GATS CHINA

------ LAUNCH OF RESULTS

Lin XiaoLin XiaoChina CDC Tabacco Control OfficeChina CDC Tabacco Control Office

Background

This is the responsibility clearly given by the

WHO Framework Convention on Tobacco Control

(FCTC) to all parties, as well as an important

component of the six most effective strategies for

tobacco control (the MPOWER package)

vigorously advocated by WHO.

It is essential to establish an effective monitoring,

supervising and evaluation system to monitor

tobacco use and obtain nationally representative

periodic data on the key indicators of tobacco use

among adolescents and adults.

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The Global Adult Tobacco Survey (GATS)

GATS is a household survey to provide strong evidence for

developing, monitoring, and implementing effective tobacco

control measures.

Sponsors: The Bloomberg Initiative to Reduce Tobacco Use

The Bill and Melinda Gates Foundation

The U.S. Centers for Disease Control and Prevention

World Health Organization

So far, 14 countries have implemented the survey

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GATS CHINA The 2010 Global Adult Tobacco Survey in China (GATS China)

was a nationally representative household survey of non-

institutionalized men and women aged 15 and older, which was

organized by China CDC authorized by MOH.

The study design and pilot surveys was conducted by China CDC

in 8 months, and the training in 4 months;

The field work was completed by more than 500 stuff from

provincial and county CDCs from December 2009 to March 2010;

Data cleaning, analysis and report writing were completed during

May to July, 2010.

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Methods of Survey

A multi-stage stratified cluster sampling method was used in

the survey in order to obtain the nationally representative

sample;

Internationally standard questionnaire was used in the survey;

iPAQ handheld was used to collect data;

The survey was completed with high qualities by mobilization

in community and strict quality control measures;

A total of 13,354 people completed the individual

questionnaire, and the total response rate was 96.0%.

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Field Work

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The sampled counties and districts

Survey Contents

Participants’ general information,

Tobacco use (smoking and smokeless),

Cessation,

Secondhand smoke (SHS),

Tobacco economic

Media

Knowledge, attitudes, and perceptions on tobacco use and

SHS

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Results of GATS CHINA

Tobacco Use

Nicotine Dependence and Cessation

Secondhand smoke

Knowledge and Perceptions of Tobacco Harm

Implementation of a series of policies on tobacco control Protecting people from the harms of SHS Protecting people from tobacco smoke Offering help to quit tobacco use Warning about the dangers of tobacco Enforcing bans on tobacco advertising, promotion and sponsorship Raising taxes on tobacco

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Tobacco Use Male smoking rate in China remains at a high level.

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Sources: Data come from the 1996 National Prevalence Survey of Smoking Pattern, the 2002 Behavior Risk Factor Survey, and GATS China, 2010.

Tobacco Use Smoking rate was higher among those with lower education Male smoking rates were higher in rural and western areas

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Smoking rates for men was the highest in machine operators and agriculture workers

Among ever daily smokers 20-34 years old, 52.7% started daily smoking before the age of 20.

Nicotine Dependence and Cessation

Half of smokers were heavily dependent on nicotine, 50.3% of

current daily smokers smoked within 30 minutes after waking.

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Among ever smokers:

• 57.5 million (16.9%) quitted

smoking,

• 112.8 million (33.1%)

relapsed,

• 17.3 million planned to quit,

• 152.8 million (44.9%) had

no intention to quit smoking.

The quit ratio for daily smoker in China was 12.8%,

second to no other GATS countries except for India.

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Quit ratio for daily smokers ： the proportion of quitters among ever daily smokers

Secondhand smoke

Prevalence of exposure to secondhand smoke was high; 72.4%

of nonsmokers were exposed to secondhand smoke.

72.7% of participants noticed smoking in indoor public places 88.5% of people noticed smoking in restaurants,

58.4% in government buildings,

Around 35% in each of the following places: health care facilities,

schools, and public transportation.

Smoking occurred in 67.3% of homes.

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Secondhand smoke exposure

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Note: among those who had visited those public places in the past 30 days prior to the survey

≥75% adults were not aware that smoking could cause stroke, heart disease and lung cancer

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75% adults were not aware that SHS causes HD & lung cancer in adults, and lung diseases in children.

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low-tar cigarettes are no less harmful than regular cigarettes

35.8% of adults thought low-tar cigarettes were less harmful than

regular cigarettes and 50.2% did not know.

The highest proportion of adults with this misconception was among

those with a college or above education, or medical staff and teacher.

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Implementation of policy package on tobacco control

Policy Indicators used in GATS China survey ResultProtect people from SHS

% of respondents who noticed smoking at their indoor work places in the previous 30 days 63.3%

% of respondents noticing smoking in indoor public places in previous 30 days. 72.7%Offer help for cessation

% of smokers reporting that they were advised to quit when seen by a doctor or other health professional during the previous 12 months. 33.9%

% of smokers who attempted to quit without any cessation aids during the previous 12 months. 91.8%

Warn about the dangers of tobacco

% of respondents who noticed information on the dangers of smoking during the previous 30 days 59.8%

% of respondents who thought about quitting after seeing the health warnings on the cigarette packages 36.4%

Enforce bans on tobacco advertising, promotion & sponsorship

% of respondents who noticed tobacco promotion during the previous 30 days. 19.6%

% of respondents who noticed tobacco promotion on TV among those who noticed tobacco marketing during the previous 30 days. 49.8%

Increase tobacco taxes & prices

Maximum expenditure to buy a pack of cigarettes paid by 50% of smokers 5 RBM & LESS

Expenditure of 100 packs of cigarettes as a percentage of 2009 GDP per capita. 2.0%23/4/19 19

Protecting people from the harms of SHS

Among those who worked indoors, 37.7% reported that there was no policy on smoking indoors at the workplace, while 31.0% reported a complete ban on indoor smoking.

During the past 30 days Among workplaces without a smoking ban, 89.2% reported smoking

had occurred at the workplace. Among workplaces with partially banning smoking, 69.3% reported

smoking had occurred at the workplace. In places with a complete smoking ban, 25.5% of people reported

seeing people smoking.

Overall, 63.3% reported smoking occurred at indoor workplaces in past 30 days.

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Offering cessation services

During the previous 12 months, only 33.9% of smokers who

had visited a healthcare provider received cessation advice.

During the previous 12 months ， smokers who had attempted

to quit ： 91.8% did not use any special cessation methods.

3.1% used smoking cessation medications

3.0% did consult

Among GATS countries, the percentage of those using

smoking cessation medications and counseling in China was

one of the lowest.

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Warning of the harms of tobacco

In the previous 30 days, 59.8% of adults had seen a message about the dangers of tobacco use or encouraging smokers to quit, via the media or in public places. Television (seen by 45.4%), newspapers and magazines (21.8%), billboards (20.5%), public transportation (20.3%), public walls (18.8%).

In the previous 30 days, despite 86.7% of current smokers having seen a warning label on a cigarette pack (“Smoking is harmful for your health” “ Quitting is benefit for your health”), 63.6% of those did not consider quitting smoking after seeing the warning label.

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Enforcing bans on tobacco advertisement, promotion and sponsorship

During the previous 30 days, 19.6% of adults surveyed had noticed tobacco advertisements and promotions in media or in public places.

During the previous 30 days, among adults who had noticed tobacco advertisements in media, 49.8% saw such advertisements on TV.

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Raising taxes on tobacco products

The distribution of cigarette prices in China was skewed.

Although some cigarettes prices were high, 50% of current

smokers spent RMB 5.0 Yuan (~US$0.74) or less on 20

manufactured cigarettes (one pack).

Only 10.0% spent 13.7 Yuan or more on a pack of cigarettes.

The median price in urban areas was 7.0 Yuan, and 4.9 Yuan in

the rural areas.

The median amount was 3.9 Yuan for agriculture workers, 5.5

Yuan for machine operator and 9.9 Yuan for leaders of

organizations.23/4/19 24

Increasing tobacco taxes and prices

The percentage of expenditure of 100 packs of manufactured

cigarette in 2009 GDP per capita is only 2%

This indicator was lower in China than several other GATS

countries (e.g., Thailand 3.4%, Uruguay 3.0% and

Bangladesh 5.0%).

The relative cost of cigarettes in China was very low, even

compared to other developing countries.

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Summary

Male smoking rate in China remains at a high level

Only 16.9% of ever smokers quitted smoking, and the

relapsing rate is high.

SHS exposure rate in nonsmokers is still very high ;

Low awareness of the harms of smoking and SHS; The proportion of medical professionals with misconceptions about

low-tar cigarettes was 54.7%, higher than farmers; further research is

needed to explore the reason for this abnormal result.

Weak implementation of strategies and measures on tobacco

control

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