About Us

    The tobacco-smoking epidemic kills about 5.4 million people globally each year. Unchecked, this death toll will exceed 8 million annually by 2030. More than 80% of these deaths will occur in less developed nations, and the epidemic will strike hardest in that subgroup of countries whose rapidly growing economies offer their citizens hope for a better life (WHO2008). China, which represents 20% of the world’s population, Tobacco produces and consumes 30% of the world’s cigarettes, and suffers one million deaths per year from tobacco use – a number which is expected to double by 2025 (Peto R & Lopez AD 2001).

        To counter the spread of tobacco use worldwide, the World Health Organization (WHO) established the Framework Convention on Tobacco Control (FCTC) in 1999, which was then fully endorsed by the member states on May 21, 2003. The Chinese National People’s Congress ratified the FCTC on August 27, 2005. To some extent, it might be said that there is a tobacco control movement in China.A key issue in the current tobacco control movement in China is the lack of a strong research agenda and infrastructure.

        Really, The FCTC has provided a general framework that is very useful in guiding tobacco control. The most recent WHO document states there are multiple interventions that can reduce smoking prevalence on the population level (World Health Organization2008). For example, if society increases the cigarette price, changes policies regarding secondhand smoke, conducts anti-tobacco media campaigns, and provides assistance in quitting, smoking prevalence will generally decline. However, how to do this in a particular culture is not always clear. For example, the fact that the government owns the Chinese tobacco industry makes it difficult to apply many of the known effective tobacco control strategies. Moreover, Chinese culture, to a large extent, is still adhering to agrarian social mores (LI M 2003, Yang K-S 1986, Yang K-S 2004). This suggests that the social values may frame people’s behavioral response models differently from those of Western countries’ (Yang K-S 2004). For example, asking people to stop smoking in public places may be quite acceptable in the West, but it is very difficult for people who adhere to Confucian values to do the same. We must explore the unique social-behavioral rules and adapt appropriate measures in tobacco control campaigns. Previous studies have already indicated that Chinese smokers have unique social psychological motivations, (Chen X et al. 2006, Yang T et al. 1988, Yang T et al. 1988,  Yang T et al.1992A, Yang T et al. 1992B, Sun J et al. 1997), and it is necessary to adopt culturally-appropriate measures in order to have an effective tobacco control campaign (Sun J et al. 1996, Yang T et al. 1993, Chan SS et al. 2008, Wang JF et al. 2008 ).

        Our researches will develop and test culturally relevant behavioral models and tools for tobacco control in China and build research capacity that focuses on applied research that is capable of providing technical assistance to real-world interventions.  

 

Preliminary Studies

        The research group at Zhejiang University (led by Dr. Yang) has conducted many studies related to socio-behavioral models of smoking in China. Since the 1980’s, Dr Yang has conducted studies on social psychological motives for smoking in Jiangsu , psychological approaches to smoking intervention, and the role of a wife in changing her husband’s smoking behavior. (Yang T et al. 1998, Yang T et al. 1992, Yang T 2007). In recent years, our research group received funds from the Bloomberg Initiative to conduct policy research, which involved working with numerous researchers from many schools of public health across China. We will briefly describe two studies that use population surveys and two studies.

Preliminary study 1:A national survey of farmers’ smoking in China

        This study employed a cross-sectional, multi-stage sampling design. Residents (N = 4,414; aged 15 years and older) were recruited from four geographic regions in China. This study examined smoking, smoking cessation patterns and factors related to tobacco use among rural Chinese male residents (Yang T et al. 2008, Yang T et al. 2008B).

Preliminary study 2:Smoking patterns among Chinese rural-urban migrant workers.

        For this study we conducted a survey of 4,198 rural-urban migrant workers, 18 years of age and older, residing in three Chinese cities. Participants were identified through multi-stage quota-sampling. They were asked about their migration history, pre-migration and post-migration smokingstatus,employment, and home life. Overall, smoking prevalence was significantly higher after migration (28.4%) than prior to migration (20.8%). The results indicate that the migrant workers’ smoking status and nicotine dependence are associated with their migratory lifestyle (Yang T et al. 2009).

Preliminary study 3:Building advocacy capacity for tobacco control among the public health workforce in China

        The project is supported by an International Union Against Tuberculosis and Lung Disease grant which is funded by the Bloomberg Global Initiative to Reduce Tobacco Use.  This was an 18-month project, which, for the first time, set out to introduce tobacco control advocacy training into the public health curriculum of seven universities across China (Yang T et al. 2009). We have successfully developed a training program on tobacco control that fits into Chinese culture, and applied it to the public health curricula of selected universities. We also conducted tobacco control advocacy activities to examine the feasibility and effectiveness of the training program’s advocacy strategies and methods. At the end of the project, all participating universities had successfully instructed public health students on tobacco control advocacy, 722 students were trained. In addition, each of the participating universities successfully introduced a smoke-free campus policy.

        We conducted a survey about the future effect of this project, July 6-9, 2009 and the results show that each university continues to conduct the advocacy curriculum, and the universities remain smokefree in indoor areas. Some teachers from this have become tobacco control experts and they are contributing to local tobacco control.

        We built a basic module, implemented strategies and programs for tobacco control advocacy capacity building among the future public health workforce through this project.  

 project:4  Tobacco Control Courses in Smoke-free Universities with Public Health Faculties

       The project will expand to include an additional 24 provincial universities with Public Health schools, like Jilin University, Tianjin Medical University, Lanzhou University, Shanghai Jiaotong University, Anhui Medical University, Guiyang Medical College, Hebei Medical University, and others. In total, the two projects combined will cover 31 universities across all provinces in China, including autonomous regions and municipalities, except for Tibet. More faculty members and graduate students will be involved in this new project than in the Preliminary study 3. This group of collaborators will be a great resource to help us with this proposed project in terms of providing consultation on various components of the proposed project. Even more significantly, they form the most active social network for us to disseminate the research results from this project.

current project:Facilitate MOH endorsement of tobacco control implementation through promoting tobacco control advocacy capacity in medical schools