Amid China’s Bad Air, a Reminder That Smoking Still Kills

December 17, 2013, 2:18 am 6 Comments

The New York Times
By AUSTIN RAMZY

As the recognition of the danger of outdoor air pollution in China grows, health authorities are trying to use that knowledge to raise awareness of an even deadlier health threat: smoking. China has about 350 million smokers, and despite efforts to reduce consumption, tobacco is still widely consumed, and about half of adult males are regular smokers, according to surveys.

Two years ago China’s health ministry introduced a ban on smoking in restaurants and other public places, but the measure included no penalties and is widely ignored. Production of cigarettes, almost all for domestic consumption, has climbed 50 percent over the last decade, according to a 2013 report by the Beijing-based Think Tank Research Center for Health Development.

Efforts to curb smoking have faltered in China, and researchers say awareness of the health risks of smoking has trailed developed nations. But awareness of the dangers of air pollution has climbed rapidly in recent years, as the government has begun releasing real-time air quality data and cities have issued emergency plans for pollution emergencies. Episodes of extreme smog — in Beijing in January, in Harbin in October and in Shanghai and much of east China earlier this month, has triggered a broad discussion in China of the dangerous side effects of the rising number of cars and the country’s rapid industrial growth.

PM 2.5, the fine particles in bad air that are particularly harmful to human health, was once an obscure metric to most Chinese. It is now the name of one of the country’s most popular brands of face mask, as Marketplace reported in February.

Zhang Shunan, head of pulmonary medicine at the China-Japan Friendship Hospital in Beijing, told the Beijing News that under normal conditions indoor air pollution is influenced by conditions outside, but in a closed environment tobacco smoke can make indoor conditions even worse.

“Many people complain about smog but they forget about someone smoking inside, that’s often a worse source of pollution,” the newspaper said. One recent study showed that a smoker indoors can experience levels of PM 2.5 as high as 630 micrograms per cubic meter. A nonsmoker sitting nearby experienced concentrations up to 160. By comparison, the World Health Organization’s recommended limit is 25 micrograms per cubic meter for 24-hour exposure.

The Beijing News cited a group of volunteers who measured indoor air pollution at 51 Beijing restaurants this year. Those that banned smoking had an average PM 2.5 concentration of 40, those that had separate smoking and non-smoking sections had an average of 184 and those that didn’t restrict smoking had a PM 2.5 level of 280.

Over the last 30 years lung cancer as a cause of death has increased by 465 percent, according to a recent conference. Smoking and pollution are both significant factors in that frightening figure. Outdoor air pollution was linked with 1.2 million premature deaths in China, according to an analysis of data first published in the 2010 Global Burden of Disease Study. The same study found that tobacco smoking was responsible for a slightly higher number of deaths, after dietary risks and high blood pressure.

This post has been revised to reflect the following correction:

Correction: December 18, 2013

An earlier version misstated the name of the head of pulmonary medicine at China-Japan Friendship Hospital in Beijing. It is Zhang Shunan, not Zhang Shu