Another half-hearted attempt to attack China's top health problem

According to a recent notice written by the China National Tobacco Corporation, cigarettes produced and sold in China will bear a new larger warning label, starting in April 2012. That's a token pass at trying to do something about the country's worst behavior/health related problem, but does anyone really believe that it's a serious attempt to proactively wipe out smoking?

Although China ratified the World Health Organization Framework Convention on Tobacco Control in 2005, the country has yet to ban smoking in public places as required by the WHO Framework.

As long as local governments realize enormous profits from the government-controlled tobacco industry, official attempts to change behaviors may prove fruitless. The fact that China has more smokers than any other nation and more deaths from smoking-related causes, 1.2 million people each year, will remain an abstract statistic for most people, while for those families losing loved ones, the nation's smoking shame will be a tragedy.

A report published in January by a group of Chinese and foreign experts entitled "Tobacco Control and China's Future" warned that tobacco is the No.1 killer of Chinese people, but unless that reality touches someone personally they are unlikely to hear that distressing message.

There is an answer, however, and it may be uniquely and personally Chinese.

As I wrote in a January China Daily Online column, smoking is largely a gender-related problem in China. About 53% of adult men in China smoke; less than 3% of women smoke. Contrast that with the US where the Centers for Disease Control reports that 24% of men smoke and 18% of women smoke.

Relatively little attention has been paid to the social norms which encourage smoking or how to utilize social norms to develop successful campaigns to wipe out smoking. Those norms are a central predictor in individuals' decisions to smoke.

Social norms are behavioral expectations or cues within a society or group. So, for example, the fact that restaurants still allow diners to smoke and may encourage that behavior by leaving ashtrays on tables means there is both an expectation that people should enjoy smoking with their meal and a social cue to light up. The Chinese government should honor its WHO pledge to outlaw smoking in public places.

In addition to anti-smoking laws, societies must establish social norms which make smoking anti-social.

One solution might be for women to begin a grass roots Internet campaign using social media in order to convince their fathers, sons, brothers, husbands, and lovers, to give up smoking. Women could organize smoke-out days, provide helpful messages to males, or suggest behavioral alternatives. In the extreme, girls could organize "kiss-off" campaigns where they don't allow guys to kiss them after they've been smoking. An old American cigarette campaign targeting women proclaimed, "You've come a long way, Baby." Maybe, it's time for Chinese women to demonstrate just how far they've come and go after the smoking scourge.

The author formerly taught Advanced Placement Psychology in the US and is now an adjunct Professor in the Temple University Masters of Law program at Tsinghua University in Beijing.