World's 3 out of 10 cigarettes smoked in China

At the turn of the 20th century, tobacco baron James Duke flicked through a world atlas, stopped at the population figure of 430 million, jabbed his finger at a map of China and announced: "That is where we are going to sell cigarettes."

One hundred years on, Duke's prophesy about the potential for cigarettes sales in China, where the population has since grown to 1.3 billion, has been realised on a literally breath-taking scale.

Three out of every 10 cigarettes produced globally are smoked in China.

Cigarette production in China increased seven-fold between 1960 and 2003, from 225 billion a year to 1.8 trillion - and 97 out of every 100 of those cigarettes are smoked within China.

More than 300 million men in China are smokers - more than the current population of Duke's home country, the US. Out of every 100 men, 67 smoke, a higher percentage than anywhere else in the world apart from Yemen and Djibouti.

Judith Mackay, Hong Kong-based policy advisor to the World Health Organisation and co-author of the newly-published second edition of the "Tobacco Atlas", says it was the obsession of Duke and his contemporaries that began China's smoking epidemic.

"The leaders of the tobacco industry have had their eyes on China for more than 100 years and they are not taking them off," she said.

"Duke was interested in China and rightly so in a sense because he could see the population numbers. That interest in China has simply never flagged."

While it was Duke's company, British American Tobacco, that first gave the Chinese a taste for cigarettes, it is China's own state-owned giant Honghe, now the fourth biggest selling cigarette brand in the world.

Between 2002 and 2005, Honghe sold 108 billion cigarettes almost exclusively within China. "It really is quite worrying," said Mackay.

In a foreword to the report, written as an advocacy tool by anti-smoking campaigners, American Cancer Society chief executive officer John Seffrin warns: "The world is facing a pandemic of epic proportions because it is under attack by a ruthless industry - the purveyors of tobacco."

That warning, the authors say, is particularly pertinent to China where they estimate that a third of Chinese men under the age of 30 will be killed by tobacco if current smoking patterns continue and where the direct health costs of smoking are already in the order of $4.29 billion a year.

The outlook for China might appear bleak, but Mackay emphasised that research had uncovered the first signs of a counter trend. For the first time, she said, there were record numbers of smokers in China who had kicked the habit.

"For the first time, there are some ex-smokers," she said. "That means there are people who smoked and who have quit. That is our first glimmer of hope for smokers in China. It just appears there is a peak effect, the message is getting through and some smokers are giving up and quitting."

Another significant development is that China is now a signatory to the World Health Organisation's Framework Convention on Tobacco Control which bans tobacco advertising, regulates cigarette packaging, bans the sale of cigarettes to minor and bans smoking in work and public places.

More significantly, however, Mackay believes there are signs on a social as well as a political level that awareness of the dangers of smoking is beginning to hit home in China.

"Fashions can change and I think we are beginning to turn a corner," she said.