Why Do So Many Chinese Men Smoke?

I find it fascinating that over 50% of men in China are smokers, while only about 5% of women are. Why such a huge discrepancy? These are massive questions for China’s public health teams: why do so many Chinese men smoke? Or you could ask the reverse questions; why do so few Chinese women smoke, and can we adapt their differing value systems to help men stop smoking?

One important thing to note first is that this 50% rate is by no means abnormal, in terms of world history. America is furthest along the anti-smoking bandwagon but smoking rates among men in the 1950’s were likely similar to that of China now. And many countries in Asia have similar or higher rates, including Japan. There seem to be common stages of the tobacco epidemic that are highlighted in the fascinating graph below (source: Lopez et al., 1994). As you can see, China is only in stage 2, where a massive percentage of men become addicted, and a couple decades down the line the rate of disease and death will skyrocket. Note how in the first stages, women smoke far less than men in all societies. Much of the west and Europe is already in Stage 4, where smoking levels taper off but the death rates peak.

(source: Lopez et al., 1994)

So, back to the main question; what is the cultural difference? I’m honestly not sure, but I would love to hear other opinions about it. Certainly there is a culture of men trying to act cool as teens, and they get hooked and can’t stop. This is a universal issue for men; but perhaps as adults there is a uniquely Chinese strong culture for businessmen to drink and smoke, especially during meetings, where it may be considered rude to refuse either a toast or a cigarette. And historically, China’s leaders Mao Zedong and Deng Xiaoping were very heavy smokers and always photographed with a cigarette.

Clearly these cultural issues will take decades of public education to change. Much quicker changes, proven in many countries, would be higher tobacco taxes, warning labels on packs with graphic pictures, and the crucial banning of smoking in all public areas. There’s no reason to think China is any different than other countries, and eventually the cultural attitudes will change here as well. Unfortunately, between now and then, millions of people are going to continue to die from this awful addiction.

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One thought on “Why Do So Many Chinese Men Smoke?”

  1. A few thoughts on WHY.

    One, that you mentioned in the article, is the cultural pressure that comes through peer pressure. Men are often challenged at the banquet table to smoke with phrases like, "you're not a MAN if you don't". And what man wants to be labeled a sissy? And then you get hooked.

    Two, the State makes a PILE of cash through cigarettes, and any cash-cow of the State is going to be carefully guarded. You can see evidence of this in things like the somewhat recent articles that unveiled the Hubei government's pressure on it's workers to smoke only government cigarettes. Why would they talk down an easy cash boost?

    Three, the social system is weak at in enforcing no smoking policies. Ride any bus in any city on any given day and you're bound to ride with a guy or three, along with the bus driver, smoking (despite clearly posted no smoking signs); and yet NO ONE says anything (I'll certainly qualify that with my favorite bus driver on the route I ride daily who actually pulled the bus over and chewed a guy out for smoking, but that's still fairly rare).

    Four, It's still cool. Period. When enough people start dying and the hospitals are packed with lung cancer patients, it will become less cool. But its still cool, and that's enough.

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