Gift-Giving and Social Etiquette: China’s long Confucian traditions emphasize reciprocity and face (mianzi) through gift-giving . In this context, cigarettes have become a ritualized gift and social currency. For example, one analysis notes “the clearest measure of…proper etiquette and social status is the gift,” and “in Chinese culture, this ritualized way of giving gifts has been incorporated into cigarettes. Acceptance of cigarettes can represent a person’s willingness to engage in future business partnerships” . Premium cigarette brands are commonly offered during holidays like Lunar New Year or Mid-Autumn Festival to show respect and status: giving expensive cigarettes signals both high esteem for the recipient and the giver’s prosperity . Tobacco companies exploit these customs by associating cigarettes with warmth, friendship and celebration during festivals . As one public health fact sheet summarizes: “The practice of gifting cigarettes is deeply rooted in Chinese culture… [and] is considered both a sign of respect and a status symbol…normaliz[ing] smoking in China” .
In Chinese social and business settings, offering cigarettes is a common courtesy. Surveys show 80.7% of people report sharing a cigarette as basic meeting etiquette, and 79.2% do so to welcome guests . A national survey also found that most smokers frequently share and gift cigarettes: 97% had shared a cigarette and 90% had given cigarettes as a gift . Cigarettes circulate freely in gatherings—friends, relatives, colleagues and clients routinely offer and accept them . In fact, one study found an item on a smoking attitudes questionnaire stating “Lots of doctors smoke, so they cannot convince me to quit,” reflecting how commonplace the habit is even among respected social roles . In practice, offering a cigarette can lubricate introductions, cement deals, or simply show friendliness.
Gender and Social Norms: Smoking in China is overwhelmingly a male behavior, driven by social expectations. Culturally, male smoking has been considered “respectable and…crucial for business and bonding,” whereas women’s smoking was long unacceptable . As a result, around 50–52% of Chinese men smoke today, while only about 2–3% of women do . Studies note common beliefs among male smokers such as “Smoking is pretty normal for men” and “There are so many smokers… it’s difficult to be different,” reflecting a widespread norm that men are expected to smoke . High smoking rates among male role models (doctors, teachers, celebrities) further reinforce this: for example, one survey item bluntly asserted that doctors smoke too, so they “cannot convince me to quit” . In short, smoking among Chinese men is socially endorsed and almost taken for granted.
Age and Social Group Differences: Smoking behavior in China also varies by age, region, and social factors. Older generations of men (e.g. born before the 1970s) tend to have very high smoking rates, reflecting habits formed when tobacco use was even more entrenched. While younger men have slightly lower rates than their fathers, male prevalence remains around 50% . Married people report sharing or gifting cigarettes more often than unmarried (married heads of households were about twice as likely to give gift cigarettes) , likely because they play more host and guest roles in social networks. Regional differences also appear: in one study Shaanxi province (Northwest China) had roughly double the cigarette-sharing and gifting of Guangdong (South China) . In summary, smoking is more prevalent in traditional or rural communities, among older/married men, and in occupations and subcultures where the practice is woven into social life.
Historical and Institutional Context: These cultural practices have deep historical roots. Tobacco arrived in China in the 16th century and gradually became woven into social life. The state-run China National Tobacco Corporation (CNTC) has long encouraged smoking (even promoting it as a patriotic industry) while also tapping into tradition. For decades, public policy has been weak partly because tobacco taxes fund local governments, and partly because social customs of sharing and gifting cigarettes are so entrenched that they “hinder the implementation of tobacco regulatory policies” . In recent years the government and health groups have launched campaigns (for example, “Giving cigarettes is giving harm”) to counteract the gift-giving norm . However, turning around decades of ingrained practice is a slow process.
Conclusion: In summary, high smoking rates in mainland China are underpinned not by ignorance of health risks but by deep-seated cultural factors. Tobacco use has been integrated into China’s social fabric as a polite gesture, a bonding ritual, and even a status symbol. These traditions – along with gender norms and historical entanglements between the state and the tobacco monopoly – explain why smoking remains so common, especially among men, even as awareness of its dangers grows. Successful change will require confronting these cultural expectations head-on, for example by redefining what gift-giving and business etiquette look like in a smoke-free world .
Sources: Authoritative surveys and analyses of Chinese smoking behavior and culture provide the basis for the above discussion. Each cited study and report offers quantitative and qualitative evidence on how traditional values and social practices in China have sustained high smoking prevalence.