BEIJING // While China leads the world in everything from car sales to exports to internet usage, the country also is a leader in a less auspicious way: it is the world's smoking capital.
With nearly 60 per cent of men smoking, China consumes one in three of the world's cigarettes and produces more tobacco than anywhere else.
About one million Chinese die each year from smoking, according to studies; by 2020 this figure will have doubled, it is predicted.
Despite living costs rising overall, smoking remains cheap: a packet of 20 cigarettes costs as little as three yuan (Dh1.7). The price relative to wages fell nearly three quarters between 1996 and 2006, so even the poorest can afford the habit.
"I know cigarettes are very bad – they affect my lungs and breathing. But my job makes me tired, and they keep me alert," said Liu Dexi, 35, a furniture company employee, while puffing away in Beijing.
"Young guys think smoking is fashionable. It's a way of socialising, especially when you enter the workforce.
"I know I might get cancer, but I cannot stop. Not that many people quit voluntarily, unless they are diagnosed with an illness."
There are plenty of others like Mr Liu in China – about 301 million others, equal to the entire population of the United States.
"They have a scale of a problem unlike any other country," said Judith Mackay, the Hong Kong-based director of the Asian Consultancy on Tobacco Control and a senior adviser to the World Lung Foundation.
A survey published this year by China's Centre for Disease Control (CDC) found 28.1 per cent of people above age 15 smoked, a rate that has changed little for nearly a decade. Just three per cent of Chinese women smoke, but for men the figure is about 57 per cent.
"There has been no substantive improvement in the smoking rate or exposure to secondhand smoke," Yang Gonghuan, the deputy director of China's CDC, said.
What makes China's continued tobacco addiction notable is that it is out of step with several neighbouring countries.
The country's male smoking rate is not the highest in Asia. In Vietnam, for example, the figure is more than 70 per cent, But many other Asian nations have seen figures plummet as prosperity has increased.
In Hong Kong, a special administrative region of China, smoking rates are thought to be lower than in any country in the world, at 11.8 per cent, according to 2008 figures. Cigarettes there are heavily taxed, have pictorial warnings on packets and smoking is banned in most public places.
In Thailand, bans on smoking in many indoor venues, and graphic photographs on packets of diseased lungs, stained teeth and patients in hospital have lowered male smoking rates to 37 per cent now from 63 per cent in 1981.
In China "they are stubbornly high in the face of male smoking rates falling all over Asia," Dr Mackay said. "Many countries in Asia have halved their smoking rates. They've come down in Thailand, in Taiwan, almost everywhere except China."
Mainland China has not seen significant reductions, Dr Mackay said, partly because it does not ban smoking in public places and it has such low taxes on cigarettes.
She said she believes the government's ownership of tobacco-producing companies helps explain why tougher action has not been taken.
Research paid for by the Bloomberg Initiative to Reduce Tobacco Use shows that profits and tax from tobacco were equivalent to 7.6 per cent of government revenue in 2005. Although that figure has probably fallen as other industries have grown, the sector remains a substantial contributor.
"They see it as a state industry that brings in a lot of revenue, so it's difficult to grasp the political nettle of tobacco control," Dr Mackay said.
The industry in China is happy to support measures such as health warnings on packets, health education in schools and a ban on sales to children but they have had little effect on smoking rates, she said.
Tougher measures such as higher taxes (in China tax rates are nearer 40 per cent instead of the 60 per cent or 70 per cent in some other Asian countries), nationwide public smoking bans and more graphic health warnings have not been introduced. A recent University of California study said hundreds of thousands of lives could be saved in China if the government increased cigarette taxes. The resulting rise in price would cause some smokers to quit.
Next year, the country is due to introduce a ban on smoking in indoor public places, offices and public transport, although the CDC's Mr Yang told media this year poor enforcement of rules introduced so far meant anti-smoking regulations existed "in name only".
Zhao Qing, 45, a Beijing businessman, said a ban would be a good idea. However, as a smoker for a quarter of a century, he appears immune to measures to encourage people to quit.
If someone tells a smoker "you are going to die, but not which day, you get used to it and ignore it", he said.