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Evaluation of smoke-free policies in seven cities in China, 2007–2012
  1. Geoffrey T Fong1,2,4,
  2. Genevieve Sansone1,
  3. Mi Yan1,
  4. Lorraine Craig1,
  5. Anne C K Quah1,
  6. Yuan Jiang3
  1. 1Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
  2. 2Ontario Institute for Cancer Research, Toronto, Ontario, Canada
  3. 3Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
  4. 4School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
  1. Correspondence to Dr Genevieve Sansone, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada N2L 3G1; gsansone{at}


Background China is the world's largest consumer of tobacco, with hundreds of millions of people exposed daily to secondhand smoke (SHS). Comprehensive smoke-free policies are the only effective way to protect the population from the harms of SHS. China does not have a comprehensive national smoke-free law but some local-level regulations have been implemented.

Objective To evaluate local level smoke-free regulations across 7 cities in China by measuring the prevalence of smoking in public places (workplaces, restaurants and bars), and support for smoke-free policies over time.

Methods Data were from Waves 2 to 4 of the International Tobacco Control (ITC) China Survey (2007–2012), a face-to-face cohort survey of approximately 800 smokers in each of 7 cities in mainland China. Multivariate logistic regression models estimated with generalised estimating equations were used to test the changes in variables over time.

Results As of 2012, over three-quarters of respondents were exposed to smoking in bars; more than two-thirds were exposed to smoking in restaurants and more than half were exposed to smoking in indoor workplaces. Small decreases in the prevalence of smoking were found overall from Waves 2 to 4 for indoor workplaces, restaurants and bars, although the decline was minimal for bars. Support for complete smoking bans increased over time for each venue, although it was lowest for bars.

Conclusions Existing partial smoking bans across China have had minimal impact on reducing smoking in public places. A strongly enforced, comprehensive national smoke-free law is urgently needed in order to achieve greater public health gains.

  • Global health
  • Public policy
  • Secondhand smoke
  • Low/Middle income country
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