Pubdate: Fri, 20 Nov 1998 Source: Examiner, The (Ireland) Contact: http://www.examiner.ie/ Copyright: Examiner Publications Ltd, 1998 SMOKING TO KILL 100M CHINESE MEN A THIRD of Chinese men under the age of 30 - about 100 million people - face a premature death because of smoking, researchers said yesterday. The tobacco death toll expected to hit a country containing a fifth of the world's population was described by scientists as a "catastrophic epidemic". Smoking already kills more than 2,000 people a day in China, mostly men. The findings from two international studies published in the British Medical Journal show that if present trends continue, by 2050 the figure may have soared to well above 8,000. The research represents the world's largest investigation into tobacco deaths, and the first in a developing country. The two studies were carried out in different ways but reach the same conclusion, so they carry considerable weight. The World Health Organisation is so alarmed that it is sending a delegation of top officials to discuss the findings with the Chinese government this weekend. Scientists from the Chinese Academies of Preventive Medicine and Medical Sciences collaborated with colleagues from Britain's Oxford University and Cornell University in the US. In the first, retrospective study the families of a million dead people were interviewed to find out whether the deceased smoked. The fieldwork involved more than 500 interviewers in 24 major cities and 74 rural counties. The second study took a prospective look at the hazards of tobacco by asking 250,000 adults about their smoking habits and monitoring them for several years to see what caused their deaths. Both came to the same conclusion: Unless habits change, tobacco will kill at least 100 million of the more than 300 million Chinese males now aged under 30. China appears to have reached the same stage the US was at 50 years ago, when 12% of American male deaths were tobacco related. By 1990, the US death male death toll had risen to 33%. Tobacco is expected to kill the same proportion of Chinese men by 2030. Total annual smoking deaths in China were expected to rise from about a million in the year 2000 to two million by about 2025 and three million by about 2050. Professor Richard Peto, from Oxford University, one of the study's principal authors, said: "Chinese adults severely underestimate smoking risk. "A 1996 survey showed that two-thirds believe smoking does little or no harm, 60% of Chinese adults don't know that smoking can cause lung cancer, and 96% don't know it can cause heart disease. "The truth is that half of all persistent smokers get killed by tobacco. As two out of every three young men in China smoke, tobacco will eventually kill about a third of all the young men in China." Not even Chinese doctors took the dangers of smoking seriously, said Prof Peto, adding: "It's not yet got to the point where these numbers are real to the Chinese government or medical profession." He feared it would take years for the message to sink in. The evidence from the West is that public education about tobacco risks has a huge impact. Britain had the world's worst tobacco death toll in 1965. Since then the number of smoking deaths in the UK had decreased faster than it had anywhere else. Distinct differences between the pattern of tobacco death in China and in the West have puzzled researchers. Whereas in Britain, 30% of smoking deaths are due to lung cancer, the disease accounts for just 15% in China. Only a small proportion of Chinese smokers die from heart disease, another big killer in the West. In China the majority of deaths, about 45%, are caused by chronic lung diseases such as emphysema. Professor Peto said that smoking tended to increase the death toll of diseases that already claimed a number of lives. These included cancers of the oesophagus, stomach and liver, and tuberculosis. Another significant trend was that while male deaths were rising, the number of Chinese women dying from smoking was getting smaller. It was expected to fall from 3% of the total in 1990 to 1% in 2030. Why this is so remains a mystery. Less than 10% of Chinese tobacco is imported, and the country has enormous potential as a market for Western manufacturers. - --- Checked-by: Rolf Ernst