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An Impending Health Catastrophe in the Middle Kingdom

Jing Jie Yu, MD; Margaret E. Mattson, PhD; Gayle M. Boyd, PhD; Michael D. Mueller, MPH; Donald R. Shopland; Terry F. Pechacek, PhD; Joseph W. Cullen, PhD

JAMA. 1990;264(12):1575-1579.

Abstract
Half of the global increase in tobacco use from 1976 to 1986 occurred in the People's Republic of China. In 1984, the first national smoking survey was conducted in China, involving over a half-million subjects. Sixty-one percent of Chinese males over age 15 smoke, with higher rates in all occupational groups than for corresponding groups in the United States. Current smoking patterns in China are similar to those in the United States during the 1950s, and these patterns forecast a steadily increasing epidemic of smoking-related deaths. It is estimated that by 2025, two million Chinese men will die annually from smoking. Foreign tobacco companies are mounting massive production and advertising campaigns in China. Government health education programs lack funds to counter these influences with sustained and comprehensive educational and interventional campaigns. To avert an impending national health catastrophe, China must launch a comprehensive smoking-control initiative aimed at public education, cessation, and legislation and policy.

(JAMA. 1990;264:1575-1579)

Author Affiliations
From the Peking Union Medical College and the National Program on Smoking or Health, Office of the National Patriotic Health Campaign Committee, Ministry of Public Health, Beijing, People's Republic of China (Dr Yu); Division of Cancer Prevention and Control (Drs Mattson, Boyd, and Cullen), and the Cancer Control Sciences Program (Mr Shopland and Dr Pechacek), National Cancer Institute, Bethesda, Md; and the School of Hygiene and Public Health, Institute of International Programs, The Johns Hopkins University, Baltimore, Md, and the Office of Health, Agency for International Development, Washington, DC (Dr Mueller). Dr Yu is now with the Division of Cancer Prevention and Control, National Cancer Institute, Bethesda, Md, as a visiting scientist; Dr Mattson is now with the Division of Prevention and Treatment, National Institute of Alcoholism and Alcohol Abuse, Bethesda; and Dr Cullen is now with the AMC Cancer Research Center, Denver, Colo.

Footnotes
Reprint requests to National Cancer Institute, 9000 Rockville Pike, Bldg EPN, Room 330, Bethesda, MD 20892 (Dr Yu).

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