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Objective To develop an approach for rapid assessment of tobacco control interventions in China. We examined the correlation between components of the Strength of Tobacco Control (SOTC) index and a proposed rapid evaluation indicator, the Policy Performance Indicator (PPI), which is based on protection of non-smokers from secondhand smoke (SHS). The PPI was used to assess the implementation of policies related to SHS at the provincial/municipal level in China. Methods Stratified random sampling was used to select five types of organisational and household respondents in two municipalities and five provinces in China (Shanghai and Tianjin, Heilongjiang, Henan, Guangdong, Zhejiang and Jiangxi, respectively). Data collection methods included key informant interviews, observation and intercept surveys (organisations), and a modified Global Adult Tobacco Survey (GATS) questionnaire (households). SOTC scores (SHS policy, capacity and efforts), PPI (no smoking in designated smoke-free places) and mid-term to long-term impact (knowledge, attitude and reduced exposure to SHS) were measured, and correlations among them were calculated. Results The PPI varied across the seven locations. Shanghai led in the component indicators (at 56.5% for indoor workplaces and 49.1% for indoor public places, respectively), followed by Guangdong, Tianjin and Zhejiang (at 30–35% for these two indicators), and finally, Henan and Jiangxi (at 20–25%). Smoke-free policies were more effectively implemented at indoor workplaces than indoor public places. The PPI correlated well with certain components of the SOTC but not with the long-term indicators. Conclusions The PPI is useful for evaluating implementation of smoke-free policies. As tobacco control programmes are implemented, the PPI offers an indicator to track success and change strategies, without collecting data for a full SOTC index.

While the ‘low-tar’ scheme has been widely recognised as a misleading tactic used by the tobacco industry to deceive the public about the true risks of cigarette smoking, a similar campaign using the slogan of ‘less harmful, low tar’ was launched by the Chinese tobacco industry, that is, State Tobacco Monopoly Administration/China National Tobacco Corporation and began to gain traction during the last decade. Despite the fact that no sufficient research evidence supports the claims made by the industry that these cigarettes are safer, the Chinese tobacco industry has continued to promote them using various health claims. As a result, the production and sales of ‘less harmful, low-tar’ cigarettes have increased dramatically since 2000. Recently, a tobacco industry senior researcher, whose main research area is ‘less harmful, low-tar’ cigarettes, was elected as an Academician to the prestigious Chinese Academy of Engineering for his contribution to developing ‘less harmful, low-tar’ cigarettes. The tobacco researcher's election caused an outcry from the tobacco control community and the general public in China. This paper discusses the Chinese tobacco industry's ‘less harmful, low-tar’ initiatives and calls for the Chinese government to stop the execution of this deceptive strategy for tobacco marketing.

Objective: To assess airborne nicotine concentrations as an indicator of second-hand smoke (SHS) exposure in public places in both urban and rural areas of China. Design: Measurement of vapour-phase nicotine concentration using a common protocol in all locations. A total of 273 samplers were placed for 7 days in urban and rural areas of China, including Beijing and the capital city, and a county (rural) area of the following provinces: Sichuan (Chengdu/Mianzhu), Jiangxi (Nanchang/Anyi) and Henan (Zhengzhou/Xin’an). Setting: Samplers were placed in hospitals, secondary schools, city government buildings, train stations, restaurants and entertainment establishments (internet cafes, mahjong parlours and karaoke bars) in each location. Main outcome measure: The time-weighted average airborne concentration of nicotine (μg/m 3 ) was measured by gas chromatography. Results: Airborne nicotine was detected in 91% of the locations sampled. Beijing had the highest nicotine concentrations in most indoor environments (median 3.01 μg/m 3 ) and Chengdu had the lowest concentrations (median 0.11 μg/m 3 ). Overall, restaurants and entertainment establishments had the highest nicotine concentrations (median 2.17 and 7.48 μg/m 3 , respectively). High nicotine concentrations were also found in government buildings and in train stations. Conclusions: The data collected in this study provide evidence that SHS exposure is frequent in public places in China. Environmental nicotine concentrations in China provide evidence for implementation and enforcement of smoke-free initiatives in public places in China and indicate the need for protecting the public from exposure to SHS.

Background: Death registration systems in rural China are in a developmental stage. The Disease Surveillance Points (DSP) system provides the only nationally representative information on causes of death. In this system, there are no standard procedures or instruments for ascertaining causes of death; hence available statistics require careful evaluation before use. Aim: To assess the reliability of data from the DSP. Methods: 14 DSP sites were selected through stratified sampling, enrolling 2482 deaths registered during June–November 2002. Defined verbal autopsy (VA) procedures were used to derive underlying causes of death. κ Measures of agreement between VA and registered diagnoses were computed. VA diagnoses were used as references to compute sensitivity and positive predictive values. Finally, patterns of cause-specific discordance between the two data sources were studied. Results: κ Scores indicate only moderate agreement for chronic obstructive pulmonary disease (COPD) and ischaemic heart disease (IHD). The results also suggest that COPD is undercounted in registration data. A significant degree of cross attribution of cause was found between the two data sources. Overall, the VA was successful in limiting deaths with ill-defined causes to Conclusions: Diagnoses based on structured symptom questionnaires in the VA approach seem plausible and reliable as compared with lay-reported diagnoses in registration data. Concerns with attribution of cause of death due to COPD, IHD and tuberculosis in registration data suggest caution in their use for research and health programme purposes. The VA methods tested in this study offer promise for implementation in the routine registration system.

The Fogarty International Center (FIC) initiative, “International Tobacco and Health Research Capacity Building Program” represents an important step in US government funding for global tobacco control. Low‐ and middle‐income countries of the world face a rising threat to public health from the rapidly escalating epidemic of tobacco use. Many are now parties to the Framework Convention on Tobacco Control (FCTC) and capacity development to meet FCTC provisions. One initial grant provided through the FIC was to the Institute for Global Tobacco Control (IGTC) at the Johns Hopkins Bloomberg School of Public Health (JHSPH) to support capacity building and research programmes in China, Brazil, and Mexico. The initiative's capacity building effort focused on: (1) building the evidence base for tobacco control, (2) expanding the infrastructure of each country to deliver tobacco control, and (3) developing the next generation of leaders as well as encouraging networking throughout the country and with neighbouring countries. This paper describes the approach taken and the research foci, as well some of the main outcomes and some identified challenges posed by the effort. Individual research papers are in progress to provide more in‐depth reporting of study results.

Research has been shown to be a critical component of successful national tobacco control programmes. China currently has a small number of dedicated researchers addressing tobacco use and control. We encourage the growth of tobacco research as an academic and governmental field of inquiry. Such research would include multiple foci: biologic and toxicologic, epidemiologic, economic, health promotion, evaluation, policy and regulatory, and legal. Developing a community of tobacco researchers would elevate the tobacco issue on the public policy agenda, encourage transparency among key stakeholders and better identify strategies of tobacco control that could be effective in the Chinese context.