Challenges for philanthropy and tobacco control in China (1986-2012).

objectiveTo identify the international philanthropies that have invested in tobacco control in China, describe their role and strategies in changing the social norms of tobacco use, and define the outcomes achieved.

methodsInformation on the international philanthropic donor China projects, including activities and outcomes, was gathered from multiple sources including organisational websites, key informant interviews and emails with project officers, and published research papers and reports.

resultsPhilanthropic donations to China's tobacco control efforts began in 1986. The donors provided funds to national, city, provincial government organisations, non-government organisations, universities, and healthcare organisations throughout China to establish a tobacco control workforce and effective programmes to reduce the burden of tobacco use.

conclusionsInternational engagement has been an important dimension of tobacco control in China. Recognising the large burden of illness and capitalising on proven effective control measures, philanthropic organisations understandably seized the opportunity to achieve major health gains. Much of the international philanthropic investment has been directed at public information, policy change and building the Chinese research knowledge base. Documenting research and evaluation findings will continue to be important to ensure that promising practices and lessons learned are identified and shared with the China tobacco control practitioners. The ultimate question is whether foreign philanthropy is making a difference in tobacco control and changing social norms in China? The answer is plainly and simply that we do not know; the evidence is not yet available.