In 2007, China set up a tobacco-control group led by the Ministry of Industry and Information Technology. It was responsible to fulfill China’s commitment from the 2006 convention. However, the same ministry simultaneously oversees China National Tobacco Corp., the largest tobacco manufacturer in the world by sales. Yang said it's a precarious and conflicting position for the ministry. “The ministry plays dual roles, as if in a sporting event one player also served as referee,” Yang said.

In November 2010, the countries that participated in the convention gathered in Uruguay to discuss the regulations on controlling tobacco ingredients and revealing their negative effects. However, the Chinese delegate strongly protested and explained that tobacco is a key industry for China. That protest won the Chinese delegate the “Dirty Ashtray” nomination.

In addition to the administrative disarrangement, the tobacco-control campaign lacks legal support to eliminate the tricky advertisements and promotional events held by tobacco companies. There are no laws that prohibit public smoking or tobacco advertisements. Furthermore, tobacco companies began using charities as promotional tools. According to the Chinese Association on Tobacco Control, 52 tobacco companies had held 79 charity affairs and promotional events from September to December 2009. In 2010, China National Tobacco Corp. donated 10 million yuan to establish the Golden Leaves Foundation.

Even more perverse, Chinese cigarette packaging usually features pleasant depictions of pandas or majestic shots of the Great Wall, instead of printing drastic warnings coupled with vivid images that show the potentially horrific consequences of smoking. The required warning occupies only a small space with the simple “smoking is harmful to your health.”

Low taxation makes cigarettes very affordable, and although China has levied five percent more taxation on tobacco wholesales since 2009, the price remains low compared with other countries. For example, a package of Marlboro costs $2.04 in China while it’s $9.39 in Singapore and $11.48 in Norway.

Experts like Yang and Wu believe tobacco control should be listed as a strategic campaign in the country’s 12th Five Year Plan and should draw attention from the State Council, which can separate the tobacco enterprises from the government management. According to the “Tobacco Control and China’s Future,” the next 20 years offer a good opportunity for China to regulate its tobacco control policies.

“It will be a touchstone to test the government’s ability to transform the health-hazardous economy into health-friendly economy,” Yang said.