Uneven progress of smoking legislation and enforcement situation in China

Abstract

Background: The literature indicates that only 100% smoke-free public places can adequately shield the public from second-hand smoke. Recent smoking bans in mainland China only partially prohibit smoking in public places despite previous comprehensive bans in some cities. This study aims to identify factors contributing to the imbalance in smoking legislation and enforcement in China. Methods: We began by reviewing literatures and policies to gather data on the current smoking laws, as well as identify potential study sites and key stakeholders. Next, we interviewed 16 key stakeholders in the two selected cities including former policymakers and tobacco control experts at municipal and district levels, enforcement officers, and employees of public places such as catering and accommodation. Results: Only 24 cities in mainland China have implemented comprehensive smoking bans, and enforcement is weak due to the limited scope of partial bans. The tobacco industry's direct involvement in discussions of smoking ban drafts and spread of misinformation to policy makers continue to influence smoking legislation. The partial smoking ban has not received enough attention from the target population, and ineffective law enforcement may result from the lack of a detailed department responsible for coordinating anti-smoking advocacy and law enforcement in the legal text. Conclusion: This study identified factors contributing to the uneven progress of smoking legislation and enforcement in mainland China. These findings underscore the complexity of the process and suggest the need for policy recommendations to address the factors affecting progress.