Statistics from Altmetric.com
Editor,—I read with interest the report by Koet al on the association between smoking and diabetes in Chinese men with an odds ratio of 1.7 of smoking on the risk of diabetes.1
China is the greatest producer and consumer of cigarettes in the world.2 The main increase in cigarette consumption in China has taken place only recently: in 1952, 1972, and 1992 the mean consumption among Chinese men was one, four, and 10 cigarettes a day, respectively.3 Deaths due to smoking will increase from about one million worldwide in 1995 to more than seven million in 2025.4 In response to comments on their earlier reports on smoking and death in China published in 1998,3 5 Petoet al reported that there are now already a million deaths a year in China alone from smoking.6 So on present day smoking patterns Chinese tobacco mortality will increase substantially.
Even more alarming is the prevalence of teenage smoking in China. Three of every five Chinese smokers begin smoking at the age of 15–20 years, and cessation is rare.7 Teenage smoking is increasingly becoming a health problem in modern China. About 200 million children living today in China will become regular smokers. Of these, about 50 million, or one quarter, will die prematurely of smoking related illness.8 The association of smoking and diabetes reported by Ko et al 1 with the attendant complications of diabetes will most likely increase further this number.