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Conflict of interest and FCTC implementation in China
  1. Xia Wan1,
  2. Shaojun Ma2,
  3. Janet Hoek3,
  4. Jie Yang4,
  5. Lanyan Wu4,
  6. Jiushun Zhou1,
  7. Gonghuan Yang1,4
  1. 1Department of Epidemiology and Statistics, Institute of Basic Medical Sciences of Chinese Academy of Medical Sciences, School of Basic Medicine of Peking Union Medical College, Beijing, China
  2. 2China Medical Board, Beijing, China
  3. 3Department of Marketing, School of Business of University of Otago, Otago, New Zealand
  4. 4Office of Tobacco Control, Chinese Center for Disease Control and Prevention, Beijing, China
  1. Correspondence to Gonghuan Yang, Chinese Center for Disease Control and Prevention, 27# Nanwei Road, Beijing 100050, China; yanggh{at}


Objective To critically review the structure of tobacco control policy making in China, examine conflicts of interest within this structure, and consider how these affected the introduction of on-pack warnings.

Methods Government policy documents and warning labels were obtained and critically reviewed.

Results Few differences exist between the on-pack warnings formerly used in China and those introduced ostensibly to meet Framework Convention on Tobacco Control (FCTC) obligations. Comparison with tobacco manufactured for export or overseas consumption shows the new Chinese domestic on-pack warnings are demonstrably inferior to those required internationally. The inherent conflict of interest in the Chinese tobacco control agency structure, which must meet commercial and public health objectives, undermined the introduction of new health warnings.

Conclusions To promote more effective tobacco control policies, the conflict of interest inhibiting the public health function of the State Tobacco Monopoly Administration (STMA) must be removed. Specifically, the public health function must be separated from oversight of commercial production, and packaging must be redesigned with pictorial warnings and messages compliant with Article 11 of the FCTC.

  • Cigarette packaging
  • health warnings
  • FCTC
  • China
  • harm reduction
  • packaging and labelling

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  • Funding Funding was received from the Bloomberg Initiative to Reduce Tobacco Use (870-2233) and NIH project ‘Epidemiology and Intervention Research for Tobacco Control in China’ (R01 RFA-TW-06-006).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Institute of Basic Medical Sciences of Chinese Academy of Medical Sciences.

  • Provenance and peer review Not commissioned; externally peer reviewed.