Letter: Newspaper coverage about smoking in leading Chinese newspapers in past nine years

Abstract

ResultsA total of 1366 articles about smoking or smoking control were located (table 1). There was a significant difference in the number of articles appearing each year (pTheme of smoking-related articles from 2000 to 2008 in ChinaThe principal focuses of 1366 smoking-related articles, as judged by headline, are shown in table 1 . For each theme, there was a significant difference in the number of articles appearing each year (p

Full text

study area (5.6) is much greater than that in
developed countries such as USA (2.6
in 2006, US Census Bureau) and Japan (2.6 in
2005, Ministry of Internal Affairs and
Communications). Thus, many non-
smoking household members may share
indoor environments with smokers.
The WHO FCTC is the first global public
health treaty that the 166 WHO member
states have already ratified.
3
Article 8 of the
WHO FCTC addresses the issue of protection
from exposure to tobacco smoke in public
places, however, there’snostatementon
protection from domestic SHS. Despite the
lack of biological data, our results clearly
indicate that SHS exposure occurs in public
places and also in households. For women and
children in particular, the household likely
represents the primary location of exposure.
6
Public educational campaigns for smoke-free
homes
78
are warranted in Southeast Asian
countries, to protect women and children
who remain exposed to SHS at home.
Acknowledgements We thank all of the project
members (Hideki Yanai, Toru Matsubayashi, Konosuke
Morimoto, Le Huu Tho and Truong Tan Minh) for
contribution to the original study.
Motoi Suzuki,
1
Vu Dinh Thiem,
2
Lay-Myint Yoshida,
1
Dang Duc Anh,
2
Paul E Kilgore,
3
Koya Ariyoshi
1
1
Department of Clinical Medicine, Institute of Tropical
Medicine, Nagasaki University, Nagasaki, Japan;
2
National Institute of Hygiene and Epidemiology, Hanoi,
Vietnam;
3
International Vaccine Institute, Seoul, Republic
of Korea, Seoul, Vietnam
Correspondence to Dr Koya Ariyoshi, Department of
Clinical Medicine, Institute of Tropical Medicine,
Nagasaki University, Sakamoto 1-12-4, Nagasaki, Japan;
kari@nagasaki-u.ac.jp
<Supplementary material (supplementary table) is
available online only. To view this files please visit the
journal online (http://tobaccocontrol.bmj.com).
Funding This study was funded by the Program of
Founding Research Centers for Emerging and
Reemerging Infectious Diseases, Ministry of Education,
Culture, Sports, Science and Technology, Japan. The
funding source did not have any role in the study design,
execution, analysis, writing of the manuscript or
conclusions.
Competing interests None.
Ethics approval This study was approved by the
Institutional Review Board (IRB) of the National Institute
of Hygiene and Epidemiology, Vietnam and the IRB of the
Institute of Tropical Medicine, Nagasaki University,
Japan.
Contributors KA initiated the study. KA, PEK, DDA and
LY were responsible for study conception and design.
VDT and DDA collected the baseline data. MS analysed
and interpreted the data. MS, LY and KA drafted the
manuscript and PEK revised it. All authors had full
access to all of the data in the study.
Provenance and peer review Not commissioned;
externally peer reviewed.
Accepted 17 December 2009
Published Online First 27 June 2010
Tobacco Control 2010;19:344e345.
doi:10.1136/tc.2009.032227
REFERENCES
1. World Health Organization.Protection from
exposure to second-hand tobacco smoke: policy
recommendations. Geneva: World Health Organization,
2007.
2. Samet JM, Yoon S-Y. WHO Tobacco Free Initiative.
Women and the tobacco epidemic: challenges for the
21st century. Geneva: World Health Organization,
2001.
3. World Health Organization.WHO framework
convention on tobacco control. Geneva: World Health
Organization, 2003.
4. Suzuki M, Thiem VD, Yanai H, et al. Association of
environmental tobacco smoking exposure with an
increased risk of hospital admissions for pneumonia in
children under 5 years of age in Vietnam. Thorax
2009;64:484e9.
5. World Health Organization.WHO report on the
global tobacco epidemic, 2008: the MPOWER package.
Geneva: World Health Organization, 2008.
6. Wipfli H, Avila-Tang E, Navas-Acien A, et al. Famri
Homes Study Investigators. Secondhand smoke
exposure among women and children: evidence from
31 countries. Am J Public Health 2008;98:672e9.
7. Thomson G, Wilson N, Howden-Chapman P.
Population level policy options for increasing the
prevalence of smokefree homes. J Epidemiol
Community Health 2006;60:298e304.
8. Priest N, Roseby R, Waters E, et al. Family and carer
smoking control programmes for reducing children’s
exposure to environmental tobacco smoke. Cochrane
Database Syst Rev 2008 Oct 8;(4):CD001746.
Newspaper coverage about
smoking in leading Chinese
newspapers in past nine years
Recent research has clearly identified the
importance of media advocacy in advancing
tobacco control objectives.
1e4
Generating
news coverage of tobacco control-related
issues is a low cost activity that can generate
extensive and ongoing coverage to which
millions of citizens, including politicians
and decision makers, are exposed. Media
advocacy has thus become an important
component of comprehensive tobacco
control programs.
China has the world’s largest population,
with 52.4% of adult men and 3.4% of adult
women smoking.
56
In China, news coverage
of health issues has increased dramatically in
recent years. In our previous study of cancer
coverage in Chinese newspapers, there was
a sharp increase in cancer-related reports
from 578 articles in 2000 to 1403 articles in
2006.
7
However, there has been little analysis
or evaluation of news coverage on smoking
in China.
In this study we aim to provide a system-
atic overview of all tobacco news coverage in
a database of major Chinese newspapers over
9 years from 2000 to 2008.
METHODS
Reports about smoking-related matters were
obtained from the Database of Important
Chinese Newspapers (http://www.cnki.net )
from 2000 to 2008. As of 18 June 2008, the
database included 152 national and 362
local newspapers. The search keywords were
fixed as ‘’,‘ ’ ( , in English:
smoking), ‘’,‘ ’ or ‘ ’ ( , ,
in English: smoking cessation, or
smoking restriction) in the title to calculate
the number of smoking-related articles.
Every smoking-related article obtained
from the database was carefully read to
ensure that tobacco was central to each
article, and articles without smoking-related
content were excluded. Articles were allo-
cated to a primary topic classification, which
included government law/policy/regulation,
health consequences, prevention/cessation
programs, affiliated organisation/business
news, negative social effects or other. Stories
about secondhand smoking, adolescent
smoking and smoking-related Olympic Games
stories were also noted.
We tested whether the number of articles
in each year was the same using the Poisson
heterogeneity test.
8
Figure 1 The number of articles focused on
passive smoking, secondhand smoking or
adolescent smoking in important Chinese
newspapers from 2000 to 2008.
Figure 2 The number of articles about the
Olympics among smoking-related articles in
important Chinese newspapers from 2000 to
2008.
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Tobacco Control August 2010 Vol 19 No 4 345
PostScript

RESULTS
A total of 1366 articles about smoking or
smoking control were located (table 1).
There was a significant difference in the
number of articles appearing each year
(p<0.001). Except for small decreases in 2001
and 2002, press attention to smoking
increased every year, indicating increasing
attention paid to smoking-related matters in
recent years. The total number of articles
was highest in May (234 articles, p<0.05)
because of press reports of ‘World No
Tobacco Day’on 31 May.
The principal focuses of 1366 smoking-
related articles, as judged by headline, are
shown in table 1 . For each theme, there was
a significant difference in the number of arti-
cles appearing each year (p<0.001). Almost
2 in 5 of all articles (535/1366) focused on the
effects of smoking on health with tobacco
prevention/cessation programs being the next
most frequent category. Examples included
‘Smoking increases the incidence of lung
cancer’,‘Smoking addiction is a risk factor for
coronary heart diseases’and ‘Smoking is
harmful to eye health’. However, in 2008
stories about government law/policy/regula-
tion concerning tobacco appeared most
frequently.
In the years prior to 2005 there were less
than 10 reports on secondhand smoke, but in
2007 and 2008 this increased to 44 and 37
reports, respectively.
References to smoking and the Olympics
numbered just 3 in 2006, and then rose
sharply to 30 in 2007, and further to 67 in
2008, suggesting that the then-forthcoming
Olympics stimulated this increase.
The total volume of articles (1366) reflects
an ongoing presence of tobacco issues in the
news, with an average of nearly one article
per day in 2007 and 2008 in Chinese news-
papers. The growing coverage may reflect
increasing attention to smoking and the
endeavours being made to promote tobacco
control in China. In our previous research, we
found 7643 newspaper reports about cancer
in newspapers between 2000 and 2007.
Smoking-related articles (1366) were far less
frequent over the same period. More atten-
tion should be paid to promoting newspaper
coverage about smoking in newspapers.
The coverage of issues in newspapers is
typically highly correlated with the presenta-
tion of the same issues in other media such as
radio and television.
9
Indeed, newspaper and
magazines articles are often cited by the public
as common sources of health information.
10
In the US and Australia, secondhand
smoke was the most prevalent tobacco-
related theme.
11
Its low ranking in Chinese
newspapers suggests there is plenty of scope
to raise coverage of this issue in the news
media in China.
There are limitations to our study. For
example, we only examined newspapers, but
did not analyse the slant of articles. The
development of strategies aimed at improving
health news reporting deserves more focused
attention from the media and researchers.
Acknowledgements This work was supported by the
Specialised Research Fund for Heilongjiang High
Education.
Yu Liu,
1
Lifei Jiang,
2
Hai Xiao,
3
Qiaojing Liu,
1
Bing Li,
4
Wanhai Xu
1
1
The Fourth Affiliated Hospital of Harbin Medical
University, Harbin, P R China;
2
Heilongjiang University,
Harbin, P R China;
3
Harbin Medical University, Harbin,
P R China;
4
Harbin Center for Disease Control, Harbin,
P R China
Correspondence to Dr Wanhai Xu, The Fourth Affiliated
Hospital of Harbin Medical University, Yiyuan Road 37,
Nangang District, Harbin, Heilongjiang Province 150001,
P R China; Liuy.doctor@gmail.com
Funding The Specialized Research Fund for Heilongjiang
High Education.
Competing interests None.
Patient consent Obtained.
Contributors YL, LJ and WX contributed to the analysis
of content of smoking-related papers. QL and BL
contributed to obtaining the smoking-related articles
from important Chinese newspaper databases. HX
contributed to the statistical analysis of results. YL and
LJ made equal contribution to this work.
Provenance and peer review Not commissioned;
externally peer reviewed.
Accepted 6 January 2010
Published Online First 14 June 2010
Tobacco Control 2010;19:345e346.
doi:10.1136/tc.2009.034793
REFERENCES
1. Clegg Smith K, Chapman S. How the news media
influence tobacco use. National Cancer Institute. The
Role of the Media in Promoting and Controlling
Tobacco Use. Tobacco Control Monograph No. 19.
Bethesda, MD: US Department of Health and Human
Services; 2008: 327e56. National Institutes of
Health, National Cancer Institute. NIH Publication No:
07-6242.
2. Champion D, Chapman S. Framing pub smoking
bans: an analysis of Australian print news media
coverage, March 1996eMarch 2003. J Epidemiol
Community Health 2005;59:679e84.
3. Durrant R, Wakefield M, McLeod K, et al. Tobacco
in the news: an analysis of newspaper coverage of
tobacco issues in Australia, 2001. Tob Control
2003;12(Suppl 2):ii75e81.
4. Chapman S, Lupton D. The fight for public health:
principles and practice of media advocacy. London:
British Medical Journal Books, 1994.
5. Kenkel D, Lillard DR, Liu F. An analysis of life-course
smoking behavior in China. Health Econ 2009;18
(Suppl 2):S147e56.
6. Shi J, Liu M, Zhang Q, et al. Male and female
adult population health status in China: a cross-
sectional national survey. BMC Public Health
2008;8:277.
7. Cai JP, Yang LD, Liu ZH, et al. The comprehensive
analysis of cancer coverage in China important
newspapers between 2000 and 2007. Support
Care Cancer 2009;17:329e32.
8. Armitage P, Berry G, Matthews JNS. Statistical
methods in medical research. Oxford; Malden, MA:
Blackwell Science, 2002:234e5.
9. Wanta W. The messenger and the message:
differences across news media. In: McCombs
M,Shaw DL, Weaver D, eds. Communication
and democracy: exploring the intellectual frontiers
of agenda setting theory. Mahwah, NJ: Lawrence
Elrbaum Associates, 1997:137e51.
10. Ellis JA, Gwynn C, Garg RK, et al. Secondhand
smoke exposure among nonsmokers nationally
and in New York City. Nicotine Tob Res
2009;11:362e70.
11. Smith KC, Terry-McElrath Y, Wakefield M, et al.
Media advocacy and newspaper coverage of
tobacco issues: a comparative analysis of
1 year’s print news in the United States and Australia.
Nicotine Tob Res 2005;7:289e99.
Misuse of the Official Information
Act by the tobacco industry
in New Zealand
The purpose of the Official Information Act
(OIA) in New Zealand is to facilitate the
democratic process by promoting the
accountability of government.
1
Tobacco
companies exploit freedom of information
acts which make official information
publicly available. For example, they
disrupted and discredited tobacco control
work with information gained from public
records requests to the California Depart-
ment of Health Services in the 1990s.
2
We examined all OIA requests to the
Ministry of Health (MoH) New Zealand,
about tobacco control and smoke-free
services from 2005 to August 2009 to deter-
mine their origin, content and the charges
made for information. Internet searches were
Table 1 Theme of smoking-related articles from 2000 to 2008 in China
Themes 2000 2001 2002 2003 2004 2005 2006 2007 2008 Total
Health 10 23 13 28 31 40 134 185 71 535*
Government law/policy/regulation 7 1 3 4 10 13 17 21 127 203*
Tobacco prevention/cessation program 18 9 4 21 11 26 54 71 72 286*
Affiliated organisation news 2 1 2 4 5 11 24 32 96 177*
Negative social effects 1 1 1 3 4 10 10 21 27 78*
Other 5 1 3 11 7 21 12 11 16 87*
Total 43 36 26 71 68 121 251 341 409 1366*
*Poisson heterogeneity test p<0.001.
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346 Tobacco Control August 2010 Vol 19 No 4
PostScript