Pubdate: Fri, 20 Nov 1998
Source: San Jose Mercury News (CA)
Copyright: 1998 Mercury Center
Contact:  http://www.sjmercury.com/
Author: Henry Chu, Los Angeles Times

SMOKING A PRIME KILLER IN CHINA

Report Links Tobacco To More Than 700,000 Annual Deaths

BEIJING -- In an alarming confirmation of the toll taken by tobacco in
the world's most populous country, researchers have found that smoking
causes more than 700,000 deaths annually in China -- a rate of 2,000
deaths every day, most of them of men in the prime of life.

If current smoking patterns continue, tobacco will claim 8,000 lives a
day here within half a century, a report published in today's issue of
the British Medical Journal predicted.

At least one-third -- or 100 million -- of the young men now under 30
will die because of their nicotine habit, half of them before reaching
their 70th birthday, the study predicted.

The study, which its authors call the largest of its kind ever
undertaken, with a staggering sample size of 1 million, provides a
grim survey of the ravages of smoking in the world's largest cigarette
market.

The study is issued as tobacco companies in the United States sign a
deal to pay $206 billion to states that had sued them over spiraling
medical bills and economic losses.

The new figures are certain to add fuel to the fight against smoking
in China, a relatively new entrant to the fray and now the target of
global anti-tobacco forces. ``This is the first step of a long
march,'' declared Chen Zhengming, an epidemiology researcher at Oxford
University and one of the principal authors of the study.

But equally, the report demonstrates just how monumental a task
public-health experts face in a land where three out of every four men
light up. By contrast, smoking among women has decreased in China in
recent years and only 1 percent of Chinese women now smoke.

Beyond the personal willpower of smokers, eliminating smoking also
will require huge political and economic will from the communist
government, because 90 percent of all domestic cigarette manufacturers
enjoy some form of state backing.

Remarkably, one-third of all cigarettes smoked in the world today are
smoked in China, for a staggering total of 1.8 trillion a year -- the
equivalent of a pack a day for every man, woman and child in the
United States.

1 in 8 deaths

``Already, about one in eight male deaths is caused by smoking,'' said
Niu Shiru, a professor at the Chinese Academy of Preventive Medicine
and a contributor to the study. ``By 2050, it will be one in three.''

If current trends continue, experts predict that in 2050, smoking will
be responsible for nearly 3 million deaths a year in China, or about
three-quarters of the entire worldwide total today.

In a curious finding, the new study -- funded by the Chinese
government, the World Bank, British medical agencies and the U.S.
National Institutes of Health -- discovered that the incidence of
smoking-related diseases in China differs from that in the West.

More Chinese smokers tend to die of chronic respiratory diseases
rather than of lung cancer, the most prevalent cause of death related
to tobacco consumption in the United States. A surprising number of
Chinese men who smoked also succumbed to tuberculosis, researchers
found in interviews conducted around 1990 with the families of about 1
million people who had died across the country.

Smoking kills people in China ``by making diseases that are already
fairly common, somewhat more so,'' the researchers wrote.

Data crunching

The researchers, from Oxford and Cornell universities and two Chinese
medical academies, said it took eight years to analyze and release
their data because of the sample's size.

Although other lung diseases are more common, lung cancer still
plagues smokers far more than those who stay away from nicotine --
three times as often, for example, among urban smokers between the
ages of 35 and 69 as among abstainers.

To prevent an even more calamitous epidemic of smoking-related
illnesses and deaths, health officials are directing their education
efforts at the young, mindful that two-thirds of Chinese men pick up
the habit before turning 25. They are also trying to figure out ways
to help inveterate inhalers quit.

In a nationwide survey two years ago, two-thirds of respondents said
they thought smoking caused little to no harm. There is also a
widespread perception that ``smoking kills Western people, not
Chinese,'' Chen said.

Another obstacle confronting any campaign against smoking is the role
tobacco plays in the economy. Nine out of 10 cigarette manufacturers
in China are state-owned or -backed. Yunnan, a poor province in
China's southwest, derives 75 percent of its income from tobacco
crops, a provincial official said.

Mercury News wire services contributed to this report.
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Checked-by: Patrick Henry