Smoking in China - Findings of the 1996 National Prevalence Survey

Context As the world's largest producer and consumer of tobacco products, C hina bears a large proportion of the global burden of smoking-related disea se and may be experiencing a tobacco epidemic. Objective To develop an evidence-based approach supporting tobacco control initiatives in China. Design and Setting A population-based survey consisting of a 52-item questi onnaire that included information on demographics, smoking history, smoking -related knowledge and attitudes, cessation, passive smoke exposure, and he alth status was administered in 145 disease surveillance points in the 30 p rovinces of China from March through July 1996. Participants A nationally representative random sample of 128 766 persons a ged 15 to 69 years were asked to participate; 120 298 (93.8%) provided data and were included in the final analysis. About two thirds of those sampled were from rural areas and one third were from urban areas. Main Outcome Measures Current smoking patterns and attitudes; changes in sm oking patterns and attitudes compared with results of a previous national s urvey conducted in 1984. Results A total of 41 187 respondents smoked at least 1 cigarette per day, accounting for 34.1% of the total number of respondents, an increase of 3.4 percentage points since 1984. Current smoking continues to be prevalent am ong more men (63%) than women (3.8%). Age at smoking initiation declined by about 3 years for both men and women (from 28 to 25 years). Only a minorit y of smokers recognized that lung cancer (36%) and heart disease (4%) can b e caused by smoking. Of the nonsmokers, 53.5% were exposed to environmental tobacco smoke at least 15 minutes per day on more than 1 day per week. Res pondents were generally supportive of tobacco control measures. Conclusion The high rates of smoking in men found in this study signal an u rgent need for smoking prevention and cessation efforts; tobacco control in itiatives are needed to maintain or decrease the currently low smoking prev alence in women.