Unnecessary Epidemic of Environmental Insults:
Public Health Policy and Communication for Social Change
Tobacco epidemic and health burden in China: new evidence
Professor Zhengming Chen
Richard Peto Chair in Epidemiology, Nuffield Department of Population Health, University of Oxford
Biography
Professor Zhengming Chen is inaugular Richard Peto Chair in Epidemiolgy at the Nuffield Department of Population Health, University of Oxford. He qualified in medicine at Shanghai Medical University in 1983, followed by further postgraduate training in public Health in China and DPhil in Epidemiology at the University of Oxford in 1991. His main research concerns causes, prevention and treatment of major chronic disease. In 2003, he initiated and established in collaboration with Chinese Academy of Medical Sciences & Peking University, and has led even since as UK PI, the China Kadoorie Biobank (CKB; www.ckbiobank.org) of 512,000 adults. In Oxford he leads a large and expanding multi-disciplinary research team, with research themes covering many different areas. In 2022 he was elected as Fellow of Academia Europaea in recognition of his scientific achievements.
Abstract
Worldwide tobacco smoking accounts for >6 million deaths annually and the mortality burden is still rising in many countries. For national disease control strategies, and for decisions about smoking cessation by individuals, the key issue is not just current, but future tobacco-attributed morbidity and mortality risks. This is particularly important for China, where the increase in cigarette consumption has been so recent that much of its eventual effect on the hazard per continuing smoker has yet to emerge. Successive nationally representative prevalence surveys and prospective cohort studies are essential to monitor and assess current and future tobacco epidemic and the associated health burden.
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Chinese men now consume >1/3 of the world’s cigarettes, following a large increase in urban then rural usage in recent decades. Our cohort studies showed that smoking now causes >20% of adult male deaths in China, up from only ~10% in the early 1990s, and this proportion is still rising, with diminishing gap between rural and urban areas. As the epidemic matures and the population grows, Chinese tobacco deaths will rise from 1 million in 2010 to ~2 million in 2030 and ~3 million in 2050, involving predominantly men, unless there is widespread cessation. Moreover, there are also substantial morbidity burdens, with significant excess risks of ~60 different diseases and hospitalisation among Chinese smokers. Encouragingly, there appeared decreasing trend in consumption levels among urban men in recent decade, and among Chinese women smoking prevalence remains extremely low.​