China is losing its battle to reduce smoking, with weak policies from health officials deftly avoided by the crafty State Tobacco Monopoly Administration (STMA) and its tobacco companies.

As the world's largest consumer and producer of tobacco, China has made some efforts to reduce smoking, especially since joining the WHO's Framework Convention on Tobacco Control (FCTC) almost five years ago. Last month, it released the final results from its first Global Adult Tobacco Survey, revealing that 300 million Chinese adults smoke.

But even more disturbing, the survey showed, is that the public has little knowledge of the hazards of smoking. More than two out of three respondents did not know the dangers of secondhand smoke, and 86 percent wrongly believed that light or low-tar cigarettes were healthier than regular cigarettes. Efforts to ban tobacco advertisements, required under the FCTC, were not accompanied with campaigns to raise awareness on the negative health effects of smoking.

Meanwhile, China's tobacco companies continue to look for new ways to increase competition and promote themselves. Despite bans that greatly limit the advertising space for tobacco, the industry has simply shifted its vast resources to other channels. For example, they have sponsored many sports events and use product placements in television shows and films. Indeed, in the entertainment industry, smoking cigarettes is often associated with glamour and sex appeal, influencing many people, especially the young, to start smoking.

A study on 11,000 middle-school students in Beijing found that 54 percent are frequently exposed to cigarettes on TV, while 39 percent think characters who smoke are "charming." Almost 33 percent would imitate characters on TV by smoking.

Supporters of tobacco control and other government departments have done little to combat the deleterious effects of the STMA. Tobacco is the No. 1 killer in China, claiming 1 million lives each year. The deaths caused by smoking have now exceeded the total number of deaths from AIDS, tuberculosis, traffic accidents and suicides, according to Hu Angang, a professor at Tsinghua University. And at the current rate, China can expect an average of 3 million deaths each year this century, according to Sarah England, a WHO representative in China.

Tobacco companies have always claimed that tobacco brings substantial economic benefits to the country, saying reducing tobacco use would cause unemployment and a decline in tax revenues. They even argue that smoking could reduce the nation's economic burden by speeding up the deaths of the elderly.

But none of this is true. Direct and indirect costs of medical care for tobacco use are higher than revenue from tobacco taxes. In 2005, costs related to smoking amounted to 2.87 trillion yuan, while the total tax revenue from tobacco was 2 trillion yuan.

It is time to change China's culture of smoking. And that change should start with – as always – the government.