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