In Dongying, Shandong, One in Four Residents Smokes; Public Restrooms Are a Major Smoking Hotspot

On August 25–26, a provincial training session on advocacy capacity building for smoke-free environments and media mobilization was held in Weihai, Shandong Province, with staff from the Dongying Center for Disease Control and Prevention attending. According to resident tobacco use surveys conducted in Dongying over the past two years, the smoking rate among Dongying residents is 25.03%, with smokers mainly being men, and with rural smoking rates higher than those in urban areas. During the investigation, reporters found that with the rollout of smoking cessation education campaigns and the wider spread of knowledge about the dangers of smoking, tobacco control efforts have achieved significant results in many respects. However, smoking bans remain very challenging in indoor public places, where people are more heavily affected by secondhand smoke.

Public restrooms have become smoking “hotspots” in public places

According to the relevant provisions of the Detailed Rules for the Implementation of the Regulations on Sanitary Administration in Public Places, smoking is prohibited in indoor public places. Reporters found that smoking bans have generally been effective in crowded areas such as lobbies and elevators in most public venues, but in relatively quiet and concealed places such as stairwells and restrooms, many smokers still ignore the rules even when prominent “No Smoking” signs are posted.

The Municipal People’s Hospital began building itself into a smoke-free medical and health institution in 2012, and has since received the titles of “2012 Provincial Smoke-Free Medical and Health Institution” and “2013 Dongying Smoke-Free Unit.” To strictly prevent patients or their family members from smoking inside the hospital, it established three outdoor smoking areas. Speaking about the current status of smoking control in the hospital, Zhou Yuelian, head of the Medical Social Work Department, told reporters that the overall effect of the smoking ban has been clear, but achieving a complete indoor smoking ban—especially in relatively concealed stairwells—remains quite difficult. “Because the flow of people entering and leaving the hospital is high, and there are currently no reward or penalty measures for smoking bans, we can only rely mainly on persuasion. Most people cooperate, but a small number still play ‘guerrilla tactics.’”

A staff member responsible for restroom cleaning in a shopping mall in Dongying revealed that smoking is also entirely prohibited in the mall, but employees and shoppers still choose to smoke in public restrooms. “We often clean up a lot of cigarette butts. Some are thrown into trash bins, while others are tossed directly into urinals or corners, and traces of ash are often found on restroom doors.”

The catering industry faces similar difficulties in enforcing indoor smoking bans. Especially in some small privately owned restaurants, even if no-smoking signs are posted, they have little restraining effect. When customers smoke inside, staff rarely take the initiative to stop them. In larger chain fast-food restaurants, however, smoking is relatively less common.

Cigarette sales fell 9% in the first half of the year compared with the same period last year

Reporters learned from the Municipal CDC that, according to resident tobacco use surveys conducted over the past two years, the smoking rate among Dongying residents is 25.03%. Among them, the smoking rate among rural residents is 33.05%, 9.99 percentage points higher than that of urban residents. Smokers are mainly male.

According to data provided by the Municipal Tobacco Monopoly Bureau (Company), cigarette sales in Dongying have declined over the past two years. In 2015, annual cigarette sales in Dongying totaled 83,700 cases, a decrease of 13,600 cases from 2014, but the tax revenue generated increased by 62 million yuan. “In the first half of this year, cigarette sales in Dongying were 37,800 cases, down 9% compared with 2015. Affected by various factors, cigarette sales have declined somewhat, but this does not necessarily mean the number of smokers has fallen; rather, individual consumption demand may have decreased,” a staff member said.

According to Cui Xiangdong, head of the Health Education Department at the Municipal CDC, on August 25–26 the Provincial CDC organized a province-wide training session on smoke-free environment advocacy capacity building and media mobilization, and two staff members from the Dongying CDC attended. They gained much advanced experience in tobacco control during the training, which will be summarized and reported, and valuable practices will be applied to Dongying’s tobacco control work. In addition, beginning in May this year, Dongying launched a citywide survey on the current state of tobacco use at construction sites. So far, 12 construction sites across the city’s three districts and two counties have been surveyed, covering 621 people. All survey information has been entered into the database and will be compiled, analyzed, and turned into a report by provincial experts. This survey will help further assess the current state of tobacco use in densely populated, highly mobile settings such as construction sites, providing a basis for future tobacco control health education and health promotion efforts, and helping advance Dongying’s smoking control and smoking ban work.

More smokers are proactively visiting smoking cessation clinics

With the gradual establishment of smoke-free units in Dongying in recent years, along with broader public awareness of the dangers of secondhand smoke, residents’ willingness to quit smoking has been encouraged to some extent. Zhang Deyong, director of the hospital’s Department of Respiratory Medicine, told reporters that since the start of this year, the number of patients proactively seeking advice on quitting smoking at the smoking cessation clinic has doubled compared with previous years. “Awareness of quitting has improved, but quitting completely is still difficult. Very few people can quit solely through willpower. At present, there is no medication that can help smokers quit completely, which is why many smokers quit repeatedly but relapse many times.”#p#分页标题#e#

Zhang Deyong said that more people are now proactively coming to the smoking cessation clinic for consultation, and many are seeking smoking control support because of illness. Through the hospital’s smoking cessation education activities, the results in helping patients quit have become evident. Based on the current situation among hospitalized patients who have a need to quit, the rate of patients who actively quit smoking has reached 30%–50%. “Now, the hospital has established a medical alliance with the respiratory specialty department of China-Japan Friendship Hospital in Beijing. That hospital has done an excellent job with its smoking cessation clinic, which will help us draw on more experience in supporting smoking control for Dongying patients in the future.”

At the smoking cessation clinic, smokers of all age groups are seen, though middle-aged people make up the majority of those seeking advice on quitting. Regarding this, Director Zhang Deyong said, “The most difficult group for smoking control is still young smokers, especially students, who almost never take the initiative to quit.” (Reporter Huang Haixia)