Abstract
Although it is known that there is a high smoking prevalence among Chinese, key issues such as social and environmental factors impacting smoking initiation and persistence, the percentage of smokers considered nicotine dependence (ND), and the availability and use of ND treatments have rarely been investigated. To address these issues, from 2012 to 2014, we conducted a large-scale study in the Zhejiang and Shanxi provinces of China using the Fagerström Test for Nicotine Dependence and other validated questionnaires. Of the 17,057 subjects, consisting of 13,476 males and 3,581 females aged 15 years or older, the prevalence of male smoking was 66.1% [95% confidence interval (CI) 65.5%, 66.9%] and that of female smoking was 3.2% (95% CI 3.0%, 3.8%). Among males, 25.8% (95% CI 25.0%, 26.5%) were low-to-moderate ND, and 11.8% (95% CI 11.2%, 12.3%) were high ND (H-ND), persons who have significant difficulty quitting without treatment. The degrees of ND were related to age, extent of education, and annual family income. The social-environmental factors examined conveyed a higher risk for smoking initiation, which is particularly true for the influence of smoking by friends. Furthermore, current smokers had a significantly higher risk of suffering respiratory and digestive symptoms. These data not only show a high smoking prevalence in Chinese men but also reveal that a relatively large number of smokers are H-ND. Considering that few Chinese smokers seek ND treatment, a comprehensive smoking prevention and treatment program designed specifically for Chinese is greatly needed.
Highlights
As the largest tobacco-consuming country in the world, the prevalence of cigarette smoking in China remains high, especially in the male population [1]
We provide further evidence of a high prevalence of smoking among Chinese male adults (66.1%) and a low prevalence in female adults (3.2%), which is in accordance with the findings from a recent study [3]
Of all male current smokers, 18.2% were categorized as H-nicotine dependence (ND) and 39.8% were categorized as low-to-moderate ND (LM-ND); these smokers typically have considerable difficulty quitting tobacco without medical assistance
Summary
As the largest tobacco-consuming country in the world, the prevalence of cigarette smoking in China remains high, especially in the male population [1]. China is facing an immense public health challenge from tobacco smoking, with about 1.4 million deaths resulting from cigarette smoking in 2010 [2]. This number is expected to increase to 2 million by 2030 and 3 million by 2050 if smoking patterns are not altered [3]. The economic burden caused by tobacco smoking in China has increased substantially during the past decade. In 2005, China ratified the treaty of the WHO Framework Convention on Tobacco Control (FCTC) to make progress on smoking prevention and reduction [5], the country is still in the early stage of addressing the threat from cigarette smoking, with significant gaps still present in the response to the requirements of FCTC [6]
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