Analyzing the Diversity and Impacting Factors of Smoke-Free Legislation and Implementation in Mainland China: A Case Qualitative Research.

This article examines the legislative and implementation variations of smoke-free laws across mainland China since the country ratified the World Health Organization’s Framework Convention on Tobacco Control (FCTC) in 2005. Through literature review, policy mapping, and qualitative interviews with 16 stakeholders in Shanghai and Chongqing, the study identifies significant delays and disparities in adopting comprehensive smoke-free laws, influenced largely by tobacco industry interference, differing policy maker attitudes toward designated smoking rooms, and challenges in enforcement coordination and resources. Economically stronger cities like Shanghai show more effective enforcement and public engagement, partly due to dedicated coordinating departments, whereas cities like Chongqing face workforce shortages and weaker oversight. The findings highlight the need for clearer transition timelines, enhanced policy advocacy, and establishment of coordinated enforcement bodies to improve the effectiveness of smoke-free legislation in China.