Discussion keeps the world turning.
This is Roundtable. Hello everybody, I'm Ha Young.
Welcome to Roundtable's special World Note Backo Day program, where we clear the air and celebrate the global strides towards the smoke-free future.
As we focus on this year's theme, youth step in and speak out.
We'll explore the impactful measures China has undertaken to curb smoking issues.
These regional initiatives have successfully driven down smoking rates and fostered smoke-free environments, paving the way for a healthier future.
For this discussion, we're honored to have Mr.
Martin Taylor, the World Health Organization, or who representative to China with us.
Welcome Martin. Thank you very much for the invitation.
It's lovely to be here. It's great to have you.
Let's start this off with the exciting things you guys are doing.
This year's World Note Backo Day theme focuses on protecting youth from tobacco industry interference.
And around the world, an estimated 37 million youth age between 13 and 15 years old used tobacco.
So, what specific activities and campaigns is the who rolling out in China to address this issue?
Excellent question. And maybe you could start by saying why we're doing this.
The important thing in terms of why we're doing this is because we're trying to protect people's future and the country's future.
Not just from the health impacts of smoking if people begin to smoke when they're young and their potential future of asthma or lung cancer or heart disease, but also because of the other things that they may not be aware of, the fact that it can impact on brain development and have therefore an impact on performance at school or university, impact on their mental health, anxiety on sexual health, on how their skin is, their age in.
So, there's lots of very good reasons to do this, which is not just about health, but it's about people's general livelihoods.
So, what we're doing here in China this year for World Note Backo Day, we have a mixture of offline and online events.
So, we have some offline events where we're bringing out the voices of young people, their perspectives and their desires and their wishes.
And this week we've been running a campaign, we have a series of posters going out, drawing attention to different aspects that people may not be aware of in terms of the impact of smoking.
And we've had kind of a quiz, like an MBTI, that kind of personality type quiz, where people can identify their different roles that they can play because of course everybody can have a different role to play in terms of combatting smoking.
Yeah, I'm a little surprised and also let's just say pleasantly surprised that you guys have actually come up with your own version of the Myers-Briggs type indicator quiz, because have you realized this is basically what Chinese youth play as the so-called icebreaker conversation when you meet new people?
It definitely, I think, will be something that would generate interest.
To figure out your, is it anti-tobacco, use personality or whatnot?
And have you guys done a lot of research in trying to find out what sort of triggers interest in China when it comes to the specific issue?
Because we know that anti-smoking campaigns or whatnot have been going on across the world, but how do you engage with your sort of your destination audience?
Absolutely. I think there's probably two aspects of that.
One of course is trying to find ways to make this subject interesting for people so that we'd not lecturing, but we're actually engaging people and helping people think about it, maybe from a perspective that they haven't thought before.
And then another aspect is that when it comes to control in tobacco, there are so many different things that people can do, and some personalities may be suited to one particular set of actions and some to another.
Some people, if they see somebody smoking where they shouldn't, will have no problem in going up to them and saying they shouldn't.
Other people will want to take action, but the different personality type, they'll need to find a different way.
So it helps everybody find a way in which they can engage.
Well, that's fascinating because I've never thought about this issue by the personality approach.
When we talk about no tobacco, I think it can be divided into at least two angles.
One is you're not smoking.
Period. You know, don't even touch that habit or drop it for good.
And the other angle is maybe when you see this in public, or are they puffing away in public, there are like two angles in this subject.
Do you see it that way? Absolutely.
And I think the second aspect, the second angle that you're talking about, I think, is a really important one when we're thinking about young people because they can't choose the environments they're in.
They go to schools, they get taken by their parents to shop in malls, to restaurants.
They can't choose whether they breathe secondhand smoke or not.
And so, you know, we believe quite strongly that everybody, especially young people whose lungs are still developing, should have the right to be in a place where the air is clear and that they're not risk in their future.
Absolutely. And the global tobacco industry is known for targeting youth through strategic advertising and social media, what can be done to counter these tactics and prevent a new generation of smokers from becoming addicted?
Very good. And that's the tough question.
Yes. So as we know, there's a lot that is done to try to lure or trap young people and you can see this around.
The most important thing is a really strong ban to stop advertising, promotion, sponsorship, all of those kinds of activities that try to glamourize smoking.
And so to enable young people to be aware of these kinds of traps, be aware of what is going on, what psychologically they're trying to be lured into.
That's a really important point.
You know, China's made some good progress on some of that in terms of ban in advertising, for example.
There's a little bit more that can be done, but there's some good things there.
Another really important thing actually is also making people aware with really graphic warnings on cigarette packets of the potential risks and dangers.
And that is something that we would love to see because it is so powerful and especially for young people.
Right. Those graphic warnings can be pretty horrific.
Could you also just give a couple of examples, maybe the ones that are not so obvious, but it's the tobacco business behind it.
It's not something that is immediately noticeable.
In terms of some of the tactics that they use.
So for example, sponsorship of events or things like that where they may not be hugely prominent, they may not be big logos, but their money is behind the scenes and helping with events would be the kind of example.
You can also see in films, in media, in social media, the way that smoking is sometimes portrayed, you know, online content, used to try to pretend that it's glamorous.
And so I think that's another important area.
So for example, when we're looking at how we can combat it, it's not just in the outside world, but on the social media world, making sure that the guidelines and the content on social media platforms also is strong and doesn't allow that kind of glamourization.
Right. And social media as well as all these digital platforms, these are kind of a new battlefield for advertising and also for all the public health campaigns to be reaching those target audiences.
And also a new battlefield, I suppose, would be e-cigarettes as well.
And this part we've seen that actually young people have been early adopters and they enjoy a far higher rate of puffing away the e-cigarettes as opposed to adults.
And that's also a relatively new territory that I see you guys are devoting some attention to these days as well.
Absolutely. It's a big concern for many reasons.
One reason, of course, is that e-cigarettes are harmful.
They pose a risk to health.
They have nicotine, which is addictive and can cause slow brain development and cause anxiety, mental health challenges.
They're also toxic substances in there as well.
So there's very good reasons.
They're not safe as a lot of people seem to assume.
There's very good health reasons why they should be treated with the same care as conventional tobacco.
And that's why we need to employ the same kinds of methods, especially actually, and we're talking about young people today because the companies are often very aggressively marketing towards young people.
And so it's really important that we have the same kinds of protections, you know, make sure that you can't use them in indoor public places so that we're still smoke-free, avoiding the promotion and advertising sponsorship, those things that I made.
And especially that point around them not having multiple different flavours or colours to try to attract young people.
As we know, there's a health risk and we also know that if somebody young starts with e-cigarettes, then they're almost three times more likely than their peers to actually move on to conventional cigarettes.
Could you just say a little bit more about the fact that e-cigarettes and vaping products are not the safer alternative?
Because I think originally when these products have been pushed into the market about a decade ago, that was sort of the really appealing tagline and it got a lot of people confused, but they're not safe.
They're not safe. That's clear.
Yeah, so using them poses a health risk.
And there's a number of reasons for that.
One is, as I said, because they still contain nicotine.
And nicotine is the addictive substance, which can also impair or slow brain development cause challenges, so if you want to have a good education and be successful in university, the nicotine is not going to help on that.
And also it's known to cause anxiety, which is linked with mental health challenges.
So there's a number of reasons why from a health perspective, the nicotine itself is not good.
And then of course there are other toxic substances in there as well, which can also have potential harm for effects.
These days in China, the country has rolled out a slate of tightened regulations on e-cigarettes.
And as early as 2022, a regulation imposed license management for e-cigarette production, wholesale and retail entities and a straight ban on e-cigarette retail outlets near schools.
Having the regulation is definitely a very important part, but also how are these regulations enforced and how do you sort of change people's perception?
That's really hard. Like we mentioned with these e-cigarettes and vaping products, they started off with this really smart tactic in establishing that you're the glamorous, new and quote unquote safe option.
Then it's actually quite difficult or it's like an uphill battle as opposed to some of the other public health issues to switch that perception.
In China, we see that this is definitely one of the areas that the authorities have paid attention to as well.
Yeah, absolutely. It's good to see that China did move quickly and there are certainly some countries, especially in our region, which have a much more difficult challenge now because they didn't compare to China.
So yes, China did move quickly.
But as an agent, this is something Director General Dr.
Tedros says, you know, is that the tobacco, the company is the companies who manufacture these products are trying to sell the same product, but in a different way now.
And so we need to think about how we address those challenges.
And that's why it's great that some of the cities that are going smoke free, so indoor smoke free public places for the entire city are also the most advanced ones, also including e-cigarettes in that.
And that's something that we would encourage for every city to consider.
I think that's quite the revelation for maybe some people, basically now you're equating e-cigarettes, vaping, pretty much classified as the similar level of hazardous risk that imposes some people with cigarettes.
So I think that's very important message to get out to people because people really need to know these things.
Absolutely. I mean, it's the harm they pose themselves, but also the fact that they are a pathway onto conventional smoking as well.
Oh, could you explain a little bit on that?
It's a combination of being adjusted to it, used to it.
OK, a dependent on it. As well as the dependence on the nicotine.
Oh, tobacco is one of the greatest public health threats the world has ever faced.
Nearly 8 million people are killed by tobacco each year.
According to China's CDC, more than 1 million people die from smoking related diseases every year in the country.
Thus, the Chinese government has attached great importance to tobacco control.
And in recent years, we've seen changes, improvements as such.
Xinjiang and Hangzhou have both achieved considerable success in reducing smoking rights and promoting smoke-free environments.
Xinjiang has seen a 16.9% reduction in its adult smoking rate as of 2023.
And the who has awarded the Hangzhou Municipality People's Government with the World No Tobacco Day Award.
So what lessons have these cities have to offer in their own experiences and China as a whole country?
What are some of the things that we can learn from international practices when it comes to this issue?
First of all, let's start with the award for Hangzhou.
So every year, the World Health Organization makes a number of awards globally on World No Tobacco Day for either individuals or organizations who have made outstanding contributions.
And that's why Hangzhou is being recognised because of their full movement towards 100% smoke-free indoor public places.
And also the very strong involvement of young people that they had in developing and enforcing that and getting the population on board.
These are so important because they help reduce the smoking rate, as you said, with those statistics.
They're very powerful tools.
But also, they protect the non-smokers.
They protect everybody and we're talking about young people who often don't have a choice which indoor place they're in, protecting them from the harms of tobacco smoke.
And so I think that's a really important thing for us to consider and to remember.
And when you're asking the question about elsewhere in China and the lessons that can be learned, the clear lesson that can be learned from cities like Hangzhou and Shen Zhen is that this protects people.
This protects people and this protects innocent children from second-hand smoke.
And also, it's very popular with the public.
Both Hangzhou and Shen Zhen, we've seen over 90% of the population support these.
So that's a huge percentage of the population who are in favour of these.
And I think they support those because they know of the benefits.
They know that it's worth protecting people.
And also we've seen in some places not just that the managers of entertainment venues, the managers of restaurants also support them.
So it's not that it's a challenge for business.
Actually, it can help business as well in terms of creating the kind of environment where people want to go to.
So it's not a kind of win-lose.
It's a win-win for cities to undertake these.
So we would love to see more cities across China doing this so that more people in China have the same levels of protections and for their health and for their future.
Yeah. That's an important point to make that is a non-smoke environment that can actually bring in more foot traffic, more business.
Absolutely. Yeah. And this reminds me of just as a younger millennial living in China.
And of course, I'm only one data point.
I don't feel I'm suitable to represent a whole bunch of people.
But around me and my friends in urban settings, it seems like the younger generation or at least a fair proportion of younger people.
Smoking isn't really seen all that cool anymore.
We only see in old movies when older gentlemen would trade cigarettes as sort of social currency.
Like that's just no longer the case.
But also, I'm a hardly representative of the whole picture.
But I think it's an interesting thought in terms of the perception towards smoking.
Intergeneration could vary and region to region varies as well.
For these changes to take place, there are a lot of factors that are in play.
Could you identify maybe some of the things or some of the observations?
In terms of some of the variations.
Yes. Okay. Because you're obviously better placed than me to talk about your peer groups and younger.
Or what about internationally as well?
Do you think that people's perception towards smoking and cigarettes might have changed generation to generation, region to region possibly?
One aspect that is very clear now compared to many years ago, let's say even my parents' generation, is that the evidence is very clear about the health impact.
It's very clear. So that filters through into people's general perceptions as well.
And many countries around the world have taken really strong measures to put graphic warnings on cigarette packets.
And so it really addresses head on that glamourisation.
So the more that you have those kinds of differences and those kinds of changes, the more it permeates I think into people's perceptions.
Also when we look at what they've done in Shenzhen, the local authorities, the anti-smoking offices, they've tried a lot of things as well.
And I wonder if these align with maybe international practices or maybe some of them are innovative strategies and I like to check with you.
One thing Shenzhen apparently has done is it's been pretty stringent in giving out hefty fines and they don't hesitate when they do that.
So there was this 30,000 Chinese Yuan or equivalent to maybe 4,000 US dollars, hefty fine and the first one to give out to those who were selling cigarettes to miners as well as the first fine as such to be levied for inadequate smoking control in internet cafes.
Because apparently that's one of the places a lot of people smoke.
These were firsts in China.
And also I saw there is this online report platform.
Basically it's a Shenzhen smoking report mini program that's embedded in WeChat, which is the most popular messaging app in this country and anybody who sees smoking in inappropriate places, you can quickly take a picture and report.
And there are consequences too.
So there's a basket of things that the locality has done to fight smoking in all these places.
Yeah. Absolutely. And one thing that we've learned from around the world is when you have a regulation for example smoke free indoor public places, there needs to be strict enforcement and the way to do that is these fines as you're saying.
Without strict enforcement, they can be diluted or fade away a little bit.
So they absolutely needs to be strict enforcement.
That's vital. But I think there's also two other things worth noting here.
And I think this is where some of the experience in China can be relevant for other countries.
One is the use of volunteers to help spread the message but also to go to places where there are people reported smoking.
I think it's a good way of mobilizing the community.
Because as I said with those figures, if over 90% of the population is in favor of this, then the volunteers can be an expression of that to help enforce.
It's part of the enforcement.
And then the app that you were talking about and here in Beijing, there's a similar one where you can report in a WeChat embedded app.
And then it comes up on a map.
Those are wonderful technologies that other countries could also learn from I think.
And other cities in China.
And it shows that this is how it can be done and it is successful.
And tobacco use not only impacts public health but also has environmental and social justice implications.
Could you elaborate on these broader consequences and the importance of addressing them?
Yes. The environmental consequences are surprisingly significant actually.
When you think about the amount of land that's used.
So just a couple of examples.
Water, 22 billion tons of water in the tobacco industry around the world.
Carbon dioxide emissions.
At the moment, everybody is very concerned as we should be about climate change.
The carbon dioxide emissions, 84 million tons a year.
These are huge figures.
And then when we move on to the waste, if you think about the littering, tobacco product is the single biggest litter in the world, 4.5 trillion filters a year in sea, in rivers, in parks on the street.
They're every there. Once you start noticing it, they're everywhere.
It's a huge pollution challenge.
Which not only pollutes the environment because of the chemicals, but it costs a lot of money to clean up.
One estimate is that it costs China $2.6 billion a year to clean these out of the environment.
So it has a huge environmental impact.
Which when we're also trying to fight climate change and keep our environment safe and secure, it's a win-win.
It's a contribution by controlling tobacco.
We're also contributing to a good environment.
And looking ahead, what are the whose priorities and goals for tobacco control in China, particularly concerning protecting the younger generation from the harms of tobacco use?
So looking ahead, protecting the young people is critical.
For the reasons I said earlier about their future health, about their brain development, their mental health, all of those aspects that are important.
In terms of how to achieve that, there's a number of key policies to pursue and campaigns.
The first is this 100% smoke free.
We're talking today with Hangzhou receiving the award.
You've mentioned Shenzhen and Beijing to have more cities.
If we can have more cities in China, 100% for smoke free, we protect more of the population and more of the young people in particular.
Structure enforcement around advertising, but in particular sponsorship and promotion.
And another one that's actually very important, which we haven't mentioned yet, is tobacco taxation.
Because young people are more price sensitive.
And so the higher the cost of a cigarette, then the more likely that will be to discourage young people.
If we can help young people resist these challenges, then they're set up for a better future, both near future and in the further future.
We've had a deeply engaging conversation on tobacco control and I want to extend my deepest appreciation to Mr.
Martin Taylor, the World Health Organization representative to China for sharing your expertise and perspectives on tobacco control.
Thank you very much, Hayan, for having us on.
The strides made by cities such as Shenzhen and Hangzhou show the power of committed action and innovative strategies.
On this world, no tobacco day, let's remember that every step taken towards the smoke free environment is a step towards a healthier, brighter future for all.
