Why China Smokes

The Political Mapping of China’s Tobacco Industry and Anti-Smoking Campaign
Cheng Li
Brookings Institution
October 25, 2012

Arguably the most important policy direction laid out in China’s Twelfth Five-Year Plan is health care. Given China’s rising standards of living and the challenges that rising medical costs present even to the developed economies of the west, this came as no surprise.

What gives this focus an edge of urgency are a cluster of looming public health crises that threaten to dwarf anything China’s medical establishment has faced in decades, perhaps ever. Atop that list of impending challenges is China’s smoking problem. Over 300 million Chinese smoke cigarettes every day (versus under 60 million Americans) and the average Chinese daily smoker has a two-pack-a-day habit. Experts estimate that tobacco-related diseases kill 1.2 million people a year in China, and that will increase to 2 million by 2020.

One of the few upsides of oligarchy is the relative ease with which you can legislate such problems away, and Beijing has done so often enough in the past that when a problem arises (like air pollution,) Chinese and foreigners alike wonder why the government isn’t doing anything. So it is with smoking. Here is a problem that the government could fix easily, following a path well-trodden in the west: why doesn’t it?

In his highly-readable but awkwardly-titled monography, Cheng Li lays out the institutional framework that feeds this national habit. The critical importance of tobacco to China’s tax revenues, potential resentment from poor smokers, and an intricate web of shared interests that tie China’s leadership with the industry all stand in the way of far-reaching anti-smoking campaigns.

All of this would make stimulating reading at any time, but given the report’s release on the verge of a major change in leadership in Beijing, the tale is particularly juicy. Among the report’s revelations are ties between Vice-Premier Li Keqiang, who holds the State Council‘s public health portfolio, and the State Tobacco Monopoly Administration. The revelations here are startling, yet one can only wonder about what Li knows but cannot put to paper.

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