Although it joined the FCTC as early as 2006 and made some changes to its cigarette packaging policies, China still has a long way to go. The State Tobacco Monopoly Bureau and General Administration of Quality Supervision, Inspection and Quarantine issued "Provisions on Domestic Cigarette Packaging" in 2008. As a result, new cigarette packaging designs in China have warnings in both Chinese and English. However, their color is the same as the packaging itself, and they are located at the bottom.

A typical Chinese cigarette case: the brand name is Zhen Long (meaning "real Chinese dragon") [China.org.cn]

In addition, the content of the warnings is overly general. It does not provide enough information to show the harms of smoking. To gauge the effects, the International Tobacco Control (ITC) conducted research in Beijing, Shanghai, Kunming and Yinchuan about the impacts of the different types of warnings on Chinese cigarette packaging, with grim results. The study showed that both the new and old types of Chinese packaging were less influential than the packaging with large pictures and warnings as seen in Canada, Singapore, Hong Kong and the European Union, with the most effective one having a clear and horrifying picture of lung cancer.

However, the reasons for not following international common practice are complicated. The effectiveness of health warnings will hurt tobacconists’ profits and reduce their tax. Additionally, most Chinese cigarette brands have names related to Chinese culture and historical heritage, such as "Zhonghua," meaning China; "Zhongnanhai"; and "Ginseng," a precious Chinese herbal medicine. As a result, people like to buy them as gifts during festive times. Some argue that the warnings will deface the Chinese image and hurt the feelings of the Chinese people.

A Hong Kong cigarette package warns in Chinese: "Smoking causes aging of the skin." [China.org.cn]

In contrast, there are also quite a few people that think health is more precious than any other factors. A total of 80.7 percent of interviewees surveyed by ITC supported the idea of putting health warning pictures on packaging. The cultural aspect can be well managed if the government chooses an appropriate form. Hong Kong, for instance, provides a good example to follow. The design of health warning pictures on Hong Kong cigarette packaging successfully conveys the harm of smoking in a culturally-acceptable way.

Some organizations and individuals are working hard to promote the change of Chinese cigarette packaging. Guangdong deputy to the National People's Congress, Huang Xihua, proposed the printing of pictures of diseases caused by smoking on packaging in March. The China Center for Disease Control called on practicing Article 11 of the FCTC in China as soon as possible. The slogan of this year’s World No-Tobacco Day on May 31 was "Show the truth: Picture warnings save lives." It’s time for China to realize this goal.