(Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths)

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(Emerging tobacco hazards in China: 2. Early mortality results from a prospective study)

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China now consumes one third of the world's cigarettes. In this week's BMJ researchers report on the largest-ever investigation on the hazards of tobacco. Involving one and a quarter million Chinese, the study finds that on current smoking patterns, at least one third (100 million) of Chinese males now aged 0-29 years will be killed by tobacco related diseases in middle or old age.

The study also reveals that the pattern of disease caused by smoking varies widely both within China and between China and the developed world. Of deaths caused by tobacco in China, 45 per cent are from chronic lung disease, 15 per cent from lung cancer and five to eight per cent from each of oesophageal cancer, stomach cancer, liver cancer, stroke, ischaemic heart disease and tuberculosis.

Two thirds of men now become smokers before age 25; few give up and about half of those who persist will be killed (about half of all persistent cigarette smokers in Britain and America are eventually killed by tobacco). Tobacco currently causes 13 per cent of deaths in men but only three per cent of deaths in women. This, explain the authors, is because the proportion of young women who smoke is currently small.

The study concludes that if current smoking patterns persist in China, then such projections cannot be substantially
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Contact: Jill Shepherd
jshepherd@bma.org.uk
44-171-383-6529
BMJ-British Medical Journal
19-Nov-1998