BACKGROUND: While media plays a crucial role in tobacco control policy advancement, little is known about how different policy contexts shape media coverage of tobacco control, particularly in China’s unique political and administrative systems. This study innovatively compares tobacco control news coverage across three regions with distinct tobacco control policy environments: Mainland China, Guangdong Province, and Macao SAR, examining how policy contexts influence media agenda-setting before and during the COVID-19 pandemic.
METHODS: Using the WisersOne database, we analyzed 749 tobacco control news articles from three influential newspapers (People’s Daily, Southern Daily, and Macao Daily) from 2017-2022. We employed a mixed-method approach combining co-word analysis and topic modeling using Python. The analysis was divided into pre-pandemic (2017-2019) and pandemic periods (2020-2022) to examine temporal changes in media coverage patterns and policy priorities.
RESULTS: Significant disparities in coverage intensity and thematic focus were found across regions. Macao Daily published substantially more tobacco control articles (596) than People’s Daily (46) and Southern Daily (107). While mainland media primarily focused on youth tobacco prevention and World No Tobacco Day, Macao’s coverage demonstrated more comprehensive themes including enforcement, legislative participation, and addiction prevention. During the pandemic, all regions showed reduced coverage but maintained distinct thematic priorities, with emerging emphasis on e-cigarette regulation and youth protection.
CONCLUSIONS: This study reveals how policy environments substantially influence media agenda-setting in tobacco control. Macao’s comprehensive tobacco control legislation corresponds with more frequent and diverse media coverage, while mainland China’s limited national smoke-free legislation is reflected in sparse, fragmented coverage. These findings suggest the need to strengthen media advocacy strategies in mainland China to advance national tobacco control policies, particularly by leveraging successful examples from regions with strong tobacco control measures.