Cigarette smoking in China. Prevalence, characteristics, and attitudes in Minhang District.

OBJECTIVE

To determine the prevalence, pattern, and financial implications of cigarette smoking and the attitudes toward and knowledge of the health effects of tobacco use in a population in China.

DESIGN

A two-stage, stratified cluster survey using door-to-door interviews.

SETTING

Minhang District, China (near Shanghai), with a population of 506,000.

PARTICIPANTS

A total of 3423 males and 3593 females aged 15 years and older.

MAIN OUTCOME MEASURES

Smoking prevalence, age of initiation of smoking, reasons for smoking, knowledge of tobacco hazards, and costs of smoking.

RESULTS

A total of 2279 males (67%) but only 72 females (2%) smoke. Many males initiate smoking in adulthood. A total of 1156 males (50.7%) began smoking between 20 and 24 years of age, and 666 (29.2%) began between 25 and 39 years of age. Among all respondents, 6202 (88.4%) believe smoking is harmful for both the smoker and those exposed passively to the smoke. Only 332 (14.1%) of all male smokers reported a desire to quit smoking. Current smokers spent an average of 3.65 yuan daily on cigarettes or 1332 yuan yearly (8.5 yuan per US dollar), which represents 60% of personal income and 17% of household income.

CONCLUSIONS

The survey reveals a dangerous health situation that in all likelihood will worsen. More than two thirds of men smoke, and people in successive age cohorts start smoking at earlier ages. Smokers spend a substantial proportion of their income on cigarettes. There is a low rate of quitting and a low desire to quit despite high awareness of the health hazards. Tobacco control measures need to be implemented urgently in China.