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New Study Shows Tobacco's Devasting Toll In China

World's Largest Study on the Effects of Tobacco in a Developing Country
November 19, 1998

Washington, DC - China is undergoing a catastrophic epidemic of smoking deaths, according to a study published in tomorrow's edition of the British Medical Journal. Smoking currently kills more than 2,000 people every day in China; the majority are men. The article includes the findings of the world's largest study ever conducted on the harmful effects of tobacco use in China. One and one-quarter million people were surveyed by 500 interviewers in 24 of the country's largest cities and 74 rural counties. 'Unfortunately, most people in China severely underestimate the risk factors associated with smoking,' said Dr. Yang Gonghuan, Chinese Academy of Preventive Medicine. 'In a nationwide survey conducted in 1996, about two-thirds of people responding believed smoking did little or nor harm. Nearly 60 percent did not know it [smoking] can cause lung cancer and 96 percent did not know it can cause heart disease.' Two types of unique research methodologies were used in the study ¾ retrospective and prospective. The retrospective study involved interviews with families of one million dead individuals to determine whether or not the deceased had smoked. The retrospective study found that among male smokers ages 35-69, there was a 51 percent excess of cancer deaths; 31 percent excess of respiratory deaths; and 15 percent excess of vascular deaths. The study compared the smoking habits of 700,000 adults who had died of cancer, respiratory or vascular causes with those of a 'reference group' of 200,000 adults who died of other causes (calculating, for example, the excess risk of lung cancer among smokers from the excess of smokers who died of lung cancer). In the prospective study, one-quarter of a million male smokers over 40 years of age were interviewed about their smoking habits in 1990. They have been monitored for several years through annual doctor's visits in order to determine what they die from. The prospective study will continue for several decades, to monitor the future growth of the tobacco epidemic in China. The prospective study indicates that in 1990, 73 percent of men smoked (68 percent urban, 75 percent rural) and currently 12 percent of all male deaths in China are a result of a tobacco-related disease. 'Chinese men smoke far more cigarettes than they used to, but surprisingly, women in the cities of China show the opposite pattern from men,' said Dr. Yang Gonghuan. 'Annual Chinese cigarette consumption grew from 100 billion in the early 1950's to 500 billion in 1980 and is now 1,800 billion. One in three of all the cigarettes smoked in the world today are smoked in China.' The research also revealed that if current smoking patterns continue in China, the country will face a dramatic increase in tobacco-related deaths. By 2050, more than 8,000 Chinese will die daily as a result of smoking. One-third of all the young men in China will eventually die from a tobacco-related disease. China now has the largest number of deaths from smoking of any country, having recently overtaken the United States. 'Tobacco companies are making empty promises domestically about not marketing their deadly products to kids. They are using their innovative and sophisticated marketing tactics to hook millions of new smokers around the world,' said Bill Novelli, president of the Washington, DC-based CAMPAIGN FOR TOBACCO-FREE KIDS, the largest initiative ever undertaken to reduce tobacco use in the United States. 'The U.S. is home to two of the largest tobacco companies in the world - Philip Morris and RJ Reynolds ¾ and this places a unique obligation on our country to take action on international tobacco control.' The study is an international long-term collaboration between Oxford University in England; the Chinese Academies of Preventive Medicine and of Medical Sciences in Beijing; and Cornell University in the United States, supported by the United Kingdom Medical Research Council; the U.S. National Institutes of Health; the Canadian Government; and the World Bank. The study is available on the Clinical Trial Service Unit ( and Globalink (http:// websites.