Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
-
China produces and consumes more tobacco than any other country in the world and as such is at the forefront of the world tobacco epidemic. Many studies have recently emerged that directly or indirectly reference the acts of giving and sharing cigarettes as a major contributor to China's high tobacco usage. The goal of this report is to review relevant literature relating to sharing and gifting cigarettes as well as provide useful historic and cultural contexts. Important differences between the act of giving individual cigarettes and the gifting of packaged cigarettes are explored as well as explanations for how both these practices have influenced current tobacco control efforts. ⋯ Traditional tobacco control efforts should be combined with culture-specific approaches to reduce tobacco usage in China. The regular exchange of cigarettes normalizes smoking across society and promotes tobacco's acceptability. Great efforts should be taken not only to minimize these practices among males but also to discourage their adoption by females.
-
To understand the reasons behind gifting and sharing cigarettes in China's rural areas and how these practices contribute to smoking initiation and hamper smoking cessation efforts. ⋯ Gifting and sharing cigarettes significantly contribute to smoking in rural China. Future tobacco control efforts should discourage both these activities to reduce tobacco usage. Tobacco control measures should also aim to inform adults about the health consequences of giving cigarettes to adolescents. Similarly, more information on the benefits of smoking cessation should be provided to China's rural elderly population. This information could lead to increased community support of cessation efforts and ultimately result in reductions in smoking in rural China.
-
As Rich and Xiao suggested, cigarette sharing and gifting play an important role in China's smoking epidemic. Understanding the cultural roots, history, and impacts of such practices should be emphasized in tobacco control efforts. "Tobacco as a social currency" is a consequence of the tobacco industry usurping traditional values and cultural customs to make cigarette gifting acceptable, desirable, and socially reinforcing. The cigarettes-social reinforcement link created by the tobacco industry can be broken by deglamorizing smoking and cigarette gifting and by reinforcing alternative healthful behaviors. A behavioral ecological perspective, with an emphasis of understanding and engineering cultures, should guide future health promotion efforts to reduce smoking and other risk practices in China.