- Tobacco Control Policy Analysis in China: Economics and Health
The volume Tobacco Control Policy Analysis in China: Economics and Health, edited by Teh-wei Hu, is an impressive addition to World Scientific’s Series on Contemporary China. The importance of tobacco growing, manufacturing, and use in China cannot be overstated. China is the world’s largest grower of tobacco leaf. The China National Tobacco Corporation (CNTC) is by far the world’s largest cigarette producer, and there are more male smokers in China than in the next seven top consuming countries combined (Shafey et al. 2009). Changes in supply-side policies and investments in tobacco farming and manufacturing over the past several years have positioned China to move from a country that largely consumes what it grows and produces to becoming a major player in the world tobacco markets (Euromonitor International 2010). The health consequences of tobacco use in China are enormous and growing, with one million Chinese dying prematurely each year from diseases caused by smoking, a figure projected to more than double in the next decade (Hu et al. 2008).
In November 2003, China signed the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC), then ratified the treaty in November 2005 (WHO 2003, 2008). As a result, China has committed itself to taking effective, evidence-based actions to reduce tobacco use and the death and disease it causes. The WHO FCTC and WHO’s subsequent MPOWER technical assistance package that focuses on the most effective tobacco control interventions (WHO 2008) provide a roadmap for governments to reduce the death, disease, and economic costs imposed by tobacco use. The papers contained in Tobacco Control Policy Analysis in China are particularly helpful in understanding the health and economic impact of both tobacco use and FCTC-induced tobacco control efforts in China.
The volume begins with a section reviewing the patterns and consequences of tobacco use in China. Gonghuan Yang clearly documents the high male and low female smoking prevalence rates in China that together imply that there are roughly 350 million smokers in China — about one-third of global smokers. Quan Gan and colleagues highlight the consequences of these high smoking rates with respect to the disease burden among smokers, as well as among nonsmokers, almost half of whom are exposed to tobacco smoke regularly. Michael Ong and colleagues show that smoking rates are nearly as high among physicians, clearly illustrating the need for information interventions to raise awareness in all segments of the population about the harms from tobacco. Teh-wei Hu and colleagues document the enormous economic consequences that result, estimating that the combined costs of treating diseases caused by tobacco use and the lost productivity [End Page 62] resulting from premature death caused by tobacco use amount to over rmb 40 billion (us$5 billion) each year, more than 3 percent of China’s national health expenditures (Hu et al. 2008). This section clearly makes the case that the health and economic toll of tobacco use in China is large and growing and requires effective interventions to reduce tobacco use. Finally, Anita Lee and Yuan Jiang review the limited existing tobacco control efforts in China, highlighting the conflicts that result in a country where the government is the tobacco industry and is weighing the sizable short-run revenues this generates against the less immediately apparent long-term health and economic costs caused by tobacco.
The next section focuses on the demand for cigarettes and the impact that spending on cigarettes has on household budgets. Zhengzhong Mao and colleagues provide new estimates of the price elasticity of demand, using data from the 2002 National Smoking Prevalence Survey. They find that demand is somewhat responsive to price, with an overall estimated price elasticity of −0.15, with just under half of the impact on smoking prevalence. They also estimate demand separately for different income groups, finding that demand is relatively less inelastic among...