Anti-tobacco fighters believe printing warning pictures on cigarette packets will change the Chinese custom of giving cigarettes as gifts.

A survey by China CDC in 20 provinces in 2008 showed that 90 percent of its 16,000 respondents would not give cigarettes as gifts if there were disgusting and horrible pictures printed on their packaging.

With pretty pictures like Mount Tai and Tian'anmen Square, cigarettes are a symbol of social status and often given as gifts in China.

The tobacco gift culture is a major obstacle for tobacco control in China.

China could improve its warnings to include graphic images of the harm tobacco does, Sarah England, a technical officer at the Tobacco Free Initiative of the WHO Representative Office in China, said.

This would educate people about the specific diseases and disabilities caused by tobacco while simultaneously making cigarettes an unattractive object to give as a gift, England added.

China's tobacco control authorities sought netizens' support to urge producers to print warning pictures on cigarette packaging, in an effort to set the agenda ahead of parliamentary and political advisory sessions this year.

More than 1.42 million netizens voiced their support for putting pictorial warnings on cigarette packages in the two weeks after the online survey began.

"We got the reply recently. The authorities refused our proposal. They said they would make the warnings on the front larger and print warnings on the back of the packs in minority languages," Wu said.

Experts say it is China's tobacco monopoly system that makes putting warning pictures on cigarette packaging difficult, as China's State Tobacco Monopoly Administration is both the tobacco producer and the regulator responsible for tobacco control.

"There is no way that tobacco control and the development of the tobacco industry can be properly done by the same department," Jiang Yuan said.

High-end cigarettes and those given as gifts contribute significantly to the tobacco industry's profits and taxes. If disgusting pictures appear on the packs, there will be no market for these cigarettes, said Hu Linlin, a doctor at the Chinese Academy of Engineering Sciences.

Now, some 23 countries print large warning pictures on cigarette packs. But smokers in 90 percent of countries and regions in the world still don't see such warnings.

There is still much to be done for tobacco control in China, and around the world, Wu Yiqun, said.

(Xinhua News Agency November 15, 2010)