The impact of tobacco on lung health in China.

China has the largest production and consumption of tobacco worldwide. It has witnessed a dramatic increase in tobacco consumption over the past two decades, with more than 34.8 million cartons of cigarettes being produced and 34.7 million sold annually. Approximately 67% of males and 4% of females aged over 15 years in China are smokers, and the total of over 320 million Chinese smokers represents about one-third of all smokers worldwide. The continuous, rapid increase in the number of Chinese smokers is largely due to teenagers taking up smoking. Among teenagers aged 15-19 years, 18% of men and 0.28% of women (making a total of 9 million teenagers) are smokers. The prevalence of passive smoking is very high at 53.5%, about 0.3 billion people aged above 15 years were affected. The average daily consumption of tobacco per person in China rose from one cigarette in 1952 to 10 cigarettes in 1990, a rate similar to that of the USA 40 years earlier. It seems inevitable that China will witness a substantial increase in mortality following this increase in smoking. Based on current smoking rates, the predicted deaths attributed to smoking in China will rise to 3 million in 2050. If the current smoking pattern in China remains unchanged, 100 million men now under 30 years will die from smoking-related diseases. The respiratory system is harmed most by tobacco smoke. Over two-thirds of all deaths related to smoking in China are attributed to chronic obstructive pulmonary disease (COPD), lung cancer and pulmonary tuberculosis. The morbidity of COPD alone in China is estimated at over 3%, or 25 million people, of whom 72% were smokers. The Chinese government consistently supports smoking control and advocates smoking abstinence via laws to restrain the sale and advertising of tobacco. These actions have been successful in some aspects, and in particular, more people are aware that 'cigarette smoking is harmful to health'. In future, the emphasis of smoking control should be directed at restraining teenagers and adolescents from smoking. Cigarette smoking has already caused significant ill-health to the Chinese population with over 1 million people dying each year of various disorders caused by smoking. However, the peak of smoking-induced diseases is still to come and therefore, it is very important to strengthen anti-smoking measures so as to have a far-reaching effect on the future health of the Chinese population.