On September 7, 2012, the China-U.S. Smoke-free Workplace Initiative – a public-private partnership that is the next cooperative effort on tobacco control between the U.S. and China – launched in Beijing. The new initiative aims to expand the number of smoke and tobacco free worksites throughout China. This latest effort demonstrates China’s and the United States’ commitment to moving forward on one of the many goals of the recent United Nations High Level Meeting on Non-Communicable Diseases. That meeting identified non-communicable diseases, many of which are caused by tobacco use, as a major global health challenge.
Tobacco use is the leading cause of preventable death and disease in the U.S. and China, and it kills six million people each year worldwide. Of these deaths, 600,000 are due to second-hand smoke. Tobacco use is estimated to cause 443,000 deaths annually (including deaths from secondhand smoke) in the United States. In China, more than 1 million people die from tobacco use annually with 100,000 of those deaths coming from second-hand smoke.
China has made significant strides in tobacco control in recent years. Most recently China has been praised by the World Health Organization for the Ministry of Health’s release of the “China Report on the Health Hazards of Smoking.” This landmark report already has drawn attention to the severity of the tobacco situation in China, where more than one million people die from tobacco use each year. Earlier this year the “Say No to Forced Smoking” campaign, launched by the Bill and Melinda Gates Foundation and web services corporation Baidu, drew significant attention to the 100,000 annual deaths caused by second-hand smoke in China.
Committed to reducing the devastating effects of tobacco use, China and the United States both have made progress toward enhanced tobacco control. China ratified the World Health Organization’s Framework Convention on Tobacco Control (FCTC) in 2003 and enacted it in January 2006. Since then, health education campaigns have been carried out throughout China and relevant regulations have been revised in support of the FCTC goals. In 2009, the Ministry of Health (MOH), in collaboration with three other government partners, launched an initiative that establishes a tobacco-free health system. Working with the Ministry of Education, the MOH also established tobacco-free schools and, since then, smoke-free indoor spaces have gradually expanded.
Tobacco control was included in China’s 12th Five Year Plan. Some municipalities and big cities already have passed tobacco control legislation and the MOH also established a national hotline to promote smoking cessation. Since the launch four years ago of a continuous mass media campaign, more than 40,000 news stories on tobacco control have been published, which has greatly increased the public’s knowledge on the related harm of smoking.
A reinvigoration of national efforts has occurred in the U.S. as well. In 2010, the U.S. Department of Health and Human Services (HHS) unveiled its first-ever national strategic plan for tobacco control entitled, “Ending the Tobacco Epidemic.” The strategic plan already has led to an unprecedented set of actions throughout HHS and the U.S. government which, in turn, have increased access to tobacco cessation services while decreasing workers’ exposure to second-hand smoke.
In July 2011, HHS expanded its existing smoke-free policy to protect the health of its employees, contractors, and visitors by prohibiting the use of any tobacco product in or near all of its facilities, including in nearby parking lots and in private vehicles on the premises. The U.S. Office of Personnel Management, which is the human resources arm of the U.S. government, adopted a groundbreaking new policy: starting in 2011, it expanded tobacco cessation treatment coverage for all current and retired U.S. government employees and their dependents. In addition, the U.S. federal government is also making substantial investments in national tobacco education campaigns designed to engage the public. Earlier this year, the U.S. Centers for Disease Control and Prevention (U.S. CDC) launched a landmark national advertising campaign that depicted the harsh realities of tobacco related illness. The campaign generated more than 200,000 additional calls to the 1-800-QUIT-NOW portal that links callers to their state tobacco cessation quitlines and more than 500,000 additional visitors to smokefree.gov, a federal website that helps people quit smoking.
Furthermore, in an effort to reach young adults, HHS collaborated with leaders of U.S. academic institutions to increase the number of tobacco-or smoke-free campuses nationwide. The Tobacco-Free College Campus Initiative promotes and supports the adoption and implementation of tobacco-free policies at universities, colleges, and other institutions of higher learning.
Collectively, the U.S. and China have worked together on tobacco control research and tobacco surveillance for many years. Most recently, in collaboration with Chinese research institutions, the U.S. National Cancer Institute (NCI) initiated nine tobacco-related research grants in China to look at different aspects of tobacco control. Some of those aspects include capacity building for tobacco control; behavioral risk factors for smoking among rural versus urban populations; the role of culture in tobacco usage among multiethnic populations; and tobacco and cancer risk. In collaboration with the WHO, the U.S. CDC and China CDC in 2010 jointly conducted the most recent Global Adult Tobacco Survey in China, an important tool in tobacco surveillance. Data from this survey informed the most recent MOH tobacco report. The two countries hope to conduct the first Global Youth Tobacco Survey in China next year, which will provide insight into the younger generation’s perception and usage of tobacco.
We view the China-U.S. Smoke-free Workplace Initiative as an exciting next step to further our cooperative efforts to reduce tobacco harm. The CUSW is unique from our previous partnerships in that it is a multi-sectoral, public-private partnership that combines the health expertise of the Chinese and U.S. health agencies with the workplace experience of businesses to create and support smoke-free workspaces. With help from our partners, we already have key businesses that have joined the initiative and are helping to make a positive change. The CUSW Initiative will support companies as they take steps to go smoke-free during the next year.
With the help of the business community, we hope to significantly reduce exposure to second-hand smoke, while raising awareness of the hazards of tobacco use and encouraging smoking cessation. We believe that the CUSW Initiative will not only provide a platform for a healthier workforce, but it will also help lead to a healthier environment in the community at-large. We look forward to this next step in our joint efforts toward a smoke-free world.（Dr. Huang Jiefu and Dr. Howard Koh）
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