Pub Date : 2024-11-20DOI: 10.1016/s2468-2667(24)00246-9
Changzheng Yuan, Yanhui Dong, Hui Chen, Le Ma, Lihong Jia, Jiayou Luo, Qin Liu, Yifei Hu, Jun Ma, Yi Song
Over the past four decades, China has witnessed an important nutritional transition, characterised by a heightened overnutrition burden among children. The country now has the largest population of children with obesity globally. In this paper, we review the epidemiology of childhood obesity in China, its determinants, and risk factors, with a particular focus on school-aged children. Evidence unveils substantial variations across age, gender, and region. We describe multilevel obesogenic determinants, including macro-level social, cultural, and environmental factors; meso-level factors related to schools and communities; and micro-level factors tied to families and individuals from the perinatal-infant stage to childhood and adolescence. The primary drivers of childhood obesity appear to be rooted in the broader macro-level social, economic, and technological environment; obesogenic factors, which have affected school, community, and family environments; and accelerated unhealthy behaviour uptake. Identifying and characterising the catalysts behind the rise in childhood obesity in China is imperative for the development of scalable, effective, and tailored prevention, control, and intervention strategies.
{"title":"Determinants of childhood obesity in China","authors":"Changzheng Yuan, Yanhui Dong, Hui Chen, Le Ma, Lihong Jia, Jiayou Luo, Qin Liu, Yifei Hu, Jun Ma, Yi Song","doi":"10.1016/s2468-2667(24)00246-9","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00246-9","url":null,"abstract":"Over the past four decades, China has witnessed an important nutritional transition, characterised by a heightened overnutrition burden among children. The country now has the largest population of children with obesity globally. In this paper, we review the epidemiology of childhood obesity in China, its determinants, and risk factors, with a particular focus on school-aged children. Evidence unveils substantial variations across age, gender, and region. We describe multilevel obesogenic determinants, including macro-level social, cultural, and environmental factors; meso-level factors related to schools and communities; and micro-level factors tied to families and individuals from the perinatal-infant stage to childhood and adolescence. The primary drivers of childhood obesity appear to be rooted in the broader macro-level social, economic, and technological environment; obesogenic factors, which have affected school, community, and family environments; and accelerated unhealthy behaviour uptake. Identifying and characterising the catalysts behind the rise in childhood obesity in China is imperative for the development of scalable, effective, and tailored prevention, control, and intervention strategies.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"1 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/s2468-2667(24)00271-8
Xiong-Fei Pan, Zhong-Ze Fang
Overweight and obesity in children have emerged as a major public health challenge in China. National statistics show that the prevalence of overweight and obesity reached up to 10% in children younger than 6 years and 20% in those aged 6–17 years,1 which is projected to continue rising in the next few years.2 In response to this public health imperative, 16 Chinese national agencies, including the National Health Commission and the Ministry of Civil Affairs, have collaboratively developed the Implementation Plan for the Weight Management Years Campaign to promote population-level weight control measures for 3 years commencing in 2024.3 More recently, the National Health Commission also officially issued the Guidelines for the Diagnosis and Treatment of Obesity, for the first time, to advance standardised clinical management of obesity.4 In alignment with these initiatives, a consortium of Chinese experts comprehensively assessed the epidemiology and determinants of childhood obesity, and critically evaluated potential interventions and policies for mitigating the challenge of obesity in this issue of The Lancet Public Health.5, 6, 7 The timely review Series complements governmental strategic directives, and offers pragmatic insights and evidence-based recommendations to inform policy makers, health-care professionals, and multisectoral stakeholders in their concerted efforts for the prevention and control of childhood obesity in China. Although the work makes considerable contributions, several additional perspectives on childhood obesity warrant consideration.
{"title":"Obesity in China: what we know and what we can do","authors":"Xiong-Fei Pan, Zhong-Ze Fang","doi":"10.1016/s2468-2667(24)00271-8","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00271-8","url":null,"abstract":"Overweight and obesity in children have emerged as a major public health challenge in China. National statistics show that the prevalence of overweight and obesity reached up to 10% in children younger than 6 years and 20% in those aged 6–17 years,<span><span><sup>1</sup></span></span> which is projected to continue rising in the next few years.<span><span><sup>2</sup></span></span> In response to this public health imperative, 16 Chinese national agencies, including the National Health Commission and the Ministry of Civil Affairs, have collaboratively developed the Implementation Plan for the Weight Management Years Campaign to promote population-level weight control measures for 3 years commencing in 2024.<span><span><sup>3</sup></span></span> More recently, the National Health Commission also officially issued the Guidelines for the Diagnosis and Treatment of Obesity, for the first time, to advance standardised clinical management of obesity.<span><span><sup>4</sup></span></span> In alignment with these initiatives, a consortium of Chinese experts comprehensively assessed the epidemiology and determinants of childhood obesity, and critically evaluated potential interventions and policies for mitigating the challenge of obesity in this issue of <em>The Lancet Public Health</em>.<span><span>5</span></span>, <span><span>6</span></span>, <span><span>7</span></span> The timely review Series complements governmental strategic directives, and offers pragmatic insights and evidence-based recommendations to inform policy makers, health-care professionals, and multisectoral stakeholders in their concerted efforts for the prevention and control of childhood obesity in China. Although the work makes considerable contributions, several additional perspectives on childhood obesity warrant consideration.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"57 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/s2468-2667(24)00251-2
Yu Xu, Jieli Lu, Mian Li, Tiange Wang, Kan Wang, Qiuyu Cao, Yi Ding, Yu Xiang, Siyu Wang, Qianqian Yang, Xuan Zhao, Xiaoyun Zhang, Min Xu, Weiqing Wang, Yufang Bi, Guang Ning
During the past 40 years, the prevalence of diabetes in China has increased from less than 1·0% in 1980 to 12·4% in 2018, an increase in line with the rapid growth of the nation's economy. To address such a burden, the Healthy China 2030 initiative and subsequent Action Plan, including a diabetes prevention and control campaign, were launched. A shift from a disease-centred approach to a health-centred approach and from treatment to prevention is the core of the Action Plan and diabetes management in China. In this Review, we discuss the challenges of diabetes prevention in China, including unhealthy lifestyle, increasing young-onset type 2 diabetes, and substantial diabetes care disparities. To address such challenges, countermeasures across different stages of diabetes prevention and targeted at different populations, are needed. Such countermeasures include primordial prevention of risk factors in the general population, primary prevention of diabetes onset in high-risk populations, and secondary prevention of cardiovascular complications for individuals with diabetes. We reflect on China's current progress, strategies, and achievements.
{"title":"Diabetes in China part 2: prevention, challenges, and progress","authors":"Yu Xu, Jieli Lu, Mian Li, Tiange Wang, Kan Wang, Qiuyu Cao, Yi Ding, Yu Xiang, Siyu Wang, Qianqian Yang, Xuan Zhao, Xiaoyun Zhang, Min Xu, Weiqing Wang, Yufang Bi, Guang Ning","doi":"10.1016/s2468-2667(24)00251-2","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00251-2","url":null,"abstract":"During the past 40 years, the prevalence of diabetes in China has increased from less than 1·0% in 1980 to 12·4% in 2018, an increase in line with the rapid growth of the nation's economy. To address such a burden, the Healthy China 2030 initiative and subsequent Action Plan, including a diabetes prevention and control campaign, were launched. A shift from a disease-centred approach to a health-centred approach and from treatment to prevention is the core of the Action Plan and diabetes management in China. In this Review, we discuss the challenges of diabetes prevention in China, including unhealthy lifestyle, increasing young-onset type 2 diabetes, and substantial diabetes care disparities. To address such challenges, countermeasures across different stages of diabetes prevention and targeted at different populations, are needed. Such countermeasures include primordial prevention of risk factors in the general population, primary prevention of diabetes onset in high-risk populations, and secondary prevention of cardiovascular complications for individuals with diabetes. We reflect on China's current progress, strategies, and achievements.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"1 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/s2468-2667(24)00263-9
Yanhui Dong, Changzheng Yuan, Jiajia Dang, Xinli Song, Guo Cheng, Yajun Chen, Haijun Wang, Jie Mi, Bo Xi, Yi Song
Prevention and control of childhood obesity in China is complex. Despite numerous existing policy endeavours, particularly Healthy China 2030, accompanied by multiministerial initiatives, childhood obesity persists and even exacerbates. In this paper, we review current national policies, assess progress of the existing system managing childhood weight, and identify implementation challenges. Leveraging insights from existing literature and guided by a PEDALS (ie, problem, evidence-based practice, determinants, actions, long term, and scalability) framework, we propose a strategy to refine and integrate current policies, interventions, and research into a policy framework, embedding evidence-based practices into practical solutions for childhood obesity prevention and control in China.
{"title":"Control of childhood obesity and implications for policy in China","authors":"Yanhui Dong, Changzheng Yuan, Jiajia Dang, Xinli Song, Guo Cheng, Yajun Chen, Haijun Wang, Jie Mi, Bo Xi, Yi Song","doi":"10.1016/s2468-2667(24)00263-9","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00263-9","url":null,"abstract":"Prevention and control of childhood obesity in China is complex. Despite numerous existing policy endeavours, particularly Healthy China 2030, accompanied by multiministerial initiatives, childhood obesity persists and even exacerbates. In this paper, we review current national policies, assess progress of the existing system managing childhood weight, and identify implementation challenges. Leveraging insights from existing literature and guided by a PEDALS (ie, problem, evidence-based practice, determinants, actions, long term, and scalability) framework, we propose a strategy to refine and integrate current policies, interventions, and research into a policy framework, embedding evidence-based practices into practical solutions for childhood obesity prevention and control in China.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"65 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/s2468-2667(24)00245-7
Changzheng Yuan, Yanhui Dong, Hui Chen, Le Ma, Lihong Jia, Jiayou Luo, Qin Liu, Yifei Hu, Jun Ma, Yi Song
China is confronted with the challenge of increasing childhood obesity. Although interventions for childhood obesity have been developed, their effectiveness and implementation can vary considerably across nations. In this paper, we review and consolidate the evidence on childhood obesity intervention strategies aimed at multiple levels and components across life, in China. School-based interventions, primarily delivered with group-based dietary and physical education, have shown potential efficacy and can be enhanced by integrating food environment reform and family support. However, most interventional studies were done in eastern and urban areas of China, which highlights the need for attention in regions with insufficient health resources where policies and initiatives are less accessible. In addition, the sparse reporting on implementation design and delivery might hinder the scalability of potentially effective strategies. Amid rapid social and economic development over the past few decades, China faces unique challenges on urbanisation, physical inactivity, and nutritional transitions, necessitating an updated policy agenda for primary prevention of childhood obesity. Structural longitudinal evaluations of public initiatives led by the government and organisations along with inclusive and equitable interventions targeting children of different ages, urban–rural regions, and different ethnic and socioeconomic groups are warranted. Tackling childhood obesity in China needs a cohesive approach that integrates social, economic, cultural, and environmental strategies, combining school-based, family-based, and individual-based approaches, and concerted efforts from multiple sectors and entities within China.
{"title":"Public health interventions against childhood obesity in China","authors":"Changzheng Yuan, Yanhui Dong, Hui Chen, Le Ma, Lihong Jia, Jiayou Luo, Qin Liu, Yifei Hu, Jun Ma, Yi Song","doi":"10.1016/s2468-2667(24)00245-7","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00245-7","url":null,"abstract":"China is confronted with the challenge of increasing childhood obesity. Although interventions for childhood obesity have been developed, their effectiveness and implementation can vary considerably across nations. In this paper, we review and consolidate the evidence on childhood obesity intervention strategies aimed at multiple levels and components across life, in China. School-based interventions, primarily delivered with group-based dietary and physical education, have shown potential efficacy and can be enhanced by integrating food environment reform and family support. However, most interventional studies were done in eastern and urban areas of China, which highlights the need for attention in regions with insufficient health resources where policies and initiatives are less accessible. In addition, the sparse reporting on implementation design and delivery might hinder the scalability of potentially effective strategies. Amid rapid social and economic development over the past few decades, China faces unique challenges on urbanisation, physical inactivity, and nutritional transitions, necessitating an updated policy agenda for primary prevention of childhood obesity. Structural longitudinal evaluations of public initiatives led by the government and organisations along with inclusive and equitable interventions targeting children of different ages, urban–rural regions, and different ethnic and socioeconomic groups are warranted. Tackling childhood obesity in China needs a cohesive approach that integrates social, economic, cultural, and environmental strategies, combining school-based, family-based, and individual-based approaches, and concerted efforts from multiple sectors and entities within China.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"14 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/s2468-2667(24)00250-0
Yu Xu, Jieli Lu, Mian Li, Tiange Wang, Kan Wang, Qiuyu Cao, Yi Ding, Yu Xiang, Siyu Wang, Qianqian Yang, Xuan Zhao, Xiaoyun Zhang, Min Xu, Weiqing Wang, Yufang Bi, Guang Ning
The prevalence of diabetes in China is rapidly increasing. China now has the largest number of people living with diabetes worldwide, accounting for approximately one-quarter of the global diabetes population. Since the late 1970s, China has experienced profound changes and rapid economic growth, leading to shifts in lifestyle. Changing dietary patterns, reduced physical activity, and stress have contributed to the growing prevalence of overweight and obesity, which are important determinants potentiating the link between insulin resistance and diabetes. Social and environmental factors, such as education, air pollution, and exposure to endocrine-disrupting chemicals, have also contributed to the growing diabetes epidemic in China. The country has one of the fastest ageing populations in the world, which forecasts continued increases in the prevalence of diabetes and its complications. This Review provides an overview of the ongoing diabetes epidemic and risk factors, providing evidence to support effective implementation of public health interventions to slow and prevent the diabetes epidemic in China.
{"title":"Diabetes in China part 1: epidemiology and risk factors","authors":"Yu Xu, Jieli Lu, Mian Li, Tiange Wang, Kan Wang, Qiuyu Cao, Yi Ding, Yu Xiang, Siyu Wang, Qianqian Yang, Xuan Zhao, Xiaoyun Zhang, Min Xu, Weiqing Wang, Yufang Bi, Guang Ning","doi":"10.1016/s2468-2667(24)00250-0","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00250-0","url":null,"abstract":"The prevalence of diabetes in China is rapidly increasing. China now has the largest number of people living with diabetes worldwide, accounting for approximately one-quarter of the global diabetes population. Since the late 1970s, China has experienced profound changes and rapid economic growth, leading to shifts in lifestyle. Changing dietary patterns, reduced physical activity, and stress have contributed to the growing prevalence of overweight and obesity, which are important determinants potentiating the link between insulin resistance and diabetes. Social and environmental factors, such as education, air pollution, and exposure to endocrine-disrupting chemicals, have also contributed to the growing diabetes epidemic in China. The country has one of the fastest ageing populations in the world, which forecasts continued increases in the prevalence of diabetes and its complications. This Review provides an overview of the ongoing diabetes epidemic and risk factors, providing evidence to support effective implementation of public health interventions to slow and prevent the diabetes epidemic in China.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"23 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-19DOI: 10.1016/s2468-2667(24)00272-x
Shiwei Liu, Zhuo Chen
Tobacco use is the leading cause of preventable death globally, accounting for more than 7 million deaths worldwide, including nearly 1·3 million deaths due to second-hand smoke.1 There is no safe threshold of exposure to second-hand smoke, and smoke-free environments are a proven way to adequately protect people from the harmful effects of second-hand smoke without harming businesses.2 Legislation is required to effectively implement smoke-free environments.2 Systematic reviews have shown that smoke-free legislation is associated with substantial reductions in morbidity and mortality from cardiovascular disease, respiratory system disease, and perinatal outcomes.3
{"title":"Implementing comprehensive nationwide smoke-free legislation in China","authors":"Shiwei Liu, Zhuo Chen","doi":"10.1016/s2468-2667(24)00272-x","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00272-x","url":null,"abstract":"Tobacco use is the leading cause of preventable death globally, accounting for more than 7 million deaths worldwide, including nearly 1·3 million deaths due to second-hand smoke.<span><span><sup>1</sup></span></span> There is no safe threshold of exposure to second-hand smoke, and smoke-free environments are a proven way to adequately protect people from the harmful effects of second-hand smoke without harming businesses.<span><span><sup>2</sup></span></span> Legislation is required to effectively implement smoke-free environments.<span><span><sup>2</sup></span></span> Systematic reviews have shown that smoke-free legislation is associated with substantial reductions in morbidity and mortality from cardiovascular disease, respiratory system disease, and perinatal outcomes.<span><span><sup>3</sup></span></span>","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"22 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142672954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-19DOI: 10.1016/s2468-2667(24)00262-7
Hongqiao Fu, Sian Tsuei, Yunting Zheng, Simiao Chen, Shirui Zhu, Duo Xu, Winnie Yip
Background
China has one of the highest levels of tobacco consumption globally, and there is no national smoke-free legislation. Although more than 20 Chinese cities have passed local smoke-free laws since 2008, evidence on their effectiveness in reducing smoking behaviours and their economic benefits is scarce. By exploiting a natural quasi-experiment, whereby a comprehensive public smoking ban was implemented in Shanghai in March, 2017, this study aims to assess the impact of the policy on individual smoking behaviours and quantify its effect on macroeconomic outcomes.
Methods
In this difference-in-differences analysis and modelling study, we used data on smoking behaviours from the 2012, 2014, 2016, and 2018 waves of the China Family Panel Studies. We used a difference-in-differences approach to investigate trends in smoking prevalence in respondents in Shanghai, relative to respondents from other direct-administered municipalities, provincial capital cities, and subprovincial municipalities (control group), after the implementation of a smoking ban in 2017. All respondents aged 18 years or older were included, with the exception of people who lived in Beijing and rural areas. The primary variable of interest in the difference-in-differences analysis was self-reported smoking status. Based on the difference-in-differences estimation of reduction in smoking prevalence, we then used a health-augmented macroeconomic model to estimate the potential macroeconomic gains if such a ban was implemented across China for the period 2017–35.
Findings
14 688 respondents were included in the analysis: 5766 from Shanghai and 8922 from the control group. After the implementation of the smoking ban in Shanghai in 2017, smoking prevalence decreased by 2·2 percentage points (95% CI 2·1–2·3), equivalent to an 8·4% reduction in the number of current smokers. The smoking ban had a larger effect on men, people with a higher level of education, unmarried people, and younger people when compared with their respective counterparts. The modelling analysis showed that implementing a nationwide comprehensive public smoking ban similar to that in Shanghai would result in a 0·04–0·07% increase in the national gross domestic product in China between 2017 and 2035, outweighing the economic costs of smoking ban enforcement.
Interpretation
The smoking ban in Shanghai shows that a comprehensive public smoking ban with strict enforcement is effective in curbing smoking behaviours. Moreover, the implementation of a comprehensive public smoking ban across China would be cost-effective.
{"title":"Effects of comprehensive smoke-free legislation on smoking behaviours and macroeconomic outcomes in Shanghai, China: a difference-in-differences analysis and modelling study","authors":"Hongqiao Fu, Sian Tsuei, Yunting Zheng, Simiao Chen, Shirui Zhu, Duo Xu, Winnie Yip","doi":"10.1016/s2468-2667(24)00262-7","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00262-7","url":null,"abstract":"<h3>Background</h3>China has one of the highest levels of tobacco consumption globally, and there is no national smoke-free legislation. Although more than 20 Chinese cities have passed local smoke-free laws since 2008, evidence on their effectiveness in reducing smoking behaviours and their economic benefits is scarce. By exploiting a natural quasi-experiment, whereby a comprehensive public smoking ban was implemented in Shanghai in March, 2017, this study aims to assess the impact of the policy on individual smoking behaviours and quantify its effect on macroeconomic outcomes.<h3>Methods</h3>In this difference-in-differences analysis and modelling study, we used data on smoking behaviours from the 2012, 2014, 2016, and 2018 waves of the China Family Panel Studies. We used a difference-in-differences approach to investigate trends in smoking prevalence in respondents in Shanghai, relative to respondents from other direct-administered municipalities, provincial capital cities, and subprovincial municipalities (control group), after the implementation of a smoking ban in 2017. All respondents aged 18 years or older were included, with the exception of people who lived in Beijing and rural areas. The primary variable of interest in the difference-in-differences analysis was self-reported smoking status. Based on the difference-in-differences estimation of reduction in smoking prevalence, we then used a health-augmented macroeconomic model to estimate the potential macroeconomic gains if such a ban was implemented across China for the period 2017–35.<h3>Findings</h3>14 688 respondents were included in the analysis: 5766 from Shanghai and 8922 from the control group. After the implementation of the smoking ban in Shanghai in 2017, smoking prevalence decreased by 2·2 percentage points (95% CI 2·1–2·3), equivalent to an 8·4% reduction in the number of current smokers. The smoking ban had a larger effect on men, people with a higher level of education, unmarried people, and younger people when compared with their respective counterparts. The modelling analysis showed that implementing a nationwide comprehensive public smoking ban similar to that in Shanghai would result in a 0·04–0·07% increase in the national gross domestic product in China between 2017 and 2035, outweighing the economic costs of smoking ban enforcement.<h3>Interpretation</h3>The smoking ban in Shanghai shows that a comprehensive public smoking ban with strict enforcement is effective in curbing smoking behaviours. Moreover, the implementation of a comprehensive public smoking ban across China would be cost-effective.<h3>Funding</h3>National Social Science Fund of China.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"69 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142672956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-04DOI: 10.1016/s2468-2667(24)00265-2
Tan M. Mandatory salt targets: a key policy tool for global salt reduction efforts. Lancet Public Health 2024; 9: e834–35—In this Linked Comment, the fifth sentence of the third paragraph should have said US$8·0 billion. This correction has been made as of Nov 4, 2024.
Tan M. Mandatory salt targets: a key policy tool for global salt reduction efforts.Lancet Public Health 2024; 9: e834-35-In this Linked Comment, the fifth sentence of the third paragraph should have said US$8-0 billion.该更正已于 2024 年 11 月 4 日作出。
{"title":"Correction to Lancet Public Health 2024; 9: e834–35","authors":"","doi":"10.1016/s2468-2667(24)00265-2","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00265-2","url":null,"abstract":"<em>Tan M. Mandatory salt targets: a key policy tool for global salt reduction efforts.</em> Lancet Public Health <em>2024;</em> 9: <em>e834–35—</em>In this Linked Comment, the fifth sentence of the third paragraph should have said US$8·0 billion. This correction has been made as of Nov 4, 2024.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"45 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-04DOI: 10.1016/s2468-2667(24)00241-x
Wenjia Cai, Chi Zhang, Shihui Zhang, Yuqi Bai, Max Callaghan, Nan Chang, Bin Chen, Huiqi Chen, Liangliang Cheng, Hancheng Dai, Weicheng Fan, Dabo Guan, Yixin Hu, Yifan Hu, Junyi Hua, Cunrui Huang, Hong Huang, Jianbin Huang, Xiaomeng Huang, John S Ji, Peng Gong
2023 was a landmark year for climate change globally, across Asia, and within China. Global average temperatures were 1·45°C higher than the pre-industrial average, making it the warmest year on record since 1850. In Asia, 2023 was the second-hottest year documented. China recorded its highest-ever average temperature at 10·71°C (0·82°C above the 1981–2010 average), had its second-lowest rainfall since 2012, and endured notable flood and drought events.
{"title":"The 2024 China report of the Lancet Countdown on health and climate change: launching a new low-carbon, healthy journey","authors":"Wenjia Cai, Chi Zhang, Shihui Zhang, Yuqi Bai, Max Callaghan, Nan Chang, Bin Chen, Huiqi Chen, Liangliang Cheng, Hancheng Dai, Weicheng Fan, Dabo Guan, Yixin Hu, Yifan Hu, Junyi Hua, Cunrui Huang, Hong Huang, Jianbin Huang, Xiaomeng Huang, John S Ji, Peng Gong","doi":"10.1016/s2468-2667(24)00241-x","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00241-x","url":null,"abstract":"2023 was a landmark year for climate change globally, across Asia, and within China. Global average temperatures were 1·45°C higher than the pre-industrial average, making it the warmest year on record since 1850. In Asia, 2023 was the second-hottest year documented. China recorded its highest-ever average temperature at 10·71°C (0·82°C above the 1981–2010 average), had its second-lowest rainfall since 2012, and endured notable flood and drought events.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"195 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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