Daniel and Nancy Okimoto Conference Room
This report discusses desirable policy directions and options in the aftermath of the Great Tohoku Earthquake. It argues that the importance of Japan’s productivity growth has not been invalidated by the disaster, and suggests that Japan should consider restoration and reconstruction from the earthquake as a great opportunity to reposition its policies.
It identifies concrete steps Japan can take to jump start growth in three broad themes: regulatory reforms (reducing the costs of doing business, stopping protection for zombie firms, deregulation especially in non-manufacturing sectors and growth enhancing special zones); opening-up of the Japanese economy (trade liberalization, reduction of agricultural subsidies and new immigration policy); and macroeconomic policy reforms (fiscal consolidation and monetary expansion to end deflation).
The elderly share of China’s population is projected to grow well beyond the capacity of the nation’s social security system. Meanwhile, family care is being challenged by a decline in fertility and an increase in migration from rural to urban areas. This paper examines the short-, mid-, and long-term effects of family support on elderly well-being in rural China, using four-wave panel data on 1,456 persons aged 60 and above in the Chaohu region of China. Findings showed that compared with living alone, being coresident with others lowered the mortality risk of several chronic diseases; but being coresident with adult children increased the mortality risk of cardiovascular diseases, though it was associated with a higher quality of life in the short and middle term. Children’s educational attainment and financial support increased the quality of life except for an increased risk of new incidence of cardiovascular disease in the middle term.
Maritime issues are increasingly at the heart of security issues between the United States and China. Historically, the Taiwan issue had dominated the relationship, but increasingly issues such as close in reconnaissance, the South China Sea, and different views on exclusive economic zone rights are shaping the security agenda. In each of these areas, the two sides are far apart. U.S. routine practices of air and sea-based reconnaissance well outside territorial waters is met with indignation by Chinese leaders. Chinese assertive policy regarding its claims of the Spratly islands has provoked several Southeast Asian nations and drawn U.S. diplomatic attentions to the region. Chinese claims on EEZ rights are outliers internationally, however the United States stands outside the key international treaty that governs such rights.
Overlaying these potentially conflicting national interests, both sides have engaged in military shifts. China has maintained double-digit growth in its military budget for nearly 20 years, with substantial attention to the naval realm. Chinese diesel submarines and advanced combat aircraft have brought the People’s Liberation Army to modern levels. New types of systems such as ballistic missile launching submarines and anti-ship ballistic missiles are changing the vary nature of China’s maritime capabilities. As the United States winds down two wars in the Middle East, its military remains attentive to these changes and includes doctrinal and force posture changes. New deployments in Singapore, Guam, and Australia supplement enhanced partnerships with the Philippines and Vietnam, and a reinvigoration of traditional alliances.
The interaction between potentially conflictual national interests and a dynamic military situation raises concerns about the future between the two giants astride the Pacific.
About the panelists
Admiral Gary Roughead is a 1973 graduate of the U.S. Naval Academy. Among his six operational commands, Admiral Roughead was the first officer to command both classes of Aegis ships, having commanded USS Barry (DDG 52) and USS Port Royal (CG 73). As a flag officer, he commanded Cruiser Destroyer Group 2, the George Washington Battle Group; and U.S. 2nd Fleet/NATO Striking Fleet Atlantic and Naval Forces North Fleet East. Ashore, he served as Commandant, United States Naval Academy, the Department of the Navy’s Chief of Legislative Affairs, and as Deputy Commander, U.S. Pacific Command. He is one of only two officers to have commanded the fleets in the Pacific and Atlantic, commanding the U.S. Pacific Fleet and Joint Task Force 519, as well as U.S. Fleet Forces Command, where he was responsible for ensuring Navy forces were trained, ready, equipped and prepared to operate around the world, where and when needed.Image
Roughead’s awards include the Defense Distinguished Service Medal, Navy Distinguished Service Medal, Defense Superior Service Medal, Legion of Merit, Meritorious Service Medal, Navy and Marine Corps Commendation Medal, Navy and Marine Corps Achievement Medal, and various unit and service awards.
Roughead became the 29th Chief of Naval Operations Sep. 29, 2007. He retired from active duty, Sept. 23, 2011.
Christopher P. Twomey is an associate professor of national security affairs (with tenure) at the U.S. Naval Postgraduate School (NPS) in Monterey, Calif. In 2004, he received his PhD in politcal science from MIT and joined the NPS faculty, later serving as associate chair for research and as director of the Center for Contemporary Conflict from 2007 to 2009. Today, he works closely with the Departments of Defense and State on a range of diplomatic engagements across Asia and regularly advises PACOM, STRATCOM, and the Office of Net Assessment. His book—The Military Lens: Doctrinal Differences and Deterrence Failure in Sino-American Relations (Cornell, 2010)—explains how differing military doctrines complicate diplomatic signaling, interpretations of those signals, and assessments of the balance of power. He edited Perspectives on Sino-American Strategic Nuclear Issues (2008), and his work has appeared in journals such as Asian Survey, Security Studies, Arms Control Today, Contemporary Security Policy, Asia Policy, Current History, and Journal of Contemporary China. He has previously taught or researched at Harvard, Boston College, RAND, the Chinese Academy of Social Sciences, and IGCC, and is currently a research fellow at the National Bureau of Asian Research. He has lived in China several times, speaks and reads Chinese, and regularly travels to Asia.Image
His research interests center on security studies, Chinese foreign policy, general nuclear strategy, strategic culture, statecraft, and East Asian security in theory and practice.
Additional information about his research and teaching can be found here.
Philippines Conference Room
Freeman Spogli Institute for International Studies
Stanford University
Encina Hall, C-327
Stanford, CA 94305-6055
Thomas Fingar is an affiliate at the The Center for International Security and Cooperation (CISAC) in the Freeman Spogli Institute for International Studies at Stanford University. He was the inaugural Oksenberg-Rohlen Distinguished Fellow from 2010 through 2015 and the Payne Distinguished Lecturer at Stanford in 2009.
From 2005 through 2008, he served as the first deputy director of national intelligence for analysis and, concurrently, as chairman of the National Intelligence Council. Fingar served previously as assistant secretary of the State Department’s Bureau of Intelligence and Research (2000-01 and 2004-05), principal deputy assistant secretary (2001-03), deputy assistant secretary for analysis (1994-2000), director of the Office of Analysis for East Asia and the Pacific (1989-94), and chief of the China Division (1986-89). Between 1975 and 1986 he held a number of positions at Stanford University, including senior research associate in the Center for International Security and Arms Control.
Fingar is a graduate of Cornell University (A.B. in Government and History, 1968), and Stanford University (M.A., 1969 and Ph.D., 1977 both in political science). His most recent books are From Mandate to Blueprint: Lessons from Intelligence Reform (Stanford University Press, 2021), Reducing Uncertainty: Intelligence Analysis and National Security (Stanford University Press, 2011), The New Great Game: China and South and Central Asia in the Era of Reform, editor (Stanford University Press, 2016), Uneasy Partnerships: China and Japan, the Koreas, and Russia in the Era of Reform (Stanford, 2017), and Fateful Decisions: Choices that will Shape China’s Future, co-edited with Jean Oi (Stanford, 2020). His most recent article is, "The Role of Intelligence in Countering Illicit Nuclear-Related Procurement,” in Matthew Bunn, Martin B. Malin, William C. Potter, and Leonard S Spector, eds., Preventing Black Market Trade in Nuclear Technology (Cambridge, 2018)."
Life expectancy at aged 65 is remarkably similar in the three Chinese cities of Hong Kong, Shanghai, and Taipei, even though the cities differ in levels of socioeconomic development, health systems, and other factors. Edward Jow-Ching Tu will discuss research that aims to understand this phenomenon. Despite unprecedented increases in life expectancy and attainment of similar current levels of life expectancy, the cities differ in the contributions of changes in major causes of death to the improvements in life expectancy among the elderly. Tu and colleagues have explored several possible determinants of these different patterns and trends in the three cities, including socioeconomic development, health service delivery systems, cause-of-death classification systems, and competing risks from cardiovascular disease and other diseases. Their analysis suggests that the effect of equity of health service delivery has become more important over time.
Edward Jow-Ching Tu is a senior lecturer of demography in the Division of Social Science at Hong Kong University of Science and Technology. His work is focused on the impact of fertility, mortality, and migration on socio-economic changes in East Asia countries with special emphasis on nations experiencing a transition from planned economy to market economy; on causes and impacts of mortality changes and health transition on aging societies; and on the causes of lowest-low fertility in many East Asia countries. He has several active research projects ongoing in China, Japan, Taiwan, Hong Kong, and Singapore. He holds graduate degress from West Virginia University, the University of Pennsylvania, and the University of Tennessee (Knoxville). Tu has worked extensively in Asia, and has served as an adjunct professor and taught in many universities in China, including Peking University, Peoples University, Nankai Univerity, and Fudan University. He had served as a senior research scientist at the New York State Health Department and as a research fellow (full professor) at the Institute for Social Sciences and Philosophy at Academia Sinica. Tu has also taught at the State University of New York in Albany.
Philippines Conference Room
Newly printed “no smoking” signs went up across China when the government rolled out a nationwide public indoor smoking ban in May 2011. A sticky gray layer of smoke residue now coats many signs, representing the challenges China’s growing tobacco-control movement faces against a multibillion-dollar government-run industry and deeply embedded social practices.
How has the cigarette become so integrated into the fabric of everyday life across the People’s Republic of China (PRC)?
To get to the heart of this question, historians, health policy specialists, sociologists, anthropologists, business scholars, and other experts met Mar. 26 and 27 in Beijing for a conference organized by Stanford’s Asia Health Policy Program. They examined connections intricately woven over the past 60 years between marketing and cigarette gifting, production and consumer demand, government policy and economic profit, and many other dimensions of China’s cigarette culture.
Anthropologist Matthew Kohrman, a specialist on tobacco in China, led the conference, which was held at the new Stanford Center at Peking University. In an interview, he spoke about the history of China’s cigarette industry, cigarettes and society, and the tobacco-control movement.
The early years
Tobacco first entered China through missionary contact in the 1600s, says Kohrman, but it was not until the early 20th century when cigarettes began gaining popularity. The first cigarette advertising was a “confused tapestry” of messages as marketers figured out what spoke to the public. “There were just as many images of neo-Confucian filial piety as there were of cosmopolitan ‘modern women,’” says Kohrman.
Through improved marketing and aggressive factory building, British American Tobacco and Nanyang Brothers, China’s two largest pre-war firms, helped increase the demand for cigarettes. The Sino-Japanese War (1937–1945) disrupted the cigarette supply, but their popularity had taken hold. Some cigarette firms shifted during the war to the relative safety of southwest China, where tobacco production has remained concentrated ever since.
Post-1949
After the founding of the PRC in 1949, the tobacco industry was nationalized and strong relationships between the central government and cigarette manufacturers in the provinces were formed. Cigarettes also began to be viewed as a part of everyday life. “Ration coupons for cigarettes were issued alongside grain, sugar, and bicycle coupons,” says Kohman. “The Maoist regime legitimized cigarettes as the right of every citizen."
During the Deng Xiaoping era (1978–1997), China’s cigarette industry really took off as manufacturers competed with one another for foreign currency to purchase cutting-edge European equipment and newer varieties of tobacco seed stock. Increased production and the return of full-scale advertising fueled greater consumer demand, and manufacturers began producing more and more varieties of cigarette. Vendors displayed glass cases filled with a colorful patchwork of cigarette packs bearing names like Panda, Double Happiness, and Red Pagoda.
The tobacco industry remained under government control as other industries privatized in the 1980s and 1990s. Party-state management of the cigarette became even more centralized in the early 1980s with the creation of the China Tobacco Monopoly Administration and its parallel external counterpart, the China Tobacco Corporation.
Since 1949, provincial protectionism has marked the cigarette market. It is now possible to purchase Beijing cigarettes in Kunming, Chengdu brands in Shanghai, and so on, but to distribute cigarettes in another province, a manufacturer must cut a deal with provincial government officials. Provincial administrations are loath to cut such deals because central government policy dictates that the portion of cigarette sales tax which does not go to the central government always is channeled to the finance bureau of the province of original production. China’s 2001 entry into the World Trade Organization opened the market ever so slightly to international brands like Marlboro and Kent, but domestic brands continue to dominate because of fierce protectionism.
...If it chooses to do so, China is in a position to lead and change the landscape in a very profound way.
-Matthew Kohrman, Professor of Anthropology, Stanford
A new era
In 2003, the World Health Organization established the first global health treaty, the Framework Convention on Tobacco Control (FCTC). Although the United States still has not yet ratified the FCTC, China signed the treaty in 2003 and ratified it in 2005. Kohrman says China’s tobacco industry giants fear competition from international cigarette brands more than they worry about tobacco-control measures related to the FCTC.
Nonetheless, the FCTC ushered in a new era of public health research about tobacco and has helped increase public awareness about the dangers of smoking. New restrictions have been imposed on print and television advertising for cigarettes, and international organizations, such as the Bloomberg Family Foundation, have begun funding anti-tobacco work in China.
A big challenge to tobacco-control campaigns, says Kohrman, is the sheer amount of money that tobacco companies have available for marketing. “In 2010, China’s tobacco industry posted profits in excess of U.S. $90 billion—that’s huge. Tobacco control research and advocacy now annually receive a few million dollars, and much of that is coming through outside funders, which have very specific projects in mind.”
China’s tobacco advertisers have adapted to the new restrictions that prevent them from openly promoting cigarettes in the media. They have instead moved to point-of-sale and soft-marketing tactics, including misinformation campaigns about the “dangers” of quitting smoking. “The actual expenditure on marketing probably hasn’t dropped very much,” says Kohrman.
Cigarettes and society
Strong marketing and the legitimization of cigarettes as a part of everyday life have led to the deep integration of cigarettes into Chinese society. While only 3 to 4 percent of women in China smoke, cigarettes are an important part of male identity and social mobility. The wide range of cigarette brands has led to the growth of high-end varieties favored by businessmen and politicians, with some brands costing as much as $50 a pack. The custom of cigarette gifting has existed in China for decades, and it is difficult for a young man to turn down a package of cigarettes from a senior colleague or supervisor.
There is also the fact that nicotine is highly addictive, and quitting is difficult in an environment where smoking cigarettes is socially sanctioned. Kohrman says, “When you take an incredibly addictive substance like nicotine and throw it into the mix of all of these norms and customs, it creates a pretty toxic brew.”
The future?
Tobacco control presents a formidable challenge in China, one that requires understanding the historical context and complex dimensions of the cigarette industry. “Cigarettes have been insinuated into so many aspects of daily life across China, and the market for this product has now become so closely enmeshed with matters of government finance and operations,” says Kohrman.
What happens in China could have implications for the entire world. “There’s a tobacco-induced human annihilation unfolding right now in almost every country and questions about how society and Big Tobacco are enmeshed, and how cigarette culture and government finance have become mutually supportive are pivotal,” says Kohrman. “Every country except Bhutan has legalized cigarette sales and is subject to many of the same general issues as China—only in China they’re on a much larger scale. But if it chooses to do so, China is in a position to lead and change the landscape in a very profound way.”
