Newspaper coverage about smoking in leading Chinese newspapers in past nine years.

Recent research has clearly identified the importance of media advocacy in advancing tobacco control objectives.1–4 Generating news coverage of tobacco control-related issues is a low cost activity that can generate extensive and ongoing coverage to which millions of citizens, including politicians and decision makers, are exposed. Media advocacy has thus become an important component of comprehensive tobacco control programs.

The number of articles focused on passive smoking, secondhand smoking or adolescent smoking in important Chinese newspapers from 2000 to 2008.

The number of articles about the Olympics among smoking-related articles in important Chinese newspapers from 2000 to 2008.

China has the world's largest population, with 52.4% of adult men and 3.4% of adult women smoking.5 6 In China, news coverage of health issues has increased dramatically in recent years. In our previous study of cancer coverage in Chinese newspapers, there was a sharp increase in cancer-related reports from 578 articles in 2000 to 1403 articles in 2006.7 However, there has been little analysis or evaluation of news coverage on smoking in China.

In this study we aim to provide a systematic overview of all tobacco news coverage in a database of major Chinese newspapers over 9 years from 2000 to 2008.

Methods

Reports about smoking-related matters were obtained from the Database of Important Chinese Newspapers (http://www.cnki.net) from 2000 to 2008. As of 18 June 2008, the database included 152 national and 362 local newspapers. The search keywords were fixed as ‘’, ‘’ (, in English: smoking), ‘’, ‘’ or ‘’ (, , in English: smoking cessation, or smoking restriction) in the title to calculate the number of smoking-related articles.

Every smoking-related article obtained from the database was carefully read to ensure that tobacco was central to each article, and articles without smoking-related content were excluded. Articles were allocated to a primary topic classification, which included government law/policy/regulation, health consequences, prevention/cessation programs, affiliated organisation/business news, negative social effects or other. Stories about secondhand smoking, adolescent smoking and smoking-related Olympic Games stories were also noted.

We tested whether the number of articles in each year was the same using the Poisson heterogeneity test.8

Results

A total of 1366 articles about smoking or smoking control were located (table 1). There was a significant difference in the number of articles appearing each year (p<0.001). Except for small decreases in 2001 and 2002, press attention to smoking increased every year, indicating increasing attention paid to smoking-related matters in recent years. The total number of articles was highest in May (234 articles, p<0.05) because of press reports of ‘World No Tobacco Day’ on 31 May.

Table 1

Theme of smoking-related articles from 2000 to 2008 in China

Themes	2000	2001	2002	2003	2004	2005	2006	2007	2008	Total
Health	10	23	13	28	31	40	134	185	71	535*
Government law/policy/regulation	7	1	3	4	10	13	17	21	127	203*
Tobacco prevention/cessation program	18	9	4	21	11	26	54	71	72	286*
Affiliated organisation news	2	1	2	4	5	11	24	32	96	177*
Negative social effects	1	1	1	3	4	10	10	21	27	78*
Other	5	1	3	11	7	21	12	11	16	87*
Total	43	36	26	71	68	121	251	341	409	1366*

Poisson heterogeneity test p<0.001.

The principal focuses of 1366 smoking-related articles, as judged by headline, are shown in table 1 . For each theme, there was a significant difference in the number of articles appearing each year (p<0.001). Almost 2 in 5 of all articles (535/1366) focused on the effects of smoking on health with tobacco prevention/cessation programs being the next most frequent category. Examples included ‘Smoking increases the incidence of lung cancer’, ‘Smoking addiction is a risk factor for coronary heart diseases’ and ‘Smoking is harmful to eye health’. However, in 2008 stories about government law/policy/regulation concerning tobacco appeared most frequently.

In the years prior to 2005 there were less than 10 reports on secondhand smoke, but in 2007 and 2008 this increased to 44 and 37 reports, respectively.

References to smoking and the Olympics numbered just 3 in 2006, and then rose sharply to 30 in 2007, and further to 67 in 2008, suggesting that the then-forthcoming Olympics stimulated this increase.

The total volume of articles (1366) reflects an ongoing presence of tobacco issues in the news, with an average of nearly one article per day in 2007 and 2008 in Chinese newspapers. The growing coverage may reflect increasing attention to smoking and the endeavours being made to promote tobacco control in China. In our previous research, we found 7643 newspaper reports about cancer in newspapers between 2000 and 2007. Smoking-related articles (1366) were far less frequent over the same period. More attention should be paid to promoting newspaper coverage about smoking in newspapers.

The coverage of issues in newspapers is typically highly correlated with the presentation of the same issues in other media such as radio and television.9 Indeed, newspaper and magazines articles are often cited by the public as common sources of health information.10

In the US and Australia, secondhand smoke was the most prevalent tobacco-related theme.11 Its low ranking in Chinese newspapers suggests there is plenty of scope to raise coverage of this issue in the news media in China.

There are limitations to our study. For example, we only examined newspapers, but did not analyse the slant of articles. The development of strategies aimed at improving health news reporting deserves more focused attention from the media and researchers.