Background: China is the largest tobacco producer globally, with Yunnan province being the largest tobacco-producing region. In China there are 20 million tobacco farmers. Showing that income from crop substitution can exceed that from tobacco growth is essential to persuading farm families to stop planting tobacco. In Yuxi Municipality, collaborators from Yuxi Bureau of Agriculture, University of California at Los Angeles School of Public Health, and Kunming Medical University initiated a tobacco crop substitution project. At 3 sites, 458 farm families volunteered to participate in a new, for-profit cooperative model. This project successfully identified an approach engaging farmers in cooperatives to substitute food crops for tobacco. Methods: The current follow-up project utilized official data from the Yuxi Municipal Bureau of Agriculture. Three pilot counties - Hongta District, Chengjiang County, Eshan County - were selected for information collection on acreage of tobacco, vegetables, fruits and other crops, and net income of farmers. Results: Compared to 2012, Yuxi tobacco planting area has dropped significantly from 763,494 Chinese mu (one Chinese mu equals 0.16 acres) to 586,404 Chinese mu in 2015, whereas the area devoted to vegetables and fruits has increased 24%. The net income change directly linked to the tobacco crop substitution was an increase of more than 3000 yuan ($ 484) per capita in Yuxi city and the three pilot project areas, observed from the 2012-2015 data. By mid-2014 and for the first time, farmers' per capita income passed 10,000 yuan ($ 1613). Conclusions: The tobacco substitutition pilot project in Yuxi reduced the density of tobacco planting and increased planting area of vegetables and fruits. The results not only increased the economic status of farmers, but also benefited the health of the public by reducing the availability of tobacco in China. The diffusion of tobacco crop substitution in Yunnan provides a good example for China.
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