Methodology of the Global Adult Tobacco Survey in China, 2010

INTRODUCTION The Global Adult Tobacco Survey (GATS) is a component of Global Tobacco Surveillance System (GTSS) under auspices of the Bloomberg philanthropy and the Bill and Melinda Gates Foundation.

Population-Based Survey of Secondhand Smoke Exposure in China

Objective To determine the extent of secondhand smoke exposure in China, and to explore the potential associated factors. Methods This study was a nationally representative household survey examining secondhand smoke exposure of non-institutionalized men and women aged 15 and older using a global standardized geographically clustered sample design. A total of 13 354 people completed the individual questionnaire with questions on gender, age, educational level, residence, profession, potential factors associated with secondhand smoke exposure, and workplace smoking policy. The data were used to determine whole population estimates of secondhand smoke exposure. Results Among non-smokers aged 15 years and older, it was estimated that 72.4% (556 million) were exposed to secondhand smoke, with 52.5% (292 million) exposed to secondhand smoke daily. The prevalence of secondhand smoke exposure was 74.1% for men, 71.6% for women, 70.5% for urban populations, and 74.2% for rural populations. The rates were 67.3%, 63.3%, and 72.7% respectively, within the household, indoor workplaces and public places. Secondhand smoke exposure was significantly reduced in workplaces with a smoking ban but not in workplaces with a partial smoking ban. Conclusion Although China has made some progress toward a smoke-free environment there remains a high degree of exposure to secondhand smoke.

Local Brand Smoking Among Adult Smokers:Findings from the Wave 5 International Tobacco Control China Survey--China,2015

Summary What is already known about this topic?Branding of cigarettes may play a role in shaping the smoking behaviors of Chinese smokers,and local brand(LB)cigarettes may reflect this influence because of greater tax and non-tax incentives compared to non-LB.Some of these brands are regional flagships that market to smokers using local landmarks or icons.What is added by this report?LB brands were significantly more likely to be the usual brand of smokers residing in provincial-level administrative divisions(PLADs)that produced their own LB cigarettes[adjusted odds ratio(AOR):30.95;95%confidence interval(CI):26.36–36.49]compared to those residing in PLADs that had non-local ventures with non-LB cigarettes.Further,smokers residing in urban areas were found to be less likely to smoke LB cigarettes(AOR:0.79;95%CI:0.67–0.93)compared to those in rural areas.What are the implications for public health practice?These findings suggest that LB smoking may be a result of industry-driven incentives to boost LB sales,fueled by such as supply-side strategies to boost LB sales or targeted cultural/social marketing that appeals to certain demographic groups.Although addressing these incentives to support LBs would be challenging given the nature of China’s tobacco industry,doing so would have potential to reduce cigarette smoking and ultimately the health burden of smoking in China.

The Progress of the Global Tobacco Cessation Strategies

The tobacco epidemic is one of the biggest public health threats the world has ever faced,killing more than 8 million people a year,mainly through noncommunicable diseases(NCDs)(1).World Health Organization(WHO)set nine voluntary global targets for NCDs to be attained by 2025,including a 30%relative reduction in prevalence of current tobacco use by 2025(2),which requires a strong commitment by governments to strengthen the national health system responses and to take action against the leading risk factors for NCDs including tobacco use,the single most preventable cause of death.Commitment to strengthening full implementation of the WHO Framework Convention on Tobacco Control(WHO FCTC)is a crucial component of action by governments.

Tobacco Use and Exposure Among Secondary School Students — China, 2019

Summary What is already known about this topic?Using the framework of the global youth tobacco survey(GYTS),China CDC conducted the first round of a national tobacco survey among junior high school(JHS)students in 2014,indicating that 17.9%and 5.9%of respondents were experimental and current cigarette smokers,respectively.

Tobacco Use and Cessation Among College Students--China, 2021

Summary What is already known about this topic?Previous studies about tobacco use among college students in China were conducted at the school level or city level,with fewer than 5,000 students participating.What is added by this report?In 2021,China CDC conducted a national tobacco survey targeting students enrolled in the public higher education system.Overall,124,119 students from 220 colleges and universities in 31 provincial-level administrative divisions participated in this survey.Current cigarette smoking,current daily smoking,willingness to quit,and smoking cessation among college students were explored.What are the implications for public health practice?The current daily cigarette smoking rate of college students was significantly higher than that of senior high school students,especially higher vocational college students.Tobacco control interventions,such as a smoke-free school policy and smoking cessation services,need to be reinforced on college campuses.

Utilization of Smoking Cessation Support Among Adults-18 PLADs,China,2020

Summary What is already known about this topic?In 2018,unassisted smoking cessation(USC)was the predominant method for quitting smoking among Chinese adult smokers,accounting for 90.1%of cases.The utilization of professional smoking cessation support was comparatively low in this population.What was added by this report?In 2020,the prevalence of USC methods increased to 93.1%.Concurrently,there was a slight increase in the utilization of pharmaceuticals(from 4.6%in 2018 to 5.5%in 2020)and counseling and quit line services(from 3.2%in 2018 to 7.5%in 2020).On the other hand,the use of e-cigarettes as a cessation aid decreased from 14.9%in 2018 to 9.8%in 2020.Smokers aged 15–24 years old were more likely to rely on pharmaceutical interventions(7.9%),and less likely to choose USC methods(79.0%).What are the implications for public health practice?The promotion of professional cessation support is essential for enhancing smoking cessation rates.

Evaluation of Smoking Cessation Intervention Effectiveness in Smoking Cessation Clinics-China,2019–2021

Summary What is already known about this topic?Since 2014,the Chinese government has advocated for the development of smoking cessation clinics(SCCs)within each provincial-level administrative division(PLAD).What is added by this report?In the 2019–2021 period,the self-reported 7-day point prevalence of abstinence rates(PPAR)at 1-month and 3-month follow-up were 26.2%and 23.5%,respectively.What are the implications for public health practice?The interventions implemented by SCCs in this investigation proved to be successful.It is imperative to employ extensive tobacco control strategies in order to enhance the motivation of smokers to seek assistance for cessation from SCCs.

Assessing the Effectiveness of a Community-Based Smoking Cessation Intervention-Shenzhen City,Guangdong Province,China,2022

Summary What is already known about this topic?Research on community-based smoking cessation interventions in China is still in its early stages.Most existing studies have focused on a limited number of communities and have primarily examined interventions conducted by study teams rather than broader community initiatives.

Effectiveness and Acceptability of a Comprehensive Mobile Health-Based Modality for Smoking Cessation-Beijing Municipality,China,2022

Summary What is already known on this topic?Mobile health interventions have been demonstrated to be effective in aiding smoking cessation among smokers.Nevertheless,research on this topic remains limited in China.What is added by this report?Following two months of utilizing the services of a comprehensive mobile health(mHealth)-based modality(“Way to Quit”modality)which integrated three online interventions through the WeChat application,29.1%of participating smokers successfully quit smoking.Participants who used a greater number of online services were more likely to cease smoking.All services were scored highly for satisfaction among smokers.What are the implications for public health practice?This study presents a practical and feasible method to assist Chinese smokers in quitting smoking.The results of this research suggest a promising direction for enhancing the accessibility and utilization of smoking cessation services.Additionally,these findings serve as a critical reference for addressing the obstacles faced by smoking cessation services in China.

Smoking Behavior Among Secondary School Students--China, 2021

Summary What is already known about this topic?In 2019,China CDC conducted the National Youth Tobacco Survey among secondary school students,and the prevalence rates of ever,current,and frequent smoking were 17.9%,5.9%,and 1.8%,respectively.What is added by this report?The prevalence rate of cigarette use in males decreased largely from 2019 to 2021 in China,while it increased in 18 provincial-level administrative divisions(PLADs)for females.The tobacco control situation remains challenging among vocational senior high school(VSHS)students.Significant geographical disparities existed in cigarette use.What are the implications for public health practice?Targeted tobacco control policies aimed at VSHS students are needed,specifically those PLADs with higher smoking rates.Additionally,close attention should be paid to female smokers.

Achieving the Goals of Healthy China 2030 Depends on Increasing Smoking Cessation in China:Comparative Findings from the ITC Project in China,Japan,and the Republic of Korea

Summary Tobacco smoking is the number one preventable cause of disease and death in China as it is globally.Indeed,the toll of smoking in China is much greater than its status as the world’s most populous country.There is a persistent and continuing need for China to implement the measures specified in the global tobacco control treaty,the World Health Organization(WHO)Framework Convention on Tobacco Control(FCTC),which China ratified in 2005.

Urgent Need to Ratify National Legislation Banning Smoking in Public Places

China produces 40%of the world’s cigarettes(1)and has more than 300 million smokers(2).How to control smoking is still a serious problem.Smoking damages people’s health and increases the burden of medical expenses of the whole society.In order to promote the construction of a healthy China and improve people’s health level,the Chinese government issued the outline of“Healthy China 2030”in 2016,which proposed specific measures and objectives for smoking control work:comprehensively promote the implementation of tobacco control,increase the intensity of tobacco control,and use tax and price,law and other means to improve the effectiveness of smoking control.

Adult Secondhand Smoke Exposure—Shanghai Municipality,2018

Summary What is already known on this topic?The average secondhand smoke exposure rate was 68.1%in China in 2018.The World Health Organization suggests that legislation must be used to achieve a 100%smoke-free environment and protect nonsmokers from secondhand smoke.What is added by this report?

Cigarette Package Warnings for Adult Smoking Cessation—China,2018

Summary What is already known about this topic?After the framework convention on tobacco control(FCTC)came into force,the health warnings on cigarette packaging in the mainland of China had been changed in three rounds.But the warning label is still only pure text and without descriptions of specific health consequences caused by tobacco use.What is added by this report?Although there were two rounds of changes from 2010 to 2018,current health warning labels did not work in increasing Chinese smokers’smoking cessation intention compared with the previous one.Large pictorial warning labels were more effective than the current health warning label in stimulating Chinese smoker’s willingness to quit.

Prevalence and Determinants of Secondhand Smoke Exposure Among Adolescent Girls-China,2019

Summary What is already known about this topic?The rate of secondhand smoke(SHS)exposure among female junior high students in 2013-2014 in China was 69.9%.What is added by this report?The rate of SHS among adolescent girls in 2019 in China was 62.8%,with 60.8%in junior high and 65.3%in senior high school,meanwhile,higher SHS exposure was correlated to higher grade levels,senior high school over junior high school,urban areas,those with more pocket money,those who’ve attempted smoking,exposure to tobacco advertisements,those with parents who smoke,those with close friends who smoke,use of e-cigarettes,and belief that SHS exposure is detrimental to health.What are the implications for public health practice?The rate of SHS exposure among adolescent girls in China still remains extraordinarily high.Targeted public health initiatives to curb SHS exposure among adolescent girls are urgently needed in China.

Characteristics and Associated Factors of E-cigarette Use Among Secondary School Students—6 PLADs in China,2021

Summary What is already known about this topic?Previous studies on electronic cigarette(e-cigarette)use in China among secondary school students have provided information on the awareness and usage of ecigarettes.What is added by this report?This study not only described e-cigarette usage rates,but also explored the characteristics of e-cigarette users’behavior and factors associated with the current use of e-cigarettes among secondary school students.What are the implications for public health practice?E-cigarette use among secondary school students,especially among vocational senior high school students,requires more attention.Although some policies have been developed to protect youths from the harmful effects of e-cigarettes,enforcement of these policies needs to be strengthened.

The Importance of Reducing Smoking in China: To Achieve Healthy China 2030 While Reducing the Severity of the COVID-19 Pandemic

The coronavirus disease 2019(COVID-19)pandemic is the most devastating threat to global health since the 1918 influenza pandemic.As of May 22,2020,there have been 5.1 million cases confirmed,with over 333,000 deaths.And we are just at the beginning of a long struggle.There is a connection between COVID-19—the greatest infectious disease outbreak in a century—and the greatest chronic disease threat in the world today—tobacco smoking.Smoking has been identified by the World Health Organization(WHO)as the“single greatest preventable cause of death in the world”(1).Tobacco smoking kills 7.1 million people a year(2),with an additional 1.2 million dying from secondhand smoke(2).