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Third of young men in China could die from smoking

Experts urge large smoking cessation to avoid deaths

Adrian O'Dowd

Friday, 09 October 2015

A third of all young men in China could die from smoking unless significant efforts are made to encourage smoking cessation, concludes research* published today in The Lancet.

UK and Chinese researchers found that recent smoking trends in the country indicated that tobacco was on track to kill around half of those who start smoking cigarettes as young men.

Currently, around two-thirds of young men in China start smoking, mostly before the age of 20.

Researchers from the University of Oxford and the Chinese Academy of Medical Sciences and the Chinese Centre for Disease Control, carried out two large, nationally representative studies 15 years apart, tracking the health consequences of smoking in a large group of people in China.

The first study took place in the 1990s, involving around quarter of a million men (220,000), and the second study is ongoing, and involves more than half a million men and women (510,000).

Their results showed that in China, the annual number of tobacco deaths, mostly among men, had reached 1 million by 2010, and if current trends continued, it would be 2 million by 2030.

Among Chinese women, however, smoking rates have fallen, as has the risk of premature death from tobacco, which is low.

Statistics show that in recent decades, there has been a large increase in cigarette smoking by young men, and the new research shows the consequences that are now emerging from this.

The proportion of all male deaths at ages 40-79 that are attributed to smoking has doubled from about 10% in the early 1990s, to about 20% now.

In urban areas this proportion is higher and still rising, while in rural areas, it is currently lower, but set to rise even more steeply than in cities, due to the high prevalence of smoking and low rate of cessation in rural China.

In contrast, women of working age in China now smoke much less than the older generation.

About 10% of women born in the 1930s smoked, but only about 1% of those born in the 1960s did so. Therefore, overall female deaths caused by tobacco are falling and less than 1% of deaths in women born since 1960 are due to tobacco.

However, the researchers cautioned that other studies had shown a recent increase in smoking uptake by young women that could eventually reverse this downward trend.

The authors noted that a growing proportion of smokers were choosing to stop, and the study results showed that between 1991 and 2006, the proportion of smokers who had quit rose from 3% to 9%.

For those smokers who stopped before developing any serious disease, after 10 years of not smoking, their risk was similar to that of people who had never smoked.

Study co-author Professor Zhengming Chen from the University of Oxford, said: “About two-thirds of young Chinese men become cigarette smokers, and most start before they are 20. Unless they stop, about half of them will eventually be killed by their habit.”

Fellow study co-author Professor Liming Li, from the Academy of Medical Sciences, Beijing, said: “Without rapid, committed, and widespread action to reduce smoking levels, China will face enormous numbers of premature deaths.”

* Prof Zhengming Chen, et al. Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. The Lancet, Volume 386, No. 10002, p1447–1456, 10 October 2015. DOI: 10.1016/S0140-6736(15)00340-2

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