Along with the speeches and ceremonies to mark the opening of the Stanford Center at Peking University, Stanford scholars from the Freeman Spogli Institute for International Studies are showcasing their work examining China’s promises, challenges and increasingly important role in the world.

The Shorenstein Asia-Pacific Research Center held a two-day workshop examining China’s relationships with its neighbors. The event draws on work being done by Thomas Fingar, FSI’s Oksenberg-Rohlen Distinguished Fellow, who is leading a new initiative to explore the nuances and complexity of China’s foreign relations and domestic issues.

Scott Rozelle, co-director of the Rural Education Action Project, planned a conference on Thursday exploring the impacts of technology on China’s health and education systems. For years, Rozelle has studied how basic medicine and better meals improve children’s performance in school. He’s lately been evaluating the best and most affordable ways to use new technology in rural Chinese schools.

On March 26 and 27, the Asia Health Policy Program will focus on the challenges China’s growing tobacco-control movement faces against a multibillion-dollar government-run industry. Anthropologist Matthew Kohrman, a specialist on tobacco in China, will lead the workshop examining the connections woven over the past 60 years between marketing and cigarette gifting, production and consumer demand, government policy and economic profit, and the other forces behind China’s smoking culture.

Newly printed “no smoking” signs went up across China when the government rolled out a nationwide public indoor smoking ban in May 2011. A sticky gray layer of smoke residue now coats many signs, representing the challenges China’s growing tobacco-control movement faces against a multibillion-dollar government-run industry and deeply embedded social practices.

How has the cigarette become so integrated into the fabric of everyday life across the People’s Republic of China (PRC)?

To get to the heart of this question, historians, health policy specialists, sociologists, anthropologists, business scholars, and other experts met Mar. 26 and 27 in Beijing for a conference organized by Stanford’s Asia Health Policy Program. They examined connections intricately woven over the past 60 years between marketing and cigarette gifting, production and consumer demand, government policy and economic profit, and many other dimensions of China’s cigarette culture.

Anthropologist Matthew Kohrman, a specialist on tobacco in China, led the conference, which was held at the new Stanford Center at Peking University. In an interview, he spoke about the history of China’s cigarette industry, cigarettes and society, and the tobacco-control movement.

The early years

Tobacco first entered China through missionary contact in the 1600s, says Kohrman, but it was not until the early 20th century when cigarettes began gaining popularity. The first cigarette advertising was a “confused tapestry” of messages as marketers figured out what spoke to the public. “There were just as many images of neo-Confucian filial piety as there were of cosmopolitan ‘modern women,’” says Kohrman.

Through improved marketing and aggressive factory building, British American Tobacco and Nanyang Brothers, China’s two largest pre-war firms, helped increase the demand for cigarettes. The Sino-Japanese War (1937–1945) disrupted the cigarette supply, but their popularity had taken hold. Some cigarette firms shifted during the war to the relative safety of southwest China, where tobacco production has remained concentrated ever since.

Post-1949

After the founding of the PRC in 1949, the tobacco industry was nationalized and strong relationships between the central government and cigarette manufacturers in the provinces were formed. Cigarettes also began to be viewed as a part of everyday life. “Ration coupons for cigarettes were issued alongside grain, sugar, and bicycle coupons,” says Kohman. “The Maoist regime legitimized cigarettes as the right of every citizen."

During the Deng Xiaoping era (1978–1997), China’s cigarette industry really took off as manufacturers competed with one another for foreign currency to purchase cutting-edge European equipment and newer varieties of tobacco seed stock. Increased production and the return of full-scale advertising fueled greater consumer demand, and manufacturers began producing more and more varieties of cigarette. Vendors displayed glass cases filled with a colorful patchwork of cigarette packs bearing names like Panda, Double Happiness, and Red Pagoda.

The tobacco industry remained under government control as other industries privatized in the 1980s and 1990s. Party-state management of the cigarette became even more centralized in the early 1980s with the creation of the China Tobacco Monopoly Administration and its parallel external counterpart, the China Tobacco Corporation.

Since 1949, provincial protectionism has marked the cigarette market. It is now possible to purchase Beijing cigarettes in Kunming, Chengdu brands in Shanghai, and so on, but to distribute cigarettes in another province, a manufacturer must cut a deal with provincial government officials. Provincial administrations are loath to cut such deals because central government policy dictates that the portion of cigarette sales tax which does not go to the central government always is channeled to the finance bureau of the province of original production. China’s 2001 entry into the World Trade Organization opened the market ever so slightly to international brands like Marlboro and Kent, but domestic brands continue to dominate because of fierce protectionism.

...If it chooses to do so, China is in a position to lead and change the landscape in a very profound way.
-Matthew Kohrman, Professor of Anthropology, Stanford
A new era

In 2003, the World Health Organization established the first global health treaty, the Framework Convention on Tobacco Control (FCTC). Although the United States still has not yet ratified the FCTC, China signed the treaty in 2003 and ratified it in 2005. Kohrman says China’s tobacco industry giants fear competition from international cigarette brands more than they worry about tobacco-control measures related to the FCTC.

Nonetheless, the FCTC ushered in a new era of public health research about tobacco and has helped increase public awareness about the dangers of smoking. New restrictions have been imposed on print and television advertising for cigarettes, and international organizations, such as the Bloomberg Family Foundation, have begun funding anti-tobacco work in China.

A big challenge to tobacco-control campaigns, says Kohrman, is the sheer amount of money that tobacco companies have available for marketing. “In 2010, China’s tobacco industry posted profits in excess of U.S. $90 billion—that’s huge. Tobacco control research and advocacy now annually receive a few million dollars, and much of that is coming through outside funders, which have very specific projects in mind.”

China’s tobacco advertisers have adapted to the new restrictions that prevent them from openly promoting cigarettes in the media. They have instead moved to point-of-sale and soft-marketing tactics, including misinformation campaigns about the “dangers” of quitting smoking. “The actual expenditure on marketing probably hasn’t dropped very much,” says Kohrman.

Cigarettes and society

Strong marketing and the legitimization of cigarettes as a part of everyday life have led to the deep integration of cigarettes into Chinese society. While only 3 to 4 percent of women in China smoke, cigarettes are an important part of male identity and social mobility. The wide range of cigarette brands has led to the growth of high-end varieties favored by businessmen and politicians, with some brands costing as much as $50 a pack. The custom of cigarette gifting has existed in China for decades, and it is difficult for a young man to turn down a package of cigarettes from a senior colleague or supervisor.

There is also the fact that nicotine is highly addictive, and quitting is difficult in an environment where smoking cigarettes is socially sanctioned. Kohrman says, “When you take an incredibly addictive substance like nicotine and throw it into the mix of all of these norms and customs, it creates a pretty toxic brew.”

The future?

Tobacco control presents a formidable challenge in China, one that requires understanding the historical context and complex dimensions of the cigarette industry. “Cigarettes have been insinuated into so many aspects of daily life across China, and the market for this product has now become so closely enmeshed with matters of government finance and operations,” says Kohrman.

What happens in China could have implications for the entire world. “There’s a tobacco-induced human annihilation unfolding right now in almost every country and questions about how society and Big Tobacco are enmeshed, and how cigarette culture and government finance have become mutually supportive are pivotal,” says Kohrman. “Every country except Bhutan has legalized cigarette sales and is subject to many of the same general issues as China—only in China they’re on a much larger scale. But if it chooses to do so, China is in a position to lead and change the landscape in a very profound way.”   

What influence might graphic warning labels have on cigarette sales? Matthew Kohrman is studying that question with experimental methods in Southwest China. Kohrman’s research is generating much-needed data in support of the expansion of China’s warning label system. Among the countries increasingly adopting graphic labels, the United States will require visual warnings on all cigarette packages by next fall.

Stanford Cancer Center News: Smoking cessation in a land of two trillion cigarettes

Tobacco is the single greatest cause of preventable death in the world today, including in China where cigarette smoking is a popular pastime. "The [tobacco] industry in China is run by the Tobacco Monopoly Administration, a central government administrative body created in the 1980s, also known as China Tobacco Corp.," said Matthew Kohrman in a February 2011 interview with NPR's Morning Edition. China nonetheless issued a nationwide indoor smoking ban on May 1. Speaking with Al Jazeera English on the first day of the ban, Kohrman predicted that Chinese citizens will increasingly comply with the ban even if in fits and starts initially. "It all has to do with implementation," he suggested. "It all has to do with changing the culture of smoking and people’s thinking about it—that takes time."

The first Liberation Technology seminar of the winter quarter on January 6, featured Jonathan Zittrain, Professor of Law at Harvard Law School and co-founder of the Berkman Center for Internet & Society at Harvard University. Zittrain focused his talk entitled, Minds for Sale, on the variety of online platforms that harness the wisdom of crowds today, and closed with a discussion of the implications of these platforms. Categorizing these new tools by the breadth of their user base, Zittrain began by describing the platforms that pay the most money per task, require the most skill, and subsequently have the least participation. Key examples of these platforms are listed below, and organized by their decreasing level on skill.

•  Xprize Foundation attempts to prompt radical breakthroughs through competitions for large quantities of prize money.
• InnoCentive creates a marketplace between engineers and scientists to encourage innovation.
• LiveOps, which bills itself as a contact center cloud, has developed a large set of independent contractors who are designated specific tasks when they sign in to the site. They may be assigned to answer calls placed to a restaurant or emergency hotline or to make political calls on behalf of Liveops clients.
• Samasource offers "dignified digital work for women, children and refugees" located in developing countries.
• Amazon Mechanical Turk (also known as Artificial Artificial Intelligence) allows users to participate in anonymous, minimally paid tasks. These tasks can be submitted by any party and are highly disaggregated among hundreds or thousands of users, each of whom receives a payout of between approximately one to fifteen cents for completing the task.
• Soylent, which calls itself "a word processor with a crowd inside" embeds workers from Mechanical Turk into Microsoft Word. When users install the site's Shortn add-in into Microsoft Word, they can use the tool to have written samples shortened in two minutes. In order to achieve this, the written sample is disaggregated by paragraphs, and each paragraph is shortened within two minutes by a "Turker"-a user who accepts the task on Mechanical Turk.
• Microtask enables disaggregating previously sensitive data to be work processed from a scanned image. The ultimate goal of this group is to put distributed work into video and computer games. For now, they disaggregate larger tasks into two-second tasks that can be distributed across a crowd.
• Games With A Purpose (GWAP) has a game-like platform designed to get users to complete disaggregated tasks for virtual points, rather than for actual remuneration. One of its more popular activities quickly attracted 23,000 players who contributed 4.1 million labels to images they were presented with in The ESP Game. Many players routinely play more than 20 hours a week.

Next, Zittrain moved on to offer some additional examples, hypothetical scenarios and questions that highlight some of his own concerns about the potential of these technologies. One key question is whether this market may be too efficient at linking up solvers and payers, if certain tasks are not in fact beneficial for society. After all, it was highly contentious when Texas governor Rick Perry set up video cameras on Texas' border with Mexico and invited people to watch the video feeds and report if they saw anything suspicious. Similarly, a site called InternetEyes allows users to watch video feed from CCTV cameras in the UK for free, offering the chance to "earn reward money, have a chance at reducing crime, and potentially become a hero and save lives," instead of actual compensation.

In another example, the University of Colorado Police Department recently offered a $50 reward for identification of students shown to be smoking marijuana in photos from a large April 20 gathering. Hypothetically, the Iranian government could use Turkers to identify Iranian protestors through national ID photographs in the very same way; by Zittrain's calculations, this task could be disaggregated and carried out quickly at a cost of only $17,000 per protester identified.

Another cluster of issues relates to the use of anonymous users to carry out disaggregated tasks that may have the effect of exerting influence on others. For example, Turkers were recently offered the opportunity to write a positive 5 out of 5 review for a product on a website, which hundreds accepted and completed for a few cents at a time. Users on SubvertandProfit.com are paid to "Like" something on Facebook, "Digg" something, or show their approval of a site or product via some other social network. The users are remunerated for their effort, and the site also profits. Taking this a step further, these platforms also enable users to pay people to evince opinions on legislative issues they do not actually care about. For example, health insurers were recently caught paying Facebook gamers virtual currency to oppose the health reform bill. By enabling any task to be disaggregated and monetized, these new platforms can have highly controversial and unethical implications.

In the past year, AHPP faculty affiliate Matthew Kohrman published in the Asia-Pacific Journal of Public Health a critical assessment of international anti-tobacco interventions. He has also been quoted in Science, Harvard Global Health Review, and Stanford University News regarding tobacco-control efforts in China and around the world.

President Barack Obama announced his intent to appoint CISAC's Mariano-Florentino Cuéllar, an expert on federal regulatory policy, public safety, and international security, to the Council of the Administrative Conference of the United States (ACUS), an independent agency of the United States government charged with improving the efficiency and fairness of federal agencies.

Professor Cuéllar, who is both a CISAC faculty member and the Deane F. Johnson Faculty Scholar at Stanford Law School, recently returned from a leave of absence he took to serve as Special Assistant to the President for Justice and Regulatory Policy at the White House Domestic Policy Council. Among other issues, Cuéllar worked on improving food safety and public health policy, expanding support to state and local law enforcement, enhancing transparency in the regulatory process, and strengthening border coordination and immigrant integration. He negotiated key provisions of the Family Smoking Prevention and Tobacco Control Act and represented the Domestic Policy Council in the development of the first-ever Quadrennial Homeland Security Review. Earlier, Cuéllar co-chaired the Obama Transition's Immigration Policy Committee and served as a Treasury official in the Clinton Administration.

As part of the ACUS Council, Cuéllar will join leading lawyers such as former U.S. court of appeals judge Patricia Wald and former solicitor general Ted Olson in overseeing the work of ACUS and setting its priorities. With the appointment to the ACUS Council, Cuéllar will draw upon his scholarly expertise in how institutions manage complex regulatory challenges as well as his experience in government.

"At a time when our country faces such enormous challenges, it is especially important for agencies to safeguard the rights of the public, cut waste, and deliver value to the American people," said Cuéllar. "I am honored by this appointment and by the chance to work on these critical issues."

Established by statute in 1964, the Administrative Conference of the United States has played an important role in promoting improvements in the efficiency and fairness in the way federal agencies conduct regulatory programs. ACUS has been on hiatus for the past 14 years, but has been revived by Congress with support from a broad range of lawyers, scholars, and judges, including Supreme Court Justices Antonin Scalia and Stephen Breyer.

U.S. Ambassador to the United Nations and former FSI Advisory Board member Susan Rice '86 urged Stanford's graduating class to fight global poverty, conflict, and repression, saying "These massive disparities erode our common security and corrode our common humanity." Conflict-ridden states not only cause suffering for their people, she noted. "Poor and fragile states can incubate threats that spread far beyond borders -- terrorism, pandemic disease, nuclear proliferation, criminal networks" and more. "In our interconnected world," she said, " a threat to development anywhere is a threat to security everywhere."

When Susan Rice graduated from Stanford in 1986, the Soviet Union was a formidable foe, China barely registered on the global economic scene and the first computer laptops – weighing in at 12 pounds each – were just hitting the market.

And if someone had told her that she'd serve in the Cabinet of the country's first black president as ambassador to the United Nations, "I would've asked them what they were smoking."

But in her remarks delivered during Stanford University's 119th Commencement on Sunday, Rice put the advances of the past 24 years in perspective. She called the fight against global poverty "not only one of the great moral challenges of all time, but also one of the great national security challenges of our time."

"The planet is still divided by fundamental inequalities," she said. "Some of us live in peace, freedom and comfort while billions are condemned to conflict, poverty and repression. These massive disparities erode our common security and corrode our common humanity."

While she did not discuss any specifics of her role as the country's ambassador to the United Nations or the organization's recent move to impose a fourth round of sanctions on Iran, Rice did talk about the link between poverty and security.

"When a country is wracked by war or weakened by want, its people suffer first. But poor and fragile states can incubate threats that spread far beyond borders – terrorism, pandemic disease, nuclear proliferation, criminal networks, climate change, genocide and more. In our interconnected age, a threat to development anywhere is a threat to security everywhere."
-Ambassador Susan Rice

Rice's address marked a very public return to Stanford. She graduated with a bachelor's in history from the university as a junior Phi Beta Kappa and Truman Scholar in 1986.

She was confirmed as ambassador to the United Nations in 2009 after being nominated by President Obama. It was a job that followed her role as Obama's senior adviser for national security affairs during his presidential campaign in 2007 and 2008. Before that, she served as the country's assistant secretary of state for African affairs and as a special assistant to President Clinton. She was also a senior director for African affairs at the National Security Council.

During a trip to a displaced persons camp in war-torn Angola in 1995, Rice saw firsthand the global poverty she talked about on Sunday. Of all the people she saw in the camp, she said one of her most striking memories is the smile she received from a malnourished little boy when she gave him her baseball cap.

But she's haunted by thoughts of what may have happened to him.

"I had to leave that camp," she said. "And when I did, I left that little boy in hell. I like to think, and I sure hope, that kid is OK. But he could well have become one of the 9  million children under the age of 5 who die each year from preventable and treatable afflictions."

And that boy, she said, should be a symbol to Stanford's graduates of the challenges that face them and the good they can do in the world.

"That little boy's future is tied to ours," she said. "Our security is ultimately linked to his well-being. So we must shape the world he deserves."

Rice's weighty remarks still left room for graduation levity. And the student procession – known as the Wacky Walk – showcased much of it.

The graduates hit the field of Stanford Stadium with balloons and signs thanking mom and dad. They were dressed as Egyptian kings and Vikings, wizards and butterflies. Some wore bathing suits and flowing togas. Others covered up with costumes paying homage to the pop culture past of Pac-Man, as well as more timeless pursuits like dominoes and poker.

It was a final blast of carefree fun for college students about to contend with an uncertain job market.

"We have everything we need on campus," said Tyler Porras, a graduating biology major who took to the field with a bolo tie and black cowboy hat. "Now it's off to the real world where you need to find a job."

The ceremony marked the award of 1,722 bachelor's degrees, 2,100 master's degrees and 980 doctoral degrees.

Departmental honors were awarded to 365 seniors, and 272 graduated with university distinction. Another 74 graduated with multiple majors and 33 received dual bachelor's degrees. There were 110 graduates receiving both bachelor's and master's degrees.

Among international students, there were 102 undergraduates from 45 countries other than the United States, and 955 graduate students from 75 foreign countries.

"As you leave Stanford, I hope you carry a deep appreciation of the values and traditions that are everlasting, as well as a willingness to be bold and to approach challenges with a fresh perspective," Stanford President John Hennessy told the graduates.

The day also gave parents a time to beam and brag.

"These kids have the potential to contribute so much to the world," said Tim Roake, whose daughter, Caitlin Roake, is graduating as a biology major and is planning to join the Peace Corps.

Roake and his wife, Kathleen Gutierrez, had front-row seats in the stadium bleachers next to Dave and Lori Gaskin. Their son, Greg, has been dating Caitlin Roake since their freshman year.

"The last four years for Greg have been such an enriching experience from an academic perspective but also on a personal level," Lori Gaskin said. "I attribute that not only to the university but the wonderful people he's met and the relationships he's made."