
It is essential to establish an effective monitoring, supervising and evaluation system to monitor tobacco use and obtain nationally representative periodic data on the key indicators of tobacco use among adolescents and adults.

This is the responsibility clearly given by the WHO
Framework Convention on Tobacco Control
(FCTC) to all parties, as well as an important component of the six most effective strategies for tobacco control (the MPOWER package) vigorously advocated by WHO.
2020/4/17 2


GATS is a household survey to provide strong evidence for developing, monitoring, and implementing effective tobacco control measures.

Sponsors:
 The Bloomberg Initiative to Reduce Tobacco Use
 The Bill and Melinda Gates Foundation

The U.S. Centers for Disease Control and Prevention
 World Health Organization

So far, 14 countries have implemented the survey
2020/4/17 3


The 2010 Global Adult Tobacco Survey in China (GATS
China) was a nationally representative household survey of non-institutionalized men and women aged 15 and older, which was organized by China CDC authorized by MOH.

The study design and pilot surveys was conducted by China
CDC in 8 months, and the training in 4 months;
 The field work was completed by more than 500 stuff from provincial and county CDCs from December 2009 to March
2010;

Data cleaning, analysis and report writing were completed during May to July, 2010.
2020/4/17 4


A multi-stage stratified cluster sampling method was used in the survey in order to obtain the nationally representative sample;

Internationally standard questionnaire was used in the survey; iPAQ handheld was used to collect data;
 The survey was completed with high qualities by mobilization in community and strict quality control measures;

A total of 13,354 people completed the individual questionnaire, and the total response rate was 96.0%.
2020/4/17 5

2020/4/17
6

 Participants’ general information,

Tobacco use (smoking and smokeless),

Cessation,

Secondhand smoke (SHS),

Tobacco economic

Media

Knowledge, attitudes, and perceptions on tobacco use and
SHS
2020/4/17 8

 Tobacco Use

Nicotine Dependence and Cessation

Secondhand smoke

Knowledge and Perceptions of Tobacco Harm

Implementation of a series of policies on tobacco control
 Protecting people from the harms of SHS
 Protecting people from tobacco smoke
 Offering help to quit tobacco use

Warning about the dangers of tobacco

Enforcing bans on tobacco advertising, promotion and sponsorship
 Raising taxes on tobacco
2020/4/17 9


Male smoking rate in China remains at a high level.
Current smoking prevalence among adults 15 to 69 years old, by gender, 1996, 2002 and 2010
70
60
50
（
%
）
40
30
20
10
0
1996 2002 2010
Sources: Data come from the 1996 National
Prevalence Survey of Smoking Pattern, the 2002
Behavior Risk Factor Survey, and GATS China,
2010.
70
60
50
（ 40
%
） 30
20
10
0 overall male female
Current smoking prevalence among adult males
≥15 years old in GATS countries, GATS China 2010
PolandEgypt
Uruguay
Brazil
IndiaMexico
Russian Federation
Ukraine
China
2020/4/17 10


Smoking rate was higher among those with lower education
 Male smoking rates were higher in rural and western areas

Smoking rates for men was the highest in machine operators and agriculture workers

Among ever daily smokers 20-34 years old, 52.7% started daily smoking before the age of 20.
（
%
）
50
40
30
20
10
0
80
70
60
Trend of current smoking prevalence among adult males aged 15-69 years in China from 1996 to 2010, by selected occupations
Machine operator
Agriculture worker
Leaders of organizations
Medical/health personnel
Teaching staff
1996
2002
2010
11


Half of smokers were heavily dependent on nicotine, 50.3% of current daily smokers smoked within 30 minutes after waking.
Among ever smokers:
•
57.5 million (16.9%) quitted smoking,
•
112.8 million (33.1%) relapsed,
•
17.3 million planned to quit,
•
152.8 million (44.9%) had no intention to quit smoking.
2020/4/17
Percentage distribution of different stage of ever smokers(%), GATS China 2010
33,1
16,9
5,1
44,9
Intending to quit
Not intending to quit
Former smokers
Relapsed
12

Quit ratio for daily smokers ： the proportion of quitters among ever daily smokers
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
Prevalence of exposure to secondhand smoke was high; 72.4% of nonsmokers were exposed to secondhand smoke.

72.7% of participants noticed smoking in indoor public places
 88.5% of people noticed smoking in restaurants,
 58.4% in government buildings,

Around 35% in each of the following places: health care facilities, schools, and public transportation.

Smoking occurred in 67.3% of homes.
2020/4/17 14

100
Percentage of adults ≥15 years old who noticed smoking at various public places, by residence, GATS China 2010
80
60
%
40
20
Urban
Rural
0
Public Transportation Schools Health Care Facilities Government Buildings Restaurants
Note: among those who had visited those public places in the past 30 days prior to the survey
2020/4/17 15

100
80
（ 60
%
） 40
20
0
Percentage of adults ≥15 years old who are aware of smoking causes diseases, by residence, GATS
China 2010
Urba n
Stroke Heart Attack
100
Lung Cancer All Three Diseases
80
Percentage of adults ≥15 years old who are aware of smoking causes diseases, by occupation, GATS China 2010
（
60
%
）
40
20
Agriculture Worker
Machine Operator
Leaders of
Organizations
Medical/Health
Personnel
Teaching Staff
0
Stroke Heart Attack Lung Cancer All Three
Diseases
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Percentage of adults ≥15 years old who are aware of the health hazards of secondhand smoke exposure, by residence, GATS China 2010
70
60
50
（
%
）
40
30
20
10
0
Heart Disease in
Adults
Lung Disease in
Children
Lung Cancer in
Adults
2020/4/17
Urban
Rural
All Three
Diseases
Percentage of adults ≥15 years old who are aware of the health hazards of secondhand smoke exposure, by selected occupations,
GATS China 2010
（
%
）
90
80
70
60
50
40
30
20
10
0
Heart Disease in
Adults
Lung Disease in
Children
Lung Cancer in
Adults
All Three
Diseases
Agriculture Worker
Machine Operator
Leaders of Organizations
Medical/Health Personnel
Teaching Staff
17


35.8% of adults thought low-tar cigarettes were less harmful than regular cigarettes and 50.2% did not know.

The highest proportion of adults with this misconception was among those with a college or above education, or medical staff and
100
90
80
70
60
% 50
40
30
20
10
0 teacher.
Awareness that low-tar cigarettes are as harmful to health as regular cigarettes, by education, GATS China 2010
100
90
No opinion
80
Unaware
Aware
%
70
60
50
40
30
20
10
0
Primary School or Less
Attended
Secondary
School
High School
Graduate
College
Graduate or
Above
2020/4/17
Awareness that low-tar cigarettes are as harmful to health as regular cigarettes, by selected occupations, GATS China 2010
Agriculture
Worker
Machine
Operator
Leaders of
Organizations
Teaching Staff Medical/Health
Personnel
18

Result Policy
Protect people from
SHS
Offer help for cessation
Warn about the dangers of tobacco
Indicators used in GATS China survey
% of respondents who noticed smoking at their indoor work places in the previous 30 days
% of respondents noticing smoking in indoor public places in previous 30 days.
% of smokers reporting that they were advised to quit when seen by a doctor or other health professional during the previous 12 months.
% of smokers who attempted to quit without any cessation aids during the previous 12 months.
% of respondents who noticed information on the dangers of smoking during the previous 30 days
% of respondents who thought about quitting after seeing the health warnings on the cigarette packages
% of respondents who noticed tobacco promotion during the previous 30 days.
Enforce bans on tobacco advertising, promotion & sponsorship
Increase tobacco taxes
& prices
% of respondents who noticed tobacco promotion on TV among those who noticed tobacco marketing during the previous 30 days.
Maximum expenditure to buy a pack of cigarettes paid by 50% of smokers
Expenditure of 100 packs of cigarettes as a percentage of 2009 GDP per capita.
2020/4/17
63.3%
72.7%
33.9%
91.8%
59.8%
36.4%
19.6%
49.8%
5 RBM & LESS
2.0%
19

 Among those who worked indoors, 37.7% reported that there was no policy on smoking indoors at the workplace, while
31.0% reported a complete ban on indoor smoking.

During the past 30 days
 Among workplaces without a smoking ban, 89.2% reported smoking had occurred at the workplace.
 Among workplaces with partially banning smoking, 69.3% reported smoking had occurred at the workplace.

In places with a complete smoking ban, 25.5% of people reported seeing people smoking.

Overall, 63.3% reported smoking occurred at indoor workplaces in past 30 days.
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
During the previous 12 months, only 33.9% of smokers who had visited a healthcare provider received cessation advice.

During the previous 12 months ， smokers who had attempted to quit ：
 91.8% did not use any special cessation methods.
 3.1% used smoking cessation medications

3.0% did consult

Among GATS countries, the percentage of those using smoking cessation medications and counseling in China was one of the lowest.
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
In the previous 30 days, 59.8% of adults had seen a message about the dangers of tobacco use or encouraging smokers to quit, via the media or in public places.
 Television (seen by 45.4%),
 newspapers and magazines (21.8%),
 billboards (20.5%),
 public transportation (20.3%),
 public walls (18.8%).

In the previous 30 days, despite 86.7% of current smokers having seen a warning label on a cigarette pack (“Smoking is harmful for your health” “ Quitting is benefit for your health”), 63.6% of those did not consider quitting smoking after seeing the warning label.
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
During the previous 30 days, 19.6% of adults surveyed had noticed tobacco advertisements and promotions in media or in public places.
 During the previous 30 days, among adults who had noticed tobacco advertisements in media, 49.8% saw such advertisements on TV.
2020/4/17 23


The distribution of cigarette prices in China was skewed.
Although some cigarettes prices were high, 50% of current smokers spent RMB 5.0 Yuan (~US$0.74) or less on 20 manufactured cigarettes (one pack).

Only 10.0% spent 13.7 Yuan or more on a pack of cigarettes.
 The median price in urban areas was 7.0 Yuan, and 4.9 Yuan in the rural areas.

The median amount was 3.9 Yuan for agriculture workers, 5.5
Yuan for machine operator and 9.9 Yuan for leaders of organizations.
2020/4/17 24


The percentage of expenditure of 100 packs of manufactured cigarette in 2009 GDP per capita is only 2%

This indicator was lower in China than several other GATS countries (e.g., Thailand 3.4%, Uruguay 3.0% and Bangladesh
5.0%).

The relative cost of cigarettes in China was very low, even compared to other developing countries.
2020/4/17 25


Male smoking rate in China remains at a high level

Only 16.9% of ever smokers quitted smoking, and the relapsing rate is high.

SHS exposure rate in nonsmokers is still very high ;

Low awareness of the harms of smoking and SHS;
 The proportion of medical professionals with misconceptions about low-tar cigarettes was 54.7%, higher than farmers; further research is needed to explore the reason for this abnormal result.
 Weak implementation of strategies and measures on tobacco control
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