China has just amended its tobacco monopoly law to include e-cigarettes, as Filter reported. This means that vaping products and their manufacturers will be regulated strictly by the Chinese government under the same process as cigarettes. It is unclear exactly what the new regulations will mean in practice—we know that companies will be required to obtain production licenses. But it could be that China is about to revolutionize global tobacco harm reduction.
China National Tobacco Corporation (CNTC), the world’s largest tobacco company, sells more than 40 percent of the world’s cigarettes and is wholly owned by the Chinese government. So it would be fair to contend that the government has a lot to gain from slowing or prohibiting the growth of safer alternatives such as vapes and heated tobacco products. At the same time, there are many incentives for the government to push things in an entirely different direction, if it takes a long-term view.
About 90 percent of the world’s vape products are manufactured in China, accounting for around 3 million jobs. More than 170,000 Chinese businesses are involved in e-cigarette production and the supply chain. In Shenzhen, the heart of e-cigarette manufacturing in China, visitors speak of a seemingly endless stretch of vaping factories lining the roads between the airport and the city center, feeding global demand for reduced-risk products that has grown exponentially since 2013.
It is difficult to imagine the government strangling the market—even if this is motivated more by profit than by its citizens’ health.
The CNTC is also the world’s biggest holder of tobacco harm reduction patents, owning almost 27 percent of all patent publications, with Kimree Technology (the fourth biggest patent holder) also based in China.
Altogether, with a booming, world-leading industry already supplying jobs and tax revenues, and billions of dollars’ worth of harm reduction research that could boost this even more, it is difficult to imagine the government strangling the market—even if this is motivated more by profit than by its citizens’ health.
Neither does the international outlook do much to dampen my optimism. The World Health Organization (WHO) is ideologically opposed to harm reduction, despite it being a pillar of the Framework Convention on Tobacco Control (FCTC) treaty—albeit one that the FCTC Secretariat would prefer had not been written into it. But it is doubtful whether that would faze China, which has always been happy enough to brush aside the WHO’s tobacco control edicts.
The Chinese government repeatedly frustrates the WHO FCTC, for example, by including tobacco industry personnel (including staff of the State Tobacco Monopoly Administration, which shares the same leadership with CNTC) amongst its delegates at Conference of the Parties (COP) meetings. At the third such meeting in 2008 (COP3), guidelines were adopted instructing Parties to restrict government interference by the tobacco industry. China reacted by declaring that these guidelines did not apply to China—and then increased the number of tobacco industry staff on its delegation for COP4, from two to five. At each subsequent COP, four Chinese tobacco industry delegates have participated in proceedings, often putting a spoke in the wheels of measures against tobacco manufacture, packaging and farming.
If China truly embraces tobacco harm reduction, it will energize the international debate like nothing we’ve previously seen.
Other countries—and sometimes surprising ones—have seemingly resisted the WHO’s prohibitionist approach to tobacco harm reduction innovations, despite not sharing China’s global clout. The Philippines, no stranger to repressive drug policies and anti-vaping Bloomberg funding, announced prior to the WHO FCTC’s COP9 last month that it is committed to a “balanced and evidence-based” approach to tobacco control, and stated that it did not intend to ban vaping or heated tobacco products. Malaysia has also signaled that it intends to regulate and tax vaping products rather than opt for prohibition.
This is all welcome news. But if China truly embraces tobacco harm reduction, it will directly benefit a much larger population—and energize the international debate like nothing we’ve previously seen.
Of course, it could still be China’s intention to stick to what it knows, and permit the lucrative export of vapes while protecting its far-more-lucrative domestic cigarette trade. But it also has a lot to gain financially from domestic harm reduction, when the country’s high smoking prevalence in an aging population creates heavy costs in health care and lost productivity.
If the new national mandatory standards for e-cigarettes sensibly regulate product quality and safety risks, it could very well influence many other nations to follow suit. And if it is true, as some believe, that the Chinese government carries a lot of weight with the WHO, might it even lead to a rethink of the WHO’s absurd anti-harm reduction stance?
We can only hope, for the good of Chinese public health and the world’s, that China chooses wisely and recognizes tobacco harm reduction’s vast potential.
Photograph of Beijing by zhang kaiyv on Unsplash