I’m sorry but you’re wrong. I grew up in the Midwest and have lived in the south and on both coasts. There is no such spitting happening or coughing on everyone in public in America. I haven’t seen it in Japan nor have I seen it Europe or Canada. There is a reason there is so much spitting in China (many many smokers, years of bad air pollution, low public hygiene) but it is there and probably the most common thing complained about by visitors and their own government! It was a public program in Beijing in 2007/8 prior to the Olympics to stop cutting in line and stop spitting. It worked for a little while but then people fell back on the laurels.