New anti-smoking policies in China could save nearly 13 million lives in next 40 years

Almost 13 million lives could be saved by 2050 in China if the country implements comprehensive tobacco control recommendations set forth by the World Health Organization (WHO).

That is the conclusion of a study led by Georgetown University Medical Center (GUMC) researchers published online today in the British Medical Journal.

China is the most populous nation in the world and is home to about a third of the world's smokers, with male smoking rates of greater than 50 percent. China is also the world's largest tobacco product manufacturer through a government-owned tobacco company.

In 2003, China joined the WHO Framework Convention on Tobacco Control (FCTC), which mandates a comprehensive set of tobacco control policies including surveillance and monitoring of tobacco use prevalence, creation of smoke-free environments, treatment of tobacco dependence, tobacco consumption taxation and other price controls, enforcement of heath warnings on tobacco packages and marketing bans.

"If the status quo is maintained, China faces a tremendous health burden in the next four decades that could result in more than 50 million deaths related to smoking," says David T. Levy, PhD, a population scientist at Georgetown Lombardi Comprehensive Cancer Center, a part of GUMC. "If the country completely implemented the WHO FCTC policies, almost 13 million deaths would be averted and smoking rates would be reduced by about 40 percent."

Levy and his colleagues utilized a computer simulation program called SimSmoke to model tobacco smoking prevalence, smoking-attributable death and the impact of tobacco control policies between 2015 and 2050. The researchers analyzed data including China's adult population, current and former smoking prevalence, initiation and cessation rates and past policy levels.

Levy says that according to SimSmoke, raising taxes on tobacco products would have the greatest impact on reducing smoking rates.

"In 2009, China raised the tax on tobacco by almost 12 percent, but the increased cost was not passed along to consumers," Levy explains. "If China raised the taxes to 75 percent of the package price and increased the price commensurately, there would be a decrease in smoking of 10 percent within three years."

China has banned smoking on public transportation. The country has implemented weak tobacco dependence treatment programs and some advertising bansthat are weakly enforced, according to Levy. These policies do not meet the FCTC requirements, he says.

"Some of the WHO FCTC policies will cost money to implement, but taxation policies and strong health warnings in particular would be cost effective," Levy says.