China, the world's most populous country, claims about one-third of the world's smokers — at least 300 million people — who collectively puff 1.7 trillion cigarettes a year. In rural areas, cigarette smoke permeates buses, shops and even doctors' offices.   

These airborne toxicants — many of which are by-products of China's economic boom — are risk factors for chronic obstructive pulmonary disease (COPD), an incurable respiratory disorder that can cause severe breathing difficulties. And they have public-health officials worldwide worried about a coming epidemic. “We're just seeing the tip of the iceberg on COPD in China,” says Don Sin, a respiratory medicine specialist at the University of British Columbia in Vancouver, Canada, who researches COPD. “In 30 years, [the number of cases] is going to explode.”

每年100万人死于吸烟至2030年将达到每年300万人的死亡

According to Sin, projections based on current trends and World Health Organization estimates show that by 2030, COPD will kill 3 million Chinese people a year — a million more than die annually now.

Because of a strong cultural stigma, only about one in fifty Chinese women smoke. But more than half of all men, and about two-thirds of middle-aged men, do. Smoking is popular among men in the city and the country, among those of all educational levels.

二手烟受害者面临的危险

China's high smoking rates explain only part of its COPD problem though, because non-smokers are also at risk. For example, even though few women smoke, women still have high rates of COPD.

Similarly, the second study, published in May 2012 by Hu and his colleagues, followed 910 non-smoking Chinese women for 17 years. They found that women who were exposed to second-hand smoke were 2.3 times more likely to die from COPD than those who were not exposed, with cumulative exposure increasing the risk⁵.

室内空气污染不可忽视

Another key factor is indoor air pollution. More than 70% of all Chinese households, and 90% of rural ones, use stoves that run on wood, crop residues, coal or animal dung. Burning these fuels releases particulate matter, as well as fumes laced with carbon monoxide, formaldehyde and free radicals.“Women being the predominant cooks for families, they would be exposed to more of that,” says Sin. That might partly explain why the COPD rates in non-smoking Chinese women are higher in rural areas than in cities — the dangerous types of stove are more common in the countryside.

结局

All China needs is a wake-up call to realize the significant human and economic burden of COPD, according to Christiani. “Once China starts recognizing the problem as something that needs to be tackled, it can make some significant strides.” But for millions of older Chinese people, any hope of avoiding COPD risks has gone up in smoke.

不要等政府采取措施，自己行动起来，抵制公共场合吸烟现象，远离吸烟人群，改变观念，认识到送烟就是送慢性毒药，吸烟就是谋杀和自杀。