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.”   

Riding around on the back of a motorcycle in 2009, Jeremy Menchik snapped photos of hundreds of Indonesian campaign posters. That number has now grown to over 5000 images, which Menchik and Colm Fox have painstakingly coded and analyzed to better understand the politics of identity in Indonesia. The initial results of their research reveal similarities between the United States and Indonesia, and shed light on the transitional democracies of the Arab Spring.

Menchik is a 2011–12 Shorenstein Fellow at Stanford University, and will take up a position as an assistant professor in international relations at Boston University in 2013.

Fox is a doctoral student at the George Washington University’s Department of Political Science.

How important is political identity in Indonesia? Why?

Indonesia is the largest Muslim-majority country in the world, and one of the most diverse. But what we found was that rather than being unique, Indonesian politicians behave remarkably similar to American politicians in using a variety of regional, religious, and ethnic identity symbols to court voters.

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What is an important factor in determining a candidate’s use of identity symbols?

What we found is that the election rules matter, a lot. Candidates are far more likely to use religious and ethnic symbols in a plurality (“winner-take-all”) system like the United States than in a proportional representation system (PR) like Indonesia. This is an important finding, because tinkering with election rules is one of the tools that international relations practitioners can use to reduce ethnic and sectarian violence. And what we are saying is that it works. Changing election rules can change the types and levels of identities that are politicized. And that is an important lesson for conflict resolution.

What are some of the most surprising results to come out of your research?

The first is how badly the dominant explanations for identity politics—modernization theory and secularization theory—fared when they were tested on a large dataset. We are at an interesting juncture in time, where our theories of religion and politics have not caught up with the way the world works.

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During last year’s Arab Spring, the ideal of democracy was celebrated throughout the world. How might your research shed light on understanding the complexities of these transitioning democracies?

Well this research has clear implications for the Arab Spring, particularly for understanding the future of Egypt. Just because religious parties like the Muslim Brotherhood or the Salafist Nour party come into office does not mean that democracy is doomed, or that religious minorities are going to suffer. As long as secular Muslims, Christians, liberals, and other groups have a stake in elections, we are likely to see cross-ethnic and cross-religious coalitions emerge. This is a very good thing. One obvious difference, however, is that we did not see a lot of overt military participation in politics in Indonesia after 1999. The military was largely absent. And that is one way that Egypt is very different from Indonesia. If there is a big threat to democracy in Egypt, it is not coming from the politicization of identity—it is coming from the suppression of the people's voice by the military.

Two Stanford graduates with close ties to FSI’s centers have been named 2012 Rhodes Scholars. A third was selected as a Mitchell Scholar.

Anand Habib was a graduate of the 2011 CISAC honors program in international security studies and a 2010 Dachs undergraduate intern. Habib and Katherine Niehaus – who is now a research assistant for a CHP/PCOR project evaluating whether HIV medication increases the risk of cardiovascular disease – will study at the University of Oxford in England under the Rhodes program. 

Philippe de Koning, who will study in Ireland as a Mitchell fellow, wrote a manuscript about Japan’s defense and financial crisis with Shorenstein APARC faculty member Phillip Lipscy. Lipscy, a political scientist, was de Koning’s advisor through his undergraduate career and also advised him on his senior thesis. De Koning was also a 2010 CISAC honors student.

More about the scholars:

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Habib is working on community health programs at St. Joseph's Clinic in Thomassique, Haiti, under a one-year global health fellowship awarded by Medical Missionaries. The nonprofit organization is a volunteer group of more than 200 doctors, nurses, dentists, and others who work to improve the health of the poor in the United States and throughout the world.

In 2011, he won a Deans' Award for Academic Accomplishment, which honors extraordinary undergraduate students for "exceptional, tangible" intellectual achievements. One of the professors who nominated him for the award described him as a "superb critical thinker" whose work is characterized by "creative genius" and "mature insights," adding that he "exemplifies exactly the kind of deeply informed, pragmatic and caring leadership that the world needs and Stanford enables."

As a Stanford student, Habib worked on behalf of politically and medically disenfranchised people in India, Mexico and Guatemala. His field research internship in Guatemala’s indigenous region during summer 2010 was carried out under the supervision of Paul Wise, professor of pediatrics and FSI senior fellow, as part of FSI’s Dachs mentored undergraduate research program.  On campus, he turned the Stanford tradition of the annual Dance Marathon into a vehicle dedicated to addressing the HIV/AIDS pandemic by engaging not only Stanford students but also local communities and corporations, raising more than $100,000. His exceptional work was recognized by his participation in the Clinton Global Initiative University Conference in April, 2011.

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She plans to pursue a doctorate of philosophy in systems approaches to biomedical science at Oxford.

At Stanford, Niehaus captained Stanford's varsity track and cross country teams, won the Pac-10 5,000 meters, and won Academic-All American status. She also served as a mentor and tutor for students in low-income families.

Working with faculty in the Center for Health Policy, Kate led a project to evaluate how well newer HIV antiretroviral drugs work compared with older drugs.  Her work was among the first to evaluate comprehensively all of the trials of new drugs in treatment of experienced patients, and showed that these drugs have substantial benefits.

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He is a Herbert Scoville Jr. Peace Fellow at the Nuclear Threat Initiative in Washington, D.C. The nongovernmental organization works to prevent nuclear, chemical, and biological threats from materializing. De Koning is researching nuclear materials security and the U.S.-China dialogue on nuclear issues.

De Koning, who earlier was awarded a Fulbright Scholarship, spent the 2010-2011 academic year at Hiroshima University in Japan. He examined various components of Japanese security policy, with emphasis on current evolution of Japanese Self-Defense Forces, policies on nuclear issues and approaches toward peacekeeping.

In 2009, he was a member of the Stanford delegation to the United Nations Climate Change Conference in Copenhagen.