according to the requirements due to the special needs of production, operation and management or smoking behaviors that need to occur on specific occasions. " Wu Yiqun, deputy director of the New Exploration Health Development Research Center, said that this regulation cannot effectively protect people from the harm of second-hand smoke, and it will increase the difficulty and burden of law enforcement, which makes it difficult to achieve the legislative purpose of this round of law revision to effectively protect people’s health. She suggested that the provisions on "exceptional circumstances" in the clause should be deleted, and the provisions in the original "draft" should be adhered to, and smoking should be completely banned in indoor public places, indoor workplaces and public transport.
Jiang Yuan, deputy director of the Tobacco Control Office of China CDC, is the Chinese chief scientist of the international tobacco control policy evaluation project. The project evidence shows that in 2007— In 2015, more than 90% smokers in Shanghai supported smoking bans in restaurants and other indoor public spaces. In April this year, the survey report of Shanghai Statistics Bureau showed that more than 90% of the citizens supported the revision of the law and agreed to ban smoking in indoor public places.
Jiang Yuan said that Ireland was the first country to legislate for a bar without tobacco and alcohol. Before the law came into effect, the average support rate of smokers for the law was only 12%, and after the law came into effect two years later, the support rate rose to 61%.
In 2006, the WHO Framework Convention on Tobacco Control came into effect in China, and it has been 10 years since then. According to the promise, China should have completely smoke-free indoor public places five years ago, and banned all tobacco advertising, promotion and sponsorship. However, the Regulations on Controlling Smoking in Public Places has not yet been promulgated. The 2015 China Adult Tobacco Survey Report shows that there are 316 million adult smokers (over 18 years old) in China, the smoking rate has not changed, and the number of smokers has increased by 15 million.
"Setting up a smoking area in a restaurant is like setting up a urine area in a swimming pool." Xu Guihua, former executive vice president of China Tobacco Control Association, said that only when smoking is 100% banned in indoor public places can the public be protected from the harm of second-hand smoke. The key to reducing secondhand smoke exposure is to completely ban smoking in public places. Smoking is prohibited in public places, and smoking areas should not be set up in airports, restaurants, bars and other public places.
Xu Guihua said that the ban on smoking in public places has been written into the "Thirteenth Five-Year Plan" and there is already a timetable and road map. A healthy China must be a smoke-free China.
It is difficult to "change face" in cigarette case warning
Cigarette case warning is like a stone mill in the workshop, push and move; Do not push, do not move; After pushing for a long time, I still circled in the same place.
Recently, Ms. Wang went to Thailand. She is a bit heavy smoker, so she ran out of cigarettes and had to buy them locally. To her surprise, even China cigarettes are printed with skeletons, black lungs and rotten teeth, which makes her sick and unable to smoke. Outside the shop, she tore up the cigarette case. Back in China, she quickly bought a cigarette. There was no warning picture on the cigarette case, which looked much more comfortable.
On October 1st this year, the Provisions on Cigarette Packaging Labeling in People’s Republic of China (PRC) (2015 edition) will be formally implemented. China’s cigarettes were changed three times, but the internationally accepted warning pictures still did not appear on the cigarette case.
Ms. Wang remembers that there was a warning on the side of the cigarette case in the past: "Smoking is harmful to health". The font was small and it looked laborious. In the 2007 edition of the Regulations, "Smoking is harmful to health" changed from the side of the cigarette case to the front. The font height of warning words should not be less than 2 mm, and the back is English warning words that most people can’t understand, accounting for about 30% of the area. In 2011, the "Regulations" was adjusted again, and the English warning words were cancelled. Although the font size of Chinese warning words was increased to 4 mm, it was much smaller than the font marked with low tar milligrams. In the 2015 edition of the Regulations, the area of warnings increased to 35%, and the words "our company tips" were added. The added warnings were "discouraging young people from smoking and prohibiting primary and secondary school students from smoking".
In the past eight years, cigarette packs have changed their faces. In China, only written warnings are used in cigarette packs. The font height of warnings has been increased from not less than 2 mm to not less than 4.5 mm, the area of health warnings has only increased from 30% to 35%, and two groups of warnings have been increased to three groups. Some people say that cigarette case warning is like a stone mill in a workshop, pushing and moving; Do not push, do not move; After pushing for a long time, I still circled in the same place.
Wu Yiqun said that although this regulation seems to have changed a little, there is still a big gap with the requirements of the Framework Convention on Tobacco Control, and there is no substantial change. No information about specific diseases caused by smoking can be seen, and the effect of effectively warning tobacco hazards and reducing tobacco use can not be achieved.
According to the data survey published by WHO in 2014, "Evaluation and Policy Suggestions on the Health Warning Effect of Cigarette Cases in China", judging from the effectiveness indicators of health warning on cigarette cases used in 20 countries, the effect of health warning in China is very weak.
As of December 2015, 85 countries and regions have adopted graphic warning packaging measures, covering more than half of the world’s population, of which more than 60 countries and regions have graphic warning areas greater than 50%. At present, Nepal’s health warning area is the largest in the world, and the graphic warning area accounts for 90% of the front and back of the package. The graphic area of Thailand, India, Australia, Uruguay, Brunei and Canada is over 75%. Since 2012, plain packaging has been implemented in Australia, that is, only large graphic warnings are used on the packaging, and the unique colors, logos, fonts and brand design elements of tobacco companies are prohibited on the packaging. According to the statistics of WHO, the number of countries implementing plain packaging will increase to 30 by 2018. At present, the countries that implement plain packaging are Australia, Ireland, Britain and France.
"I want to tell you, because I love you", which is the theme of the activity "Warning the cigarette case in the picture". Wu Yiqun said that a picture is worth a thousand words. Graphic warning can clearly and clearly convey the health risks of using tobacco to the public, and the public with low education level can also understand the dangers of smoking. If cigarettes are printed with real and shocking graphic warnings, it can not only warn people, but also help to change the social custom of taking tobacco products as gifts.
The more cigarettes are sold, the cheaper they are.
The tax contribution of tobacco industry is far from enough to make up for the cost of the whole society. If effective measures are not taken, the disease burden caused by tobacco hazards will show a "blowout".
Liu Qinglin, 35, works in a state-owned enterprise and has been smoking since he went to college. For more than 10 years, the cigarettes he smokes have risen from 10 yuan to 12 yuan, which is negligible for him.
China Statistical Yearbook 2000— According to the data in 2014, the retail price index of food doubled, wine increased by 38%, beverages increased by 18%, and cigarettes only increased by 4.6%. Jiang Yuan said that considering both the cigarette price and the increase rate of personal income, it was found that the cigarette price in 2014 was half cheaper than that in 2000, and smokers could afford cigarettes more than other consumption.
China’s cigarettes are cheap, and the important reason lies in the low tobacco tax. Hu Dewei, a professor at the Institute of Public Health of the University of California, USA, said that WHO suggested that 70% of the retail prices of countries should be tobacco tax, while the tobacco consumption tax rate in China is only 56%.
Take France as an example. In 2004, the price of a pack of 20 cigarettes was 5 euros (about RMB 35 yuan), which rose to 6.8 euros in 2014. Of the 6.8 euros, the consumption tax was 4.3 euros, the value-added tax was 1.1 euros, and the tax rate was 80%.
WHO’s 2015 global tobacco epidemic report shows that since 2012, a total of 106 countries and regions have raised the level of tobacco consumption tax. South Korea raised cigarette tax and price in January 2015, which is one of the countries with the largest increase in tax and price recently. The average price of cigarettes per box rose from 2,500 won to 4,500 won.
Jiang Yuan said that if we follow the WHO’s effective tobacco control strategy of "increasing tobacco taxes and prices", it will not only reduce fiscal revenue, but will increase fiscal revenue. According to statistics, in May 2015, the retail price of tobacco in China increased by 10%. From the implementation effect in one year alone, the tobacco consumption has decreased by 2.36%, and the fiscal revenue has increased by 91.9 billion yuan, thus reducing tobacco consumption, reducing tobacco harm and increasing fiscal revenue.
Compared with the social harm caused by tobacco, the tax contribution of tobacco industry is far from enough to make up for the cost of the whole society. Smoking and tobacco smoke have a serious impact on citizens’ health, which has become a major challenge for public health in China. According to statistics, nearly 1 million people die of smoking-related diseases every year in China. Among them, there were 733,000 new cases of lung cancer closely related to smoking in 2015, and as many as 610,000 patients died of lung cancer.
Zhi Xiuyi, a professor from Beijing xuanwu hospital, said that among the clinically diagnosed lung cancer patients in China, more than 70% were advanced lung cancer, and they lost the opportunity of surgical treatment. The average cost of treatment for patients with advanced lung cancer exceeds 110,000 yuan, and the high medical expenses cause poverty due to illness. If effective measures are not taken, the disease burden caused by tobacco hazards in China will show a "blowout".
Xu Guihua suggested that special funds should be allocated from tobacco industry profits and taxes to support tobacco control. She believes that the so-called tobacco marketing is "marketing death". China should legislate to prohibit the promotion and sponsorship of tobacco industry and speed up the process of tobacco control implementation. (Reporter Wang Junping)
■ Extended reading
Harmful substances in cigarettes enter the body, affecting the secretion of sex hormones, damaging the skin and even affecting fertility.
Female smoking is prone to premature aging.
Because of the special physiological structure, women’s smoking is much more harmful to their health than men’s. It mainly includes:
Cause menstrual disorders and dysmenorrhea: Nicotine in tobacco can reduce the secretion of female sex hormones, leading to menstrual disorders. Studies have shown that women who smoke more than one pack a day are twice as likely to have irregular menstruation as non-smoking women. In addition, smoking makes blood vessels contract, and the blood flow in endometrium decreases, resulting in dysmenorrhea and spasm.
Can cause premature aging: when smoking, a large number of harmful substances will enter the body, which will damage the skin. Women who smoke tend to have dry, rough skin, low elasticity, many wrinkles, gaunt face and gray color. In particular, the wrinkles at the corners of the eyes, upper and lower lips and corners of the mouth have increased significantly, and the appearance is older than the actual age.
Decline in fertility: Nicotine in cigarettes will affect fertilization and implantation of eggs, thus affecting female fertility. Studies have shown that the chances of female smokers suffering from infertility are 2.7 times higher than those of non-smokers If both couples smoke, the possibility of infertility is 5.3 times higher than that of non-smoking couples. In addition, women who smoke are more likely to have miscarriage, premature delivery or ectopic pregnancy.
It can harm offspring: the deformity rate of babies delivered by smoking women is 2-mdash higher than that of non-smoking women; 3 times, of which the risk of leukemia is twice as high. In addition, the incidence of anencephaly and dementia has also increased significantly. Among the children born to women who smoke, the rate of mentally retarded and mentally ill is also relatively high.
Susceptible to cardiovascular disease: 1-mdash daily; Women who smoke four cigarettes are more than twice as likely to have a stroke as women who don’t smoke, and those who smoke more than five cigarettes are more than five times as likely. It is worth mentioning that if smoking women take oral contraceptives at the same time, they are 10 times more likely to suffer from coronary heart disease than non-smoking women.
Susceptible to cancer: The risk of lung cancer, breast cancer, cervical cancer and ovarian cancer in smokers is 5.5 times, 40%, 14 times and 28 times higher than those in non-smokers, respectively.
(Reporter Shen Shaotie finishing)