Cigarette sharing and gifting in rural China: a focus group study.

OBJECTIVES To understand the reasons behind gifting and sharing cigarettes in China's rural areas and how these practices contribute to smoking initiation and hamper smoking cessation efforts. METHODS A convenience sample of 31 current smokers and nonsmokers was selected from a rural farming town in Hunan, China. Participants were divided into 6 focus groups according to gender and smoking status. Focus groups discussed the reasons behind gifting and sharing cigarettes as well as the effect these practices have on tobacco initiation and cessation. RESULTS In rural China, individual cigarettes are primarily shared as a mechanism to convey respect and intimacy. Packs of cigarettes are given primarily due to their convenience as well as being well liked by both smokers and nonsmokers. Sharing individual cigarettes by both peers and older relations contributed to individuals beginning to smoke. Sharing cigarettes among friends was also a major hindrance to smoking cessation. CONCLUSIONS Gifting and sharing cigarettes significantly contribute to smoking in rural China. Future tobacco control efforts should discourage both these activities to reduce tobacco usage. Tobacco control measures should also aim to inform adults about the health consequences of giving cigarettes to adolescents. Similarly, more information on the benefits of smoking cessation should be provided to China's rural elderly population. This information could lead to increased community support of cessation efforts and ultimately result in reductions in smoking in rural China.