It took several days of continuous dense, choking smog for the Beijing government to issue their first ever air pollution red alert at the beginning of December. However, there are still many people who worked out, walked their dogs or took small children to school despite the smog. Even though China has had a serious pollution issue for many years, the spread of information about the damage smog can do has been insufficient and the majority of people, especially vulnerable seniors, are still ignorant about the health risks.

Two women take a selfie on a heavily polluted day in Beijing, November 30. Photo: Li Hao/GT

To help with the effects of Beijing's depressing smog, Lu Bing (pseudonym) bought drugs from Canada online with a group of friends.

She saw a friend place an advertisement on WeChat for Deidou "lung cleaning" drugs on December 2, right after the wind blew Beijing's toxic smog away. The friend, worrying about her own health, decided to buy the drugs and try to cleanse her lungs, and Lu tagged along.

On the official website for Deidou, it stated that the so-called lung cleanser "helps the lung to move stagnant pollutants from the lung into the general blood circulation where they can be filtered and removed." It didn't specify if the drug can be taken to counter the effects of the tiny particles found in air pollution. In fact, a friend living in Canada even left a comment on Lu's friend's post arguing the drug helps mostly smokers, not people who live in smog, but it didn't matter to Lu.

"Who knows, it might have some positive effect," she said. "But even if it doesn't, it won't hurt me."

Buying drugs is one of the many ways Chinese people are shielding themselves from the effects of pollution nowadays. Compared with a couple years ago, the public is more aware of the pollution issue due to its frequent occurrence, but the overall awareness level is still low and efforts by the government and media to educate people leave a lot to be desired.

Becoming more aware

With the reoccurrence of smoggy days, the public seems to have gained more awareness of its hazards.

During the smoggy days at the beginning of December in which visibility was down to a few hundred meters in the Chinese capital, a few media outlets shared an old piece of news from 2008. Many foreign athletes that came to China to participate in that year's Olympics were seen at Beijing airport with anti-air pollution masks on, which led insulted Chinese people to flood the Internet with comments demanding the athletes apologize.

Eventually, several athletes apologized. But now, some media outlets are looking back and pointing out that the athletes had the right idea. 

It is clear that in recent polluted days, more people are wearing masks when going outside compared with previous periods of dirty air. During the red alert days, the Global Times reporter encountered significantly less people out on the streets and on public transport than during "blue sky days." When the reporter asked people with masks on - especially seniors - about why they chose to wear them, many responded that they heard people in their families or neighborhoods talk about how unhealthy the smog is and wanted to take precautions.

Over the years, people have worked to raise the profile of the air pollution problem. Take a recent example, at the beginning of 2015, a documentary filmed by former CCTV reporter Chai Jing about the smog issue was watched millions of times in a matter of days before being taken down. Under the Dome began by talking about health hazards of the smog and how it needs to be treated.

In earlier report in the Global Times published right after the documentary was released, significant short-term changes in the public's attitude were noted across China. For example, producers of air purifiers said their sales had gone up. A cell phone app that shows a map of areas  affected by air pollution was downloaded thousands of times more than usual. The number of citizens reporting pollution to government departments also reached a new high.

Finding the right way

As public anxiety about smog rises, misinformation becomes increasingly pervasive, both about the real state of the smog problem and what people can do to stay safe.

During the red alert earlier this month, a photo purportedly showing the smog went viral online. It was taken from an airplane and showed a sea of churning black clouds underneath the plane. The caption claimed that the photo was taken in December above Beijing and to show how heavy the pollution was.

The photo was quickly shared widely on Weibo and many commented on it, lamenting the pollution level. It wasn't until later that it was revealed it was an old photo, taken the year before, and likely showed rain clouds, rather than pollution.

But long after the rumor was revealed as untrue, the photo was still being shared and forwarded on social media.

Faced with this hyperbole and the unpleasant reality, many people turn to ineffective ways to protect themselves because they haven't received clear guidance on what to do. People buy medicine that isn't proven to help, as Lu did, and lists of food that supposedly clean one's lungs have become popular.

Gu Zhongyi, a nutritionist at Beijing Friendship Hospital, has been keen on the pollution issue for a few years and is devoted to spreading awareness. But he says right now people who interact with his work or pay close attention to protecting themselves are still mostly young people.

He is invited into local communities sometimes to talk about nutritious diets and he noticed that during smoggy days, most elderly people still don't have protective gear. Of those who do, they usually have on the wrong kind.

"It's very rare that they have on N95 masks - which are proven to be effective against smog," he said. "Most people just have on cotton masks, the ones that keep you warm only."

Tackling the issue 

During the red alert days, Gu Zhongyi once again shared a "survival brochure" on Weibo that he wrote a long time ago.

The post included a few tips on how to protect oneself, including wearing masks and buying air purifiers. He also included a section that talked about the hazards of the smog, how pollution can accumulate in one's body and cause cancer.

He started writing about the smog online in 2011, when he discovered foreign medical journals and news had information about the smog in China, while Chinese people knew little.

Gu noted changes over the years. At the beginning, he mostly wrote about what smog is and what kind of health hazards it could cause. Now, since his followers are mostly equipped with basic knowledge, he moved on to writing about preventative measures.

But he admits it's mostly young people who read his posts. He feels it would help a great deal if the government was more involved in spreading this kind of information.

Organizations and scholars have been trying to spread awareness on this issue and they are happy to see development over time. But there is disconnection between organizations and government bureaus and the public.

For example, in 2014 a report was released saying heavy air pollution in 31 provincial capitals and municipalities in the Chinese mainland could have caused some 257,000 premature deaths in 2013. The report was by Pan Xiaochuan, a Peking University scholar. But the public could only find out about this research if they pay close attention to news reports on these matters as this was not a high-profile story.

Right now, the burden falls on grass-roots organizations to educate the public.

Lin Hong, a consultant at Friends of Nature, an environmental NGO, told the Global Times the organization has done a lot of activities to educate the public about smog.

Starting last year, the organization started running a program called Blue Sky Lab, which helps the public understand what smog is and what they can do to protect themselves. She saw all kinds of people attending the lectures, including the elderly, college students and mothers bringing their children.

They also made videos about protective measures that people need to take and these videos are now being played on subways and buses.

The most important thing in educating the public is finding ways to reach them, and the government and organizations are both responsible for it, Lin said.

She has seen some improvement on the government's part. During previous smoggy days, information released by the government is available mostly on subways. But during these red alert days, many locals received text messages on their phones reminding them to stay indoors, and they could also see this information on TV and social media.

Public opinion is also shaping government action. Li Zuojun, a deputy director of the Development Research Center of the State Council, told the Global Times in an earlier story that public opinion had pushed the government to take more measures, such as the red alert, to curb the smog.

 "But awareness is one thing, and doing something to change their actions is another matter," Lin said. "I think that will take a long time."